The story of the New England Journal of Medicine

January 01, 2013
by Nancy Ryerson, Staff Writer
The story of the New England Journal of Medicine

It’s hard to imagine that the New England Journal of Medicine was once purchased for $1. The oldest continuously published medical periodical, the prestigious journal celebrates its 201st birthday on January 17, 2013. Since its founding in 1812, the journal has published a wide array of influential and groundbreaking articles, from early anesthesia to today’s latest cancer treatments.

The NEJM was a relative latecomer to the medical publishing scene in the northeastern United States; medical journals had already cropped up in New York, Philadelphia and Baltimore. The journal was introduced as the New England Journal of Medicine and Surgery and Collateral Branches of Sciences – not a particularly catchy name – by a Boston physician named John Collins Warren in 1812. Its first issue included reviews of general progress in the sciences, essays on clinical problems and an account of an attempt to decipher a secret French remedy for gout. In 1828, it merged with the Boston Medical Intelligencer, after that magazine ran into financial troubles just five years after its launch. Together, they formed the Boston Medical and Surgical Journal.

A boom in medical journals, many of them short-lived, took place over the next half century. In an 1879 issue of BMSJ, Surgeon General John Shaw Billings commented, “It is as useless to advise a man not to start a new journal as it is to advise him not to commit suicide.” Many prominent journals struggled and folded during the Civil War era, and even the BMSJ asked readers for financial support. It managed to stay afloat and was published weekly for almost 100 years, until the Massachusetts Medical Society purchased it for $1 in 1921. In 1928, it was renamed the New England Journal of Medicine. The journal’s logo represents the founding of its previous incarnations with the dates those publications began.

Notable articles cropped up early in the journal’s history. In 1846, it chronicled the first public demonstration of ether anesthesia. According to the article, it was first performed at a hospital using an agent created by a Boston dentist, Dr. Morton [for more on Morton, read December 2008’s This Month in Medical History ]. At first, patients who were put under retained some consciousness, but soon patients reported complete oblivion during the operation. After speaking with a woman who had a tumor removed while “insensible,” the writer notes: “No doubt, I think, existed, in the minds of those who saw this operation, that the unconsciousness was real; nor could the imagination be accused of any share in the production of these remarkable phenomena.”

The journal went on to report on other remarkable medical firsts. It published a lecture in 1872 by a neurologist who described the then-unknown idea that one side of the brain could influence both sides of the body. The first full description of a spinal-disk rupture appeared in 1934. The first successes of early childhood leukemia treatment, using a folic acid antagonist, were described in 1948. In 1952, the journal published an early report on the resuscitation of the heart. It continued publishing groundbreaking articles into more recent times, providing in 1981 some of the first accounts of what would later be known as AIDS. In 2001, the journal published some of the first breakthroughs in chronic leukemia, and in 2004 described advances in the treatment of lung cancer.

Today, more than 600,000 people in 177 countries read the journal each week. It is the most cited medical journal in scientific literature. Free online access is generally available six months after an article is published, though articles are available immediately upon publishing in 100 low-income countries. In addition to access to the full New England Journal of Medicine archive launched on in 2010, the website also published a retrospective for its 200th anniversary in 2012. Taking a look back at the New England Journal of Medicine provides an interesting glimpse into the history of health care and health research in the United States. The journal published several articles offering snapshots of treatments from different moments in the last two centuries, such as “200 years of diabetes” and “Two centuries of neurology and psychiatry in the NEJM.” Other articles examine the health care system throughout the ages, with perspectives like “The Evolving Primary Care Physician” and “A Century of Health Care Reform in the U.S.”

In addition to its website, the NEJM offers two podcasts to accompany each issue, one featuring interviews with study authors and another summarizing the articles in the issue. Without a doubt, from its humble beginnings struggling amongst scores of competing journals to its influential present, the NEJM has made itself as the go-to journal for medical breakthroughs for the last two centuries.