One week following the royal assent to the 1832 Reform Act, an editorial in the medical journal the Lancet remarked: ‘The abuses under which we groan in all the departments of our profession have but one source, and that is, misgovernment. Hence to this one point, and to this one point only, should the whole of our remedial exertions be directed.’ The Lancet's identification of ‘misgovernance’ as its prime target is indicative of a fundamental assumption shared by reformers in medicine and politics – that is, their diagnosis of the ills of society as essentially political in nature. Given the characteristics of this particular crusading journal, its focus on governance should come as no surprise. Founded in 1823 by the surgeon Thomas Wakley, the Lancet stood at the centre of a sustained and vitriolic campaign for wholesale medical reform, a campaign in which medicine and politics blended insensibly into one another. Wakley's own activities and associations embodied this very conflation: a regular participant and chair of National Political Union meetings in the 1820s and 1830s, an intimate of William Cobbett, Henry Hunt, and Joseph Hume, editor of the short-lived Ballot newspaper (1830) dedicated to the cause of radical political reform, and from 1834 MP for the newly created borough of Finsbury, Wakley was deeply engaged in metropolitan radicalism.

This political engagement is fully evident in both the tone and substance of Wakley's medical journalism.