Medical practitioners, inevitably scattered across the country, need frequent periodicals to communicate the latest medical information. Journals are an essential component of the infrastructure of modern medicine, yet they were slow to achieve firm roots in Britain during the eighteenth century, with few sustained quarterly periodicals and the only attempt at a monthly lasting a year. Then in 1799, Richard Phillips, owner of the Monthly Magazine, published the Medical and Physical Journal, the first sustained monthly medical journal, which lasted for thirty-four years. Ever since, Britain has never been without a monthly or weekly general medical journal. Responding to the need for a strong commercial focus, the Journal used a magazine format which blended reviews and abstracts of already published material with original contributions and medical news, and it quickly achieved a national circulation by close engagement with all types of practitioners across the country.

Contrary to the historiography, the Journal was distinctly different from the contemporaneous monthly science journals. The key to success was two-way communication with all practitioners, especially the numerous surgeons and surgeon-apothecaries who were increasingly better trained and confident of their status. Much of the content of the Journal was written by these readers, and with rapid, reliable distribution and quick publication of correspondence, controversial topics could be bounced back and forth between all practitioners, including the distinguished. Initially, the editors tried to maximise circulation by avoiding any controversy, but this started to change in the first few years of the next century.