NEJM Audio Summary - Jan 5, 2012

Excerpted Script

"NEJM@200 — Two Centuries at the Journal"
Beginning in this Northern Hemisphere winter of 2012, the Journal starts its third century of publication. Thanks to our readers and contributing authors, the Journal has been fortunate enough to publish important work in many fields and is now considered to be one of the premier journals in the field. Our special anniversary website, NEJM200.NEJM.org, includes a timeline of important discoveries across the medical spectrum, historical images with an entertaining Image Challenge, videos that convey the history of the Journal and its editors, and other exciting features. We want you to become involved in our anniversary celebration. Please post a story, video, or comment about your own path as a physician or health care professional. Tell us who or what inspires your work in medicine, or share an experience that has influenced your work. How does the Journal help you with your practice, patients, and peers? How does it help you with your research? And how could the Journal do a better job of meeting your needs? The Journal may be viewed as a mirror of our times and, we hope, a force for change as well. We welcome your feedback, whether criticism or praise, as we continue to provide the very best information so that you can provide the best care to your patients.
"A Reader's Guide to 200 Years of the New England Journal of Medicine",
A perspective article by Allan Brandt.
From Harvard Medical School, Boston.
A call for papers issued in late 1811, explained the goals of Warren and his collaborators: “The editors have been encouraged to attempt this publication by the opinion, that a taste for medical literature has greatly increased in New England within a few years past. New methods of practice, good old ones which are not sufficiently known, and occasional investigations of the modes in common use, when thus distributed among our medical brethren in the country, will promote a disposition for inquiry and reflection, which cannot fail to produce the most happy results.”
At a time of intense debate and controversy regarding the causes of disease, the nature of therapeutics, and the basis of professional authority, the young Journal worked to steer a middle course. This was certainly advisable from a commercial point of view, since it could easily alienate diverse medical readers by endorsing a particular therapeutic system or theory. But this approach also established the ecumenical temper of the Journal, which based its early publications on a commitment to empirical observation and an outlook skeptical of conventional medical wisdoms. As the editors explained in 1837, “It has been a point of ambition with us . . . to make these pages the vehicle of useful intelligence, rather than the field of warfare. . . . The Journal is to all intents and purposes, designed to be a record of medical and surgical facts. It is the medium through which the profession may interchange sentiments and publish the results of their experience”
The observation and investigation of disease is perhaps the most salient consistent feature of the Journal. From the meticulous description of angina pectoris in the first issue to the early descriptions of AIDS in the early 1980s, there has been an ongoing recognition that therapeutic approaches must await the sharp articulation of symptoms.
In 1832, as cholera raged in New York City, the Journal published an article advocating immediate treatment upon diagnosis with 100 drops of laudanum “mixed with nearly as much of the spirit of essence of peppermint into a wineglass, and filled with brandy.” The author cautioned against the use of bloodletting and cathartics (showing impressive therapeutic restraint, given their popularity).
The first demonstration of surgical anesthesia, conducted at Massachusetts General Hospital in 1846 in an amphitheater soon to be renamed the “Ether Dome,” was first reported in the Journal
In 1850 one surgeon wrote in the Journal, “I performed the amputation of an arm, the second under the use of ether, while the patient was dreaming of her harvest labors in Ireland, and felt grating but not painful sensations, `as if a reaping-hook was in her arm'”
In the past 200 years, the Journal has covered and participated in seismic change in medical knowledge and practice. Yet the Journal 's history also exposes a stability of orientation and approach to fundamental problems of disease in patients and populations.
To see the interactive timeline providing access to the journal archives, please visit NEJM200.NEJM.org

1812年は、チャイコフスキーの「序曲1812年」やフランシスコ・デ・ゴヤの「1812年憲法寓話」でも分かるとおり、欧州はナポレオン戦争の最中であり、新大陸では米英戦争が戦われた年である。そして、1861年の南北戦争よりも半世紀も前の年、そんな年にNEJMは産声を上げた。それから200年、その歩みが、NEJM200.NEJM.orgに公開されている。