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In addition, The Lancet is currently, perhaps, a victim of its own history. It was founded by Thomas Wakley in 1823. Wakley was a considerable man, fearless in defense of what he thought was right (he was right more often than he was wrong), who in the first ten years of the publication fought no fewer than ten libel suits brought by those whose vested interests he had attacked in print. He often emerged technically the loser, but morally the winner; The Lancet was his property, and he stood or fell by what he wrote. The main target of his wrath was the corrupt leadership of the medical profession, of which he was a member at the time; his courage on behalf of the small man against the oppression of the great was indomitable.

I suspect that the editorial team of The Lancet would like to recapture the glory days of Wakley by pretending to be as fearlessly radical as was he. Wakley put himself in peril, but Wakley had fun. It does not wash, however. Marx said that history repeats itself; it comes first as tragedy and then as farce. In this case, it comes first as courage and then as humbug. It is one thing to put yourself in the way of personal ruination by attacking the powerful on matters both of principle and practice, and quite another to blather high-sounding phrases of no conceivable application in order to appear intellectually courageous and morally advanced.

Conditions have changed. The Lancet is owned by a giant company, Elsevier, and the worst anyone faces who works for it in a senior capacity is the sack with a large payoff. I need hardly point out that life has also become much more complex; Wakley started out when all human life was precarious and the infant mortality rate (for example) was about 200 per thousand. Generals are said always to fight the last war, and editors, it seems, are no better.

If I were dictator”€”which, thankfully for us all, I am not”€”I would make humbug a criminal offense, punishable by forced memorization of the Maxims of La Rochefoucauld. If it were not for the evident failure in the early 19th century of the Society for the Suppression of Vice, vice having prospered ever since, I would found a Society for the Suppression of Humbug. It would have much to do.