The Lancet first appeared on Oct 5, 1823. From the beginning, Wakley’s aim was to entertain, instruct, and reform. Instruction came in the form of transcribed medical lectures from the London teaching establishment; entertainment in the early days of the journal came in the form of theatre reviews and piquant political comment. The Lancet has been, first and foremost, a reformist medical newspaper known for its campaigns, for example, our focus on child survival in recent years. Thomas Wakley and his successors aimed to combine publication of the best medical science in the world with a zeal to counter the forces that undermine the values of medicine, be they political, social, or commercial.