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Saturday, 24 March 2018

Constructing Scientific Communities - Kenneth William Millican (1853-1915): medical practitioner and journalist

Posted: 23 Mar 2018 02:00 AM PDT In an earlier blog post, I profiled the Midland Medical Miscellany, a proudly provincial medical journal which was conducted by Kenneth William Millican. As editor, he framed himself as a spokesperson for ordinary provincial practitioners. Yet he went on to have a peripatetic and cosmopolitan career, as this post reveals. Millican was born in Leicester in relatively prosperous circumstances. His father William was an architect, a member of the Conservative Party, and a colonel in the Volunteers. The young Millican was educated at Atherstone Grammar School in Warwickshire, and later Emmanuel College, Cambridge, where he graduated with honours in the classical tripos. He then entered St Mary’s Hospital in London with a natural science scholarship. During his medical training, some of his case notes were printed in the Lancet and the BMJ; early glimmers of his interest in medical journalism.[1] In 1879 Millican took the diploma of the Royal College of Surgeons of England (RCS) and a year later he became a licentiate of Royal College of Physicians of Edinburgh.[2] Despite his reasonably illustrious education, Millican’s medical career had humble beginnings. He worked as a ship’s surgeon for the Ocean Steamship Company. Openings such as these provided immediate paid work, but they were widely considered to be temporary situations for young men rather than a long-term career choice. In The Student’s Guide to the Medical Profession (1878), Charles Bell Keetley suggested that a sea voyage might restore the constitution of young men exhausted by their medical education, but warned that more than a year at sea would be ‘demoralising’ and might drive a man to drink.[3] Kineton_Village_Centre Kineton Village, where Millican practised (Credit: Arlo 715, Creative Commons). Following his brief time at sea, Millican soon settled as a general practitioner in Kineton, a village in Warwickshire not far from where he went to school. It was common for newly qualified medical men to return to their roots, since they could use their family’s local connections and standing to attract patients. At the outset of his practice, Millican launched the Midland Medical Miscellany, which he edited from 1881-5. The journal sought to represent ordinary provincial practitioners, implying that they were excluded from the mainstream medical press. Yet Millican was simultaneously a prolific contributor to journals such as the Lancet and the BMJ. He offered them observations from his practice, commenting on subjects as varied as fracture of the leg,[4] the relief of toothache,[5] and treatment for facial neuralgia.[6] He was also active in local medical societies. In 1882, he showed samples of bacilli from cases of diarrhoea to the Midland Medical Society.[7] Millican’s efforts to make a name for himself were rewarded. The Lancet’s overview of medical activity in 1882 namechecked Millican as having advanced the therapeutics of intestinal obstruction.[8] One of Millican’s principal medical interests at this time was the ‘germ theory’ of disease. In 1882, he presented a paper on ‘The Etiology of the Acute Specific Diseases’ to the section on public medicine at the Annual Meeting of the British Medical Association (BMA). Drawing on his own experiences and championing the interests of the provincial practitioner, he argued that the aetiology of infectious diseases was much easier to trace in rural districts. While endorsing the germ theory of disease, Millican maintained that – from his observation – some infectious diseases (such as scarlet fever) could materialise de novo and that these ‘self-originating’ cases were more likely to present atypically.[9] A year later, he produced a book on The Evolution of Morbid Germs (1883). His obituary in the Lancet would commend the volume for its ‘remarkable foresight’ in applying ‘Darwinian doctrines’ to disease.[10] Millican not only commented on clinical matters, but a range of issues surrounding professional life. In 1883, for example, he complained to the BMJ that his paper had been ‘crowded out’ at a sectional meeting of the BMA due to poor scheduling and overrunning presentations from more senior colleagues.[11] In 1884, he criticised the opening hours of the RCS’s library and museum in a letter to the Lancet. He suggested that early closing was ‘prohibitive’ for ‘juniors’ who spent their days engaged in study and tuition.[12] In letters such as these, Millican represented himself as industrious but overlooked. Though he succeeded in getting his name into print, he seemed to identify with the portrait of the hard-working and unappreciated general practitioner which he put forward in the Miscellany. In the mid- to late-nineteenth century, enterprising medical men often abandoned provincial general practice to pursue specialist medicine in the metropolis and Millican’s career followed this trajectory. After his time in Warwickshire, he set himself up as a specialist in throat diseases in Wellbeck Street, London. In 1887, he was appointed as surgeon to the Margaret Street Hospital for Consumption and Diseases of the Chest and Throat, where he specialised as a laryngologist.[13] He also worked as surgeon to the West End Hospital for Paralysis and the Throat Department of the Queen’s Jubilee Hospital in Queen’s Gate, South West London.[14] Though popular with patients, some professionals regarded specialties as self-serving and akin to quackery.[15] In 1887, Millican wrote to the Lancet to reject claims he was a homeopath and to staunchly defend his status as a regular, rational practitioner. Nevertheless, he highlighted his indebtedness to certain homeopathic practitioners and the drugs they had introduced. [16] Despite his apparently dogged determination to advance his medical career, Millican also pursued other interests. While in London, he produced two volumes of verse – ‘Smoke Clouds’ (co-written with Dr A.B. Clarke) and ‘Passion Spray’. Millican’s obituary in the Lancet remarked on his display of ‘literary capacity’, noting that he showed ‘considerable command of metre’. It also commented on his theatrical interests. In 1887, he had helped to produce a domestic drama, Fettered Freedom, at the Vaudeville, and he was also known as an amateur actor. Like his father, Millican took up voluntary military service as well, serving as Captain in the 9th Battalion of the King’s Royal Rifle Corps. His obituary remarked that he was ‘a thoroughgoing soldier in spirit’ and ‘an authority on military administration’.[17] California Mines Gold mining in California (Wellcome Images) After about five years working as a specialist in London, Millican left the country in 1892. He was hired as a surgeon by the British and Foreign Steam Navigation Company, and subsequently became medical officer to mining works in Mexico. Three years later he resigned this post for an appointment with the Mountain Copper Mines in California, where he worked until 1897. Once established in America, Millican pursued a career as a medical editor and journalist. In 1897/8 (reports vary), he became associate editor of the New York Medical Journal and in 1904 he assumed ‘editorship and entire charge’ of the St Louis Medical Review.[18] Two years later, the BMJ recorded him participating in a meeting of the American Medical Editors’ Association. He voiced his opinion that not all medical advertising should be decried, but that greater honesty was needed.[19] In 1907, the BMJ remarked that the St Louis Medical Review had become ‘one of the most readable of the American journals’ under Millican’s ‘able editorship’, but that it was shifting from weekly to monthly publication.[20] By this time, however, Millican had joined the editorial staff of the Journal of the American Medical Association. His journalistic activities were tracked in the British professional press, which avidly followed the progress of medical journalism on the other side of the Atlantic. Obituary Millican Millican’s obituary in the BMJ In 1911, Millican became Assistant Editor of the Lancet, joining the journal he had once covertly attacked through the Miscellany. Millican’s first outing as an editor was not even mentioned in his obituaries. Perhaps the Miscellany (which folded in 1895) had already faded into relatively obscurity, though the Lancet subsequently printed a follow-up note to say that the Pharmaceutical Society of Great Britain’s librarian had pointed out their oversight.[21] Millican died on 28 November 1915, the day after his 62nd birthday; his obituaries reported that he had been ill with heart trouble for some time. Married twice, he left a grown-up son and daughter from his first marriage (both had settled in the United States), and a 12-year-old daughter from his second wife, who survived him.[22] Millican seems to have been enterprising, energetic and industrious and his working life illustrates the mobility of medical men in this period. In its obituary of Millican, the Lancet reflected on his meandering career path. It quoted a letter from his friends, which described him as ‘a man of singularly versatile and varied talent; so versatile, indeed, that it probably operated against his obtaining a great success in any one direction’.[23] Nevertheless, his patchwork career saw him ascend the proverbial ladder and secure recognition for his medical journalism. Millican’s visibility in the medical press allows us to put together a detailed portrait of his career. He supplied clinical communications and correspondence to the leading professional journals, conducted his own periodical, and joined the editorial teams of high-profile journals. His journalistic endeavours were recorded in ‘Literary Notes’ and finally in his obituaries. Reading across these different forms of content in the medical press enables researchers to re-construct medical careers of the past. [1] ‘A Mirror of Hospital Practice, British and Foreign: St Mary’s Hospital’, Lancet, 19 July 1879, pp. 80-1. ‘Reports of Medical and Surgical Practice in the Hospitals and Asylums of Great Britain and Ireland’, BMJ, 19 July 1879, p. 87. [2] ‘Obituary: Kenneth William Millican’, BMJ, 11 December 1915, p. 878. [3] Charles Bell Keetley, The Student’s Guide to the Medical Profession (London: Macmillan, 1878), pp. 29-30. [4] Kenneth W. Millican, ‘Surgical Memoranda: Fracture of the Leg’, BMJ, 20 May 1882, p. 738. [5] Millican, ‘Letters, Notes, and Answers to Correspondents: The Relief of Toothache’, BMJ, 1 September 1883, p. 455. [6] Millican, ‘Correspondence: Gelseminum in Facial Neuralgia’, BMJ, 26 March 1881, p. 490. [7] ‘Midland Medical Society’, Lancet, 23 December 1882, pp. 1078-9 (p. 1078). [8] ‘The Annus Medicus 1882’, Lancet, 30 December 1882, pp. 1119-31 (p. 1122). [9] ‘The Etiology of the Acute Specific Diseases’, BMJ, 30 September 1882, pp. 629-31. [10] ‘Obituary: Kenneth William Millican’, Lancet, 11 December 1915, pp. 1319-20 (p. 1319). [11] ‘Correspondence: The Sectional Meetings: A Grievance’, BMJ, 11 August 1883, p. 299. [12] Millican, ‘Notes, Short Comments, and Answers to Correspondents: The Library of the College of Surgeons’, Lancet, 22 November 1884, p. 941. [13] ‘Margaret Street Infirmary’, BMJ, 9 April 1887, p. 797. [14] ‘Medical News: Medical Appointments’, BMJ, 16 April 1887, pp. 859-60 (p. 859). [15] See Lindsay Granshaw, ‘ “Fame and Fortune by Means of Bricks and Mortar”: The Medical Profession and Specialist Hospitals in Britain 1800-1948’, in The Hospital in History, ed. by Granshaw and Roy Porter (London: Routledge, 1989), pp. 199-220. [16] ‘Correspondence: [Untitled]’, Lancet, 23 April 1887, p. 849. [17] ‘Obituary’, Lancet, 11 December 1915, p. 1319. [18] ‘Literary Notes’, BMJ, 24 September 1904, pp. 761-3 (p. 762). [19] ‘Medical News: The American Medical Editors’ Association’, BMJ, 30 June 1906, p. 1547. [20] ‘Literary Notes’, BMJ, 27 July 1907, pp. 213-14 (p. 213). [21] ‘Obituary’, Lancet, 18 December 1915, p. 1372-3 (p. 1372). [22] ‘Obituary’, Lancet, 11 December 1915, p. 1320. [23] ‘Obituary’, Lancet, 11 December 1915, p. 1319.

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