Early pitfalls in establishing the British Journal of Anaesthesia

‘Those who do not remember the past are condemned to repeat it.’

George Santayana (1863-1952)

The British Journal of Anaesthesia (BJA) will reach its centenary in 2023. An informal history of its first 25 yr has been published.¹ Recent access to correspondence of the foundation Editorial Board and subsequent investigation has provided further information on the early development of the Journal.

The original Editor of the BJA (1923) was the American Dr Hyman Maurice Cohen, who having re-qualified in medicine in England in 1916, settled in Manchester.² His wife, Esther Rothband, was Mancunian, the daughter of William S. Rothband, an India rubber manufacturer, in Cheetham Hill, Manchester.³ Dr Cohen became a senior anaesthetist to St Mary’s Hospital for Women and Children, and the Educational Committee School Clinics in Manchester.⁴ Esther came from a commercially minded family: the company her father started, W.S. Rothband & Co., is still running (now WSR Medical Solutions).⁵

On 11 May 1923 Hyman Cohen wrote to the members of the proposed inaugural Editorial Board (including Harry P. Fairlie of Glasgow), informing them of the acquisition of about 50 guarantors so far and expressing confidence that the Journal would be launched. This letter was typed on the official paper of the Journal, which showed that its address was the home of Dr and Mrs Cohen. The 12 members of the Editorial Board were listed in the left-hand margin. Going straight to the commercial points, Cohen asked the Committee to recruit subscribers and also personally approach possible advertisers with quotations. He advised: “It would probably be advantageous to make this a personal matter with the firms who receive patronage from us – “one good turn deserving another” sort of thing.”⁶

Cohen also sent to Fairlie and the other members a memorandum dated 31 May 1923 on the initial income and expenditure, noting 106 guarantors @ £2 each.⁷ In this memorandum Cohen referred to the necessity to have “legal status in order (a) for the Journal to have an Ownership, and (b) for each member of the Board to have an equal Proprietorship as well as equal responsibility”. He wrote: “To this end it is suggested that the 12 members form a simple partnership by agreement. This procedure is economical and avoids a large number of formalities, while it also limits the liabilities of each of us. Papers will be prepared and forwarded shortly for necessary signatures, since the final arrangements with the Printers cannot be entered into until the agreement amongst ourselves has been effected.” The printers selected were Sherratt & Hughes of Manchester.⁷

At the first meeting of the newly formed Editorial Board, S.R. Wilson was persuaded to become, in addition to Treasurer, the Honorary Secretary. Sadly in 1927 he died,⁸ so Hyman Cohen’s wife became Secretary of the Journal. Cohen had also been named joint Honorary Secretary of the Anaesthetic Section, British Medical Association (BMA) in 1929 and organised their annual meeting in Manchester over 23rd – 25th July that yr.⁹ The stress of this may have exacerbated his ischaemic heart disease as he died suddenly a month later, in his 54th yr.^2,4

The new Editor of the BJA, appointed after Cohen’s death, was Dr Joseph Blomfield, a senior anaesthetist at St George’s Hospital (and others) in London. There was no autumn 1929 issue of the journal; the first issue under Blomfield’s editorship was January 1930. This began with the new Editor’s Note, explaining the delay as a result of “the sudden lamented death of the late Editor”. After this was a four-page obituary of Dr H.M. Cohen² and a report by Harry P. Fairlie on the BMA’s meeting in Manchester (July 1929), focusing on the Anaesthetic Section.¹⁰ Mrs Cohen moved to Cheshire and continued as secretary.

On 11 August 1936 Blomfield wrote to the members of the Editorial Board (including Harry P. Fairlie)¹¹ updating them that in May 1936 he had given Mrs Cohen notice of termination of her appointment, but she had refused to accept this or to give up “her journal and her heritage.” She had then sent Blomfield a solicitor’s letter and when the July issue was in print, refused to distribute it, because it contained a notice to subscribers to send their subscriptions in future to: The Secretary, 19 St Andrew’s Mansions, Dorset Street, London W1. This “Important Notice” appeared as a cover note in the July 1936 issue and ended with the following statement:

“Subscriptions and correspondence previously sent to the publishers, Messrs. Sherratt & Hughes, should still be sent to them at Manchester.

By Order of the Editorial Board. June 1936.”¹²

It seemed to Blomfield that Mrs Cohen had threatened the printers with libel action if they sent out the journal. The practical difficulty was that Mrs Cohen held the names and addresses of all subscribers and he had no means of getting them!¹¹ Continuing in this letter Blomfield opined that the current editors should win if it came to a court case, but it would be foolish to take that course because it would probably bankrupt the Journal. He suggested it would be best to have no more to do with Mrs Cohen or the printers, let the Journal die, and then start another in its place, preferably under the auspices of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) – he noted the forthcoming October meeting of their Council, which he thought would be conducive to this. Blomfield pointed out that Mrs Cohen also held on to all the account books, so he could not prepare a balance sheet, but he thought the bank balance was about £40. He asked (Fairlie) for his views on three options: (1) all retire from the Board so that the BJA ceased to exist; (2) try to get the Association to start a journal in place of it; or (3) themselves start a fresh journal.¹¹

It is unknown what next transpired between Blomfield and Mrs Cohen, but the July 1936 issue of the Journal was distributed with its “Important Notice” to subscribers and advertisers.¹² Although Mrs Cohen’s probate from the late H.M. Cohen was not small (effects £2335–19s-4d¹³ – equivalent £149 500 in 2016), her chances of finding another job in 1936 were low. She moved to Bournemouth, where she died in 1969, aged 92 yr.¹⁴

Blomfield was well placed to discuss a replacement journal with the Council of the AAGBI, because he was its President in 1935–38. The minutes of the AAGBI Council meeting of September 1936 confirm that he did raise the issue:¹⁵

“The President reported that the British Journal of Anaesthesia would probably shortly cease publication. He considered that there should be a British periodical concerned exclusively with anaesthetics and that it should be under the aegis of the Association. 105 out of 116 members to whom the question was put had agreed to subscribe an additional amount of 10 shillings per annum for a journal. After a full discussion it appeared that the general opinion of the Council was that the practical difficulties were such that the matter should be left for the present. The matter was not to be brought up officially at the Annual Meeting (on 30 October 1936).”

Ironically, in December 1935 the AAGBI had sought to get the British Journal of Anaesthesia to be its organ, but this was resisted by Blomfield!¹⁶ If he had accepted, the Journal would have had the backing of the AAGBI and the crisis of 1936 could have been averted. However, the future development of the BJA would have been very different indeed.

A significant factor in the administrative problems of the BJA may have been that the Editor (Blomfield) was in London, while the secretary and printers were 200 miles away in Manchester. The recovery of the financial status of the Journal was arduous. It is recorded in the minutes of the AAGBI Council of 11 May 1939 that, in response to a plea from Blomfield, the Council agreed to donate £25 to the BJA¹⁷ (equivalent £1600 in 2016). By this time most of the original Board members had either retired or died. During the Second World War the Government restrictions on paper severely limited the Journal, which was vulnerable to take over. In December 1945 one of the options the AAGBI considered in starting its own journal was buying the BJA.¹⁸ Ultimately in February 1946 the AAGBI chose independent publication of its own journal (Anaesthesia).¹⁹

Blomfield continued as Editor until his death in 1948. One would think that his experiences regarding clarity of ownership of the Journal would have led him to prevent a repetition of this problem in the future. But in fact he risked perpetuating the problem. His second wife, Mrs D. Kathleen Blomfield (née Bell) became secretary of the Journal and continued to be involved with it until 1967.^1,20 According to T.C. Gray, the next Editor (jointly with E. Falkner Hill), when Joseph Blomfield died it was not clear whether claims of ownership of the Journal “might have been made by Mrs Blomfield or even by the publishers”. Therefore one of the first actions of the new Editorial Board was “to establish itself as a Board of Proprietors with a constitution”;²¹ this revitalised the Journal.

The four earliest surviving anaesthetic journals are Current Researches in Anesthesia & Analgesia (1922), BJA (1923), Anesthesiology (1940) and Anaesthesia (1946). Of these the BJA was the only one that was not initially the organ of a Society/Association. As such, the BJA could only make money from subscriptions and advertising, whereas each Society/Association could generate further funds through conferences and teaching. In Germany two anaesthesia journals were founded in 1928: De Schmerz and Narkose und Anaesthesie – neither were the organ of a Society. These merged in 1929 into Schmerz, Narkose, Anaesthesie, but publication ceased in 1943.²²

There are several learning points from the early history of the BJA: any journal should be set up with a robust constitution and articles; a board of management is required; trustworthy legal advice should be readily available; and clear financial arrangements are necessary – particularly a contract with an expert publisher. Some of the challenges of scientific publishing are unchanged, but the arrival of electronic publishing will inevitably produce new, unpredictable difficulties.

Acknowledgements

Thanks are owed to the following: Dr Henry Fairlie for access to the letters from H.M. Cohen and J. Blomfield; Sarah Dixon-Smith, Heritage Assistant, AAGBI for help locating the relevant minutes of the AAGBI Council; the AAGBI Executive for permission to publish the excerpt from the minutes.

Declaration of interest

A.G.M. is Honorary Archivist, AAGBI.

References