The New England Journal of Medicine

"The rise of the was vigorously debated in the Journal in the late 19th century. ... ... With germ theory, the scientific foundation for the use of vaccines, new and old, was at last demonstrated. was a constant topic of debate in the Journal from its earliest years, as it remains in contemporary societies, conveying ongoing tensions between social mandates and individual liberties, the good of the many and the risks to the few. The Journal would report many “firsts” in subsequent years, including the first major quantitative study linking smoking to (1928), the introduction of the (1970), and early clinical descriptions of AIDS (1981). And breakthroughs reported elsewhere quickly found their way to the Journal. , for example, first described in the ' in 1922, received extensive review and discussion in the Journal later that year, and many articles analyzing its optimal use in diabetes followed. Myriad new diagnostic technologies accompanied changes in the theory and treatment of disease. The Journal offers a window onto the rise of new medical technologies, from stethoscopes to improved tourniquets, from 's x-rays to and beyond. Technologies that probe and visualize the body represented a critical aspect of the development of modern medical practice and the conceptualization of pathologies. The focus on disease specificity and causal mechanism that emerged with the germ theory would ultimately drive research at the molecular and genetic level that continues to be reflected in the Journal."

"The New England Journal of Medicine is facing criticism for publishing a scathing review of a book which claimed that industrial and environmental pollutants may be responsible for outbreaks of cancer. The review was written by Dr Jerry Berke, the medical director of , a chemical company currently being blamed for polluting drinking water in a Boston suburb and for contaminating soils in Maryland with ."

"The New England Journal of Medicine was made great by , who banged on every important door in Boston urging researchers to admit their best studies to the journal. The journal assumed the effortless but often genuine superiority of Bostonians so well described—but also ridiculed—by Henry James. ... To some this felt like arrogance, and the journal has always been hated as well as admired. Often the motivation for such hatred may have been jealousy or resentment at failure to make it into its hallowed pages. Ingelfinger was followed by , and the journal grew richer as well as grander. The Massachusetts Medical Society, the owner of the journal, made US$88m from publishing in 2005. My guess is that the journal accounts for at least US$75m of that and that its profits are probably at least US$15m. The society has grown fat on the profits and is keen not only to keep the profits coming but also to exploit the brand. This has led to tensions between the journal and the society, and those tensions were in many ways the undoing of and , the successors to Relman. Both Angel and Kassirer after leaving the journal published books bemoaning the excessive influence of the drug industry, ... while the society appointed a new editor, , who was depicted by some as a creature of the industry. ... He had had financial connections with 21 drug companies between 1994 and 2000."

"At a recent cardiology conference in New Delhi, the cardiologist Deepak Natarajan raised the concern that commercial were corrupting medical journals ... Natarajan cited “manipulated” publications in The New England Journal of Medicine (NEJM) as one example to support his view. His comments were met with silence and an air of indignation. Natarajan’s medical colleagues were stunned, disbelieving, and then, angry. Their response stemmed in part from the NEJM’s reputation as the premier medical journal in the world. The NEJM has the highest impact of any medical journal and physicians tend to see the NEJM – to use Natarajan’s words – as “the holy grail of publishing” ... Physicians wear their NEJM publications as a badge of prestige given the journal’s reputation and influence. But as Natarajan noted, so do research sponsors who compete to have their research studies published in the NEJM to influence prescribing habits of physicians and increase drug market share. Journals can profit handsomely from research sponsors buying reprints of their studies to distribute to physicians. And the NEJM does not make public what it earns from reprints."