This post is by Alison Moulds, DPhil candidate and researcher on the Diseases of Modern Life project.
The release of The Man Who Invented Christmas (2017) – a film which tells the story of how Charles Dickens penned A Christmas Carol in 1843 – has reignited the popular myth that the Victorians ‘created’ the festive season. Historians and literary critics have long emphasised the earlier antecedents to our yuletide traditions, while recognising the close relationship between print culture and Christmas. They have shown how books, cards, periodicals, and advertisements variously shaped ideas about the holiday season. With this in mind, I began to consider how medical journals – the subject of my own research – represented Christmas. Like other contemporary periodicals, they printed festive-themed content, which reflected broader socio-cultural ideas about the season and influenced how Christmas was imagined and observed.
Trawling through digital editions of the Lancet (1823-) and British Medical Journal (1840-), it seems there was an upsurge of Christmas coverage in the second half of the nineteenth century, when the journals began publishing similar seasonal content on an annual basis.
In the run-up to Christmas, both journals reviewed popular fiction and periodicals. While the medical press engaged with non-medical and literary texts at other times of the year as well, in December the journals specifically reviewed books that might make suitable Christmas presents. The Lancet observed that it was well-known Christmas was ‘the most popular publishing season’ and highlighted the wealth of children’s literature produced. The BMJ noted with pleasure that children were more willing to ‘receive with enthusiasm the gift of a book at this than at any other time of the year’. In 1885, it suggested that H. Rider Haggard’s King Solomon’s Mines was ‘a brisk story of adventure’ sure to ‘stir the hearts of boys’, while in 1894 the Lancet congratulated Mary Elizabeth Braddon on having abandoned ‘the realms of imperfectly understood pathology’ (which it felt characterised her sensation fiction) in favour of ‘a clear, sensible children’s story’ in the form of ‘Christmas Hirelings’.
The medical journals received review copies of new books from publishers, as well as cards, calendars and diaries. These items were also reviewed for medical readers. In 1882, the Lancet praised the ‘amount of time, ingenuity, and artistic skill’ that went into producing Christmas cards. Although typically festive in tone, such reviews were not uniformly positive. In 1888, the BMJ complained that ‘Christmas cards are this year, perhaps, less novel and interesting than usual’. Nevertheless, elsewhere the journal enthusiastically supported the tradition. Five years previously it actively encouraged the officers of medical institutions to exchange cards with their patients, which it felt ‘would largely aid the joyous and kindly influences of the season’.
In the final decades of the century, both the Lancet and BMJ reported on the festivities that took place among major hospitals, in London and elsewhere in the UK. In the late 1860s, the BMJ drew attention to the plight of patients hospitalised over Christmas and welcomed the way in which some London hospitals had gradually begun to mark the season. In 1869 it enthusiastically declared that ‘Christmas-Day dawned more brightly in the wards of the hospitals of the metropolis than, we believe, it has ever previously done’. A year later, the journal reassured readers that ‘even in hospital Christmas can be remembered, and efforts made to render it cheerful and pleasant to the sick and suffering’.
The journals’ reports provide a fascinating insight into how Christmas was celebrated in hospital. The festivities variously included decorations, carol singing, dinners of roast beef and plum pudding, entertainment in the form of music and readings, and the exchange of presents among staff and patients. At King’s College Hospital and Guy’s Hospital, male patients were even allowed to smoke on the wards on Christmas Day, while the Consumption Hospital in Brompton marked the season with an impressive fifteen-foot high tree in 1870. While twenty-first-century consumer culture typically foregrounds the importance of advent, these celebrations usually took place in the final week of December and first week of January.
The journals actively encouraged hospitals to mark the season. Festivities were thought to have a practical benefit by discouraging sick patients from leaving hospital over Christmas. They were also considered a way to de-stigmatise hospital attendance among the poor and to inspire charity among the middle- and upper-classes. Historian Barry Doyle has produced a wonderful blog post on Christmas in the inter-war hospital, which shows that many of these practices continued into the twentieth century, with celebrations becoming more elaborate and institutionalised.
Medical journals also broached the holiday season from a clinical perspective. Festive foodies will be delighted to hear that medical commentators were sometimes positive about the benefits of gastronomic indulgence. In 1897, the BMJ welcomed the fact that Christmas took place during ‘the darkest and dreariest period in northern climes’ since ‘more food is naturally required by the body in cold weather’. It emphasised the value of consuming fats and carbs. Ten years later, the Lancet noted that food was the ‘principal item’ of festive entertainment. However, while praising the Christmas pudding as the ‘embodiment of good things’ and roast beef as ‘a satisfying invigorating food’, it warned against ‘a bout of gluttony carried, as it often is, to swinish extent’.
The journals regularly printed sober reflections on the season as well, warning that overindulgence could pose a risk to public health and safety. In 1893, the Lancet reported on an incident at the Surrey County Hospital where a game of snap-dragon had burnt several people and resulted in the death of a choir boy. It highlighted that accidents could be caused by Christmas decorations (particularly lights on the tree) and states of intoxication.
Winter mortality was also presented as one of the dangers of the holiday season. In a piece on ‘White Christmas’, the BMJ warned of ‘the fatality of what is called seasonable weather’ and highlighted that mortality was particularly pronounced among the poor and the elderly. It soberly reflected that ‘a white Christmas will doubtlessly long maintain its popularity, although it is very desirable that no misconception should exist as to its cost in disease and death among the poorer of the working classes’. In pieces such as this, the journals urged readers to consult their social conscience. In 1900, in an item entitled ‘Christmas Shopping and Public Health’, the Lancet highlighted that shop assistants worked long hours over the Christmas period, at risk to their health. It encouraged readers who were able to do so to shop ‘earlier in the day’ or ‘sooner in the season’ rather than leaving it to the last minute.
If the journals were circumspect about the dangers of Christmas, they nevertheless recognised that the holiday season generally had a positive impact on public life. In 1893, the Lancet emphasised that yuletide celebrations helped relieve the pressures of modernity. It suggested that, ‘the more we as a people become over-worked and over-strung the more do such interludes of idleness and irresponsibility play an important part in our social economy’. In 1909, the journal even likened Christmas to a doctor’s ‘prescription’, suggesting it had ‘a good tonic effect upon the people’. It reasoned that most people behaved sensibly enough.
Rather than adopting an overly sentimental or saccharine view of Christmas, the journals generally seem to have represented it as a time of merriment for both the profession and the public. It was portrayed as a period of escapism but not one in which people should abandon their social obligations. While recognising the novelty of some celebrations (such as hospital festivities and the increasing popularity of Christmas cards), the journals contained many thoughtful observations about the festive season (including its consumerism and overindulgence) that will be familiar to modern-day readers.
Exploring the representation of Christmas demonstrates the broad scope of the Victorian medical press. It elucidates how medical commentators applied their expertise to a range of socio-cultural issues pertinent to public life and shows the importance of non-clinical content to medical journalism.
Today, medical journals continue to print a range of festive-themed content, from articles on charitable giving to popular literature. In 1982 the BMJ published its first-ever dedicated Christmas issue. Its website notes that it ‘welcome[s] light-hearted fare and satire’ but cautions that it will not ‘publish spoofs, hoaxes, or fabricated studies’. Setting the ‘tone’ for the Christmas issue appears to be a paramount consideration. As in the Victorian period, festive content might be fun but it should not be entirely frivolous. Then and now, Christmas is portrayed as a time in which medical professionals and their patients should enjoy themselves, but it is also represented as a serious subject upon which medical authority and expertise can shed new light.
 ‘Christmas Books’, Lancet, 15 December 1894, pp. 1443-4 (p. 1443).
 ‘Notes on Books: Christmas Books’, BMJ, 3 December 1898, pp. 1694-6 (p. 1694).
 ‘Christmas Books’, BMJ, 12 December 1885, pp. 1118-9.
 ‘Christmas Books’, Lancet, p. 1444.
 ‘Reviews and Notices of Books: Christmas Cards’, Lancet, 9 December 1892, p. 989.
 ‘Notes on Books: Christmas Cards’, BMJ, 8 December 1888, pp. 1295.
 ‘Notes on Books’, BMJ, 8 December 1883, pp. 1135-36 (p. 1136).
 ‘Christmas-Day in the London Hospitals’, BMJ, 2 January 1869, p. 14.
 ‘Christmas in Hospital’, BMJ, 31 December 1870, pp. 709-10 (p. 709).
 ‘Christmas in Hospital’, pp. 709-10.
 ‘Christmas in Hospitals’, Lancet, 10 January 1874, p. 71.
 ‘Christmas Fare and the Sense of Taste’, BMJ, 2 January 1897, pp. 35-6 (p. 35).
 ‘Christmas Dietetics’, Lancet, 21 December 1907, pp. 1773-4.
 ‘The Sad Sequelae of Christmas’, Lancet, 30 December 1893, p. 1645.
 ‘A White Christmas’, BMJ, 28 December 1878, pp. 965-6.
 ‘Christmas Shopping and Public Health’, Lancet, 15 December 1900, p. 1751.
 ‘The Sad Sequelae of Christmas’, p. 1645.
 ‘A Prescription for Christmas’, Lancet, 25 December 1909, p. 1933.