Sir james Lowther of Whitehaven (1673–1755) suffered from gout, and eventually had his right leg amputated in 1750. He also experienced other serious illnesses. Surviving correspondence between Lowther, in London, and his Whitehaven steward, contain graphic accounts of his health, particularly the serious illness and amputation of 1750. From these letters, and a document surviving in the British Museum describing an attack of erysipelis in 1742, a short, documentary account of Lowther's medical history has been compiled. If for no other reason, he deserves to be remembered for surviving an amputation without anaesthetic, at the age of seventy-seven.

Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view.