The founder of The Lancet, Thomas Wakley, is well known as a powerful figure whose outspoken and radical views dominated the journal over many decades. His influence went beyond his own term as editor, as the journal was handed first to one son, then the other, and finally to his grandson. The Wakley dynasty ran the journal for 85 years but the 20th century demanded new approaches, and a series of remarkable men took charge of the journal and steered it through the fast-changing world of medicine and journalism. Continuity was maintained by the practice of appointing, In most cases, from within the existing staff of the journal. The story of the editors is the story of the journal itself. These were men of their time--no women so far--who stamped their own ideas on the journal, but who did so within the framework of reliable and radical reporting which the Wakleys established. There have been only 12 editors during the journal's 175-year existence, and their biographies provide a rare insight into the interface between personal qualities and professional achievements during this period.