This article examines links between mid-Victorian opposition to commerce in popular works on sexual health and the introduction of a legal test of obscenity, in the 1868 trial R. v. Hicklin, that opened the public distribution of any work that contained sexual information to prosecution. The article demonstrates how both campaigning medical journals’ crusades against “obscene quackery” and judicial and anti-vice groups who aimed to protect public morals responded to unruly trade in medical print by linking popular medical works with public corruption. When this link was codified, it became a double-edged sword for medical authorities. The Hicklin test provided these authorities with a blunt tool for disciplining professional medical behavior. However, it also radically narrowed the parameters through which even the most established practitioners could communicate medical information without risking censure.