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Systems of Medicine

The initial coexistence between western and Indian medical systems gradually disappeared by the end of the 19th century and the triumph of western medicine was marked by its professionalism. This paper examines the Indian response to western medicine and surgery and the opinion of doctors in the British medical administration regarding the two systems in the first two decades of the 20th century. It also explores the complexities in the encounter between the system of medicine and Indian society.

Systems of Medicine

Issues and Responses in Bombay Presidency

The initial coexistence between western and Indian medical systems gradually disappeared by the end of the 19th century and the triumph of western medicine was marked by its professionalism. This paper examines the Indian response to western medicine and surgery and the opinion of doctors in the British medical administration regarding the two systems in the first two decades of the 20th century. It also explores the complexities in the encounter between the system of medicine and Indian society.

MRIDULA RAMANNA

T
he western system of medical education was introduced in colonial Bombay with the establishment of the Grant Medical College in 1845, and its graduates served in different parts of the Bombay Presidency. While most of them were convinced of the efficacy of western medicine, they also tried a combination of western and Indian medicines in their practice, the most notable example being Bhau Daji Lad. They read papers at the Grant College Medical Society describing the Indian remedies that they prescribed for their patients. J C Lisboa and Dhargalkar related their use in treating skin diseases, Bhau Daji’s brother, Narayan Daji and R N Khory wrote treatises on ‘materia medica’ and therapeutics, and Sakharam Arjun made a catalogue of Bombay drugs and medicinal plants available locally. These doctors were the vital intermediaries in the promotion of western medicine and surgery, in the cities of the presidency, by the end of the 19th century. Though they had flourishing private practices even in the 1880s, only one-tenth of the population of Bombay went to them, and the rest continued to consult ‘vaids’ and ‘hakims’. The Indian systems of medicine were efficacious, cheap and time tested and did not offend long established religio-cultural beliefs. Besides, there was also the pertinent fact that the colonial state failed to perceive, that some Indians preferred western medicine for surgery and the indigenous systems of medicine for skin diseases, digestive and even respiratory complaints. In the context of this background, this paper looks at the relative position of the western and Indian systems of medicine in Bombay, in the first two decades of the 20th century. This will be examined from the viewpoint of Indian response to western medicine and surgery and the opinion of doctors in the British medical administration regarding the two systems. These years also saw the triumph of western medicine through the passing of the Registration of Medical Practitioners Act (RMPA) in Bombay Presidency in 1912. Indian doctors had been supportive of the registration of medical practitioners from the 1880s. They were dismissive of the number of quacks, described so vividly by Sakharam Arjun though these practitioners also provided medical relief, by dispensing roots to cure piles and using “crude” methods of bone setting and tooth filling [Ramanna 2002]. The RMPA laid down that state-run and aided dispensaries would employ registered medical practitioners and that no certificate would be valid, unless signed by a medical practitioner, registered under it. The vaids and hakims, were thus effectively kept out, the intent of the government being not only to protect the profession from the “irregularly qualified doctor”, but also to establish the dominance of western medicine. In the light of the passing of the RMPA, the Bombay government ordered the closure of the popular Poona Ayurvedic dispensary in 1915, on the grounds that the medical officer-in-charge was “irregularly qualified”. This step led to protests from Ayurvedic organisations all over the country and debates in the contemporary press, public meetings and petitions in the city of Poona, in which Lokmanya Tilak was involved. The order was consequently rescinded. This particular event shows that the progress of western medicine was far from smooth, and the opposition to it reflected the nationalist spirit of the times.

The paper is based on primary source material consulted at the Maharashtra State Archives (MSA), Mumbai and at the India Office Library, London.

Dispensation of Medicines

In the initial phases, British medical policy encouraged Indian drugs and there was a coexistence between the two systems of medicine, and, in fact, hospital budgets had an allocation for bazaar medicines. It has been shown that, by the end of the 19th century, western medicine had moved away from the Indian medicine owing to an increasing professionalisation [Bala 1990]. Western drugs and surgery were familiar at least in the cities of the presidency, as testified by the number of hospitals and dispensaries, the presence of Indian doctors doubtless making them more acceptable. But in the rural areas, “ignorance and dislike of European medicines” were noted. This was also tied up with the question of their being expensive. It was pointed out that the Indians “however well-to-do had no shame” whatever in asking for and accepting both advice and medicines at dispensaries as long as they were free and if required to pay, they went to vaids and hakims, whom they could pay with a handful of grain or a measure of ghee [MSA 1987]. In their reactions to western drugs or immunisation techniques, like smallpox vaccination, Indian responses were by no means uniform. Indian doctors played a crucial role in their acceptance, the success of the smallpox vaccination campaigns in the city of Bombay was thus due to the tireless efforts of Ananta Chandroba Dukhle. But plague control measures like segregation, inoculation and even rat destruction during the epidemic of 1896-97, met with vehement opposition. John Andrew Turner, health officer in Bombay (from 1901-19) in his paper on ‘Sanitation in India’ read at the Bombay Medical Congress, 1909, ascribed an interesting

Economic and Political Weekly July 22, 2006 explanation for differing responses to these two diseases. While the smallpox vaccine, taken from the venerated cow or calf was accepted, the plague inoculation was objected to, because of the supposed animal origin of the vaccine. The ‘purdah nashin’ system precluded the notification of disease, though a marked improvement in the first decade of the 20th century was noted. Turner also gave a vivid description of the methods adopted to elude the vigilance of plague officials, like secreting the sick and dead together in a locked room or tying up corpses in the sitting posture near cooking places to make it appear, as if they were preparing meals for the household [Turner 1910]. Nevertheless, these years saw the gradual acceptance of the plague prophylactic, developed by W H Haffkine, due to the efforts of Indian doctors, and a policy of promotion with public cooperation. The governor, Lord George Sydenham Clarke invited editors of vernacular newspapers to the Bombay Bacteriological Laboratory to see for themselves the preparation of the vaccine. Their endorsement of its efficacy doubtless contributed to the gradual breaking down of reservations.

During the influenza epidemic of 1918-19, when the government of Bombay threw up its hands in despair, not knowing what the flu was or how to treat it and facing an acute shortage of doctors, because many of them were away at war, the contemporary press suggested the use of Indian medicine. The Deccan Ryot observed that the doctor, depended on a supply of medicines from Europe or America, making him both expensive and unreliable in times of emergency. On the other hand, Indian medicine was cheap and could be dispensed by schoolmasters, postmasters and village officers, who could be trained as apothecaries.1 The Praja Mitra and Parsi referred to attempts made to put down the indigenous system through the operation of the RMPA; and speculated what could be the condition of the large mass of the people, when even the small section, dependent upon practitioners of western medicine, had felt the dearth of adequate medical relief.2 It would seem that ayurvedic and unani medicines were used in the treatment of patients in the community hospitals and dispensaries, set up during this epidemic.3 In fact, contemporary newspapers, including English language, carried a variety of influenza specifics, not only from Squibbs or Adam’s, but also of “shastric medicines”. The latter was advertised as having been developed by the “world renowned inventor” of Amrtidhara, Kavi Vaidyabhushan Pandit Thakur Datta Sharma. These medicines, called ‘Laxmi Vilas Ras and Chandraparabha bati’ were meant to cure the debilitating after-effects of influenza.4

Responses to Surgery

In the 19th century, Indian patients had resorted to hospitals for surgery, despite reservations of ritual pollution. The use of anaesthesia had made surgery acceptable. Dislocations, amputations and the removal of stones were the commonly performed surgeries. Here reference may be made to the success of Tribhovandas Motichand Shah, who practised in Kathiawar in the late 19th century, and recorded a hundred rhinoplasty operations in four years. He used chloroform and morphia to perform this surgical operation to replace the cut nose with skin flaps from other parts of the body like the cheek or thigh. He observed that men and, more often, women lost their noses to Makrani outlawry and as punishment for suspected infidelity, respectively [Motichand Shah 1889]. That pollution taboos regarding hospitals persisted are apparent. Thomas Blaney, a popular English private practitioner of Bombay, observed that plague patients died of fright rather than of plague when taken to hospitals.5 Forty plague hospitals were organised temporarily, on caste and community basis, during the 1896-97 epidemic. Turner regretted that thousands of patients had left the hospitals, hale and sound after plague, but had not advised their caste men to resort to them. Subsequently, N H Choksy, based on his experience of two decades with infectious diseases in Bombay, recommended the permanent maintenance of separate infectious diseases hospitals for communities, on the lines of the Parsee fever hospital.6

The number of hospital admissions for “injuries”, caused mainly by industrial accidents, ranked second, after malaria. Among surgeries, the largest number were for the removal of “vesical calculi” (stones in the kidney), followed by the extraction of the lens for cataract. Other surgeries included abdominal operations, operations for hernia, abscess of the liver, removal of cysts and tumours and amputations. The surgical techniques used for the removal of tumours were excision, curetting, ligature and incision of cysts, by excision, enculcation and of abscesses by aspiration and drainage. Other operations listed were of the larynx, pharynx and oesophagus, for the arrest of haemorrhage, for the removal of lymph glands or adenoid growth and even for the removal of the cancerous breast.7 The surgical work was commended for its high standard, and was facilitated by “improved means of carrying out aseptic work”.8 The level of progress was in the large hospitals, where much was done to update the operation rooms, and provide aseptic instruments, but these facilities were wanting in the mofussil. It was observed that sometimes acute surgical cases were received in hospitals after being treated by Indian practitioners, narcotics having been given to stifle the pain.

The highest number of women outpatients in hospitals were treated for uterine diseases, “labour” cases topped the list of admissions for inpatients. Attendance of women at hospitals in the presidency for “labour” increased to 21,440 in 1917-19 from 18,296 in the previous triennium, indicating an increase in popularity of maternity wards and doubtless due to the increased presence of Indian women doctors.9 The removal of fallopian tubes, fibroids, ovarian cysts and uterine appendages, caesarean operations, forced delivery, hysterectomies and induction of premature labour are listed as surgeries on women. Nevertheless, it was observed that minor obstetric and gynaecological procedures, which were not operations, were also recorded as surgeries.10 Yet, most women were confined at home. Mary Billington, who had visited India in the late 19th century, had been impressed with the detailed knowledge of sexuality and reproduction found among Indian women, which she found difficult to reconcile with the idea of their being downtrodden and ignorant. She was dismissive of “tinkering meddlers” (missionary and social grievance seekers) who would “graft a lot of European excrescences on to Eastern habits” [Bellington 1895]. In a paper read before the Anthropological Society of Bombay, lt col K R Kirtikar, IMS, pointed out that the age of a girl at the time of the birth of her first child would be, on an average between 14 and 16 years. He deprecated this practice and urged the adoption of immediate and stringent measures to remove an evil which made a girl a mother, when she should be at school [Kirtikar 1891]. Jerbanoo Mistry, a Bombay-based Indian lady doctor, in her paper presented at the All-India Social Service Conference in 1923, made a forceful plea for more maternity homes, antenatal care for expectant mothers, and the training of

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midwives and dais [Mistri 1924]. Thus, with both medicine and surgery, Indian responses remained mixed.

Registration of Medical Practitioners Act, 1912

The state’s preference for practitioners of western medicine which was apparent during the anti-plague campaigns, at the turn of the century, had been criticised by the local press. They protested against European medical men, unacquainted with Indian customs, being sent to India and employed on high salaries “in preference to numerous native doctors”. 11 A Bombay weekly saw it as European doctors being sent to carry away money from this land.12 It was observed that there was not a single exponent of the Indian science of medicine, at the Bombay Medical Congress, all the papers presented being on western medicine.

Bombay Presidency was the first to pass the RMPA in 1912. Western educated Indian doctors had a distinct presence in the cities, by this date. The RMPA spelt out the “recognised” qualifications – university degrees, government school diplomas in medicine, surgery and midwifery, and those possessed by military assistant surgeons or sub-assistant surgeons or hospital assistants. As K N Panikkar has observed the intent of the government was clearly to supplant indigenous with western medicine [Panikkar 1995]. The debates in the legislative council before the passing of the RMPA show distinctive perceptions. The surgeon general H W Stevenson clarified that the bill had only one object and that was to benefit the public, and was not aimed at indigenous practitioners. He pointed to the quacks, with a slight smattering of medical knowledge, who gave cough mixture to tuberculosis patients and prescribed quinine for ordinary fever. R P Karandikar held that there were not enough doctors to serve the population of the presidency, of 2,47,00,000. He contended that the allopathic system was still on trial and that the system of Indian medicine was not quackery, but had fallen into incapable hands and urged the government to encourage the ‘swadeshi’ science. He further observed that homeopathy was progressing, and called upon the medical fraternity to encourage Indian medicine. Based on his experience of the mofussil, Karnadikar pointed out that the medical officers there could not carry out their functions without the assistance of the practitioners of Indian medicine. Gokaldas Kahandas Parekh, speaking of Gujarat, observed that a number of people there believed that for certain maladies Indian remedies were more efficacious than the occidental and that certain medicines should not be taken on religious grounds. Dattaraya Venkatesh Belvi, describing his district of Belgaum, stated that there were thousands of men and women, who would have no European medicine except in the liquid form. Moulvi Raifuddin saw the proposal as a move to keep out vaids and hakims. He made the pertinent point that elsewhere, in Delhi, for instance, the government of India had encouraged indigenous medicine and conferred the title of ‘Hafis ul mulk’ on a hakim of Delhi. The Bombay government, however, would not accept that there was a disagreement with the government of India. Lt col Jackson of the IMS declared that he was not impressed with the work of the vaids or hakims. Pheroseshah Mehta countered this criticism, by showing “the other side”, of the way Indian patients were treated by “qualified medical practitioners”. He stated, “The enormous mass of the people will have nothing to do with the western medical science and so long as that prejudice exists – the vaids and hakims will flourish”.13 Notwithstanding these arguments, the RMPA was passed.

Even as the proposed act was being planned, ayurvedic and unani practitioners had held a protest meeting in Bombay.14 After the passing of the RMPA, another meeting of vaids and hakims was held and a petition submitted to the governor, seeking redress of their grievances. They maintained that “myriads” of the Indian people had unshaken confidence, in the healing power of their systems of medicine, and wanted recognition of the death certificates that they granted and the right to sue patients for failure to pay their bills. By excluding all indigenous practitioners from the right to get registered, the government was seen to have cast a slur on them and favoured only allopathy. One suggestion made was that government should develop the Indian system of medicine and make arrangements to provide instruction, and hold examinations in the ayurvedic and unani systems.15 The governor assured them that when “native” medicine improved, it would be recognised. But Kesari asked what encouragement had been given to it?16 Neshat Quaiser has shown that the All-India Vaidic and Unani Tibbi Conference in 1910 had mooted the idea of proper colleges for the indigenous systems [Quaiser 2001]. On the other hand, there was the view that the “native” practitioners had to bestir themselves to get rid of quacks and mountebanks, amongst them before claiming to decide questions of life and death.17

Poona Ayurvedic Dispensary

Given this background, the collector of Poona, in July 1915, under government directives, ordered the municipality to close the free ayurvedic dispensary, with effect from the August 1, 1915. The reason given for the closure was that the RMPA had made it necessary that the officer-in-charge of even an unaided dispensary should be qualified. The ayurvedic medical man-incharge was not, he was a graduate of the ‘Aryan School’. The Poona municipality had maintained the dispensary since 1892, at the cost of Rs 1,200 per annum. The average daily attendance at the dispensary was 150 patients as against 200 patients, attending the two other “English” dispensaries.18 While each patient at the former cost two annas per day, it was two annas nine pice at the latter. It was observed that the dispensary was used by the poor, who, from religious sentiments, did not use English medicine.19 Patients went there for treatment of common diseases like fever, colic, itch and diarrhoea.

The citizens of Poona held a public meeting on July 18,1915 and subsequently submitted a memorial, dated July 30. The meeting presided over by H N Apte, had both extreme and moderate views expressed. Tilak, H N Apte and Paranjpe resolved that government should be asked to amend the act. The memorial stated that the dispensary, “had all along been approved of as a suitable agency for giving medical relief to numerous classes of citizens, who are habituated to the native system of medicine”.20 It further pointed out that the RMPA was intended to apply only to medical institutions conducted on western principles, and cited the legislative council debates where it had seemed that the bill was not to affect practitioners of ayurveda and unani or other indigenous systems. Unfortunately, the government had not made provisions for examinations, or for giving diplomas or degrees to the latter. The memorial pointed out that the advice to close the dispensary was given under misapprehensions about the act. Sardar Nowroji Pudumji of the municipality reminded that the act had never intended to apply to any system other than allopathy.21 Krishnashastri Kavade, of the

Economic and Political Weekly July 22, 2006 Poona Vaidyak Mandal (‘Ayurveda Chikitsa Griha’) endorsed the memorial. In his petition, he pointed out that the government of India had conferred titles on distinguished practitioners and the government of Bihar had provided for teachers of Ayurveda at the Muzaffarpur Sanskrit College. He reminded that surgeon general Stevenson had assured the legislative council, when the bill was being discussed, that it was not aimed at the indigenous practitioners. The Mandal submitted that the language of the framers was unmistakable and unambiguous, the RMPA had left the vaid his practice untouched.22 The councillors of the Poona municipality were unanimously of the opinion that they should continue to maintain the dispensary.

The protests in the press were immediate, the Kesari warned that if the dispensary was closed, not only did the will of the government become evident but it would also serve as test of the determination and resourcefulness of the people of Poona.23 Both Kesari and Sudharak called upon the government to amend the RMPA.24 The Bombay Chronicle contended that the RMPA unduly subjected the ayurvedic system to a number of disadvantages. The testimony to its effectiveness had been borne by the western doctors and scholars. The paper cautioned that since the government had not evolved a system of registration of medical practitioners, it was incumbent to see that ayurveda and unani were not killed by one sided legislation.25 The collector’s suggestion that a registered medical practitioner be put in charge of the dispensary was rejected as being “impractical” by The Hindu of Madras which had reported the case.26

There were protests by ayurvedic practitioners from all over India: from members of the ‘Ayurveda Pracharini Sabha’, the ‘Vaidya Sabha’ of Moradabad, the Bihar Vaidya Association, Bankipore, and the ‘Sri Vaidya Sabha’, Lucknow. Petitions were adopted at a public meeting at Bilaspur, while major B D Basu, IMS (retd) also registered his opposition to the closure. The members of the All-India Ayurvedic Conference discussed the move and pointed out that they had conducted examinations every year for three grades and granted certificates to successful candidates. Similar examinations were held by the Ayurveda school, Bombay, Vaidshastrottejak Sabha, Poona and the State Board, Baroda. Under these circumstances, the government could either recognise for registration the successful candidates of the above examinations or make arrangements on the lines of the Bihar government.27 The stand of the government of Bombay which was different from that of Bihar and Orissa, which had established Sanskrit colleges and provided for the study of ayurveda shastra, was particularly criticised both by Maratha and Kesari. In fact students of the Madrasa-e-Tibbia had been employed in the Delhi municipality.28

The protests had their desired effect. A public meeting was held in Lahore in September 1915, where Khan Ghulam Sahib Jilani observed that the clear and strong assurance to the practice of ayurveda and unani, had been held out by the government and the favourable speeches in the legislative council had held out hope. Noting that several representations and local officers had deprecated its closure, the governor in council decided to amend Section 11 of the Bombay Medical Act, VI of 1912, by reserving to himself the power to allow in special cases unregistered persons to hold appointments of the nature specified in the section and in the meanwhile permitted the Poona municipality to maintain the dispensary.29 The government of India stated that it had no objection.30 The dispensary was subsequently restored. The Bombay Medical Act amendment bill was passed in 1916, under which it was in government’s power to sanction or refuse to maintain an ayurvedic dispensary, maintained by a municipality. The Indu Prakash commented, “So the desirable but herculean task of reviving and regenerating the indigenous system is made more herculean”.31 While this removed the disability under which the Poona dispensary had been labouring, the regret among Indians was that this concession was not extended to ayurveda as whole.

Another incident, which was widely seen as injustice done to the Indian medical systems, was when the Madras Medical Council struck off the name of Krishnaswami Iyer from the medical register, on the grounds that his association with an ayurvedic dispensary was regarded “unprofessional conduct”.32 Ironically, he had been responsible for having the medical registration act passed in Madras, and “he never thought he would be the first victim”.33 The Madras government, however, acted and set aside the order of the council. The Bombay Medical Council, like its Madras counterpart, issued a notice to Popatram Parbhuram Vaidya, to sever his connections with the local ayurvedic college. The paper Indu Prakash termed this move “Allopathy Amuck”, and warned that it would be foolish to enforce the customs and manners of the west. In fact, it was pointed out that Leonard Rogers had praised Indian drugs at the Asiatic Society of Bengal. The weekly, Bombay Gujarati asked why medicines manufactured by sons of the soil should be made to suffer in the interest of western medicine.34 The Maratha condemned the RMPA, “which empowered the medical council to penalise as infamous conduct the association of a registered practitioner with a practitioner of native medicine...”.35 While conceding that many persons, who passed off as vaids and hakims were quacks, the press felt this phenomenon would go on unchecked unless the government gave encouragement to ayurveda and unani.

Views of the British Medical Establishment

How did the British medical establishment in Bombay view the competitive systems of medicine? While major Evans, the senior surgeon, Jamsetji Jejeebhoy Hospital, Bombay, maintained that Indians of all shades appreciated “our therapeutics and surgery at its value”, his colleague at Poona, lt col Smith noted that “well-educated England returned” Indians used western medicine in alternation to the treatment provided by vaids. and hakims. Lt col Collie of St George’s Hospital, Bombay, on the other hand, pointed out that Indians went no more to vaids and hakims than people in Europe patronised quacks, bonesetters and chemists. Private practitioners were to be found in every small town of the presidency. Vakils and sirdars attended free dispensaries along with labourers and fishermen in Ratnagiri. Among the doctors, he noted that, European private practitioners charged more (Rs 5-10 per visit) than their Indian counterparts, (Rs 3-5 per visit), and hence, Europeans from “every walk of life” went to the latter.36

Major general A Hooton, IMS, surgeon general, government of Bombay, averred that “500 years earlier, both the Hindu and Mohomedan physicians were greatly superior to those of Europe. The names of Charaka and Susruta were placed beside those of Hippocrates”.37 But the vaids had confused arteries with tendons and tendons with nerves and their theory of pathology was merely speculative. The remedies they employed were on an empirical footing and doses were not properly worked out. Thus, necrosis

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and total loss of the lower jaw had resulted from excessive doses of mercury, while a large dose of croton oil for intestinal obstruction had led to death. Hooton suggested that the modern system had incorporated many of the old remedies, and various developments of hydrotherapy and the deprivation of salt in dropsy and light splinting and early movements of fractures in surgery were instances. Since the doctor was too expensive to be multiplied for country work and the alternative was the utilisation of the vaid and hakim, the question was whether the latter was to be trained in the indigenous or the western systems. He cited the example of Japan, which had violently opposed western innovations from the 16th to the 18th centuries, but had gradually displaced ancient learning, “respectable though hopelessly antiquated”, with modern scientific medicine.38 Hooton pointed out that the pharmacological unit of the Haffkine Institute, Bombay, was investigating such Indian drugs, as had been incorporated in the regular pharmacopoeias. Sir Pardey Lukis, the director general of the IMS, advocating a synthesis of the two systems, said, “I do not recognise any fixed line of demarcation between eastern and western medicine – Many of the socalled discoveries of recent years are rediscoveries of facts known centuries ago” [GoI 1948]. He referred to similar views held by Sir Havelock Charles King of the Guindy Institute and J A Turner, from Bombay.

On the other hand, lt col W D Sutherland, IMS, dismissed ayurveda as unscientific. He declared that ‘a system which teaches that, for his own sake, the physician should refuse to treat a patient whom he deems to be in dire peril of his life does not accord with ethics”[Sutherland 1919]. Victor Heiser of the Rockefeller Foundation (RF) recorded in his diary that Hooton met him to discuss means that might be employed to offset the influence of ayurveda. He observed that one of the charges made was that regular or allopathic medicine as it was “erroneously” called, had done nothing for the relief of the villagers in remote places. To meet this charge, Hooton was providing school teachers with instruction in first aid. The establishment of an ayurvedic school in Bombay, where courses in biology, physiology, anatomy would be given by medical officers had been considered. Hooton also mentioned the work of the pharmacological section of the Haffkine Institute investigating ayurvedic drugs. To this Heiser, who seems to have had a poor opinion of the latter, commented, “One cannot help but wonder whether it is justifiable to conduct researches into a huge amount of chaff to find a few kernels”.39 He noted Mahatma Gandhi’s well known opposition to western medicine. Another RF official, W S Carter found the National Medical College (NMC) established in 1921, during the non-cooperation phase of the national movement, to be the “weakest” in India, comparable to the Calcutta Medical School. Though the NMC was not a recipient of government aid, he felt that it was not worthy of any financial support. Because of its association with the nationalist movement it was not recognised by the government. It had as its goal, “to impart to its students sound medical training of the progressive western medical science and also to preserve and popularise the best in the indigenous systems, i e, to combine the best of the west with the best of the east”.40 On the other hand, Carter, was impressed by the G S Medical College, which not only had the finest building in India, but restricted the numbers of students, so that small groups would receive clinical instruction. Adjacent to it was the King Edward Memorial teaching hospital, with a capable honorary staff and a system of rotating internees. This institution was unique in that it was the first to be exclusively staffed by Indians.

Only in 1938 did the Bombay government pass an act to regulate the qualifications and provide for registration of indigenous practitioners of the Indian systems of medicine, With the view to encourage the study and spread of these systems, a statutory board of Indian systems of medicine was set up in 1939. It prescribed a four-year course and recognised nine institutions, seven in Bombay, one in Baroda and another in Nawanagar, and examinations were conducted by the state government.

Conclusion

The issues explored in this paper show the complexities in the encounter between the systems of medicine and Indian society. The Indian system was preferred for one set of diseases and the western medicine was adopted for immunisations or surgery. The presence of western educated Indian doctors doubtless made the latter acceptable among the public. Yet these doctors were not hostile to Indian medicine. Ranina, a doctor, in a paper read before the Anthropological Society of Bombay contended that the surgical instruments described by Susruta were no different from those used in surgery that was practised in the 19th century. The doctors like M G Deshmukh and Kirtikar were associated with the founding of the Ayura Vidyalaya in Bombay. The Indian doctors were critical of contemporary vaids, who followed the old methods of the rule of thumb and knew nothing of aetiology or pathology of the diseases. Thus they were ambivalent towards Indian medicine just as the public was in its responses to western medicine. As for the position of Indian doctors vis-a-vis their western colleagues they were still considered second rate, “the sole qualifications for professional positions in medical colleges are the white skin and membership of the IMS”.41 The case of the Poona dispensary revealed the tensions between Indian medicine and the state. While the Bombay government favoured western medicine, they could not ignore popular wishes. Besides some in the medical administration, as shown above, could see the utility of vaids and hakims in giving healthcare to the masses, which the state could not provide for.

EPW

Email: mridularamanna@hotmail.com

Notes

1 Report on Native Papers, Bombay Presidency, (hereafter RNP,) Deccan

Ryot, October 31, 1918.

2 RNP, Praja Mitra and Parsi, October 1, 4 and 5, 1918.

3 RNP, Praja Mitra and Parsi, October 25, 1918.

4 The Bombay Chronicle, January 1919

5 RNP, Mumbai Vaibhav, May 4,1899.

6 Annual Report of the Municipal Commissioner of Bombay, 1920-21, Part

II, Report of the Health Officer, 1920, pp 50.

7 Report of Civil Hospitals and Dispensaries, Bombay, 1919, pp 74-81.

8 Ibid, 1908, p 2.

9 Triennial Report on Civil Hospitals and Dispensaries, 1917-19, p 4. 10 Administrative and Progress Report of Civil Medical Institutions in the City of Bombay for the Year 1897, Bombay, 1898, p 12. These were the use of douches and the introduction of specula or tampons, in obstetric practice.

11 RNP, Jam-e Jamshed, June 19, 1899. 12 RNP, Punch Dand, June 25, 1899. 13 Proceedings of the Legislative Council of the Government of Bombay,

Bombay, 1912, pp 571-85.

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14 RNP, Rashtramat, March 4, 1910. 15 RNP, Rast Goftar, November 26, 1911. 16 RNP, Kesari, March 19, 1912. 17 RNP, Dnyan Prakash, April 19, 1911. 18 Administrative Report of the Poona City Municipality for 1915-16,

Appendix, XII, Poona, 1916, p 6.

19 GD 1326, 1915, Collector/Commissioner Central Division, No Mun- 67/ 4 of 1914, September 25, 1914.

20 GD, 1326, 1915, Memorial, July 30, 1915.

21 Ibid, Sardar Pudumji/Secretary, Legislative Council, No 18-863, July 26, 1915.

22 Ibid, Petition of Poona Vaidyak Mandal, no date.

23 RNP, Kesari, August 2, 1915.

24 RNP, Kesari and Sudharak, February 2, 1915.

25 Bombay Chronicle, July 12, 1915.

26 GD, 1326 of 1915, Extract from The Hindu, August 13, 1915.

27 GD 1326, 1915, Letter from Members, All India Ayurvedic Conference, August 2, 1915.

28 RNP, Rast Goftar, February 28, 1909.

29 GD 1326, 1915, Government of Bombay/Government of India, Home Department (Medical) Letter No 7776, October 7, 1915.

30 GD, 1326, 1915, Government of India, Home Department (Medical)/ Bombay Government, No 330-c, November 22, 1915.

31 RNP, Indu Prakash, March 16, 1916.

32 RNP, Bombay Samachar, November 12, 1915.

33 RNP, Indu Prakash, February 10, 1916.

34 RNP, Indu Prakash, Novembr 29, 1915, Bombay Gujarati, November 28, 1915.

35 RNP, Maratha, October 14, 1917.

36 GD, 75, 1910, Accompaniment to GR No 5001, October 11, 1910.

37 Triennial Report on the Civil Hospitals and Dispensaries in the Bombay Presidency for the Years 1923-25, Bombay, 1927, p 13.

38 Ibid, pp 14-17.

39 Victor Heiser’s Diary, Rockefeller Archive Centre, New York, (hereafter RAC), Rockefeller Foundation Collection, (hereafter RF) Record Group:1.1 Projects, Series: 464, box: 10, folder:78.

40 ‘National Medical College’ RAC, RF, 1.1 Projects, Series: 464, box 9, folder 68.

41 RNP, Kaiser-I-Hind, June 6, 1909.

References

Bala, Poonam (1990): ‘State Policy towards Indigenous Drugs in British Bengal’ Journal of the European Ayurvedic Society, Vol 1, pp 167-76.

Bellington, Mary (1895): Woman in India, London, p 176.

GoI (1948): Report of the Committee on Indigenous System of Medicine, Vol 1, Ministry of Health, Government of India, p 83.

Kirtikar, K R (1891): ‘On the Ceremonies Observed among Hindus during Pregnancy and Parturition,’ Journal of the Anthropological Society of Bombay, 1, 1891, pp 394-402.

Motichand Shah Tribhovandas (1889): Rhinoplasty, Being a Short Description of One Hundred Cases, Junagarh, pp 3-6, 79.

Mistri, Jerbanoo (1924): ‘Training and Provision of Dais and Midwives’, Report of Social Service Conference, Bombay, p 57.

MSA (1987): General Department Volumes, Maharashtra State Archives, Mumbai, (hereafter GD), 49, 1903, Letter, January 31.

Panikkar, K N (1995): Culture, Ideology, Hegemony: Intellectual and Social Consciousness in Colonial India, New Delhi, p 150.

Quaiser, Neshat (2001): ‘Politics, Culture and Colonialism: Unani’s Debate with Doctory’ in B Pati and M Harrison (eds), Health, Medicine and Empire, Hyderabad, p 341.

Ramanna, Mridula (2002): Western Medicine and Public Health in Colonial Bombay,1845-1895, Orient Longman, Hyderabad, pp 38-44.

Sutherland, W D (1919): ‘Ayurveda of Today’, Indian Medical Gazette, March, pp 81-90.

Turner, J A (1910): ‘Sanitation in India’ in W E Jennings (ed), Transactions of the Bombay Medical Congress 1909, Bombay, pp 469-71.

Economic and Political Weekly July 22, 2006

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