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

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

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

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

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.

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.

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

Ryot, October 31, 1918.

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

Bombay, 1912, pp 571-85.

Appendix, XII, Poona, 1916, p 6.

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

28 RNP, Rast Goftar, February 28, 1909.

31 RNP, Indu Prakash, March 16, 1916.

32 RNP, Bombay Samachar, November 12, 1915.

33 RNP, Indu Prakash, February 10, 1916.

35 RNP, Maratha, October 14, 1917.

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

38 Ibid, pp 14-17.

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

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