Medical Encounters in British India
Medical Encounters in British India
Medical Encounters in British India
British India
by Deepak Kumar and R.Basu
Sudarshan
Ranjith
Vivek
Haritha
Amulya
Gouthami
Probing History of
Medicine and Public Health
in India
By
Deepak Kumar
Contd
Hybrid of Muslim-Hindu system known as Tibb. From Islam, the concept of
arka (distillation).
Several Sanskrit medical texts were translated to Arabic and Persian. Vice
versa is rare.
Hakim Sharif Khan, a great physician wrote ten important texts on Ayurvedic
herbs and unani medicine.
Unani practitioners introduced concept of hospitals( bimaristans). In 1595,
Quli Shah built Dar-us-Shifa (House of Cures) in Hyderabad. During
Muhammad Shahs (1719-48) reign in Delhi he constructed a large hospital
whose annual expenditure was more than Rs. 300,000.
Some works ahead of their time; Nurul Haqs Ainul-Hayat (1691) is a rare
Persian text on Plague and Pandit Mahadevas Rajsimhasudhasindhu (1787)
refers to cowpox and inoculation.
Western
1. Emphasis on the cause of the
disease, the latter on nidana
(treatment).
2. Forced to take cognizance of
indigenous drugs
3. Difference in conceptualization
of body : Diseased Body
4. Preferred Bloodletting
Indigenous
1. Emphasis on power of
resistance of human body
2. Vaidyas took to anatomy, ready
delivery of medicine, quick
relief etc.
3. Ayurvedic perspective : Body in
Disease
4. Preferred urine analysis and
urine therapy
Contd
From the Indian point of view, mid 19th century was a period of fresh
opportunities and acquiring new knowledge.
2. Raja Serfoji
Last Maratha ruler of Tanjore : Surrendered power to the British and spent
time in pursuit of knowledge.
Opened the Dhanvantri Mahal (abode of Dhanvantri, God of Medicine) for
research in medical sciences . Assembled physicians from Ayurvedic, Yunani,
Siddha and western systems. Result of interactions and investigations
compiled in Sarabendra Vaidya Muraiga.
Maintained a set of Opthalmic case sheets with authentic pictures of the
eye and its defects for research purposes. Early example of Methodical
Clinical research under native patronage.
3. Bal Gangadhar Jambhekar
First Indian to teach mathematics at the Elphinstone College in Bombay.
Wanted native practitioners to improve by studying Anatomy from the
natural subject even though touching a dead body was taboo at that time.
Felt ordinary Vaidyas and Hakims would respond better than more learned
practitioners and wanted to enable dissemination of medical knowledge to
them in local languages. ( part of opinion given in 1837 to the British who
were setting up med school in Bombay)
Advent of Dissection
Dissection is necessary to establish relationship between symptoms manifested
externally during life and state of diseased internal organs examined after death.
Curtis: The patient dies. The body is permitted to be opened and this is supposed
to explain everything, Much experience does it require and many dissections of
similar cases, to enable us to judge and distinguish accurately between the causes
and effects of diseases and even between the effects of the disease and the effects
of death.
New paradigm of Organ localization of disease was a definite disjuncture from
humoral pathology, but still carried traces of humoralism.
Dr. Paisley : In a climate where all capital disorders arise from putrid bile, or
obstructions, nothing must be shut up. (Reference to bile).
Consequences of Dissection
Indian body image demystified. No more a divine body. Provided concrete
ground for organ localization of disease. Body is no longer merely a bodily frame
through which saps, humors and fluid flow. 3 dimensional reality.
Precise anatomical knowledge yielded excellent surgical results. Better cause effect
relationship.
Great social significance.
a.
Radhakanta Deb, an orthodox Hindu : I shall introduce and recommend your
advice and medicine both here and in the interior. The human lives which will be
saved will , I trust, be an ample reward for the trouble that you have taken.
b. Rammohan Roy to Dr. Patterson of Edinburgh : Sent set of 10 Hindu skulls and
said he is willing to send more of any particular type that they make require for
their research and in any numbers.
Indian experiences related to medicine, surgery, pathology and pharmacology
found their applications in Britain and other colonies. Ex : Maclean - Discovered
rudiments of treatment for intermittent fever in India that he extended to yellow
fever in West Indies.
Contd
Indigenous practitioners vehemently denied that their system was
unscientific or irrational. They were willing to adopt the scientific method
in reforming their system but not in changing the fundamentals of the
system.
Dwijendranath Tagore : By the raging light and scorching heat of English
education, orthodoxies are being increasingly banished from the metropolis
to the fringes of villages.
A critical anti-colonial spirit permeated the indigenous response as argued
by Neshat Quasier.
Quote: Knows no method of treatment, but Doctors dared to challenge
Unani. In a closed bottle, a fairy has come full of anger from foreign lands.
The bouquet stolen from the garden of Unani Tibb has been rearranged in a
new fashion.
Sankritik connotations of the terms described in Ayurveda were evacuated
of their meaning and the vacuum filled with modern anatomical meanings.
Context-free, universal logic of modern medicine refigured the contextsensittve character of Ayurveda
Contd
Pilgrims to Mecca from Egypt and Indonesia were compulsorily vaccinated
against smallpox and cholera. Inoculation of pilgrims going to Prayag Kumbh
was held impractical, inexpedient and even dangerous.
Enlightened native states like Baroda, Mysore and Travancore were more
open to new ideas.
1. Mysore (1930) - Worlds first Birth Control Clinic
2. Bombay (1935) Society for study and promotion of Family Hygiene
3. Even Indian National Congress included studies on population and health in
its planning committee.
Bazaar Medicine
Bazaar Medicine
Summary: Impact of colonial medical revolutions on Europe.
Why did medical practices vary across colonies?
Difficult to document.
Ayurvedic views
Susruta
Charaka
Toxicology.
Reinstating Dietetics
Introduction
Many writings regarding medicine
Engagement of educated section with Western medicine
Colonial sanitary and public health measures buttressed the
authority commanded by Western medicine
This generated rich corpus of medical tracts in Hindi
Educated section were learning about the body and its well being and
sought a pedagogical role
They were setting up civic organizations to engage with sanitary issues,
trying a carve out a niche for themselves
A Mixed Record
Malaria Control in Bombay Presidency,1900-1935
Mridula Ramanna
Introduction
Indian responses were not very oppositional as plague
Quinine was available which prevented greater loss
Indians resorted to Western medicine for surgery and
believed that it could act for a short time,while Indian
medicine,though slow to act,was considered effective,cheap
and locally available.
Bombay City
There was a small brake in anti malaria campaign due to first
world war which was resumed in 1920s by efforts of
malariologists,doctors and press
Followed decline in spleen ratesdue to public
involvement,adequate funds
Cities like Poona,Ahmedabad and Karachi also made efforts
but in small cities like Surat and Broach finance was a
constraint
The medical missionary is one who seeks to serve his God as these
men served their country and king.( James Mcphail, observed while reading a paper at the
medical conference)
Rate of Success
In South India
Statistical Evidence
One can hardly judge the exact situation from statistical returns,
methods of registration were more often than not faulty, large
number of cases returned as fever had been found to be really due
to TB
INTRODUCTION:
Increased interaction amongst individuals across the globe- unintended
consequences
Open-field agrarian practice to close-door crowded industrialization
Theories for the spread:
(i) Poor record keeping
--Cultural: Human body not considered of worth it - no means to
maintain records
--Other: purposeful negligence & inefficient mechanism of
maintaining records by the British
--Prime motto of imperial govt. - extraction of resources;
benevolence towards population to justify territorial
expansion
(ii) Erroneous method of data collection because of archaic methods
leading to
large margin of error
--Deliberate negligence by the British
Available statistics show magnitude and nature of death due to TB far excess than
plague, small pox or cholera- established fact by 1916
1:5 death to reported cases ratio; Deaths during Bengal famine of 1943: 150%
annual death due to TB
Black magic of Bengal or White Plague
VULNERABILITY TO BACILLUS
Vulnerability:
(1) Putting blame back on the sufferer- women painted as more
vulnerable due
to their own fault
(2) Special care for the sufferer- efforts made to understand causes
and
eliminate the disease
Pre-independence, morbidity statistics hardly available. TB always existed,
intensity unknown
Few regions and groups more susceptible. North-West province and Punjab
endemic regions; Gurkhas, Pathans more susceptible than army soldiers;
Women more susceptible
Mohammedeans
Hindus
Others
Community
Male
Female
Male
Female
Male
Female
Deaths from
Phthisis
150
299
59
86
15
21
In the late 17th century and early 18th century, two major causes :
(i) Inherent defectiveness of female physiology essentialism. Azell in
1875: consumption and failure of the female menstrual cycle have
parents of each other interchangeably
(ii) Feminine characteristics of the disease- erratic emotional patternwomen were sickly and sickness was feminine
victim blaming
Indian picture by Lankaster, Sparwson and others:
(1) Bovine to human TB : affected children of the affected European
women. Off late ruled out by Sprawson in 1938
(2) Purdah system: Women kept in Zenana - ideal condition for growth of
tubercle bacillus; Cultural diffusion from the West where the elite women enjoyed
leisure at home; Men effected less
(3) Child marriages: not a direct reason. Two ways: strict pardah after
marriage and frequent cases of successful and unsuccessful pregnancies; women
considered as impure and secluded to keep the infant from sheetal vayu.
(4) Industrialization and sanatorium in combination with isolation:
Short-term movements ; Women confined to households after getting infected;
Doctors not allowed to examine women.
Cultural practices in India reasons for higher prevalence. Justification for the
logic using diffusionist approach that also rationalizes cultural and economic
imperialism.
Diffusion- developed underdeveloped (higher section)
underdeveloped (lower sections)
CONCEPTION OF TB
Conception of TB- few key factors: climate, heredity, nature of disease, social
structure
Contagious character known by 16th century but measures died by 19th
unsupportive British physicians
Tuberculosis is a communicable disease but not infectious- diffusion not easy
Resolutions of British Congress 27 July, 1901- TB sputum declared main agent for
the conveyance of the virus but govt. didnt do much
Either affordability or ignorance caused further spread
SUMMARY : No logical explanation as to why women more vulnerable. But women not
given equal importance as men; Industrialization one major reason
Delivering the
Murdered Child
Infanticide, Abortion and Contraception in Colonial
India
Indira Chowdary
INTRODUCTION
Abortion and Child birth as means of the twin sites of exchange of medical and
colonial ideologies.
Criminalization of social practices ad bodily functions - process that is marked by
the colonial encounter
Illicit intercourse exists in Indian society just as elsewhere but didnt have
access to the scientific contraceptive knowledge ; Scientific contraceptivessafety, efficacy and cost; Indigenous contraceptives- abortifacients
Marie Stopes pamphlet in 1935 : abortion for married women - not published
because abortion was supposed to be practised only by Indian women who
had illicit pregnancies
Summary:
Foucauldian framework social & medical domains
interaction 19th century Rubbishing to 20th century
Medicalization - governmentality at work. 3 to 4 decades
after independence some focus on womens issues(?)
Health and
Sovereignty in the
New Asia
Post-Colonial Visions of
Development
Two overlapping narratives: Tropical Discourse vs Historical
Discourse on Poverty
Conception of Asia gave rise to many colonial disciplines. Ex:
Tropical Geography, Tropical Medicine
The relationship between health and development remained
ambiguous. Technology vs Social Justice
Cholera, Heroic
Therapies and Rise of
th
Homeopathy in 19
Century India