Medicine in India: Modern Period

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General Editior: D. P. Chattopadhyaya

The Volumes of the Project on the History of Science, Philosophy and culture in Indian civilization aim at discovering the main aspects of India’s heritage and present them in an interrelated way. These volumes, in spite of their unitary look, recognize the difference between the areas of material civilization and those of ideational culture. The Project is not being executed by a single group of thinkers and writers who are methodologically uniform or ideologically identical in their commitments. In fact contributions are made by different scholars with different ideological persuasions and methodological approaches. The Project is marked by what may be called ‘methodological pluralism’.

In spite of its primary historical character, this Project, both in its conceptualization and execution, has been shaped by many scholars drawn from different disciplines. It is for the first time that an endeavour of such a unique and comprehensive character has been undertaken to study critically a major world civilization like India.

The present volume is an outcome of extensive research over several years in the area of history of medicine in India and represents a substantial contribution to the scholarship in the field. The study of the history of medicine is important for a deeper understanding of the theory and practice of medicine. It tells us not only about health and illness, but also about prevalent philosophy, science and social conditions. Unless we know the past, we cannot fully comprehend the present or the future. An example of this is the resurgence of many diseases that afflicted mankind in the past, and were then curbed but reappeared again in modern times.

The work deals with modern medicine extensively, but also delves deeply into the indigenous systems of medicine — ayurveda, unani, homeopathy, nature cure, faith healing and yoga. The result is a comprehensive historical treatise on the evolution of medical services, medical education, medical research and public health in India over the centuries in the context of the social and cultural atmosphere of the times.

D. P. Chattopadhyaya, obtaining his Ph. D. from Calcutta University and London School of Economics, taught Philosphy at JUadavpur University, Calcutta. He is the founder Chairman of Indian council of Philosophical Research, New Delhi. Currently, he is Chairman of the Center of Studies in Civilizations, and General Editor of this Project. Chattopadhyaya is one of the profounder of interdisciplinary studies in the country with his wide knowledge on philosophy, political theory, economics, history, and science. His publications include Individuals and Societies: A Methodological Inquiry (1967); History, Individuals and World (1976); Ru pa, Rasa 0 Sundara (in Bengali, 1980); SriAurobindo and Karl Marx (1988); Anthropology and Historiography of Science (1990); Induction, Probability and Skepticism (1991); Sociology, Ideology and Utopia (1997).

O. P. JAGGI, an eminent medical scientist, is former professor and Dean of the Faculty of Medical Sciences, University of Delhi. He was also the Head of the Department of Clinical Research at Vallabhbhai Patel Chest Institute, Delhi.

During his professional life extending over 4 years, he has traveled widely and researched on health problems under different environments. He is the author of History of Science, Technology and Medicine in India, a fifteen volume project, which is regarded as the authoritative work on the subject. He has been a member of the National Commission on Compilation of the History of Sciences in India, and Chairman of its Modern Period Committee.

Although this extensive (if not exhausting!) work of Professor O.P. Jaggi deals with the modern period, in effect it considers medicine in India from the early times of Charaka and Sushruta, wherever indicated up to nearly the present time. It also, I think quite wisely, considers developments in the medical field during the period under consideration in Britain and also mentions the Portuguese and French connections with India. The work deals with modern medicine in extensor, but also delves deeply into the indigenous systems of medicine— ayurveda, unani, homeopathy, nature cure, faith healing and yoga. Their origins and development parapets with that of allopathic medicine in India are presented. The result is a comprehensive historical treatise on the evolution of medical services, medical education, medical research and public health over the decades and centuries in India.

The first chapter serves as a background and is devoted to a detailed consideration on the development of medical education from ancient times in India, female education, age at marriage, status of women, remarriage of widows, and the Brahmo Samaj movement and its reforms. The author says, ‘Almost all the important social reforms of the 19t1, century centered around women.’ There is a description of the degraded position of women and the ‘lower’ castes. The impact of western rule with its baggage of western culture and social norms is described.

In Chapter 3, there is an interesting account of life in the ancient University of Nalanda, which admitted foreign students as well as Indian students, and where there was much competition for admission, as now. But unlike now, students and teachers had close interaction, living on the grounds of the university; food, clothing and tuition were free. The attributes desired in students and teachers are described—teachers whose knowledge of the medical sciences should be supplemented by other branches of study, and students who exhibit politeness and practice dharma (duty). Memorizing without understanding was ‘like an ass carrying sandalwood and not perceiving the fragrance’. In medicine, students learnt about herbal combinations. Debates and discussions were encouraged; the seminar was an important mode of learning. Atreya once asked his pupils to go to the pine hill and bring back ‘that which is no remedy’. While other students brought some plant or the other, Jivaka returned empty-handed, saying there was none that was not a remedy for one disease or the other. Jivaka was declared successful.

The story then moves on to the beginnings of medical education in India under British influence, together with a description of the corresponding scene in Britain. The Portuguese period of medicine in India began in 1540, at a time when 10 Viceroys and Governors died in Goa from prevailing diseases. Twenty-five thousand troops died in the Royal Hospital between 1602 and 1632. Medical education in Goa began at the Royal Hospital in 1703.

An account of medical education in early British India makes fascinating reading. In those days students received a stipend of Ps 8 per month, when in service Rs 20 per month, with an extra allowance of Rs 5 on field duty. Calcutta was naturally the seat of the early development of allopathic medicine in India under British influence. At first, instruction was in Urdu or Sanskrit for a very brief period at the Calcutta Madrassa and the Calcutta Sanskrit College. The year 1835 was a turning point in medical education in India, with English being made the medium of instruction. Thus were established the first medical colleges in Calcutta (Calcutta Medical College), Madras (Madras Medical School, later Madras Medical College), and Bombay (Grant Medical College). Admissions at that time were without reference to caste or creed.

Then follows a detailed account of the establishment of other medical colleges, up to nearly the present time. In 1914, there were five medical colleges and 18 schools of medicine, at the time of Independence there were 25 medical colleges and the number today is 136, and still climbing. In those days, admission of women in medical studies was resisted from many quarters. Queen Victoria was stated to have asked in 1882, ‘How can they tell me there is no need for medical women in India?’ The role of female Christian missionaries in training and rendering medical service has received attention. There is extensive consideration of the Bhore Committee Report, a watershed in medical education and the development of health services at the time of India’s independence. We are brought up to date with the establishment of the All-India Institute of Medical Sciences.

The story of the development of hospitals and public health services in India has received considerable attention, dating back from the time of Changragupta’s and Harsha’s charitable dispensaries in Pataliputra, to which the poor and destitute could go. There were dispensaries in the Deccan during the Pallava period (AD 574—879) and in the south during the Chola period (AD 900—1200). How the wealthy, the kings, nobility and princes built hospitals and supported them is narrated. Unani medicine, brought into India by the Muslim conquerors, receives much attention and it is stated that in those days, in respect of medical care, Delhi was the envy of Baghdad and the rival of Cairo. Amir Khusraw said Delhi was the intellectual competitor of Bukhara, the famous university city of Central Asia.

The introduction of the germ theory, antisepsis and aseptic surgery into India is described. Until then, wire baskets filled with lumps of coal were suspended in hospital wards in the belief that they acted as miasma absorbers.

The beginnings of modern public health in India are traced, with an account of the unsanitary conditions prevalent in the 19t1, century. Sir Leonard Rogers, working at the Calcutta School of Tropical Medicine at the beginning of this century, describes a water tank with a notice: ‘This end of the tank is reserved for drinking purposes’ and at the other end, ‘This end of the tank is reserved for bathing purposes’. The motivation for developing public health was the high mortality of British troops.

Institutions were established successively for education and research, such as the Medical Research Department and the Indian Research Fund Association, the precursor of independent India’s Indian Council of Medical Research (ICMR), and others. A good part of the volume is devoted to the history of major infectious diseases which are still, unhappily, with us—cholera, plague, smallpox, malaria, kala-azar, typhoid fever, tuberculosis, leprosy and venereal diseases. This is done in considerable detail, with accuracy. Ronald Ross’s exciting discovery of the mosquito transmission of malaria in Secunderabad is described in detail. Coincidentally, 1997 is the centenary of the discovery, and a world meet of parapsychologists took place in Secunderabad in August 1997.

There is a valuable description of maternal health and mortality, of childbirth, the traditional of midwives (dais), and the infrastructure and development of the nursing services. The role of army doctors (IMS) in providing care to civilian society is described. There is an interesting chapter on the political and social influences exerted by European physicians and surgeons on the royalty in India. The establishment and growth of institutions such as the Medical Council of India is presented. Medical ethics through the ages particularly relevant today with the unfolding of the human genome and its implications for civic society, has not escaped Dr. Jaggi’s attention.

The book is notable for its extensive coverage of the state of indigenous systems of medicine and their development up to the present time. The grand finale of the book is a section on yoga, with a quote from Dr Sarvapalli Radhakrishnan: ‘It is good to know that the ancient thinkers required us to realize the possibilities of the soul in solitude and silence and transform the flashing and fading moments of vision into a steady light which could illumine the long years of life.’

It is understandable that man, shaped by Nature, would like to know Nature. The human ways of knowing Nature are evidently diverse, theoretical and practical, scientific and technological, artistic and spiritual. This diversity has, on scrutiny, been found to be neither exhaustive nor exclusive. The complexity of physical nature, life-world and, particularly, human mind is so enormous that it is futile to follow a single method for comprehending all the aspects of the world in which we are situated.

One need not feel bewildered by the variety and complexity of the worldly phenomena. After all, both from traditional wisdom and our daily experience, we know that our own nature is not quite alien to the structure of the world. Positively speaking, the elements and forces that are out there in the world are also present in our body-mind complex, enabling us to adjust ourselves to our environment. Not only the natural conditions but also the social conditions of life have instructive similarities between them. This is not to underrate in any way the difference between the human ways of life all over the world. It is partly due to the variation in climatic conditions and partly due to the distinctness of production- related tradition, history and culture.

Three broad approaches are discernible in the works on historiography of civilization, comprising science and technology, art and architecture, social sciences and institutions. Firstly, some writers are primarily interested in discovering the general laws which govern all civilizations spread over different continents. They tend to underplay what they call the noisy local events of the external world and peculiarities of different languages, literatures and histories. Their accent is on the unity of Nature, the unity of science and the unity of mankind. The second groups of writers, unlike the generalist or transcendentalist ones, attach primary importance to the distinctiveness of every culture. To these writers’ human freedom and creativity are extremely important and basic in character. Social institutions and the cultural articulations of human consciousness, they argue, are bound to be expressive of the concerned people’s consciousness. By implication they tend to reject concepts like archetypal consciousness, universal mind and providential history. There is a third group of writers who offer a composite picture of civilizations, drawing elements both from their local as well as common characteristics. Every culture has its local roots and peculiarities. At the same time, it is pointed out that due to demographic migration and immigration over the centuries an element of compositeness emerges almost in every culture. When due to a natural calamity or political exigencies people move from one part of the world to another, they carry with them, among other things, their language, cultural inheritance and their ways of living.

In the light of the above facts, it is not at all surprising that comparative anthropologists and philologists are intrigued by the striking similarity between different language families and the rites, rituals and myths of different peoples. Speculative philosophers of history, heavily relying on the findings of epigraphy, ethnography, archaeology and theology, try to show in very general terms that the particulars and universals of culture are ‘essentially’ or ‘secretly’ interrelated. The spiritual aspects of culture like dance and music, beliefs pertaining to life, death and duties, on analysis, are found to be mediated by the material forms of life like weather forecasting, food production, urbanization and invention of script. The transition from the oral culture to the written one was made possible because of the mastery of symbols and rules of measurement. Speech precedes grammar, poetry prosody. All these show how the ‘matters’ and ‘forms’ of life are so subtly interwoven.

The PHISPC publications on History of Science, Philosophy and Culture in Indian Civilization, in spite of its unitary look, do recognize the differences between the areas of material civilization and those of ideational culture. It is not a work of a single author. Nor is it being executed by a group of thinkers and writers who are methodologically uniform or ideologically identical in their commitments. In conceiving the Project we have interacted with, and been influenced by, the writings and views of many Indian and non-Indian thinkers.

The attempted unity of this Project lies in its aim and inspiration. We have in India many scholarly works written by Indians on different aspects of our civilization and culture. Right from the pre-Christian era to our own time, India has drawn the attention of various countries of Asia, Europe and Africa. Some of these writings are objective and informative and many others are based on insufficient information and hearsay, and therefore not quite reliable, but they have their own value. Quality and view-points keep on changing not only because of the adequacy and inadequacy of evidence but also, and perhaps more so, because of the bias and prejudice, religious and political conviction, of the writers.

Besides, it is to be remembered that history, like Nature, is not an open book to be read alike by all. The past is mainly enclosed and only partially disclosed. History is, therefore, partly objective or ‘real’ and largely a matter of construction. This is one of the reasons why some historian’s themselves think that it is a form of literature or art. However, it does not mean that historical construction is ‘anarchic’ and arbitrary. Certainly, imagination plays an important role in it.

But its character is basically dependent upon the questions which the historian raises and wants to understand or answer in terms of the ideas and actions of human beings in the past ages. In a way, history, somewhat like the natural sciences, is engaged in answering questions and in exploring relationships of cause and effect between events and developments across time. While in the natural sciences, the scientist poses questions about nature in the form of hypotheses, expecting to elicit authoritative answers to such questions, the historian studies the past, partly for the sake of understanding it for its own sake and partly also for the light which the past throws upon the present, and the possibilities which it opens up for mounding the future. But the difference between the two approaches must not be lost sight of. The scientist is primarily interested in discovering laws and framing theories, in terms of which different events and processes can be connected and anticipated. His interest in the conditions or circumstances attending the concerned events is secondary. Therefore, scientific laws turn out to be basically abstract and easily expressible in terms of mathematical language. In contrast, the historian’s main interest centers round the specific events, human ideas and actions, not general laws. So, the historian, unlike the scientist, is obliged to pay primary attention to the circumstances of the events he wants to study. Consequently, history, like most other humanistic disciplines, is concrete and particularistic. This is not to deny the obvious truth that historical event and processes consisting of human ideas and actions show some trend or other and weave some pattern or other. If these trends and patterns were not there at all in history, the study of history as a branch of knowledge would not have been profitable or instructive. But one must recognize that historical trends and patterns, unlike scientific laws and theories, are not general or purported to be universal in their scope.

The aim of this Project is to discover the main aspects of Indian culture and present : them in an interrelated way. Since our culture has influenced, and has been influenced by, the neighboring cultures of West Asia, Central Asia, East Asia and South East Asia, attempts have been made here to trace and study these influences in : year mutuality. It is well known that during the last three centuries, European Presence, both political and cultural, in India has been very widespread. In many ‘volumes of the Project considerable attention has been paid to Europe and through Europe to other parts of the world. For the purpose of a comprehensive cultural study of India, the existing political boundaries of the South Asia of today are more of a hindrance than help. Cultures, like languages, often transcend the bounds of changing political territories.

If the inconstant political geography is not a reliable help to the understand: z of the layered structure and spread of culture, a somewhat comparable probes encountered in the area of historical per iodization. Per iodization or setting time is a very tricky affair. When exactly one period ends and another:-zones are not precisely ascertainable. The periods of history designated as anent medieval and modern are purely conventional and merely heuristic in chapter. The varying scopes of history, local, national and continental or universal, new what like the periods of history, are unavoidably fuzzy and shifting. Amidst all these difficulties, the volume-wise details have been planned and worked out the editors in consultation with the Project Director and the General Editor. I : rise that the editors of different volumes have also profited from the reactions d suggestions of the contributors of individual chapters in planning the volumes.

Another aspect of Indian history which the volume editors and contributors of the Project have carefully dealt with is the distinction and relation between civilization and culture. The material conditions which substantially shaped Indian civilization have been discussed in detail. From agriculture and industry to metallurgy and technology, from physics and chemical practices to the life sciences and different systems of medicines—all the branches of knowledge and skill which directly affect human life—form the heart of this Project. Since the periods covered by the PHISPC are extensive—prehistory, proto-history, early history, medieval history and modern history of India—we do not claim to have gone into all the relevant material conditions of human life. We had to be selective. Therefore, one should not be surprised if one finds that only some material aspects of Indian civilization have received our pointed attention, while the rest have been dealt with in principle or only alluded to.

One of the main aims of the Project has been to spell out the first principles of the philosophy of different schools, both pro-Vedic and anti-Vedic. The basic ideas of Buddhism, Jainism and Islam have been given their due importance. The special position accorded to philosophy is to be understood partly in terms of its proclaimed unifying character and partly it is to be explained in terms of the fact that different philosophical systems represent alternative world-views, cultural perspectives, their conflict and mutual assimilation.

Most of the volume editors and at their instance the concerned contributors have followed a middle path between the extremes of narratives and theoretic. The underlying idea has been this: If in the process of working out a comprehensive Project like this every contributor attempts to narrate all those interesting things that he has in the back of his mind, the enterprise is likely to prove unmanageable. If, on the other hand, particular details are consciously forced into a fixed mould or pre-supposed theoretical structure, the details lose their particularity and interesting character. Therefore, depending on the nature of the problem of discourse, most of the writers have tried to reconcile in their presentation, the specificity of narratives and the generality of theoretical orientation. This is a conscious editorial decision. Because, in the absence of a theory, however inarticulate it may be, the factual details tend to fall apart. Spiritual network or theoretical orientation makes historical details not only meaningful but also interesting and enjoyable.

Another editorial decision which deserves spelling out is the necessity or avoid ability of duplication of the same theme in different volumes or even in the same volume. Certainly, this Project is not an assortment of several volumes. Nor is any volume intended to be a miscellany. This Project has been designed with a definite end in view and has a structure of its own. The character of the structure has admittedly been influenced by the variety of the themes accommodated within it. Again it must be understood that the complexity of structure is rooted in the aimed integrality of the Project itself.