SOCIAL HISTORY OF MEDICINE IN COLONIAL INDIA

MARK HARRISON & BISWAMOY PATI (ED.)

SUBMITTED TO – DR. SANTHOSH ABRAHAM,

FACULTY MEMBER, HISTORY

BY – KARTHIK SURESH,

2010-33

1ST YEAR, 2ND SEMESTER

NALSAR UNIVERSITY OF LAW

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 Table of Contents
SOCIAL HISTORY OF MEDICINE IN COLONIAL INDIA MARK HARRISON & BISWAMOY PATI (ED.)...............1
Introduction.................................................................................................................................................3
Summary.....................................................................................................................................................5
Critical Evaluation.....................................................................................................................................11
Conclusion.................................................................................................................................................14
Bibliography..............................................................................................................................................15
Gyan Prakash, ANOTHER REASON: SCIENCE AND THE IMAGINATION OF MODERN INDIA,
Princeton University Press (2007).............................................................................................................15

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 Introduction
India has had a long history of health by ancient methods of healing; Ayurveda and Unani forms
of medicine have been in practice since eons. The history of healthcare in India has been replete
with convergences of social interaction and healthcare – healthcare also plays a great role in
Indian culture.

It has been one of the pillars of India’s literary heritage too, the Atharvana Veda, case in point.
Chittabrata Palit and Achintya Kumar Dutta, who have written on pre-British forms of
healthcare, classify health in India into periods of Indus Valley, Vedic, New Religion
(Buddhism) and ’Muslim’ period in their book1. Brahmananda Gupta, who wrote a chapter in
this book, spoke of the various time-periods and described the Indus Valley period as one where
great importance was attached to health and social care – cleanliness and hygiene were
paramount and one can see the importance they attached by the intricate sewers, garbage
disposal, open roads and areas etc. In the Vedic period, there were various texts, the Atharvana
Veda was written and it was shruti literature which had divine sanction (they were literally
considered to be heard from the Gods). Again one can see how socially relevant healthcare in the
Vedic period was2.

During the times of the Islamic Sultanates that ruled from Delhi, Unani, being the Islamic
science of medicine, was the official Court remedy 3. But Ayurveda did not die out, it remained as
an established form of medicine which Hindus practiced. But in Hindu as well as Islamic
kingdoms (Delhi Sultanate and Mughals included), there was no specific ministries or offices
dedicated to healthcare, as superstition about diseases were rampant. However there were
officers who would supervise the state of sanitation and cleanliness in most kingdoms.

Now we move on the Colonial period. When the British came to India and established the
Company Rule in Calcutta in 1757, there were many interactions between the colonizers and the
colonized. This was to be true in the case of public health care as well – the British did study the
Ayurvedic systems and tried to implement them. Gradually the British started to impose the
1
Chittabrata Palit and Achintya Kumar Dutta, THE HISTORY OF MEDICINE IN INDIA: MEDICAL
ENCOUNTERS, Corpus Publications Kolkata (2005).
2
Ibid, p. 207
3
Ibid, p. 212

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Western system of medicine in Calcutta, trying out the new ideas that had been in vogue in
Britain at that time. There were new experimentations carried out, e.g. the first sanatorium in
India opened (there was no concept of Sanatorium in India till the time the British arrived), the
first medical college imparting Western medical education. Never before was healthcare viewed
in India with such a lens.

The Social History of Health and Medicine in Colonial India attempts to chronicle these
events and their social bearings. This book which has been reviewed by the student could be
described as an attempt to analyze the diverse facets of the topic, in Colonial India. India, a
colony of the British, had adopted Western form of medicine, by the mid-1800s, slowly
replacing traditional forms of healing like Ayurveda and black magic of the tribal parts. In the
opinion of the Student, this book is a very good compilation of articles that show the
transformation in the healthcare pattern change of India, with the first Western-medicine training
college for Doctors in Calcutta opened, to the British administration’s response to Indian
diseases, to religion and medicine in India with health problems arising due to pilgrimages, etc. It
explores a unique set of themes that capture the diversities of India, such as public health,
medical institutions, mental illness and the politics and economics of colonialism.
The subject of ‘public health’ has been very much to the fore in the historiography of
medicine in India over recent years. To quote from the introduction of the book, the main
questions are that of the colonial legacy in public health, and whether or not the British made
much progress in this regard. This book makes much information clear and, apart from being a
stimulating read wholly, also enriches the largely untapped areas of research on this aspect.
In the course of the review, the student will put forth how the idea of Western medicine
being inherently better and more ‘advanced’ than the traditional forms of medicine, how the
British considered themselves to be more evolved than the ‘natives’ and the Indian systems.
Comparisons with literature have been done, with other books in the same category in the critical
evaluation section.

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 Summary
Since this book is a compilation of individually-written chapters, the student has
summarized each chapter separately, to keep the uniqueness of each author’s scholarship intact.

The first chapter, written by eminent historians and compilers of the book Mark Harrison
and Biswamoy Pati, brings an introduction to the topic, and speak of the history of public health
in India in general during the British era. It begins with speaking of Calcutta, the erstwhile
Capital of the British Raj. Calcutta was almost like the ‘experiment ground’ of the British in this
regard, as with almost every other utility, primarily because Calcutta was the first urban setup the
British had control on. This chapter goes on to explain the earliest thoughts of the British, with
their Western training, notions and standards of healthcare, and how the Indian situation seemed
‘polluted and impure’ in comparison. It started from quarantine restrictions – as the chapter
argues – the materials on quarantine provisions for ships bound to and fro India were vast and
extensive. It explains the biases countries, while taking the case of Mediterranean nations like
France and Italy, had towards ships bound to and from India.
Also, the chapter speaks of therapeutics in the role of pre-British Indian healthcare, when
the systems of Ayurveda and Unani were in use. Chapters on the plague and leprosy, and
epidemics like cholera (Indian cholera was feared by all of Europe in the late 1800’s), are
prologued in this chapter. Given the Indian social reality of caste hierarchy and economic factors,
also religious differences, it is notable to understand how health was dispensed to the poorer and
socially backward people by the British authorities – whether they followed local custom of
discrimination or they dealt with them in the famed egalitarian, yeoman-like healthcare service
of the British. But the British administration did not share this egalitarian spirit, often
downplaying the value of Ayurvedic healing in public healthcare across the subcontinent, and
keeping well-qualified Indians to only the lower rungs of the British Indian Medical Service
(IMS) order. Focus is also thrown on the role of gender – as in the British period women were
not allowed to practice medicine, and this did present an inhibition not only for the women to be
examined but also their male relatives sending them to a gentleman doctor.
The second chapter, by Partho Datta, begins with a British East India Company surveyor
C G Nicholls’ words on the city and the health status of Calcutta. It speaks first of an idyllic view

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the British had fantasized about the Orient, but when they actually began to administer the land,
they realized it was fraught with problems and their accounts began lesser and lesser flattering.

So, how could the sector of public health be any different? The British, initially were full
of praise for the local traditions, but later began to discover their inherent drawbacks. The state
of public healthcare in Calcutta, and India at large, was in poor health. So, the British had to do
something to improve the state of affairs. They built the first public hospital, and the Calcutta
Medical College. In 1794, the General Hospital was opened, along with the Police Hospital. In
Calcutta, hospitals were modern institutions, very much a Western import. They attested to the
gradual importance of Western medical practice to state policies. Lunatic asylums and leper’s
houses were later constructed. More light on the duo would be illustrated in the later chapters.

The author then goes on to speak about hospitals being started with more economic than
social causes behind the objective. Wealthy Indians wanted to convalesce in better conditions,
and, as the testimony of Dr. Vos points out, the Indian habitat being made ‘habitable and
bountiful for Europeans’ was the objective.
Then the chapter shifts its focus to the Bengali culture. It cites the Indologist, Martin and
basically portrays the British view of Bengali culture, which is rather disparaging in nature
calling the (in the opinion of the student) the intellectual forwardness of the Bengalis. The author
then links these portrayals of Bengali culture to the situation of public health in Bengal, and does
so in a very enlightening manner.

In the opinion of the student, the third and fourth chapters must be read together. The
reason being, Hajj is a pilgrimage to the Holy City, and the traditional medicinal systems of
Unani and Ayurveda have always been considered as ‘Islamic’ and ‘Hindu’ medicine
respectively. Effectively, this chapter deals with the interplay of religion, traditions and customs
with public health.

Chapter 2 speaks of the Hajj pilgrimage – the student found this article so well written
that he would have written more that the ten lines he is but due to paucity of space and other
constraints. He elaborately describes the hardships which the Indian Haji had to encounter, more
so that of health. India then was considered a breeding ground for diseases like cholera and
typhoid, which were fatal at that time, so there were numerous restrictions of quarantine (as

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indicated earlier), etc. on the Indian Haji. For a woman to perform the Hajj at that time was next
to impossible. The book goes on to speak of the administrative hassles one had to encounter,
more so related to these health and quarantine issues.

Chapter 4 deals with Indian staff in the Western health system at its earliest onset. The
indigenous population of India played a very significant role in the shaping and reshaping of
colonial health policy. The response of the general population, to these measures are vital to
realize how these policies were framed after acceptance, and its hostility to certain state
interventions such as inoculation and sanitary change during the nineteenth century was
documented. One can see a fascinating interplay here between the local vaid and hakim, who
were the traditional practitioners of the ancient Ayurveda/ Unani tradition, and how the British
made them functionaries of their own system, effectively amalgamating the three to achieve the
primary aim of betterment of facilities for healthcare.
Chapters 5, 6 and 7 deal with communicable diseases and the ways the administration
decided to control the spread of these diseases. Chapter 5 deals with the spread of the Indian
Plague. The infamous disease, which was the most feared and often life-claiming disease, was
the subject of a lot of international public health discussions, and was often the core subject issue
in matters of sanitation. This chapter deals with sanitary measures employed by the British in the
mid and late 1800s, especially in Central Asia. India was the victim of plagues on various
occasions, one knows of the Poona plague of 1895, (which is known to be the background of
Lokmanya Tilak’s struggle against the British excesses and inefficiency), the Calcutta plague of
the 1850s that introduced new health reforms in the city, and many more.

The next chapter deals with the disease of Kala-azar, another very frightful disease of the
time, this disease was affecting mainly the plains of North-Central India, and whose cure was
found only in 1942 by P C Ray in Bihar after extensive research. Contributions made by Officers
of the Indian Medical Service are also noteworthy.

The seventh chapter deals with isolation of the leprosy patients in Orissa, pretty much the
trend followed in India and across the world. Lepers faced a lot of hardships; social exclusion,
and other such problems, and the delicate issue is, the commissioners of such exclusion are only
acting in good faith as they did not want the disease to spread. This has been disproved now, but
at that time it was considered that a leper even polluted the air! This chapter does a good job of

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documenting the history of the time concerning the disease of leprosy, and documents the
measures against it therefore.

All these chapters are very well-written, and are good examples of fact documentation.
Particularly interesting is the chapter on the plague and its response by the British authorities and
their Indian functionaries.

A series of chapters deal with these topics - Creating a consumer: Exploring medical
advertisements in colonial India, chapter 12, Racial pathologies: Morbid anatomy in British
India, 1770–1850, chapter 10, Prejudices clung to by the natives; Ethnicity in the Indian army
and hospitals for sepoys, c. 1870s–1890s, chapter 9, Institutions, people and power: Lunatic
asylums in Bengal,c. 1800–1900, chapter 8, and, ‘Subordinate’ negotiations: Indigenous staff,
the colonial state and public health, chapter 4.
Five chapters, in the book, directly deal with different aspects of the central theme of the book.
Social History of Public Health is best seen through the lens of these chapters. A brief review, of
a critical nature, is given after each chapter has been spoken about.
Chapter 8 of the book debates on an issue of noteworthiness – mental health and sanity in
India during the Raj. Specifically in Bengal, where the first Western-style asylums were built,
the concept of institutions began to gain respect there among the native populace. Again, there
was discrimination here, with regards to Indian and European facilities. A case study of the
Bhowanipur Asylum in Calcutta was made, and its day-to-day activities were painted together to
create a picture of the British system displacing the medieval Indian one where the Indians
actually welcomed the move instead of competing or having apprehensions.

Chapter 9 deals with the Indian Army and military healthcare. Today, we have the Armed
Forces Medical Corps to deal with the issue, but in 1870’s, this was specifically a problem that
needed immediate and grave redressal. One can observe that there were ethnicity constrictions
which came into play, which of various regiments made of different ethnic groups were
providing health facilities in different manners altogether. It then goes on to speak of
International agreements on the issue Britain had signed and India, effectively, had become party
to. It also speaks of the inherent disparities between European officers and their Indian sub-
ordinates in this regard.

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 Chapter 10 addresses one of the most glaring social divides between the British and
Indians, and its place in Social History of Medicine: race. A very profound piece of writing by
Mark Harrison, he took the case of morbid anatomy practices in the earliest Indian medical
colleges and elaborated on this topic. Typical of the time, it was very difficult to get bodies for
dissection, so the training of a surgeon, therefore was long and arduous. There was the concept
of ‘racial pathologies’ which then was wanted to be studied – the British believed that there was
difference in colour and matter of the blood of the British and the natives. Extensive anatomical
‘research’ was done on this, and the obvious result was produced.
In the eleventh chapter dealing with, pharmacology of India, namely Ayurveda and
Unani, are discussed in the light of public health measures undertaken by the British. Written by
Projit Bihari Mukherjee, it begins with the Orientalist, and tending-to-Romanticist views of the
Europeans in studying the native plants and their medicinal uses. Botanists like Garcia da Orta
and Arnold’s observations have been noted here. John Fleming’s observations on quinine in
India and its use on malaria have been quoted. Even Sir William Jones, who is now a classroom
name in history lectures all over the Commonwealth, had done research and published books on
the same. But O’Shaughnessy, held that knowledge from the ‘real natives’ is necessary
compared to Sir William whose data was collected from basically Brahmin sources.

Chapter 12 of the book shows the advent of medical consumerism, and therefore, medical
advertising in India, particularly Bengal, in the nineteenth century. It speaks of advertising by
European medical companies, like Holloway’s and Bayer and their advertising effort in India at
the time. Due to subsequent improvement in healthcare facilities as a result of the partial success
of the British policies, the standard of healthcare began to grow, and wealthier Indians would
purchase medicines imported from Europe (later some of these companies would establish
themselves in India as well). Also, the British used the concept of Colonial Other to its fullest
potential, depicting the Indians as weaker and thereby needing to consume ‘stronger’ European
medicines to become better.
The thirteenth chapter, on the use of opium in Indian tradition, is different from the first
two as the first two chapters deal with socio-religious topics of health which are considered
‘pure’ or ‘good’ in nature. The use of opium in India has been practiced, albeit with
discouragement, since time immemorial. But this chapter talks of the household uses of opium,
and its study as a drug by the British (who had fought wars over the humble poppy flower) for

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cure or relief from different ailments. The use of opium as a painkiller is widely known, and it
had come to the stage of being introduced into western medicine owing to the research in India.
Also, certain humorous [sic] instances of British Officer’s experiences of opium in India,
especially the Huntley Commission, make for an amusing read.

Summing up, this book was a well-threaded compilation as could be seen from the
summarization itself. Now we shall move on to the critical analysis of the book.

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 Critical Evaluation
In this chapter, the student will critically analyze the book and its chapter, and shall also
speak a little on the contemporary available literature.

Sociological historical study of medicine in India is a contemporary field of study, as the

compilers of the book themselves point out. Many young PhD students, as they themselves say,
are producing very good articles of scholarship on this aspect of medicine and history. This book
is perhaps one of the best works of compilation in this body of literature, and, coming from
Cambridge scholars, has an element of a British lens to it.

The chapters in this book are by different authors, so one could comment only chapter-
wise. The first chapter, by the compilers of the book, is a very well-familiarizing introduction to
the compilation; it explains why the compilers chose only those particular chapters for
publishing in their book. The second chapter goes on to speak about Calcutta, according to the
student. He thinks that the author has done a commendable job of accurate reporting of the facts
and interpretations, especially the Bengali’s ‘backwardness’ is rather disparaging in nature
calling the (in the opinion of the student) the intellectual forwardness of the Bengalis. The author
then links these portrayals of Bengali culture to the situation of public health in Bengal, and does
so in a very enlightening manner. One can observe the sharp grasp of the author in the subject. In
all, this chapter is well-written, and the student particularly liked the way the author linked the
British literature of Bengal, took their behavioral contentions, and applied them to the situation.

Chapter three speaks of the Hajj and the scenario of public health in India in view of this
arduous journey. This was one of the student’s most liked chapters in the book; it gave a very
holistic interpretation which was fairly neutral in nature of the British critique of diseases of
India that would spread to Europe through Arabia. It is also a very unique chapter, with the
researcher not having come across any other article dealing on this specific subject.

Comparing another piece of literature, Anil Kumar began in the opening lines of his
articles itself, that every British ship would have an Edinburgh-educated surgeon on board, this
doctor would consider himself superior to any local form of medicinal practice 4. This article
4
Anil Kumar, EMERGENCE OF WESTERN MEDICAL INSTITUTIONS IN INDIA, in the book: Chittabrata Palit
and Achintya Kumar Dutta (ed.), THE HISTORY OF MEDICINE IN INDIA: MEDICAL ENCOUNTERS, Corpus

11
speaks of how the British set up institutions of Western medicine in Calcutta between 1780 and
1820. The first medical college in India, as well as the first sanatorium, was set up in Calcutta.

In the fourth chapter, Projit Bihari Mukherjee has contributed to very meticulous
research, and it is very comprehensive for anyone who wishes to study the botanical findings of
the British in colonial India. However, he should have concentrated a little more on the Islamic
system of Unani, since the pharmacology of Unani is equally as popular as Ayurveda at that
time.

In the fifth chapter, the sixth and seventh chapters, which are of the same broad theme,
the community health problem of communicable diseases are spoken of, plague, kala-azar and
leprosy, in that order. One would remember the devastating rages of bubonic plague that would
ravage the Indian countryside. The lax responses of the British, as well as the Indian efforts to
fight it, have been well-recorded. In the chapter dealing with kala-azar, the emphasis has been on
research and control of the disease. There are statistical data and documented research efforts to
fight it. (However kala-azar was not to be put to the ground till P C Ray mass-produced many
medicines and chemicals to fight this odious disease). The seventh chapter deals with the history
of leprosy in India and the seclusion principle the British adopted, with a case study done on
leper colonies in Orissa. It speaks of how the British introduced the principle of seclusion and A
literary piece the student took to research comparatively was Sanjiv Kakar’s Leprosy in British
India, 1860-1940: colonial politics and missionary medicine 5. It speaks of bringing on an official
leprosy policy, and formulating a proper administrative look-into. Both these articles, the student
found, were accurate to the points and they satisfied similar purposes. All these chapters are very
well-written, and are good examples of fact documentation. Particularly interesting is the chapter
on the plague and its response by the British authorities and their Indian functionaries.

This chapter focuses on the institutional history of psychiatric institutions established by

the British in Bengal during the nineteenth century. It involves with the question whether the
‘subjugation of unreason’ and panopticon housing of the insane were key features in colonial
institutions in Bengal. It finally argues that actual medical systems and patient-doctor

Publications Kolkata (2005), p. 159

5
Sanjiv Kakar, Leprosy in British India, 1860-1940: Colonial Politics and Missionary Medicine, Med
Hist. 1996 April; 40(2): 215–230.

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relationships were varied and not always operated by the fixations of colonial power alone. It is a
comprehensive write up on the state of doctors and patients, practitioners in early Colonial India.
The ninth chapter involves with the ethnicity of the native ‘sepoys’ in the Indian Army.
In this chapter, the author has done a stupendous job, of painting well the inherent disparities
between European officers and their Indian sub-ordinates, in the foreground of military hospitals
and military healthcare. The tenth chapter is based on morbid anatomy as a case study through
which to examine the relationship between colonial expansion and the production of medical
knowledge. Relatively little attention has been paid to this aspect of the colonial medical
encounter in comparison with the role played by medicine in the colonization of indigenous
societies. Nevertheless, the significance of colonial expansion for the development of British
medicine was profound. The eleventh chapter deals with the pharmacology of native Indian
plants and the British interest in them. The British were interested in chronicling the ‘exotic
plants and shrubs of the Indies’, and studying them for scientific and commercial purpose. A
documentary analysis has been done here.
The twelfth chapter, a paper on advertisements of medicines and common drugs during
the British era, is by far the most subjective and well-conceptualized scholarly article in the
book. It was a very interesting topic, with a very remarkable outlook on how various forms in
which cosmetics, medications etc. were advertised in British India. The thirteenth and last
chapter dealt with opium and its domestic use in India. India has since ancient times used opium
and the author delves into the uses of it, both as food stuff and as a drug. It also, quite amusingly,
chronicled a few British experiences with the drug.

As we have seen in the critical analysis, this book incorporated the social reality of the
pro-Colonial era, when colonialism first hit India, and connected, integrated it to the medicinal
situation of the day. Critically speaking, this was a novel concept, and the student admires the
compilers of the book for such a thoughtful approach to deal with this subject and the readings.

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 Conclusion
This book, Social History of Medicine in Colonial India, has spoken about the social
impact medical institutions and aspects had during the Company era and after it as well, it spoke
of the interplay the British institutions and medicine cultural attitudes and their symbiosis in
some aspects, their divergence in others. It spoke of cultures, it spoke of attitudes, it spoke of the
power ratios between the colonizer and the colonized.
What does one gather from this book? No doubt, information about the transition from
Indian to British in India, the transition from Islamic rule to colonialism, this book goes beyond
mere documentation of facts and reporting information. This book does actually delve into the
topic of colonial exchanges, the first few days of the British consolidation in India, and link them
magnificently to social medicine.
A very remarkable thing about this book is the way this book is able to connect
threadfully many different subjects and topics, a range of myriad works and thread them
beautifully to create a completely whole new contribution to research.
On the whole, the book is a good attempt at research into a topic, as the compilers
themselves point out, has gained attention in the academia only recently. It makes for a good
read, it is suited for those who are interested in the topic of public health in the colonial era, as
well as those who would read out of curiosity.

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 Bibliography

Books Referred (other than the book to be reviewed) –

Chittabrata Palit and Achintya Kumar Dutta (ed.), THE HISTORY OF MEDICINE IN INDIA:
MEDICAL ENCOUNTERS, Corpus Publications Kolkata (2005)

Gyan Prakash, ANOTHER REASON: SCIENCE AND THE IMAGINATION OF MODERN

INDIA, Princeton University Press (2007)

Articles Referred –

S Kakar, LEPROSY IN BRITISH INDIA, 1860-1940: COLONIAL POLITICS AND

MISSIONARY MEDICINE, Med Hist. 1996 April; 40(2): 215–230.

Websites referred –

www.jstor.com

www.scholar.google.com

www.books.google.com

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1037096/?page=1

www.wikipedia.com

http://india_resource.tripod.com/colonial.html

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