Bhattacharya, J. the Genesis of Hospital Medicine in India- The Calcutta Medical College (CMC) and the Emergence of a New Medical Epistemology

The genesis of hospital medicine in India: The Calcutta Medical College (CMC) and the emergence of a new medical epistemology

Jayanta Bhattacharya

Independent Scholar, West Bengal, India

The history of the Calcutta Medical College (CMC) is intertwined with the rise of hospital medicine and modern medical pedagogy in India. This article will argue that the extension of medicinal practice in India ushered in a new paradigm of knowledge: the singular act of cadaveric dissection introduced indelible changes in the perception of the body and disease. The CMC was constituted by an ensemble of different componentsmedical teaching at University College London (UCL), the unique surgical practices of the Companys surgeons and the specificity of a uniquely colonial praxis. The transition from military medical train-ing to general medical education involved various processes of acculturationvisual, verbal and psychological. CMC played a key role in the materialisation of public health programmes in colonial India. Consequently, Ayurvedics were caught in a position of simultaneously being modern as well as original. As a result of the interactive process, the western medical toolkit reconstituted the terminologies and practice of Ayurveda so that, epistemologically speaking, they became a variant of modern medicine.

Keywords: Calcutta Medical College, hospital medicine, medical education, dissection, epistemology, Native Medical Institution, Sanskrit College, Ayurveda

An important textbook of internal medicine suggests that we are living in an era of bio-medicalisation or techno-medicine. To quote:

The hospital is an intimidating environment for most individuals. Hospital-ized patients find themselves surrounded by air jets, button, and glaring lights; invaded by tubes and wires; and beset by the numerous members of the health care teamIt is little wonder that patients may lose their sense of reality.1

1 Longo et al., Harrisons Principles of Internal Medicine, p. 6.

The Indian Economic and Social History Review, 51, 2 (2014): 231264SAGE Los Angeles/London/New Delhi/Singapore/Washington DCDOI: 10.1177/0019464614525726

Acknowledgements: I am grateful to the suggestions of the anonymous referees of the IESHR and the editorial help of its staff.

at Harvard Libraries on February 11, 2015ier.sagepub.comDownloaded from

232 / Jayanta Bhattacharya

The Indian Economic and Social History Review, 51, 2 (2014): 231264

In such a milieu, the doctor is often the only tenuous link between the patient and the outside world. S/he becomes both a scientific person and a healer. Roy MacLeod has argued that, Medicine, in its conceptual, professional and political dimension, is both shaping and shaped by the cultural circumstances that surround it, and that give it at any time its particular character.2 A common culture of medicine sustained by the image of science as the universal agent of progress, and scientific medicine as its instrumentbecame the hallmark of European empires throughout the world.3 The success of western medicine was facilitated by the expansion of hospitals to the non-European world.

However, while it is still possible to conceive of the dissemination of Western medicine through the institution of the hospital, as Harrison points out, this process did not represent a uniform trend towards medical modernity, but sometimes accom-modation with local, non-Western modernities and traditions.4 In this enterprise, it had to negotiate between metropolitan push and peripheral pull on the one hand, and its own colonial dynamic on the other. It is with this problematic in mind that I will study the institution of the CMC in this article.

The CMC has been an object of study for a long time. The focus of earlier accounts was primarily the diffusion of English medical knowledge amongst the native population.5 In later writings such as that of Kumar, the focus shifted to a study of the internalisation of Western medical practice and its encounters with Ayurvedic and indigenous practitioners at multiple sites and levels.6 On the other hand the scholarship of Bala has shown that the professionalisation of medicine in India represented British attempts to carry over the medical practices of an industrial society into a vastly different developing society.7 David Arnold too has contributed to the debate on medicinal practice in India and considers the CMC as the watershed between indigenous medical knowledge and modern medicine.8 The dividing line between the two knowledges was anatomy: The basis of all medical and surgical knowledge is anatomythere can be no rational medicine, and no safe surgery, without a thorough knowledge of anatomy.9 With the foundation of the CMC, a new hegemonic medicine appeared on the horizon leading to a gradual marginalisation of indigenous medical knowledge.

With the help of Michel Foucaults writings on medicine and the clinic, Sen and Das have attempted a conceptual distinction between a techne, and an epis-teme.10 To them, [b]eing both an educational and a scientific clinical institute,

2 MacLeod, Introduction, p. 1.3 MacLeod, Introduction, p. 3.4 Harrison, Introduction, pp. 23.5 Roy, On the Past and Present State of Medicine in India, p. 547.6 Kumar, Probing History of Medicine and Public Health in India.7 Bala, Imperialism and Medicine in Bengal, p. 67.8 Arnold, Colonizing the Body, p. 57.9 Smith, Use of the Dead to the Living, p. 4.10 Sen and Das, A History of the Calcutta Medical College and Hospital.



The genesis of hospital medicine in India / 233

[the CMC] was the centre of a new form of knowledge of the body and newer practices of medical interventions.11 In an elaborate discursive engagement, they note that the birth of the colonial clinic is yet a story untold. However, it seems that the Foucauldian clinic seems to differ from hospital medicine in the South Asian context. Studies of the clinic in the west make it clear that it was an out-come of specific socio-historical and economic developments.12 As a result I will briefly delve into the genesis of the hospital as an institution and study its cultural mutations across the globe.

Some useful work has been done by Bhattacharya on the rise of hospital medi-cine in India and modern anatomical teaching.13 And Mark Harrison has usefully traced how the clinical practice of dissection in the East India Companys medical service became one of the key factors in the development of hospital medicine in India.14 Although Harrison talks about surgical and pathological practices of the EIC surgeons, their practice did not automatically lead to the rise of hospital medicine in India. Elsewhere, Harrison argues that it is possible that the early history of hospitals beyond the West may shed some light on what constitutes a modern hospital, some of which lay beyond Europe.15 In my argument, hospital medicine is a distinct phase in the evolution of modern medicine which, though intimately related, is clearly demarcated from the hospital itself. This distinction is often overlooked.

In the Indian context, four basic changes principally heralded the beginning of the new medicine: (a) a conceptual change of the two-dimensional bodily image to the three-dimensional one; (b) the treatment of the patient in a hospital setting, not in his/her domestic environs; (c) touching and measuring the patients body with a stethoscope, thermometer and other modes of inspection; and (d) a transition to a new type of modern identity, that is, from the socially embedded individual to case number in a hospital.

In my analysis, the CMC represents an admixture of the secular and advanced methods of medical teaching adopted at the University College London (UCL), medical and surgical practices of the Companys surgeons and the discriminatory nature of colonial practice on the one hand and, on the other, the transition from military medical training to modern medical education in India. Since the period of the foundation of the CMC, the structure of medical education in India, like Euro-pean medical schools, acquired the ability to control its own education and training followed by examination, certification and registration.16 Though registration was

11 Sen and Das, A History of the Calcutta Medical College and Hospital, p. 479.12 See a similar line of argumentation in Harrison, Introduction, p. 4.13 Bhattacharya, Arrival of Western Medicine; Bhattacharya, The first dissection controversy.14 Harrison, Disease and Medicine, p. 89. Note also his arguments in Harrison, Medicine in an

Age of Commerce, p. 4.15 Harrison, Introduction, in Medicine in an Age of Commerce, p. 6.16 Loudon, Medical Education and Medical Reform, p. 233.




a later development, graduates from the CMC initiated modern professionalism, distinct from both indigenous medical practitioners and the native doctors of the Native Medical Institution (hereafter, NMI). The mode of training followed at the NMI, influenced by surgical practices pursued in British hospitals since the late eighteenth century, was improvised at the instance of its introduction in regular clinical training at the bedside of patients in the hospital.17

Hospital medicine is a much debated issue, especially in Western scholarship. Following Ackerknecht, the three pillars of the new medicine (that is, hospital medicine)physical examination, autopsy and statisticscould only be devel-oped in the hospitals.18 Ackerknecht offered a classification of the major stages in the history of Western medicine that proved to be remarkably influential.19 It gained further momentum after the publication of Jewsons now classic paper The Disappearance of the Sick-man from Medical Cosmology, 17701870.20 Jewson, among others, stressed on four specific issues(a) medical cosmology character-istic of Western European societies during the period 17701870; (b) the universe of discourse of medical theory changing from that of integrated conception of the whole body to that of a network of bonds between microscopic particles; (c) social production of knowledgeraw material of production; and (d) a collegiate system of educational control emerging within the community of medical investigators. In his commentary on Jewsons paper, Pickstone stressed that it may be profitable to think of a historical and analytical shift from a series-model of successive types of medicine (bedside to hospital to laboratory to, now, techno-medicine) to a model of co-existence and inter-penetration of types where novel forms co-exist with the old one in contested cumulations.21 Nicolson finds that medical knowledge of the pre-hospital medicine era was exoteric as opposed to the esoteric form of medical knowledge in the era of hospital and labarotary medicine. This meant that the signs and symptoms that disease inscribed on the suffering body, were now intelligible only to the expert physician.22 The disappearance of the sick-man from medical cosmology as Armstrong argues, could mark the very crystallization of a new form of modern identity, albeit initially in an anatomical form.23 Somewhat similar to the American scenario,24 anatomical or pathological signs became an expression

17 Unlike the NMI, in the Madras system, a new method of training was well developed to produce compounders and dressers from the sons of soldiersa sort of half-casteto be educated at the hospitals as sub-assistant surgeons. But such a plan was finally discarded in 1826 by the Medical Board in favour of the NMI. For Madras training see, Chakrabarti, Neither of meate nor drinke, but what the Doctor alloweth.

18 Ackerknecht, Medicine at the Paris Hospital, p. 15.19 Jacyna, Medicine in transformation, p. 53.20 Jewson, The Disappearance of the Sick-man from Medical Cosmology, 17701870, pp. 62233.21 Pickstone, Commentary: From History of Medicine, pp. 64649.22 Nicolson, Commentary: Nicholas Jewson and the Disappearance of the Sick Man, pp. 63942.23 Armstrong, Commentary: Indeterminate Sick-man, pp. 64245.24 Sappol, A Traffic of Dead Bodies.




of modernity. In India, during the mid-nineteenth century, British doctors derived their claims to scientific objectivity and authority largely from their studies of morbid anatomy and their attempts to relate the state of diseased internal organs examined after death to the symptoms manifested externally during life.25

Following Foucault, in the newly emerging clinic and medicine, there was an essential mutation in medical knowledge.26 Maulitz notes that for the first time in modern Europe, there was a context, a set of structures and arrangements which centered on the existence of a newly ecumenical faculty and within which a new theoretical canon could flourish.27 Scholars have argued that Northwestern Europe and North America were the regions in which a certain kind of nation-state, with particular social and economic forms, medical organizations, and intellectual culture first generated a widespread view that science in medicine would benefit not only some individuals but all citizens universally.28 This very phase of European medicine surpassed anything prevailing before it. With the rise of hospital medicine it was no longer possible to practice without examination. Surgeons, used to extirpating the lesions of the disease, and physicians, used to administer systemic medicaments, all suddenly now needed a blanket system that could unite heretofore disparate perspectives on the seats and causes of disease.29 The person of the patient was transformed into pathology inside the body. The old medicine had been deeply entangled with theory, but the new medicine, like the old surgery, would be devoted to practice.30 The hospitals of England experienced no revolutionary change, but there too the new attitudes took root.31 Pickstone shows the interrelation between medicine and politics and how the health crisis of 183132 coincided with the political crisis over electoral reform.32 Techniques of physical diagnosis helped establish the significance of the hospital as a place of medical learning.33

Opening the Space for Western MedicineThe Gestation of Hospital Medicine

Medicine, unlike other branches of the natural sciences, deals with living people; and the better understanding of disease demands the dissection of cadavers. In its transformation from the art of healing to biomedical cure, western medicine had to incorporate advances in the basic sciences that were already currentand

25 Arnold, Colonizing the Body, p. 53.26 Foucault, Birth of the Clinic, p. xviii. 27 Maulitz, Morbid Appearances, p. 4.28 Cook, Introduction, p. 2.29 Maulitz, The Pathological Tradition, p. 178.30 Bynum, Science and the Practice of Medicine, p. 28.31 Pickstone, Medicine and Industrial Society, p. 48.32 Pickstone, Medicine and Industrial Society, p. 54.33 Reiser, The Science of Diagnosis.




this transformation had an integral political dimension to it. Larwood for example has traced the establishment and consolidation of the British empire in India as coincident with the expanding interests and achievements in science in Europe.34 It is noteworthy therefore that British power watched with peculiar anxiety the introduction into India of medical science in its European form, and its rise and progress as a plant from a foreign land, adopted and recognized by the natives.35 In short, it had to go beyond the enclavism of British hospital practice for this purpose in India.36

Favourable attitudes towards Western medical practice, I argue, was an outcome of general scientific education which began in India during the late eighteenth and early nineteenth century. The introduction of stethoscope was one of the most potent tools in this regard. Conwell, a staff surgeon of the East India Company, Madras, was possibly the first person to submit the cases he studied and his notes on the stethoscope in 1827.37 In similar ways (but in a slightly different context) the Serampore missionaries pioneered popularisation of general scien-tific education in the subcontinent. Sivasundaram, for example, exposes how the Serampore Mission of Bengal sought to bring indigenous traditions into a dialogue with European science, so that the former could give way to the latter.38

In his brilliant analysis, Raj depicts how Calcutta gradually became the capital city for a world of scientific knowledge construction. The British could not sustain control over the territory by relying solely on the mere 1200 civil and military agents of the Company, who were, in addition, poorly trained for administrative tasks,39 They were, therefore, always in need of people who could internalise Western science. In Rajs argument, for the construction of knowledge as such one should look to the process rather than to the event.40

Initially, the introduction of modern medical education in India had to over-come the impact of Ayurveda and Unani as well as the conventional repugnance of touching dead bodies instilled by social habits and custom. Curiously, even as late as the 1830s, Company surgeons seemed to be treated with low esteem in England: the medical practitioner, in the service of our Honorable East India Company, is estimated somewhat under a butler in London! By the said Company a man is considered as far inferior to a horseand consequently a surgeon is sub-ordinate to a black-smith!41 So, elevating the professional status of the Company surgeons in their homeland was strongly needed. In 1837, Goodeve felt, Within

34 Larwood, Western Science in India before 1850.35 Anonymous, Sketch of an Indian Physician, p. 48.36 Arnold, Colonizing the Body.37 Conwell, Observations Chiefly on Pulmonary Disease in India, p. v.38 Sivasundaram, A Christian Benares. 39 Raj, The Historical Anatomy of a Contact Zone, p. 65.40 Raj, The Historical Anatomy of a Contact Zone, p. 56.41 Anonymous, Review of the Medical Department, p. 113. [Italics added]




the last twenty or fifteen years Anglo-Indian medicine has advanced with rapid stride, and, accordingly, he believed, [t]he immense improvements which have taken place in the medical sciences in Europe have doubtless contributed to this desirable end; for eventhese distant regionsfeelthe influence of scientific discoveries at home.42

During the period under study, health treatment and other amenities for the common people of Bengal was in a nascent state of development. A ryot with a wife and two children seldom earned more than five rupees a month, out of which he ha[d] to defray all expenses.43 The common people of Bengal, it was reported, had to bear the barbarous treatment of the Kobirajes and the half-educated quackan Eastern type of Dr Sangrado who required a fee of one rupee in many cases from the poor fellows.44 In 1824, some people of Calcutta wrote to the editor of the Sangbad Coumudy (the Moon of Intelligence), The people of this country have been relieved from a variety of diseases since it has been in the possession of the English nation.45 They wrote that the ten rupees which poor people earned every month was barely sufficient to sustain the family, and, consequently, the populace have generally not the means of calling in a European doctorwhereby the poor might avail themselves of the medical treatment of European doctors.46 They argued, Were the Hindoo physicians to instruct their children in the knowledge of their own medical Shasters first, and then place them as practitioners under the superintendence of European physicians, it would prove infinitely advantageous to the Natives of the country.47

According to the reporting, this endeavour would benefit the society in four ways. First, pupils would be acquainted with both the English and Bengali mode of learning. Second, by going to all places, and attending to poor as well as rich families, and to persons of every age and sex, he could render service to all. Third, he could go to such places as were inaccessible to European doctors. Fourth, this kind of medical knowledge, and the mode of treatment by passing from hand to hand, would be at length spread over the whole country.48 The new medicine, heralding its universality with the words [for] every age and sex, also incorporated a kind of secular nature into it. Bearing only the faint trace of the gurukul system in which knowledge could be passed from hand to hand, the English mode of teaching had to be incorporated for better efficacy. It was in such an intellectual climate and bolstered by such favourable social attitudes (at least in a particular section of society) that the NMI struck its deep roots in Bengal.

42 Quoted in Harrison, Medicine in the Age of Commerce, p. 96.43 Anonymous, Miscellaneous Critical Notices, p. xix.44 Anonymous, Miscellaneous Critical Notices.45 Anonymous, MiscellaneousBengally Newspapers, p. 387.46 Anonymous, MiscellaneousBengally Newspapers.47 Anonymous, MiscellaneousBengally Newspapers, p. 388.48 Anonymous, MiscellaneousBengally Newspapers.




Homasjee Bhicajee, a respectable native merchant and shipbuilder, was induced to lay aside prejudice, and submit to the operation of lithotomy performed by Dr Fogerty and the result of that and other operations led to the conclusion, that the natives of the country are daily becoming more and more alive to the benefit derived from the employment of European skill in the treatment of diseases.49 More convincing was the cranial surgery done by Ramnarain Doss, a student of the Medical College who treated a boy with severe concussion of the brain and operated on the boy to restore him to consciousness, and ultimately to health.50 It was the first triumph of the Medical College and must be gratifying to the Professors.51

The first Legislative enactment recognising the policy of education in colonial India was Act 53, George III, Cap. 153 of 1813. Cooke observed that owing perhaps to the unsettled state of Europe at the time, and the breaking out afresh of the war with Bonaparte, with the consequent monetary disturbances in the English markets, no steps were taken to carry this resolution of the Government into effectremained unfulfilled till the year 1823.52 The twin need for an educational economy as well as a cohort of trained native doctors to supply vacancies in regiments53 was the principal motive behind educating native doctors in India. In 1855, the Lancet reported, It is little more than thirty years ago since the wants of the army caused the Medical Boards of Madras and Calcutta to commence instructing natives in some of the simple varieties of medical knowledge, though these were of the humblest possible description.54 The economic need of the state was explicitly stated: Native surgeons, educated at the Companys Medical College in Calcutta, could be easily procured, and would be glad to be employed, at from Rs 25 to Rs 50 per month, with rations and a free passage.55 For each English soldier, on the other hand, it would cost the state 100 to train him for duty.56

From 1819 new influences were at work at India House in London with the appointment of James Mill, the Utilitarian philosopher.57 During this time, there appeared strong voices against monopoly of the Company on the one hand, and the singular monopoly of the College of Physicians in England,58 on the other. Medicine and medical profession were even compared with sum of good and like commodities in commerce be limited only by demand.59 All these factors

49 Anonymous, Excerpta, p. 162.50 Anonymous, Medical Students Skill, p. 171. It was fully reported in the British and Foreign

Medical Review, 1845, p. 76.51 Anonymous, Medical Students Skill.52 Cooke, Education in India, pp. 3940.53 Anonymous, Education of Native Doctors, p. 11854 Anonymous, Sketch of an Indian Physician, p. 48.55 Report of the Select Committee on Transportation, p. 196.56 Moore, Health in the Tropics, p. 6.57 Ahmed, Social Ideas and Social Change in Bengal, p. 138.58 Anonymous, An Exposition of the State of the Medical Profession, p. 4.59 Anonymous, An Exposition of the State of the Medical Profession, p. 1.




intersected one another in many tangible and intangible ways in the shaping of the CMC. The earliest reference to black doctors is possibly found in a return of the Companys Bengal Army on 21 June 1762. There were 19 black doctors among 8338 English soldiers, or about two per battalion of a thousand men.60 When the Company raised a standing army, native medical attendants were appointed to each crops and regiment.61 Similar developments occurred in Madras and Bombay: those who were referred to as Native Dressers in Madras corresponded to, it seems, the Black Doctors of Bengal.62

A Government Order (GO) of 15 June 1812 approved of a plan submitted by the Medical Board for training boys from the Upper and Lower Orphan Schools and from the Free School, as compounders and dressers, and ultimately as apothecaries and sub-assistant surgeon in Bengal. It was stated that twenty-four boys of fourteen or sixteen years of age were to be selected. They were to be posted as followsten at the General hospital at the Presidency, ten at the Garrison Hospital, Chunar and four at the General Dispensary. They were placed under the immediate charge of the Superintending Surgeon.

When these pupils are considered by Superintending Surgeon, and the Surgeons under whom they will be more immediately educated, duly qualified for exer-cising the duties of Compounders and Dressers, they shall then be stationed at the recommendation of the Medical Board with such native corps as may more peculiarly require their aid.63

Such medical training was of a purely military nature, to serve only military purposes. Moreover, it was not an institutional training, but rather an individual tutoring under the superintending surgeon with the aim to produce compounders and dressers. It had no syllabus, no proper examination system or certification.

However one important change began to occur. As Seema Alavi has shown how, [m]ost of this training took place not in a classroom but at the bedside of the patient. It was here that British doctors instructed native doctors on matters of medical practice.64 Often passages from medical journals were read out to them: The native doctor noted this medical knowledge with a piece of chalk on the floor, at the foot of the patients bed. Later they memorized it.65

As I stated earlier, visual and verbal acculturations began to take shape, especially at the NMI. The superintendent of the NMI was to direct the studiesto give demonstrationsto take every available means of imparting to them a practical

60 Broome, History of the Rise and Progress of the Bengal Army, Appendix P, p. xxxi.61 Crawford, A History of Indian Medical Service, Vol. II, p. 102.62 Crawford, A History of Indian Medical Service, Vol. II, p. 103.63 Crawford, A History of Indian Medical Service, Vol. II,64 Alavi, Islam and Healing, p. 71.65 Alavi, Islam and Healing.




acquaintance with diseases of most frequent occurrence in India, the remedies best suited to their cure, and the proper mode of applying those remedies.66

From its inception (21 June 1822) to its abolition (1835), the NMI was a colonial institution serving colonial ends. Khaleeli notes, The Indians were to watch and learn rather than contribute.67 MCosh specifically noted the duty of native doc-tors as tosee that the prescriptions are taken, attend to the sick in the absence of the surgeonand perform minor operations of surgery.68 For the purpose of acquiring practical knowledge of pharmacy, surgery, and physic, the pupils of the NMI were attached to the Presidency General Hospital, the Kings Hospital, the Native Hospital and the Dispensary.69 The only practical information given on the subject was obtained from the dissection of lower animals and from the post mortem examination of persons dying in the General Hospital.70

The exposure to dead bodies began to erase the social taboo against touching the dead. Before the foundation of the CMC, students were exposed to the post-mortem examination and attended clinical classes at the General Hospital. This prepared the environs for exposing the new generations of pupils to visual and psychological acculturations with the new culture of medicine. When the cholera epidemic struck Calcutta in the 1820s, twenty of Bretons (a superintendent at the NMI) most experienced pupils were dispatched among the local population with the hope that a decrease in the number of cases of cholera in the town will now admit of the aid of his students.71 In a letter to Dr Breton, Radhakanta Deb wrote, I shall introduce and recommend your advice and medicine, both here and in the interior; and the human lives which will thereby be saved.72 Thus the background for the gestation of public health in India was prepared. Western education became successful in producing its agency through elite people like Radhakanta. Moreover, by suiting the desires of the government and the population at large, the NMI avoided confrontation with the established medical men of pre-colonial India.73

New experiments and trials in a hospital setting were also conducted, for example, by Dr Gilchrist,

a quantity of finely powdered bark and cinnamon, with a due proportion of lau-danum, into a bottle of Madeira wine, to shake the mixture wellto take a wine glassful of the medicine, to be repeated every half hour, until one of ourselves could attend in person. This experiment was tried with the utmost success74

66 Minutes of Evidence, Public, p. 447.67 Khaleeli, Harmony or Hegemony?, p. 95.68 Mcosh, Medical Advice to the Indian Stranger, p. 6.69 Anonymous, Education of Native Doctors, p. 118.70 Chuckerbutty, Popular Lectures, p. 142.71 Anonymous, Education of Native Doctors, p. 115.72 Anonymous, Education of Native Doctors, p. 114. 73 Alavi, Islam and Healing, p. 73.74 Anonymous, Liberality of the Indian Government, p. 20.




The year 1826 is significant because it is then that Dr Tytler commenced his lectures according to the Western method at the College on Medicine, and Profes-sors were appointed to teach Caraka, Suruta, Bhva Praka, etc. Classes for the yurvedic students were opened in 1827.75 Tytler organised his classes around four major departments of medical science, namely, Anatomy, Pharmacy, Medicine and Surgery.76 According to Tytler, it was no small recommendation of Anatomy, that it has a most powerful influence in counteracting prejudices that arise from birth, or station, or cast, by demonstrating that, however mankind may differ in their externals, their internal organization is the same.77 Anatomy, in this descrip-tion, becomes the great social levellerBefore the knife of the anatomist every artificial distinction of society disappears; and if all the individuals of the human race be equal in grave, they are still more so on the dissecting table.78

To the beginners in the fourth class he taught anatomy in the following way

After a preliminary lecture, I begin with the bones and commencing as usual with the head go regularly through the wholeon the bodies of sheep begin-ning with the Viscera and Thorax, then the Abdomen, the Pelvis and Brain and organs of sensethere are frequent opportunities of seeing these in Post Mortem examinations at the General Hospital.79

The gradual marginalisation of Indian medical texts were coterminous with the extension of western medical pedagogy in India. Although the original intention was to instruct boys in the Ayurvedic and Unani systems of medicine without excluding the European system, the latter gradually and inevitably gained impor-tance under European superintendence.80 The process reached such a height that Durshun Lall, a Hindu pupil, brought Tytler a skull his friend had picked up in the banks of the river.81

Opening up the cavity of an organism made pupils further aware of the depth and the third dimension of the body, as opposed to the received understanding of the two-dimensional idea of the body upheld by both Ayurvedic and Unani systems of medicine. Students would learn zootomy by dissecting goats and lambs. But, at the CMC, the subjects were taught practically by the aid of the Dissecting Room, Laboratory, and Hospital.82 Additionally, new instruments of investigations like the thermometer and stethoscope and new modes of physical examination like inspection, palpation, percussion and auscultation were introduced. It is

75 Mukhopaddhyaya, History of Indian Medicine, Vol. 2, p. 15.76 Sen, The Pioneering Role of Calcutta, p. 43.77 Tytler, Anatomists Vade-Mecum, p. 14.78 Tytler, Anatomists Vade-Mecum.79 Sen, Scientific and Technical Education, pp. 13940.80 Sen, Scientific and Technical Education, p. 149.81 Sen, Scientific and Technical Education, p. 142.82 Report of the General Committee of Public Instruction (henceforth GCPI), 1841, p. 34.




important to note, however, that the NMI did not have a proper institutional structure to incorporate the new medical education as yet, or in the offing.

Since its very beginning, the new medical training was secular in nature. A report from a Select Committee was to state: Hindoos and Mussulmans were equally eligible, if respectable.83 Seema Alavi has further pointed out that any coolie attached to the army, once he became well versed in the Nagri script and qualified in basic hospital skills, could rise to become a native doctor.84 For the first time in India, at the NMI, students were inducted into the procedures of individual case-history formulation. The pupils, wrote Tytler, keep a case-book of the symptoms and treatment of the sick on the establishment.85

Another dimension in the changes inaugurated by western medicine lay in the temporality of disease investigation and cure. The materiality of western medical practice lies in the transcription of evidence in written form which is thereafter abstracted as a medical record of observed events.86 The conceptual basis of the clini-cal case thus lies in the ordering of its facts by the agency of time. The introduction of time as an ordering variable in the construction of clinical cases was completely new in Indian practice; gradually the seasonal time of indigenous Indian medical practice transformed into the clinical time of Western practice.

It became widely accepted that the British government could not have estab-lished an institution calculated to be of greater benefitthan the Native Medical Institution [NMI].87 Macaulays efforts seemed only to add a snowballing effect to the process already started by the students of the NMI and Calcutta elites taken together. During the decade of its existence, the number of native doctors which this institution furnished to the public service between 1825 to 1835was 188.88 Eight of the pupils who had been educated in this seminary were appointed native doctors, and sent with the troops serving in Arracan.89

My contention is that the brief phase of the NMI and the medical classes at the Calcutta Sanskrit College represents the period of gestation of hospital medicine in India. Medical classes at the Sanskrit College started in 1827. But the preparatory phase to introduce pupils to modern scienceits technology and techniquehad begun earlier. The report of 1828 stated that the progress of the students of the

83 Appendix to the Report from the Select Committee, p. 270. 84 Alavi, Islam and Healing, p. 71.85 Williams, Original Papers Illustrating the History of the Application of the Roman Alphabet, p. 57. 86 Reiser, The Technologies of Time Measurement, p. 31.87 Anonymous, Liberality of the Indian Government, p. 24.88 Calcutta Medical College, Centenary Volume, p. 9. 89 Minutes of Evidence, 1832, p. 448. Interestingly, in mimicry of the NMI, the earliest record of

an association of indigenous practitioners is the Native Medical Society, founded in Calcutta in 1832. It was solely confined to the Vaidya caste, the Byodya practitioners should refuse to undertake any case where medicine has been administered to the patient by any practitioner of another caste. It was also decided that medicines of all sorts will be prepared by the Society but will be sold to no one who is not of the Byodya caste. See, Anonymous, Native Medical Society, pp. 8485.




medical classes had been satisfactory in the study of medicine and anatomy; and particularly that the students had learned to handle human bones without apparent repugnance, and had assisted in the dissection of other animals.90 They also performed the dissection of the softer parts of animals, and opened little abscesses and dressing sores and cuts.91 Moreover, at the Sanskrit College of Calcutta the number of pupils was then 176, and was rapidly increasing and of these only ninety-nine received allowances from the college.92 This estimate makes it clear that seventy-seven students were without allowances and still pursuing their studies at their own expensethe lure of English medical education can be unmistakably discerned from these facts.

In Fishers memoir, The report of 1829 states that 300 rupees per month had been assigned for the establishment of a hospital in the vicinity of the college.93 Though curricula were in accordance with Sanskrit medical works, a hospital of some kind was thought absolutely necessary for proper medical teaching. As a letter written in 1831 conveys, [t]here is now every reason that medical education in India will be improved in a very material degree by this institution.94 It was thought that the institution would have the benefit of affording to the medical pupils ample opportunities of studying diseases in the living subject.95 One graduate, N.K. Gupta, who had been trained as an apothecary, was apparently doing quite well in the position at the hospital. Though no Hindu had yet performed a major operation, they regularly performed minor ones such as opening little abscesses and dressing sores and cuts.96 In 1833, Dr J. Grant wrote to Major Troyer, the then secretary of the Sanskrit College,

The students of the Medical Class having attained a respectable knowledge of elementary Anatomy and Physiology as far as the means at our disposal per-mitted consistent with Native prejudices: The next point of importance was to give them some correct notions of European Medical and Surgical knowledge.97

In the same letter he made mention of ninety-four House Patients (as stated earlier) and one hundred and fifty-eight out-patients. Of the Two Classes of Patients, the House ones sleep and dieted (sic) in the Hospital.98 He also stated that the out-patients were visited if unable to come at their own residence by the Apothecary, when practicable.99 The Asiatic Journal also published a similar report:

90 Anonymous, Native Medical Society, p. 436.91 Kopf, British Orientalism, pp. 18384.92 Minutes of Evidence, 1832, p. 494.93 Sharp, Selections from Educational Records, p. 183.94 Letter, in Public Dept. to Bengal, 24 August 1831, Appendix to the Report, 1833, p. 498.95 Letter, in Public Dept. to Bengal, 24 August 1831, Appendix to the Report, 1833.96 Kopf, British Orientalism, p. 184.97 Calcutta Medical College, Centenary Volume, p. 126.98 Calcutta Medical College, Centenary Volume.99 Calcutta Medical College, Centenary Volume.




The poor afflicted and helpless sick are now admitted to this hospital, and are furnished with medicine, food and beds; and, in fact, they are attended better than they could be by their own families at home.100

I suggest that these were the first instances when Indian patients were dislocated from their domestic setting to the environs of the hospital. A new notion of treat-ment, which found its final shape in the CMC, began to emerge within social life. By this time, a shift in the vocabulary of medicinal pedagogy was effected and the word education in lieu of the older training gained currency.101 Mr Wilson, who examined the medical class in 1830, ecstatically claimed, the triumph gained over native prejudices is nowhere more remarkable than in this class, where not only are the bones of the human skeleton handled without reluctance, but in some instances dissections of the soft parts of animals performed by the students themselves.102

Concurrently there was a more fundamental shift in the linguistic sign system which determined the development of medicine as an edifice of knowledge in the subcontinent. The essence of the Sanskrit texts was metonymically reconstituted to suit the purpose of modern medicine. As Vasudha Dalmia has shown, by 1827, within western Orientalism, there occurred a radical shift from awe and a certain mystification of [the] wisdom of the East to a marginalization of this knowledge and the degradation of the bearers of it to the position of native informants.103 In the fundamental reconstruction of the indigenous cognitive world Dalmia shows that the pundits had to deliver the raw material so to speak [and] the end products were to be finally manufactured by superior techniques developed in Europe.104 Hoopers Anatomists Vade mecum was translated into Sanskrit as Sarira Vidya by Madhusudan Gupta, for which he was paid a sum of `1000. It was intended to convey to the medical pandits throughout India, who are an exclusive caste of hereditary monopolists in their profession, and all study their art in Sanskrit, a more correct notion of human Anatomy.105 Modern anatomical knowledge came in the guise of the indigenous oneOnce placed in a Sanskrit dress, the Euro-pean system of anatomy would be accessible all over India for subsequent transfer into Hindi dialects of every province if requisite.106 Interestingly, somewhat at the same time, Tytler translated two chapters of the First of Sooshroota into English107, while, in the Bombay School for Native Doctors the Sooshroota Shereer was translated into Marathi.108

100 Anonymous, The Hindu Hospital, p. 8.101 Anonymous, Medical School at Bombay, pp. 31115.102 Minutes of Evidence, 1832, p. 494.103 Dalmiya, Orienting India, p. 48.104 Dalmiya, Orienting India. 105 Anonymous, Proceedings of the Asiatic Society, p. 663.106 Anonymous, Proceedings of the Asiatic Society, p. 664.107 Sen, Science and Technical Education, pp. 16061.108 Anonymous, Medical School at Bombay, p. 313.




Unlike the NMI, the aim of the Sanskrit College was not the production of native doctors. Here students from higher castes of Bengali society were first exposed to general scientific training, and, then, gradually incorporated into the fold of Western medical education. The English and the medical classes at the Sanskrit College were eventually abolished in 1835 and the decision was hailed by a section of conservative diehards.109

Taking a cue from Gelfand,110 I have shown that the CMC was not a sudden phenomenon exploding on the subcontinental scene in one clear move. This sec-tion has attempted to show that the new medical epistemology had its gestation perioda period exemplified by the work of the NMI. By virtue of their training in a medical institution (NMI), the students had the opportunity to be inducted into the basic sciences like rudimentary chemistry, material medica and pharmacopoe-ias along with their primary training in surgery.111 The NMI systematised medical instruction and laid out strict codes of medical apprenticeship and training.112 This pre-CMC training also foregrounded the absolute necessity of hospital of some kind for proper medical teaching.113 All of this had simply inaugurated a predica-ment in which hospitals and medical pedagogy of an altogether new type became necessary. The gestation period described in the section above, ushered in an era of hospital medicine and a new kind of medical cosmology and education in India.

CMC: The Beginning, Changes and Development

In 1828, Montgomery Martin laid the project and plan for a new medical college before Viceroy Lord Bentinck. The plan was rejected at the time by the Supreme Government, lest Hindoo prejudices should be offended.114 It was the Act of 1833 in England that injected fresh vigour into both the Home and Foreign divisions of [the] oriental administration[and] medical and general education began to experience something like the attention it deserved.115

Bentinck had indeed subscribed in 1826 for two shares in the newly founded University College, Londonan institution under combined whig, Benthamite and Dissenting control, and a forward battalion in the march of mind.116 Unlike Oxford and Cambridge, the students of UCL did not require subscription to the thirty-nine Articles of the Church of England. This new university tried in the 1830s to join the theoretical study of science to the practical work of the clinic, as was

109 Ahmed, Social Ideas, p. 146.110 Gelfand, Gestation of the Clinic.111 Jaggi, Medicine in India, p. 42.112 Alavi, Islam and Healing, p. 75.113 Sen, Scientific and Technical Education, p. 147. 114 Martin, Statistics of the Colonies of the British Empire, p. 305.115 Anonymous, Sketch of an Indian Physician, p. 48.116 Rosselli, Lord William Bentinck, p. 85.




already underway in Germany.117 UCL became a site at which the crucial issues of the content of orthodox medical knowledge and of the locus of medical authority were contested and decided.118

All these happenings in England had their profound influence in shaping the mode of clinical training and curricula of the CMC. Percival Spear urges us to look to England rather than to India for the decisive changes in Indian educational policy. The two sources of these ideas, writes Spear, were, briefly, Evangelical and the Utilitarian.119 Interestingly, like UCL, when the Medical College Hospital was built in 185253 it was also built in Corinthian style. In 1834, Bentinck wrote to his friend Peter Aubre, The mind of this country is receiving a new impulse and excitement, and we must keep pace with it. Three thousand boys are learning English at this moment in Calcutta and the same desire for knowledge is universally spreading.120 In an assured note, he continued, My firm opinion on the contrary is that no dominion in the world is more secure against internal insurrection.121 Against this changed scenario, the foundation of the CMC was firmly declared in a Government Order (G.O No. 28) of 28 January 1835.122 Moreover, as the remarks of Goodeve would suggest to us, beyond this socio-political reason the vestiges of humoral theory had also been superseded by rational medicine at the CMC.123

Before the issuance of the GO, a committee was formed in 1833 by Lord Bentinck to look into the state of medical education in the subcontinent. The Committee was to summarise the defects of the NMI. Some of the remarkable points brought forth were(a) the absence of a proper qualifying standard of admission; (b) scanti-ness in the means of tuition; (c) the entire omission of practical human anatomy in the course of instruction; (d) the short duration of the period of study; and (e) the mode of conducting the final examination.124 On a closer look, one would realise that a paradigmatic shift from military medical training to medical education has taken place.

The following narrative will reveal the changing dynamics which led to the emergence and structuration of hospital medicine and medical education in India: Efforts were made to procure every appliance necessary to place it on the same footing of efficiency as European colleges was (sic) furnished with a bountiful hand.125 The duration of education was fixed at four to six years. All foundation pupils were required to learn the principles and practice of the medical sciences in

117 Bonner, Becoming a Physician, p. 144.118 Jacyna, Medicine in transformation, p. 21.119 Spear, Bentinck and Education, p. 245.120 Philips, Correspondence of Lord William Cavendish Bentinck, Vol. 2, p. 1279.121 Philips, Correspondence of Lord William Cavendish Bentinck, Vol. 2, pp. 127980.122 Spry, Modern India, pp. 31014. 123 Harrison, Medicine in an Age of Commerce, p. 96.124 Crawford, History, Vol. 2, p. 435.125 Marshman, History of India, Vol. 3, p. 68.




strict accordance with the mode adopted in Europe.126 The aspiring candidates for admission were to be examined by the Education Committee and the Superinten-dent of the Institution.127 Public service was to be supplied with Native Doctors from the institution. Definite provisions were mentioned to witness the practice of the General Hospital, the Native Hospital, the Honourable Companys Dispensary, the Dispensaries for the poor, and the Eye Infirmary (thirty-first clause). Students, not the professors, passing out from this institution were allowed to enter into private practice (twenty-second clause).

Through the functions of the CMC, hospital medicine and the new medical education were merged together. All the foundation pupils received a stipend at the rate `7 (first class), `9 (second class) and `12 (third class). This was quite differ-ent from the circumstances of medical students in London: according to the 1834 Report on Medical Education, about one third of the London medical students went to a private schoolThe core of the private schools teaching, however, was anatomy.128 They were never paid by the government. In regard to stipend, Trevelyan explained that the professional training at the CMC was carried so much beyond the period usually allotted to education in India, that without this assistance, the poverty or indifference of the parents would often cause the stud-ies of the young men, particularly when they come from a distance, to be brought to a premature close.129 From his own experience, Dwarakanath Tagore wrote to Bramley, no inducement to Native exertion is so strong as that of pecuniary rewardyou will find difficulties disappear in proportion to the encouragement offered to the Students in this particular.130 Another report of the same time gives us slightly different evidence regarding the effects of pecuniary encouragement to undertake medical education. This report informs us that, [c]ertain students of the medical college have volunteered to attend the poor in cholera cases gratuitously. They were offered 30 Rs. per mensem for the duty, but refused it.131 By this time, the responsibility of medical education was transferred from the domain of the Medical Board (military character) to the Education Committee (general educa-tion). Unlike England then, the emergence of the CMC in the subcontinent can be traced to the point of departure where medical practice in India shifted from the dominion of the military to the civil domain.

The original staff of the CMC consisted of a superintendent, Assistant Surgeon M.J. Bramley, with Assistant Surgeon H.H. Goodeve as his only assistant. By G.O. No. 10 of 5th August, 1835, Bramleys official designation was changed from Supt. to Principal, that of Goodeve from Assistant to the Supt. to Professor of Medicine

126 Spry, Modern India, p. 311.127 Spry, Modern India.128 Mazumdar, Anatomy, Physiology and Surgery, p. 128.129 Trevelyan, On the Education of the People of India, p. 31.130 Spry, Modern India, Vol. 1, p. 315.131 Anonymous, Native Doctors, p. 27.




and Anatomy; while a Professor of Materia Medica and Chemistry was added to the staff, Assistant Surgeon W. B. OShaughnessy.132 After Bramleys death the office of principal was abolished, a non-medical man being appointed instead as Secretary.133 Hence, a clear division was made between areas of administrative and academic expertise.

The CMC introduced the timid Hindoo youth to the use of scalpel, without offending the delicate nerves and still more delicate conscience too sensitively.134 Webb, in his lecture before the students of CMC, reminded them that the college was no longer regarded as an experiment, but as an admirable, beneficent and established triumph, as Graduates are being educated at the Medical College in a manner not inferior to some of the most celebrated schools of medicine in Europe.135 Once the experimental phase of medical education was declared over, Webb emphasized the vast difference between the marvellous rapidity and success of lithotomy surgery in the hands of European professors and the rude barbarism of SUSHRUTA.136 Webbs criticism of Indian surgical practice seems to come out of what Christopher Bayly refers to as the insecurity of European knowledge which was a potent element in their rages.137

Initially, the CMC, often going against the prevailing educational trend of the time, had created a space for the generation of original, theoretical and insightful scientific thinking. Gorman noted that the students were just as capable and enthu-siastic about chemistry as they were about anatomy. They came out successfully from the rigour of examination by outside examiners.138 A contemporary journal reported, the chemical department has, within a twelve month [period], reached such a state of organizationwith such eminent success, as to supersede the neces-sity of any other school of chemistry on the same scale in the colleges in and about Calcutta.139 OShaughnessy proposed to construct, at the CMC, a galvanic battery of one thousand cups, on Mullins principle.140 He even undertook to conduct the application of galvanism in case of aneurism.141

OShaughnessy was an ardent and enthusiastic advocate of science as a means of bringing India into line with mainstream intellectual trends in Europe. In 1836, in his Introductory Lecture to the students of the CMC, he made it clear that in every bazaar of India the raw material was to be found from which all the valu-able remedies from the use of which your countrymen are now debarred, can be

132 Crawford, History, p. 438.133 Crawford, History, p. 439.134 Anonymous, Native Medical Institutions, p. 226.135 Webb, The Historical Relations, p. 2.136 Webb, The Historical Relations, p. 29. [Italics added]137 Bayly, Empire and Information, p. 281.138 Gorman, Introduction to Western Science, p. 287.139 Anonymous. Native Education, p. 12.140 Anonymous, Medical and Physical Society, 1837, p. 64.141 Bellingham, Observations on Aneurism, p. 101.




prepared.142 OShaughnessy had counted the number of medicines then imported from Europe. It amounted to several hundred, all of which, except about eighty, might be prepared or grown in India. Moreover, For these 80 many efficient substitutes exist in known indigenous productions.143

OShaughnessy was also a pioneer of intravenous fluid transfusion for cholera patients.144 In Calcutta, Dr Stewart half-heartedly tried it for cholera patients, but without any results.145 A committee was also formed to experiment upon and report on the extent to which injections into the veins may be practiced with safety upon animals.146 OShaughnessy was selected as the secretary of the committee. It remains unknown how long this committee functioned. Later on, he diverted his attention to the use of Indian plants in the treatment of cholera.

The first annual report of the CMC was prepared by Bramley. But he could not present it himself due to his premature death at the age of thirty-six. Bramleys first annual report contains some notable features. First, a considerable portion (first seventeen pages out of thirty-seven) is allocated for detailed discussion on the techniques to build up the physical and mental mould of his Indian students in conformity with Victorian Englands social aspirations. Second, only one paragraph is provided for Goodeves work, while a good portion of the report (five pages) speaks for OShaughnessys experimental endeavour. Third, Bramley provided a proposal to build a new hospital within the college campus and to unite it with the college. He specifically differentiated the new education at the CMC from the trends of instruction that had hitherto existed in India. The new educational curricula included Lectures upon General and Practical Anatomy, Physiology, General and Practical Chemistry, Theory and Practice of Physic, Elements of Medical Botany and Materia Medica, Practical Pharmacy, together with hospital attendance.147

Bramleys plan was to establish a systematic mode of teaching, and as far as means and circumstances would permit to frame the general Instruction of the College on the mode of the English Medical Schools.148 The first course of lectures spanned from June 1835 to September 1835. During this period students were only instructed in surface anatomy of the large arteries, the principle muscles and nerves, etc.149 Gradually, a large portion of the class came to witness with considerable interest the examination of the bodies which had died in the hospitals they visited.150

142 OShaughnessy, Lectures on General Chemistry and Natural Philosophy, p. 16.143 OShaughnessy, Lectures on General Chemistry and Natural Philosophy. 144 OShaughnessy, Blue Epidemic Cholera, pp. 36671.145 Anonymous, Medical and Physical Society, 1836, p. 313.146 Anonymous, Medical and Physical Society, 1836. 147 GCPI, 1837, p. 48.148 GCPI, 1837, pp. 4849.149 GCPI, 1837, p. 50.150 GCPI, 1837, p. 54.




It seemed that poor people dying in the hospitals became virtually coterminous with becoming subjects for dissectionthis trend would become a cause for some concern regarding the projected utility of the hospital. Concern was expressed, for example, in A.R. Jacksons evidence before the Committee for Fever Hospital that

if once the idea gets abroad into the minds of the Native population, that the Hospital is a part of the College establishment, and the source from whence subjects for dissection are to be supplied to it, its usefulness for the purposes of a General Hospital of relief to the sick Natives is at an end.151

Bramley admitted that dissection is seldom approached by the uninitiated even in Europe. An English report noted the natural feeling which leads men to treat with reverence the remains of the Dead to regard with repugnance, and to persecute, Anatomy.152 In 1849, for example, two students of the CMC absconded out of dread of the practical duties of [the] Dissecting Room, and their dislike of the Bengal climate.153 Thus, the relentless and continuing efforts to indoctrinate native students into the white coat ceremony of practical anatomical teaching, which had been continuing since the work of the NMI did not see immediate fruition.

The summer session of the CMC (AprilSeptember) was occupied primar-ily by lectures on basic sciences. The second regular anatomical course did not commence till October 1836.154 Throughout this period, examinations were held regularly on each Sunday, and these were generally conducted in the presence of medical gentlemen who came on Bramleys invitation.155 Bramley did not want to put the dissecting knife into the hands of the students until they had acquired some familiarity with the nature and situation of the parts and, also, not until their moral training had been so ripened as to admit of the final.156

According to Bramley, four of the most brilliant students, whose names were not disclosed for the fear of social repugnance, did the first dissection on 28 October 1836. Up to that period actual dissection had not been practiced by the class.157 He admitted, the probable publicity of this document, forbids my making the disclosure.158 Out of this practical dissection by Indians, the majority of the students could be considered on a par with the pupils of the English schools of medicine, possessing the same, if not more abundant, opportunities for its acquisition, equal intelligence, zeal, and industry.159 A few years later, Dr Goodeve reconfirmed that

151 Appendix C. Evidence, p. civi.152 Report from the Select Committee on Anatomy, 1828, p. 3.153 Report of the General Report on Public Instruction (henceforth GRPI), 1849, p. 24.154 GCPI, 1837, p. 53.155 GCPI, 1837, p. 50.156 GCPI, 1837, p. 53.157 GCPI, 1837, p. 53.158 GCPI, 1837, p. 55.159 GCPI, 1837.




the most important blow which had yet been struck at the root of native prejudices and superstition was made possible by the establishment of the CMC, and the introduction of practical anatomy as a part of the professional education of Brah-mins and Rajpoots, who may now be seen dissecting with an avidity and industry which was little anticipated by those who know their strong religious prejudices upon this point twenty years since.160 Lectures and instruction on the Theory and Practice of Physics afforded the pupils an insight into pathology and explained to them the nature and cause of disease in general.161 With the beginning of the new session, arrangements were made for the pupils attendance at the Native Hospital, the General Hospital, the Eye Infirmary, and the Kolingah Dispensary. Most of them were anxious and ready to assist in the various minor operations, and some of them performed them with confidence and dexterity.162

As the cornerstone of hospital medicine, hospital practice was academically necessary to make the students accustom to the disagreeable sights and impres-sions to be met with amongst the sick in the hospital.163 Visual and psychological acculturations, initiated at the NMI, were now carried on with a greater extent and momentum. Thus, although the NMI was abolished the process of acculturation continued with the CMC.

A new medical person was in the making. They were studying in a foreign lan-guage and, in the study of Practical Pharmacy, the pupils had to prescribe in the language and signs of the British Pharmacopoeia.164 In the classes on Chemistry and Materia Medica delivered by OShaughnessy, several of the young menevinced a strong desire to become experimentalists themselves and twenty of the most distinguished pupils were instructed in the manipulation of apparatus, prepa-ration of reagentsand with the mode of preparation of many of the most useful mineral remedies.165 Such a spirit of experimentation had been first kindled by the instruction in making new chemical substances by student of the NMI.

Bramley tried his best to adopt the system of concourse of chemistry, medicine and botany followed in all the medical institutions of France, and where it ha[d] been adopted in England as the leading principles of the College.166 The labo-ratory contained an enormous electro-magnet, and pharmaceutical preparations illustrating English and Hindu drugs were also in the laboratory.167 Gorman notes, [a]t a time when a chemical laboratory in an American medical school was rare, this course with lectures and laboratory work was the equal of any in a European

160 Goodeve, Hindu Medical Students, p. 190.161 GCPI, 1837, p. 56.162 GCPI, 1837.163 GCPI, 1837.164 GCPI, 1837, p. 58.165 GCPI, 1837, pp. 5960.166 GCPI, 1837, p. 61.167 Calcutta Medical College, Centenary Volume, p. 18.




medical institution.168 Moreover, instead of giving a medal for brilliant results as was the conventional practice, there was also a proposal to give a microscope and several volumes of standard medical works to the students.169 Through such activities, students were supposed to be drawn more towards the science of medicine and not to its merely speculative domains. Goodeve and OShaughnessy proclaimed that as teachers in a new and experimental institution they built their courses of study from the contents of British and foreign journals for this purpose. Of the seventeen medical journals they used, nine were French and eight British. It must not be said of us in Europe, that expatriation has rendered us inefficient in the advancement of our profession.170 They strove to excite among the brethren of the fatherland some surprise to prove that amidst the many impediments which beset them in India, they still pursue the unabated zeal the various useful and ennobling branches of their truly philanthropic art.171 Some of the more advanced students of the CMC, inspired by the spirit of OShaughnessy and Goodeve, formed the Chemical Demonstration Society to perform and independently dabble in experiments. They performed all the experiments in illustration of their learning.172 Bramleys premature death as well as OShaughnessys early dissociation with the institution seems to have put an end to such initiatives.

In 1837, in his letter to Sutherland, Secretary of the GCPI, David Hare cat-egorically emphasised clinical training in the hospital for better exposure to Indian diseases and not only European ones.173 Moreover, this new teaching was supposed to bridge the chasm between the native hospital being exclusively intended for Surgical cases and the General Hospital for instruction in all Medical diseases.174 The century-long dichotomy between the physician and surgeon seemed to get resolved through the production of new graduates from the CMCwho were trained to become physicians and surgeons at the same time. In this way the CMC embodied one of the distinct hallmarks of hospital medicine.

In an earlier observation, Lord Bentinck had declared that all the foundation pupils [should] be expected to practise human dissection and perform operations upon the dead body, or be discharged.175 A few years later, Dr Mackinnon reported, Post Mortem examinations were performed by each of the students in my pres-ence and they wrote descriptions of the result in which they all evinced practical knowledgeand an acquaintance with the healthy and morbid appearances of the different structures and organs.176

168 Gorman, Introduction of Western Science into Colonial India, p. 287.169 Sessional Papers, p. 517.170 Quarterly Journal, pp. vvii.171 Quarterly Journal. 172 Anonymous, Miscellaneous, p. 433.173 GCPI, 1837, pp. 16364.174 GCPI, 1837. [Italics in original] 175 Philips, Correspondence, Vol. 2, p. 1403.176 GRPI, 1855, p. 96.




In 1838, there were two divisions of classesGeneral Classes and Junior Classes.177 A secondary vernacular class, chiefly through OShaughnessys exer-tions, was opened in 1839. Here, [t]he pupils were required to dissect, and were taught entirely on European principles and were employed, at the same time, on practical hospital duties.178

In the 184445 session, the CMC made a great advance in remodelling its system of instruction to bring it up to the standard of the Royal College of Surgeons in England, and procure the recognition of the institution by that body so that the Institution [would] be duly registered and recognized, and those of its pupils who may hereafter visit Europe for the purpose of graduating or obtain-ing the Diploma of Surgeon.179 Following European Colleges, new regulations were made so that no single teacher would teach more than one subject and each subject would consist of not less than seventy lectures. It was also required that every student should, in addition, compound in the dispensaries of the Medical College under the superintendence of Mr Dally, the House Surgeon and Apoth-ecary.180 The legacy of producing compounders and dressers, as was the case in Madras as well as in some modified ways at the NMI, were incorporated at an extended level in the CMC.

In eight years, from 1837 to 1844, nearly 3500 bodies were dissected.181 This was an incredible figure! There seems to have been a never ending supply of unclaimed bodies of hapless poor Indian people. Everyone knows that this city contains thousands of poor strangers, of all ranks, without wealth, connexion, or friendssome die on the road, and many perish for want of two pice worth of medicine.182 Buckland noted that a large proportion of the corpses, instead of being burnt, were either thrown into the river, or consigned for dissection to the Medical College hospital, to be afterwards disposed off in the same way.183 This was possibly the reason why, unlike in England, there was no need for a replica of the 1832 Anatomy Act in colonial India. The body was colonised and cadavers were plentiful.

Along with the revision of the medical curriculum, the system of examination was modified so that it would be more nearly assimilated to that which obtains [in] most European Universities.184 In addition to a written and a practical examina-tion in the dissecting room, every final student was subjected to a special trial for twenty minutes at least. It was much more difficult than that for the Diploma of the Royal College of Physicians and embraces everything required from a Graduate

177 Hare, Medical College, Calcutta, p. 267.178 Calcutta Medical College, Centenary Volume, p. 17.179 Anonymous, Annual Report of the Medical College of Bengal; Session, 184445, pp. xxxvxxxvi. 180 Anonymous, Annual Report of the Medical College of Bengal; Session, 184445.181 Webb, Pathologia Indica, p. 237.182 Peggs, Indias Cries to British Humanity, p. 203. [Italics in original]183 Buckland, Bengal under the Lieutenant Governors, Vol. I, p. 296.184 Anonymous, Annual Report of the Medical College of Bengal; Session, 184445, p. xliii.




of the University of Edinburgh.185 The method of giving marks to the candidates at the final examination began in the 184647 session. In awarding the number of marks, the written and practical examination was valued as equaleach at fifty marks apiece; so that the aggregate of both examinations would be calculated at one hundred for the highest number.186

Following changes in the 184445 session, the period of study in CMC was extended from four to five years for better clinical and surgical training.187 Moreover, the establishment of the Fever Hospital was to complete the amount of practical and clinical instruction furnished so as to rank with any of the provincial schools of Great Britain, or the second class schools of medicine, in the centre of England, Scotland or Ireland!188

All these changes show the dynamic character of medical education in its initial years. Duncan Stewart, in reply to the question of the relative advantages of Dispensary and Hospitals, reveals his faith that an essential part of Medical education had to be conducted in the practical domain of the Hospital, since there alonecan Clinical instruction be given with propriety.189 To substantiate the importance of the hospital for a wholesome medical education, Martin pointed out that attendance on large bodies of sick in their own houses would be obviously impracticable, even were it desirable.190

With the passage of time, by 1841, the gender question regarding admissions to the CMC was resolved as well. A large Female Hospital, intended to embrace the advantages of a Lying-in-Hospital with instruction in Midwifery was built and was ready to receive patients.191 It could accommodate more than one hundred patients. In 1850, the policy was worked out to encourage women to resort to the Institution for delivery, and, for this purpose, it became necessary to hold out many little advantages to them (for the present at least) in the shape of clothes for themselves and their children when they depart, allowances for tobacco.192 Providing such advantages might have arisen out of a threat from the indigenous practice of midwifery. Poor people were allured to institutional deliv-ery, and this led to a gradual marginalisation of indigenous practice of midwifery. Madhusudan Gupta reveals that [s]uch women so instructed and employed, would readily find employment at a moderate charge among Hindu women of all castes and ranks, at their own houses.193 Hence, the introduction of the new midwifery

185 Anonymous, Annual Report of the Medical College of Bengal; Session, 184445.186 GRPI, 1847, p. 97.187 Calcutta Medical College, Centenary Volume, p. 25.188 Anonymous, Annual Report of the Medical College of Bengal; Session, 184445, p. xliii.189 Appendix C, p. xcvi. [Italics in original]190 Appendix C, p. xciv.191 GCPI, 1841, p. 35.192 GRPI, 1851, p. 129.193 Abridgment of the Report, p. 89.




practice not only marginalised indigenous ones, but also created newer spaces of employment.

After nine years of successful experiments in 1844 the rules and regulations of the Bengal Medical College were codified. No stipendary student was permitted to present himself for final examination until he had completed five sessions of study in the College.194 They were also strictly required to perform the duties of clinical clerk and dressers for not less than eighteen months, collectively.195

After 1844, when the new medical education was free from its initial uncertain-ties, enrolment expanded: along with stipendiary students those who were referred to as Free Students were allowed into the CMC. It was claimed that [t]he number of students wishing to obtain a complete medical education at their own expense shall be unlimited.196 Moreover, Diplomas and certificates bestowed on the free students, shall be the same as those granted to Sub-Assistant Surgeons at the annual examination.197 The Military Class was also brought under the regulations and placed under the control of Pundit Madhusudan Gupta. The internalisation of Western medicine advanced further with the replacement of European teachers by Indian ones in the Military Class. For example, the subject of anatomy and surgery was taught by the Superintendent, and Practice of Medicine with Materia Medica by Baboo Shibchunder Kurmoker.198

The secrecy with which the first dissection was carried out in 1836 was no longer necessary in 1844: A certain number of the senior students shall, during each dissecting sessionthemselves dissect and become practically acquainted with the anatomy of the human body.199 Additionally, there were three cases for the teachers, second-hand capital cases for exhibiting all operations on the dead subject, a post mortem case.200 Not only dissection, dressing, compounding and clinical training, the students were also taught to read prescriptions and the instruc-tions given by the Medical Officers, for the administration of medicines during their absence.201 For the first time every dissecting student was to deposit a sum of two rupees in the office of the College, to make good any loss or destruction, to which the instruments may be subjected, independent of fair wear and tear.202

The hospital attached to the Medical College was divided between the depart-ments of surgery and medicine, holding in all 112 beds. The everyday functioning of this hospital was detailed meticulously and the ritual of admission was described

194 Rules and Regulations of the Bengal Medical College, 1844, p. 3.195 Rules and Regulations of the Bengal Medical College. 196 Rules and Regulations of the Bengal Medical College, p. 5.197 Rules and Regulations of the Bengal Medical College, p. 6.198 Rules and Regulations of the Bengal Medical College, p. 20.199 Rules and Regulations of the Bengal Medical College.200 Rules and Regulations of the Bengal Medical College, p. 24.201 Rules and Regulations of the Bengal Medical College. 202 Rules and Regulations of the Bengal Medical College, p. 23. [Italics added]




as follows: after admission into the hospital, patients would be immediately seen by House-SurgeonThe disease shall be noted on a ticket with the diet, date of admission &c.203 A general register of all the cases admitted in hospital shall be kept, and available for statistical purposes.204 As an outcome of these rituals and procedures the person of the patient began to disappear and, in turn, began to be known as a number: Enter and you will find East Indians and West Indians, Ben-galees and Madraseesthey are of all classes; and (as all patients are distinguished not by name, but by numbers), were one to ask for Now Number Sahib.205 The significant exception in the secular nature of the new medicine was determined by its colonial context where differences were often noted by caste and racial inscription. The daily charge for the diet of each patient, for example, was for Europeans four annas, and for Natives one anna.206

In 1847, Balfour felt that perhaps one of the most striking features of the present history of India was the wonderful success with the opening of Dispen-saries.207 Dispensaries, in his view, were held by the great majority of the people with increasing favour. They were manned by graduate sub-assistant surgeons of the CMC. Thus, it was through the dispensary that a space for modern public health was opened up in a true sense. The success of these strategies was also dependent on the internalisation of certain rules of behaviour by the population at large. Medicine thus acquired political status inasmuch as it gained a new relevance to the interests of the state.208 Sykes reported about 94,618 patients who were relieved in the Charitable Dispensaries of India in 1847.209

Importantly, ether anaesthesia was administered on 22 March 1847, while chloroform was applied on 12 January 1848within two months after its first introduction in London.210 Among the prominent points of interest referred to were the extraordinary success of some of the graduates of the College in the performance of the formidable operation of lithotomy, and the valuable results which had followed the introduction of chloroform into the practice of surgery.211 Dr Jackson crushed large stones in the bladder by making the patient insensible to pain by chloroform. One hundred and thirty two operations were done in the Native Hospital during the years 1848 and 1849.212 On 7 February 1849, J. Jackson of the

203 Rules and Regulations of the Bengal Medical College, p. 30.204 Rules and Regulations of the Bengal Medical College, p. 32.205 Ray Choudhury, Calcutta a Hundred Years Ago, p. 4 [italics added]. Note also the argument of

Trohler regarding quantification and statistics gatheringthe flagship of hospital medicine. See Trohler, Quantification in British Medicine and Surgery 17501830.

206 Rules and Regulations of the Bengal Medical College, 1849, p. 40.207 Selections from the Records of the Government, p. 116.208 Jacyna, Medicine in transformation, p. 82. 209 Sykes, Government Charitable Dispensaries in India, pp. 137.210 Pillai, Understanding Anaesthesiology, p. 13.211 GRPI, 1851, p. 122.212 Webb, The Historical Relations, p. 29.




CMC even corresponded with Simpson (the discoverer of chloroform) describing the administration of chloroform in a case of severe pain.213

Stewart also mentioned the successful introduction of new anaesthetic agents in his report. Chloroform was given in two obstetric cases of operative procedure with perfect safety and success in the presence of several of professors, and a number of the students of the CMC.214 This report was sent for publication in the Register of Indian Medical Science.

The CMC, like its European equivalent, became a space for new scientific experi-ments. All these experiments were transmitted throughout India and, also Europe, through publications like the Transactions of the Medical and Physical Society of Calcutta, Quarterly Medical Journal and, later, the Indian Medical Gazette. Hospital medicine thus gained its universal character beyond its European origin to the extent that in some ways the peripheral location of the colony had a large role in influencing the development of the field in central metropolitan England.

Conclusion

The foundation of the CMC, as this article has argued, not only gave birth to hospital medicine and modern medical education in India, but it also influenced education in India in general terms. In 1845, four of the students of the CMC made their voyage to England and, supposedly, overcame the dread of the sea, so firmly implanted in the mind of every Hindu.215 They became the role model for future Indian scientists and students.

The CMC produced trained graduates who extended the applications of modern medicine and public health, as shown above, throughout India. Lord Hardinge was convinced of the impact of dispensaries and eulogised it216 as a way that would extend the benefits of modern medicine. In this way the CMC may have also played a role in the future of public health in India.

The birth of the CMC converged with the years in which the Anglicist Orientalist debate would be resolvedfrom here on English would become the language of higher education. The CMC was also possibly the first Indian institution to work on the plan of suitable [residential] accommodations within the precincts of the College.217 Residential education was considered one of the most essential and important features in the normal training of teachers in the schools of Germany, Holland, Switzerland and France.218 The CMC introduced this model to India. Native medical students were to be accommodated within the

213 Simpson, James Young Simpson Collection, letter no. 156.214 GRPI, 1848, Appendix E. No. VII, p. cli.215 GRPI, 1848, p. 96.216 GRPI, 1848, p. 88.217 GRPI, 1848, p. 100.218 GRPI, 1847, p. 82.




precincts of the college to make them immune from every influence resulting from ignorance, superstition, the prejudices of caste, and similar means of weakening the effects of the intellectual and moral training he is undergoing in our schools and colleges.219

The advocates of the new medical education saw themselves as the historical agents and visionaries for a new future of India. Sykes confidently proclaimed the successful colonization of the subcontinent via western medical pedagogy: we shall have left a monument with which those of Ashoka, Chundra Goopta, or Shah Jehan, or any Indian potentate sink into insignificance and, at the same time, those of Auckland, as protector, and of Goodeve, Mouat, and others, as zealous promoter of scientific Native medical education shall remain embalmed in the memory of a grateful Indian posterity.220 Notably, in this new history, pragmatic and success-ful people like Auckland, Goodeve and Mouat were mentioned to the occlusion of OShaughnessy, the person with an original inquisitive mind who was on advocate of the spirit of free thinking.

Despite the European intervention, Chuckerbutty likened these medical officers to only bird[s] of passage and, as a result, they could not, therefore, permanently improve the position and prospects of the profession out of the service.221 In a move to replace these birds of passage, internalisation of modern medicine was of prime importance. Following the European method, he began his trials with iodide of potassium at the CMC in the treatment of aneurism.222 It is important that Chuckerbutty preceded similar British trials in this regard. His trial was pub-lished in July 1862, while the British one was published in January 1863.223 He strongly advocated for compulsory registration of medical graduates. This was to counter the presence of unqualified imposters: [e]very druggist and chemist, every apothecary and quack, every sluggard, fool, and rogue, enjoys as yet full liberty to style himself a doctor and prescribe for the sick.224 In 1864, he enumerated 29 types of different medical practices prevalent in Calcutta alone.225 If Chuckerbutty embodies the agency of modern medicine, Mahendralal Sarkar and Bholanath Bose represented two other distinctly visible trends. Sarkar, who was himself a gradu-ate of the CMC, championed homeopathy of a distinctly Indian kind. He was also the founder of the Indian Association for the Cultivation of Science (1876). Bose, I would propose, advocated for a hybrid of allopathy and homeopathy. He wrote two books, A New System of Medicine and Principles of Rational Therapeutics. which the reviewer in The Philadelphia Medical Times described

219 GRPI, 1847.220 Sykes, Government Charitable Dispensaries of India, p. 23. 221 Chuckerbutty, The Present State of the Medical Profession in Bengal, p. 88.222 Chuckerbutty, Iodide of Potassium in the Treatment of Aneurism, p. 61.223 Roberts, The Successful Use of Iodide of Potassium in the Treatment of Aneurism.224 Chucke

Bhattacharya, J. the Genesis of Hospital Medicine in India- The Calcutta Medical College (CMC) and the Emergence of a New Medical Epistemology

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