58 58 History College: Ajourneyofmorethen150years College: Ajourneyofmorethen150years CharitableHospitaltoMGMMedical Indore CharitableHospitaltoMGMMedical Hospital &the IndoreCityDispensary& there In 1851there wastheIndoreCharitable 2,800/-. epidemics. Thecostofthis buildingwasRs. women wasusedforInfectious diseases& godowns. Thisbuildingwhen unoccupiedby females. Ithad2roomsfor 10beds&attached Impey hadanotherbuildingconstructedfor their naturalmodesty&purdah special facilities A Charitable Hospial. therefore nomenclaturedastheIndore Charity W 2 for themilitary&travellingtroopsother Superintendent. 25ofthebedswerereserved 1st Sept.1849,withDr Holka was Rs.8,500/-chieflygrantedbyT The expenseincurredinbuildingthisHospital accommodate 25bedseach. there weretwowardssufficientlylargeto Theatre. Oneithersideofthecentralroom as aDispensingroomwellanOperation building hadaCentralroomwhich City ofIndoreandtheadjacenttowns.This the meetingpointofprincipalroads City ofIndoreinanopenspaceadjacentto between theBritishR was e o (1851-1871) Dr The IndoreCharitableHospital E. territory in1847whichwastakenoverbyDr D British troopsandtheirfamilies. Bruce asR back to1837, and ModernMedicineisCentralIndiadates The History Departments ofSurgery(Retd.)and*Opthalmology(Retd),M.G.M.MedicalCollegeM.Y.Hospital,Indore,India S. College: Ajourneyofmorethen150years Indore CharitableHospitaltoMGMMedical College: Ajourneyofmorethen150years College: Ajourneyofmorethen150years Indore CharitableHospitaltoMGMMedical Indore CharitableHospitaltoMGMMedical n 5 r K.Shukla,P.Sethi* t . MurraystartedasmalldispensaryinHolk thetimeofitsinception,therewereno . Impey(1847-1854)andDr R the recommendationofSir were reservedforthepublic&calledas opey in1848 r-II. Thishospitalstartedfunctioningon x cellently andconvenientlylocated ards. Thispremierinstitutionwas esident Surgeontolookafterthe This secondInstitutionwasbuilt of MGMMedicalCollege,Indore when BritishersappointedDr for femalepatients.Seeing esidency areaandthe . E.Impeyasthe . R. Hamilton . W served both system Dr u . G. Kane k oji Rao and . ­ a r . . D the Hospital, was amanualbyDrouitt.Theentiremaintenanceof set upof one toothinstrument.Thisshowsthemeagresurgical cupping case,onepocketcaseandstomachpump& amputation case,onehydroceleeye In 1852theSurgicalarmamentariumusedtobeone were dispensariesinUjjain, chloroform as ananesthetic operations under time to1881when Hospital. Itisindeedaninteresting factthatfromthis s In 1865,Dr changes intheIndoreCharitable Hospital. attitude soonbroughtmajorstructuralandfunctional D major operationswere Charitable Hospitalwasabout2500annually In 1864,theoutdoorpatientsattendanceinIndore R In 1864,Dr D caused byafall. successfully used later onmoresuccessfullybycalomel.Electricitywas in thenosewere ozs offluidfrom measuring fingers The surgeriesconsistedofremovaltumoursfrom & wineweregivenwhenrequired. consisted ofdal,rice,ghee,attaandvegetables.Meat The dietcostoneanna,2pieperpersondayand one ortwoblank was only2124 & outdoorattendanceof the Superintendent Newenham M.D. to tea By 1855thenumberofMalwaDispensarieshadrisen u esidency Surgeon. r r r r . T . ArthurNewenham(1854) . Beaumont’sdevotion,zealand gery onscientificlinesat theIndoreCharitable . Beaumont(1864-1881) ten &theyweresupervisedbyDr and earsremovalofureteralcalculus Indian J Surg|February 2006|Volume 68|Issue1 that time.Thesur 1.1/2" x1.3/4"andweighing54grams.16 . Beaumontperformedthe firstcataract . Beaumonttookover amounted toRs.250permonth. in theyear who wastheR ets, adariandcharpaiwasgiven. a hydrocelewasremoved.Maggots for treatingparalysisofthebladder initially treatedbyturpentineand he retiredDr at thistime.Thecombinedindoor General Anaesthesia using performed intheentireyear the IndoreCharitableHospital . T g agent. Ratlam, Dhar&Manpur o ical bookrecommended everyadmittedpatient . Beaumontdidalleye esidency Surgeonand charge asthe humanitarian . Arthur and 18 . . History

Little must have Dr. Beaumont realised the tremendous Dr. Beaumont had advocated a pupil, Ganpat Singh, impact his eye surgery was to have in the forth cominc in the Indore Charitable Hospital. Pleased with his years. The remarks in the Agency Reports work he sent him to the sub-assistant surgeons classes 0 1868 depict the status of Dr. Beaumont and were for two years and he acquired a well grounded indicative of the stature he was to achieve “People knowledge of the profession. travel long distance to consult Dr. Beaumont whose skill and kindness are proverbial. In operation of eye, In 1878, Dr. Beaumont establised the first Medical he has been very successful.” In this very year, separate School in Central India enrolling four native students huts were erected for cases of infection and contagious Gopal Purrusram, Gopal Bajee Rao, Assadyar Khan and diseases. Atmaram Raghoba, This School in the next century was rechristened “The King Edward Medical School” In 1871 another ward was constructed to accommodate and finally blossomed into the authors’ Alma Mater, 18 patients. The Raja of Dhar donated Rs. 1000/- to the “Mahatma Gandhi Memorial Medical College” a construct five substantial little houses for respectable glorious heritage indeed! persons or females. Dr. Ganpat Singh worked in the capacity of an Assistant Such was the impact of Dr. Beaumont’s personality and Superintendent was an excellent teacher in the Medical surgery that the Raja of Dhar became his unequivocal School and a skilled surgeon of no mean repute. admirer and granted funds to build a separate hospital for lepers adjacent to Indore Charitable Hospital. Prof. Lister’s antiseptic methods of treatment of wounds was introduced in the Hospital in 1880 and in 1881, Dr. Beaumont was not only an Ophthalmic Surgeon 70 large abscesses were treated by this method with but also an excellent General Surgeon in addition to good results. being an equally good physician. His observation on phagedenic ulcers, fevers and leprosy speak of the Dr. D. F. Keegan (1881-1894) incisive innate intelligency which he possessed. His devotion to medical science and the nobility of his In June, 1881 Dr. T. Beaumont retired and Dr. Surgeon character are clearly depicted when we go through his Major D.F.Keegan took-over charge as a residency report when he was plagued by the not so good results surgeon in the Indore Charitable Hospital. of amputations. “The results of the operation of the year were successful and might easily have made them In Dec. 1881 the Surgeon General, Government of much more so by simply avoiding to operate in a few India, Dr. Cuningham visited the Indore Charitable desperate cases which gave the greater number of hospital and remarked that he was most agreeably deaths, but I consider it my duty, to operate in all cases surprised at the great amount of surgical & medical if the patient wishes it, when there is a possibility of work done at Indore Charitable hospital. saving life, which if left alone, must necessarily be lost.” Dr. Keegan continued the excellent clinical & surgical An epidemic resulted in a sudden influx of a large work established initially by Dr. Beaumont at the number of patients in 1872. For this a large grass shed Indore Charitable Hospital He became internationally and “chhappar” were erected which served as a known for using a forehead skin flap for the permanent wards for a couple of years. A male and reconstruction of cut-nose for the first time in the female waiting room, dispensary room, prescribing world. The result of this work culminated in the room, which also served as an operation room were printing of a book on Rhinoplasty Operation in 1900 constructed and the large grass shed no longer required, and the results therein match the finest surgery done was knocked down. any where in the world today.

In 1875, 10 lithotomies were successfully performed In 1883, the Indore Charitable Hospital was the first and 3 obstetric operations were performed in Indore in India to adopt the then modern operation of for the first time. In 1879, 20 single roomed houses Lithotripsy of one sitting for bladder stones. were constructed with small a cooking place in each. In 1885 the Viceroy of India, Lord Dufferin and Lady Plastic Surgery was also successfully carried out. In Dufferin visited the Indore Charitable Hospital and the the words of Dr. Beaumont “Last year I operated on a Viceroy was pleased to express his approval of the bunniah for a very unsinghtly harelip. The lip united working of this Hospital. so evenly and perfectly as to have scarcely a trace of the operation. The man was so delighted that he has In 1885 Bigelow’s operation (Litholapaxy or rapid become quite an impassioned of plastic surgery, seizing evacuation) for bladder stones was introduced. Indore villagers with harelips in the market places and hauling Charitable Hospital was one of the first in India to treat them to the Hospital. boys with bladder stones by this method of surgery.

Indian J Surg | February 2006 | Volume 68 | Issue 1 59 History

In 1886 a female ward was constructed of a cost of Rs. administrative rooms were constructed and by 1912 1500 and in 1887 a female medical class was started completed. The old Daly College Building was given in the Medical School enrolling 6 female students. to the Medical School in 1910 and education continued to be imparted in this handsome traditional In 1887, at the Indore Charitable Hospital 518 major architectural marvel till the construction of the M.G.M. surgeries were done and of these, 296 operation were Medical College Building in 1948. on the eye. Many cataract surgeries were done with successful results in over 90% of cases. What a Dr. F. A. Smith (1912-1921) wonderful record for Dr. Keegan! The Indian Medical Degrees Act No. VII of 1916 was passed. With this Act the Superintendents of the Dr. Caldecott (1894-1897) Hospitals were deprived the right of giving a In 1894, Dr. Keegan retired and Dr. R. Caldecott took recognizable qualification to the Medical Students. over the charge of Residency Surgeon in the Indore Matriculation became essential for admission to the Charitable Hospital. Earlier in 1885 Dr. Caldecott had Medical School. To get a recognized Medical Degree been posted at the Indore Charitable Hospital when students had to appear in the LOPS examination of Dr. Keegan was on privilege leave from 9th August to Bombay or LMP examination of Nagpur. The advent 10th November, 1885. At that time, he introduced local of the first world war put a serious set back to the Anaesthesia in Ophthalmic Surgery at the Indore development and maintenance of the Hospital. After Charitable Hospital. The local Anaesthetic agent was the world war Khan Sahib Lukman Bhoy of Ujjain Cocaine. constructed a new Bohra ward. The Keegan’s Ward was rebuilt at a cost of Rs.25000/- from the KEH and In 1894 the depreciation of the Rupee and also the Medical School Fund. imposition of custom duty strained the resources of the hospital. A year later the Bohras of Ujjain rebuilt a Dr. G. D. Franklin (1921-23) large row of hospital buildings. At this time the operation theater was repaired and the laboratory extended. Dr. G.H.D. Gimlette (1897-1901) Lt. Col. Gimlette remained as the Residency Surgeon Five new Blocks were erected for compounders. up to 1901 when Lt. Col. Sir James Roberts took over Dark-room and accessory room was added to the X- charge as Residency Surgeon, Indore. Though Dr. ray room. The paucity of funds led to the closure of Gimlette was better known as General Surgeon the school for a year and no new admissions were made particularly skilled in the operation of Litholapaxy, yet during that time. his skill as an Ophthalmic Surgeon was also well established. Dr. W. R. Battye (1923-1928) Immediately on joining, Dr. Battye improved the Dr. Roberts (1901-1912) financial condition of the school restructuring the fees During Dr. Roberts administration the number of and obtaining donations. The Medical School was then students who were to become “Hospital Assistants” restarted in 1923. In 1923 The European Infantry rose from nearly twenty to eighty by 1904. he was Barracks (Gora Barracks) were converted into Medical the first to suggest the introduction of Specialists to Hostel to accommodate about 130 students. In 1928 a improve the efficiency of the Hospital. In his words Leprosy Ward and Ear Nose and Throat Department “The Work of these Large Hospitals should be were added. parcelled out into Departments each under the charge of men whose endeavour it will become to train Dr. J. R. J. Tyrell (1928-1931) themselves as Specialists, & who will have the sole Dr. Tyrell remained in the Hospital for three years only. responsibility of their charge.” He also recommended After his retirement he joined the State Services the creation of a Sanitary Department to deal with as Inspector General for Civil Hospitals and member public health sanitation, vital statistics & inchage of the Medical Department. In both these epidemiology. capacities he helped the Institution considerably. A female out patient and Maternity department was The Tukoji Rao Hospital opened 1901. The added. Caldecott memorial eye Hospital was constructed at a cost of 39,500/- and was completed in 1905. Dr. R. F. D. Mac Gregor (1931-1933) Dr. Mac Gregor remained incharge for a very short tine The medical school which had come to be known as to be succeeded by the dynamic Dr. Nicholson. the Central India Medical School was rechristened as the King Edward Hospital and Medical School in 1911. Dr. M. A. Nicholson (1933-1945) at this time a separate operating Block, T.B. ward and During his period a Children ward was added in 1936.

60 Indian J Surg | February 2006 | Volume 68 | Issue 1 History the Hostel Dining Hall was constructed at a cost of Rs. Chikitsalaya in 1985. 25000/- which was donated by Rai Sahib. A 90 bedded Cancer Hospital was commissioned Jamnalal Ramlal Kimtee in 1937. Donations also in’1969 and it has the privilage of having the most resulted in the construction of a Building for modern cathetron therapy. It is one of the better Cancer Physiology Department, Laboratory and Ladies waiting Hospitals of the country having diagnostic and room. These were later used as Drug Laboratory. In 1­ therapeutic equipments worth Rs. 50 lacs. 938 the Government of India enunciated the policy of having only one class of Medical Practitioners that is The two storeied new spacious Out-door block was the graduate of medicine. It now became essential to completed in 1970 and has brougth much needed relief convert the school into a college. The second world to the out-patients. It also houses the Artificial Limb war presented its own problems but in 1944 Col. Dr. Fitting Center, which is one of the 30 centers in India Nicholson issued an appeal for collection of funds. The started by the Artificial Limb Corporation of India and idea of reservation of seats on contribution was mooted aided by the State Govt. and a system of capitation fees was introduced. The college started in1948 with an admission of 50 Dr. H. W. Farrell (1945-1947) students annually. This was increased to 75 in 1956, In his brief stay of two years he advanced the College when the college and hospital. buildings were and Hospital projects. completed. The present admission strength has gone to 140 students annually from 1976 without actually Dr. S. K. Mukhrji (1947-1948) doubling the facilities. During Dr. Mukhrji’s brief charge of nearly four months it was decided to change the name of Central Indian Postgraduate degree courses were started in 1954 and Medical College to Mahatma Gandhi Memorial Medical the Diplomas in 1956. At present there are 87 students College. The panel of Inspectors from Agra University registered for M.D. M.S. and 36 for Diploma annually. inspected the Institution for according permission to Sanction for starting few more Diplomas is expected. start the college. The development of the subspecialities has kept pace Dr. B. C. Bose (1948-1966) with the growth of the institution. There are speciality Dr. B.C. Bose was appointed the first Principal of sections of cardiology, neurology, gastroenterology, M.G.M. Medical College in March 1948 and the haematology, endocrinology, dermatology, foundation stone of the Medical College and M. Y. venereology and chest in the department of Medicine. Hospital were laid by the Union Health Minister, By the end of 1978, a dialysis unit was set-up. In Rajkumari Amrit Kaur on 6th June 1948. Surgery, there are cardio-thoracic and paediatric units while Opthalmology has an Argon Laser Photo Though the college was started in July 1948 it remained coagulater and also an Eye Bank. Paediatrics has its a private institution and the students had to pay a special clinics, peripheral services, neonatology capitation fees of Rs. 1500/- in addition to the tution section and its own established biochemistry and other fees. This state of affairs lasted upto March laboratory. The Department of E.N.T. is doing 1957 when the college was taken over by the Madhya microlaryngeal surgery. The Department of pathology Bharat Government and the capitation fees abolished. is well equipped and has got laboratories for microbiology, immunology, cytology and a well The handsome Medical College building was established blood bank. In the development of these completed in 1954 at a cost Rs.18 Lakhs and the specialities, there was substantial help from Maharaja Yeshwant Rao Hospital in 1955. Maharaja Rockfeller foundation, World Health Oraganisation, Yeshwant Rao donated IRS. 35 Lakhs for the M.Y. Technical Co-operation mission and Colombo plan. Hospital which in all was constructed at a cost of Rs. These contributions were both in equipment and 66 lakhs. The College was designed and constructed fellowships. Mention must be made of Shri by a Hungarian architect Mr. Heinz. The next Govindram Seksaria, Badjatia K.B. Illava and R.C. Jall expansion was in the form of construction of the Trust, who donated generously for the development Manorama Raje T. B. Hospital with a contribution of of Cardiology, Indigenous Drug Research and Rs. 5 lakhs from Maharaja Yeshwant Rao. Nutritional laboratory, Haematology and Dialysing unit respectively. The M.D. and MS courses were started in 1953 and Diplomas from 1956 onwards. Further expansions Various All India conferences have been regularly hosted were the construction of the Preventive and Social begining from All India Paediatric conference in 1956. Medicine Block in 1958, a 90 bedded Cancer Hospital in 1969, a new Outdoor Block in 1970, a separate Research work is being done in every Dept. and over Microbiology Block in 1975 and Chacha Nehru Bal 1,200 publication have come out of this institution both

Indian J Surg | February 2006 | Volume 68 | Issue 1 61 History in Indian and Foreign journals. new specialties specially Cardiothoracic Surgery & Peadiatric Surgery. Closed Cardiac Surgery was started Partly from ad-hoc grant of Madhya Bharat Govt. and along with Dr. Chamanlal Nagrath in 1959 and was party with Foreign aid the library was organised. It now one of its few centers in the country doing so. has 19,000 books 124 currently subscibed journals and Similarly a separate unit of Peadiatric Surgery was 102 journals with back numbers. Microfilm reading started in 1958 and is continuing till date. This and photo copying services are also available. surgical center was renowned for its major surgical procedures & patients from neighbouring states of UP, The college of Dentistry was established in 1961 and Maharashtra, Rajasthan & Gujrat used to come with was first of its kind in M.P. confidence. Plastic Surgical procedures of Rhinoplasty & various pedicle grafts were commonly The college of Nursing for training students for the done, since 1948 when such procedures were not been Degree of B.Sc. (Nursing) was started in 1960 and its done at most of the places. new building was completed in 1968. 25 students are admitted every year. A separate hostel has been He became President of ICS in the year 1960 -1964 completed in 1977. and took part actively in various activities of ICS.

The college is one of the 25 college selected by the Department surgery is developing gradually in all Govt. of India for Rural Oriented Medical Education Fields. Established modern of trauma centre. Intensive Programme under’ which all the primary Health centers Burn Unit. Intensive Surgical Unit. Pediatric Surgery are taken by the college in a phased programme, and Pediatrics Surgery - neouatolocv Unit Urology thereby making specialty care available in the rural Centre, Plastic Surgery and Neuro Surgery Unit. areas. More than 600 Album of this college are working in Dr. B. B. Ohri (1948-1968) various capacities in LTSA Dr. C. S. Ranawat - a Dr. Ohri headed the department from its beginning. renowned Orthopedic Surgeon who was accorded He worked as Surgeon & Ophthalmologist in K.E.M. Padma Bhushan by Govt. of India is one of theist Hospital from 1938 to 1948 & as Prof. Anatomy, Asstt. Similarly more than 300 Alumini are in U-K- and other Surgeon to Resident Superintendent Jt. & Surgeon of part of the world achieving great heights in their fields. His Highness Holkar along with Col. Nicholson. It is a well equipped institution serving not only NI.R He was pioneer in lifting the Department & bringing but the people of Central India,

Overview of medical services in Indore 1904-1923 Year In patients Out patients No. of operations Remarks 1904 2080 22906 Medical students-80, Beds-164, Total expenditure-Rs. 27,117 1905 2876 27849 Med. Students-80, Beds-164, Hosp. expenditure- Rs. 24,488 1906 1907 1908 1909 25889 Medical expenditure - Indore Rs. 89,680 1910 3722 27590 1564 Beds - 190 1911 2923 25491 1308 Total students - 172 (61 new admissions) 1912 3458 29729 1122 Total students - 174 (23 new admissions) 1913 3143 29922 1693 Total students - 186 (37 new admissions) 1914 3446 28681 1554 Total students - 162 1915 2809 25991 1002 Total students - 180 (58 new admissions) 1916 2913 23931 1813 Total students - 213 (71 new admissions) 1917 2477 23754 1456 Total students - 201 (9 new admissions) 1918 2364 27183 1027 Total students - 171 (16 new admissions) 1919 2936 22941 1201 Total students - 143 1920 2933 33448 1280 Total students - 200 (61 new admissions) 1921 2633 19283 391 Total students - 209 (66 new admissions, 62 joined) 1922 2634 17062 1090 Total students - 160 (No new admissions) 1923 1966 17009 801 Total students - 206 (92 new admissions) 2005 49715 276452 19603 Total students – 956 (150 New Admission)

Interesting operations Longest: the most protracted reported operation has been one of 96 hours performed from 4-8 Feb 1951 in Chicago, USA, for the removal of ovarian cyst. During the operation the patients weight fell from 280 Kg to 140 Kg. Most endured: Since 22 Jul 1954 Charles Jensen of USA has had 925 operations (till Feb 1993) to remove the tumours associated with basal cell naevus syndrome. This is a rare genetically determined disorder characterized by multiple skin lesions which are usually first noticed in childhood and increase in size and number in late adolesence. Oldest patient: The greatest recorded age at which anyone has undergone an operation is 111 years 105 days. It was a operation on the hip in the year 1960.

62 Indian J Surg | February 2006 | Volume 68 | Issue 1