STATE AND INDIGENOUSMEDICINE IN NINETEEENTH- AND TWENTIETH-CENTURYBENGAL: 1800-1947 Poonam Bala Thesis submitted for the Degree of Doctor of Philosophy University of Edinburgh 1987 DECLARATION I hereby declare that this thesis has been composed by myself and that the work is my own, unless otherwise stated. None of it has been submitted for any other degree or other professional qualification. """y"""""""""""""""""" Poonam Bala E OC,tober 1987. CONTENTS Page List of Tables and Figures 1 Abbreviations 111 Abstract iv Acknowledgements vii Chapter I INTRODUCTION 1 Chapter II Indigenous Medicine in Ancient and 19 Medieval India: Its State Prior to British Rule in India Chapter III Indigenous Medical Policy in Bengal 68 Chapter IV Imperialism and Medicine in Bengal: 113 Attempts at Professionalisation Chapter V Public Health Policy in Bengal 162 Chapter VI Ethnic Background in Medical Education 195 Chapter VII CONCLUSION 245 APPENDICES: Chapter II: Appendix I Classification of Medical Practitioners 252 in Ancient, Medieval and British periods in India Appendix II Dates of Existence of Medical 253 Authorities and their Works in Ancient India Appendix III Greco-Arab (Unani) Medical Works of 254 Medieval India Appendix IV Development of Medical Knowledge in 258 Medieval India Chapter III: Appendix V Stages of Development in Calcutta 259 Medical College BIBLIOGRAPHY 261 1 LIST OF TABLES Page Chapter VI: Table I Government Expenditure on English Education for the Indian 201 population in Bengal (1834-35 to 1871-72) Table II Government Appointments from 207 1867 to 1871 Table III High-caste Hindus in Medical 213 Education Table IV Ethnic Background at Medical Schools and Calcutta Medical 218 College (1880-1891) Table V Total Expenditure on Medical Education in Bengal, by sources 222 Table VI Expenditure on Calcutta Medical 225 College, by sources Table VII Expenditure on Medical Schools 226 in Bengal, by sources Table VIII Number of Students in Calcutta Medical College and Medical 232 Schools (1866-67 to 1936-37) Table IX Religion and Nationality of Students at Calcutta Medical 237 College Table X Hindus and Muslims in the Population in General and 239 in Western Medical Education 11 LIST OF FIGURES Page Chapter VI: Figure Ia Ethnic Background of Students 219 at Medical Schools Figure Ib Ethnic Background of Students 220 at Calcutta Medical College Figure II Expenditure on Medical Education 223 Figure III Expenditure on Calcutta Medical 227 College - Government and Fees Figure IV Expenditure on Medical Schools 2241 in Bengal - Government and Fees Figure V Expenditure on Medical Education 230 in Bengal - From Fees in Calcutta Medical College and in Medical Schools Figure VI Students in Calcutta Medical 236 College and Bengal Medical Schools ABBREVIATIONS N. M. I. - Native Medical Institution I. M. S. - Indian Medical Service N. A. I. - National Archives of India GOB - Government of Bengal GOI - Government of India a iV ABSTRACT The thesis examines medical education and medical policies in British Bengal over the period 1800 to 1947. The material for this was gathered from the Libraries and Archives in Edinburgh, London, Calcutta and Delhi . The thesis starts with an outline of indigenous medicine in ancient and medieval India. It examines the nature of relationship between ruling authorities and the growth of the Ayurvedic and Unani systems of medicine. Although medicine in India was, by the time of British rule, represented as a set of static rituals and practices, the history of medicine was, in reality, a history of accommodation and change, frequently associated with invasion or changes in rulers. The remainder of the thesis examines the impact of British rule and British medicine as the last of a series of major challenges facing Indian medicine. The period is one in which western medicine, in particular, medicine in Britain, was changing and " professionalising. Thus, much of the thesis concerns attempts to professionalise medicine in India where competition and accommodation between the different forms of medicine werea primary consideration. V Initially, it seemed possible that the two systems of medicine could live in peaceful co-existence and mutual accommodation, but gradually, with professional pressure from Britain and State sanctioning in India, western medicine moved to a dominant position in State provision of medical services. By the end of the nineteenth century, advances in western medicine undermined the similarities of theory and practice which, earlier, made extensive co-operation seem at least a possibility. Western medicine, in common with other professions in India, required facilities and education in English. These were concentrated in Bengal in an elite section of the community, commonly kown as the Bhadralok. Ironically, but perhaps not surprisingly, this section of the community not only experienced the greatest advantage in their relationship with the British State in India, but, as the best-educated and articulate section of the community, was most active in the growing nationalist movement from the end of the nineteenth century. They dominated medical education but were receptive to the idea of the regeneration and promotion of indigenous forms of medicine. In these circumstances, western medicine never achieved a total dominance and by the end of the period, medical education in Bengal contained aspects of both systems. vi Social and religious conditions in India were vastly different from those in Britain and, to a large extent, the failure of western medicine to achieve the sort of professional dominance common in Britain, is hardly surprising. State policies were formed to serve commercial and administrative purposes but these did not always coincide with the interests of either the indigenous population or of medical practitioners. Thus, as with earlier periods, medicine in the period under study has to be understood in terms of competition and accommodation. vii ACKNOWLEDGEMENTS I take this opportunity to express my gratitude to my supervisor, Dr. Roger Jeffery, for his useful criticisms and discussions during the course of my research. His part in the generation of this thesis is thankfully acknowledged. I have been exceptionally fortunate to receive all possible help and encouragement from Professor Alexander Stewart, former Head of the Sociology Department, University of Edinburgh. His constructive crti isms in the final year of my study have been immensely useful. My thanks are due to the Association of Commonwealth Universities, London, for financing me during the first three years of my study in Britain. I am indebted to the staff of the following libraries: 1. Edinburgh University Library. 2. Indian Office Library, London - special thanks to Dr. M. Moir, Deputy Archivist. 3. National Library, Calcutta - special thanks to Professor A. Dasgupta, Director, and Miss Uma Majumdar, Assistant Librarian, without whose help access to very old records would have been impossible. 4. Asiatic Society and Bengal Secretariat Library, Calcutta. viii 5. National Archives of India, and Central Council for Research in Ayurveda and Unani, Delhi. 6. Finally, Jawaharlal Nehru University, Delhi University and History of Medicine Unit at the All India Institute of Medical Sciences, Delhi. My warmest thanks must go to my colleague, Mr. Tariq Khan, for keeping me in good spirit in various stages of my research. He made himself freely available for help at all times. I am indebted to my family, especially my sister, Dr. Shashi Bala, for her support during the course of my research. Finally, my thanks to Mrs. Terry Inkster for patiently typing this thesis. My friend, Ruth Forrester, also has been a great help. CHAPTERI INTRODUCTION The study assesses the impact of the State on medicine in India To nineteenth- and twentieth-century . explore this relationship within a manageable context, the principal emphasis is upon Bengal. Bengal has not been explored in as much detail as other parts 1 of India (for example, Punjab: Hume, 1977), though the beginnings of State support to indigenous medicine are to be found there. Concomitantly, the interaction between the State and medicine is most obviously seen in the policies carried out here-. A unique feature of the social structure of Bengal is the existence of the three upper castes - Brahmins, Kayasthas and Baidyas, together called the Bhadralok. They formed the dominant group in British Bengal in western medicine as, in other fields. In British India, Calcutta was the first important centre of trade and commerce, followed by Madras and Bombay. These three centres were the first to become subject to western influence and 2 cultural interaction. -2- Following the British victory at the Battle of Plassey in 1757, the East India Company deputed Clive to stabilize its affairs in Bengal. In 1765, he secured from the Mughal emperor, the Diwani (the right of collecting the revenue) of Bengal, Bihar and Orissa. This gave the Company the right to control the entire revenues and civil administration of these provinces. The Regulating Act of 1773 established Calcutta as the seat of the Company's central government and. the headquarters remained there until 1912 when they were transferred to Delhi. It was again in Bengal that a regular system of district administration was first evolved and perfected. For these reasons, Calcutta was the first among the Indian towns to become effectively influenced by European ideas and institutions. British State and its Impact on Indian Society - some viewpoints Until recently, writings on the impact of British conquest of India shared one feature - they focused on the adverse effects of imperialist policies on the culture and society of India. The lack of development in India is often linked with unfavourable policies of the British. Many believe that it was not until World War I that imperial policies expressed concern for the Indian masses. Pressure 4 for change was due largely to nationalists during this period. Among nationalists, the near unanimous claim is that the decline of traditional culture, science and religion, was a result of the adverse consequences of foreign rule.