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 training 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. Hospitalized 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
Acknowledgements: I am grateful to the suggestions of the anonymous referees of the IESHR and
the editorial help of its staff.
Longo et al., Harrisons Principles of Internal Medicine, p. 6.
The Indian Economic and Social History Review, 51, 2 (2014): 231264
SAGE Los Angeles/London/New Delhi/Singapore/Washington DC
DOI: 10.1177/0019464614525726
Downloaded from ier.sagepub.com at Harvard Libraries on February 11, 2015
232 / Jayanta Bhattacharya
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 accommodation 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 episteme.10 To them, [b]eing both an educational and a scientific clinical institute,
MacLeod, Introduction, p. 1.
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.
2
3
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 outcome 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 medicine 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 European medical schools, acquired the ability to control its own education and training
followed by examination, certification and registration.16 Though registration was
Sen and Das, A History of the Calcutta Medical College and Hospital, p. 479.
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.
11
12
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 developed 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 characteristic 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
Arnold, Colonizing the Body, p. 53.
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.
25
26
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 scientific 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 overcome 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 subordinate 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
Larwood, Western Science in India before 1850.
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]
34
35
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.
Quoted in Harrison, Medicine in the Age of Commerce, p. 96.
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.
42
43
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
Anonymous, Excerpta, p. 162.
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. 118
54
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.
49
50
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 exercising 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
Broome, History of the Rise and Progress of the Bengal Army, Appendix P, p. xxxi.
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.
60
61
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 doctors 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 postmortem 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 laudanum, 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
Minutes of Evidence, Public, p. 447.
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
72
73
74
Anonymous, Liberality of the Indian Government, p. 20.
66
67
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 Professors 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 description, 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 beginning 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 importance 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
Mukhopaddhyaya, History of Indian Medicine, Vol. 2, p. 15.
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
82
Report of the General Committee of Public Instruction (henceforth GCPI), 1841, p. 34.
75
76
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 clinical 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 established 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
Appendix to the Report from the Select Committee, p. 270.
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.
83
84
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 permitted 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 outpatients were visited if unable to come at their own residence by the Apothecary,
when practicable.99 The Asiatic Journal also published a similar report:
Anonymous, Native Medical Society, p. 436.
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
98
Calcutta Medical College, Centenary Volume.
99
Calcutta Medical College, Centenary Volume.
90
91
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 treatment, 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 European 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
Anonymous, The Hindu Hospital, p. 8.
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.
100
101
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 section 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 pharmacopoeias 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 predicament 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
Ahmed, Social Ideas, p. 146.
Gelfand, Gestation of the Clinic.
111
Jaggi, Medicine in India, p. 42.
112
113
114
Martin, Statistics of the Colonies of the British Empire, p. 305.
115
116
Rosselli, Lord William Bentinck, p. 85.
109
110
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) scantiness 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
Bonner, Becoming a Physician, p. 144.
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.
117
118
strict accordance with the mode adopted in Europe.126 The aspiring candidates for
admission were to be examined by the Education Committee and the Superintendent 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 different 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 studies 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 education). 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
Spry, Modern India, p. 311.
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.
126
127
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 enthusiastic 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 necessity 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 valuable remedies from the use of which your countrymen are now debarred, can be
Crawford, History, p. 438.
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.
132
133
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
OShaughnessy, Lectures on General Chemistry and Natural Philosophy, p. 16.
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.
142
143
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 primarily 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
Appendix C. Evidence, p. civi.
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.
151
152
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 Brahmins 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 impressions 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 language 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 men
evinced a strong desire to become experimentalists themselves and twenty of the
most distinguished pupils were instructed in the manipulation of apparatus, preparation 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 laboratory 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
Goodeve, Hindu Medical Students, p. 190.
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
160
161
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 categorically 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 presence 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
Gorman, Introduction of Western Science into Colonial India, p. 287.
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.
168
169
In 1838, there were two divisions of classesGeneral Classes and Junior

Classes.177 A secondary vernacular class, chiefly through OShaughnessys exertions, 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 obtaining 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 Apothecary.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 friends
some 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 examination 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
Hare, Medical College, Calcutta, p. 267.
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.
177
178
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 delivery, 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
Anonymous, Annual Report of the Medical College of Bengal; Session, 184445.
GRPI, 1847, p. 97.
187
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.
185
186
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 uncertainties, 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 instructions 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 departments 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
Rules and Regulations of the Bengal Medical College, 1844, p. 3.
Rules and Regulations of the Bengal Medical College.
196
Rules and Regulations of the Bengal Medical College, p. 5.
197
198
199
200
201
202
Rules and Regulations of the Bengal Medical College, p. 23. [Italics added]
194
195
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, Bengalees 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
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
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.
203
204
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 experiments. 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
Simpson, James Young Simpson Collection, letter no. 156.
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.
213
214
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 successful 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 published 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 graduate 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
GRPI, 1847.
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
Chuckerbutty, The Present State of Medical Profession in Bengal, p. 111.
225
Chuckerbutty, The Present State of Medical Profession in Bengal.
219
220
in the following manner: [t]o those who view the present system of medicine as
an inchoate mass of empiricism, and who are searching for something new and
startling, we recommend the above works.226 Bose seems to have problematised
the prevailing medical practice by emphasising the distinction between disease and
sickness.227 Notably, he used a unique term kyaitisa hybridisation of the Sanskrit
kaya, meaning body, and itis from modern pathology, meaning inflammation.228
Was he incorporating the concept of svasthya of Indian connotation?
As late as 1868, it was regretted that though under British rule,[native
medical practitioners] have disappeared altogether from political life, and socially
have little or no standing in European society, and yet in native society, all over
the country, these men (Hakeems and Vaidyas) still hold their own, and are greatly
respected.229 Possibly, out of desperation, Buckland wrote about the great difficulty
to convince natives to take English medicines properly and regularly, and to submit
themselves to reasonable treatment. He lamented, how much of the effect is lost
when medicine is given to a set of ignorant and doubting people in the villages,
who probably do their best to destroy the valuable properties of the English drugs
by combining with them (as they fancy) the prescriptions of the kabirajes or the
wise and aged women of the village.230
We discern some epistemological fissures from inside as well as outside
the modern medical cosmology in India. But modern medicine became the
referent against which all other medical praxes could be measured. Alavi shows
how, when the legitimating contexts of pre-colonial practitioners of Unani medicine were lost, Unani practitioners dispersed into qasbas and towns of the North
Indian countryside, where their ideas, terms and culture contested colonial medical
drives in the period of high nationalism.231 In an asymmetrically overdetermined
space, a great part of Ayurvedics, endeavouring to be modern (navya-ayurveda),
unscrupulously copied anatomical illustrations from English handbooks and
replaced English terms with Sanskrit names.232 Finally, the core of Ayurveda was
reconstituted. For all these historical phenomena, the CMC emerged as an event
as well as a historical process.
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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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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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The genesis of hospital medicine in India:

The Calcutta Medical college (CMC)

An important textbook of internal medicine suggests that we are living in an era

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

232 / Jayanta Bhattacharya

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a later development, graduates from the CMC initiated modern professionalism,

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of modernity. In India, during the mid-nineteenth century, British doctors derived

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The genesis of hospital medicine in India / 237

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238 / Jayanta Bhattacharya

Homasjee Bhicajee, a respectable native merchant and shipbuilder, was induced

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acquaintance with diseases of most frequent occurrence in India, the remedies

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242 / Jayanta Bhattacharya

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prepared.142 OShaughnessy had counted the number of medicines then imported

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medical institution.168 Moreover, instead of giving a medal for brilliant results

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In 1838, there were two divisions of classesGeneral Classes and Junior

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of the University of Edinburgh.185 The method of giving marks to the candidates

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