A 350-year old medical heritage - The Hindu - Mar 12 2003

A 350-year old medical heritage

Western medicine appears to have first arrived in India with the Portuguese in the 1500s. But with Portugal unable to spread its domain in India and the Dutch - who could well have had a hospital in their chief settlement in India, Pulicat, just north of Madras - deciding to move further east, the healthcare system in India is a legacy of the British who by the 1750s had firmly established their presence in coastal India.
ACROSS THE road from the headquarters of the Southern Railways is the sprawling campus of the General Hospital and the Madras Medical College. My picture from the past shows what it was like in the 1930s, a far cry from the congested space it is today. Gone from that picture today is the main block of the hospital, a rather unnecessary bit of wrecking by those with little sense of history. But that is another story. Today's is of all that that huge block stood for.
Western medicine, allopathic medicine if you will, appears to have first arrived in India with the Portuguese in the 1500s. In fact, the records speak of a Portuguese hospital in Goa dating to the early 16th Century. But with Portugal unable to spread its domain in India and the Dutch - who could well have had a hospital in their chief settlement in India, Pulicat, just north of Madras - deciding to move further east, the healthcare system in India is a legacy of the British who by the 1750s had firmly established their presence in coastal India.
Surat, where the English first established a trading post in 1600, and the next British settlement, Machilipatnam, were served by ships' surgeons - and all East Indiamen appear to have had one abroad - who also tended the English living on shore. But it was only with the founding of Madras in 1639 and the development there of Fort St.
George by 1640 that a look began to be taken at more permanent medical facilities. John Clarke was the first `surgeon' to be based in the Fort. It was 1664, however, before any doctor got himself a bit of space for his patients. Governor Sir Edward Winter wrote to the East India Company, "The fresh soldiers which came forth this year taking up their habitations in the bleak wind in the hall fell sick in that four of them are dead, and about ten remain at the time being sick and complain not without reason that the wages are not sufficient to supply them with what is necessary at the time of their sickness. So rather than see English men drop away like dogs in that manner for want of Christian charity towards them, we have thought it very convenient that they might have an house on purpose for them and people after them and to see that nothing comes in to them, neither meat nor drink but what the Doctor alloweth. We have for that purpose rented Mr. Cogan's house at two pagodas per month (about Rs.50 today), which we hope you will so well approve of as to continue it for the future."
And, so, Madras got its first Western style hospital. It was from this house in Fort St. George that the vast Indian health system was to develop, though it was to be many years before this nucleus of what became the Madras General Hospital admitted Indians as patients. When the house proved inadequate, a large two-storey building was built in the 1680s to specifically serve as a hospital; the 838 pagodas it cost were raised by public subscription. A few years later Governor
Elihu Yale persuaded his Council that a still bigger hospital was needed and, in his inimitable fashion, went ahead and did exactly what he wanted to do: Give Madras a new hospital in 1688 at a third location, just north of where the Fort Museum now is.
The French occupation of the Fort in 1746 and the subsequent wars of the Carnatic had the hospital moving from site to site, in and just outside the Fort, ever in search of greater space for its increased requirements. Eventually, it was decided to custom-build a hospital at a permanent location and, in 1772, a double block of buildings was inaugurated where the General Hospital now is. The two blocks were
designed by Patrick Ross and built by John Sullivan for 42,000 pagodas. The buildings underwent changes over the years and acquired in two steps, in 1859 and 1893, that shape seen before the wreckers' hammers got at it. The expansions were undertaken to meet the growing civilian needs; in 1842, Indians were admitted for the first time, the hospital being described by the Madras Medical Board as "an
institution for the reception of sick, both European and Indian, civil and military". In 1899 it became a purely civil hospital. Work began in 1928 on modernising the hospital and further expanding it. Writing in 1939, the legendary Dr.A.Lakshmanaswami Mudaliar, who was that year appointed the first Indian Principal of the Madras Medical College, said, "The Madras General Hospital now presents an inspiring pile of buildings, of which Madras may well be proud and
which delights the eye of every professional visitor to this city." Until General Hospital began admitting Indians, it was the Native infirmary established by Surgeon John Underwood in 1799 in the Monegar Choultry, a refuge for the less fortunate that offered space for sick Indians. Government took it over in 1809 and amalgamated it with the Native Hospital that had been established in Purasawalkam a few years earlier and named it the Monegar Choultry Hospital. Expanding
the hospital and improving its facilities, Government renamed the Hospital the Royapuram Hospital in 1910 and over the next few years raised the buildings that stand today. In 1938, it was renamed the Stanley Hospital.
The third major teaching general hospital established by Government is Kilpauk Medical College Hospital, set up in 1960 on both sides of Poonamallee High Road. The College functions from what was the home of the Government School of Indian Medicine when it was established in 1925, its Principal the legendary Dr. G. Srinivasa Murti.
The school became a college in 1957 and now functions in Anna Nagar. To all three hospitals much is owed, for all of them are teaching hospitals and have provided city, State and country a galaxy of doctors over the last 150 years. Madras Medical College, had its genesis in the Madras Medical School established as an adjunct of the Madras General Hospital in 1835. Surgeon Mortimer was in charge and the first
students were ten Anglo Indian medical apprentices, to be trained to become apothecaries in time, and 11 Indians, to be trained to become dressers, but both taught diagnostic skills and aftercare. The institution became a college in 1850, Dr. James Shaw its first Principal. In 1863, it was affiliated to the University of Madras (founded in 1857) and degrees and diplomas were granted solely by the University. In a pathbreaking step - an extraordinarily bold one for the times - the College
began admitting women students in 1875, when Europe was still debating the issue and only one institution in the U.S. had taken the step just a year or two earlier.
Madras Medical College was expanded when the Auxiliary Royapuram Medical School was established at the Monegar Choultry Hospital in 1877. The school became the Stanley Medical School in 1933. When the Lady Willingdon Medical School for Women, started in 1923, was merged with it in 1938, the school became a college and together with the Royapuram Hospital took the name of Governor George Stanley, who had in his time upgraded the school, but had failed to get it
recognised as a college.
From this College flowed a steady stream of doctors who made medicare in Madras renowned and whose successors have made the city the medicare capital of the country.
S. MUTHIAH