HISTORY OF MEDICINE
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- Title
- HISTORY OF MEDICINE
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RF_MP_9_SUDHA
2.
It serves as a source of inspiration too !
"The medicine in India, if it does not equal the best achievements
of the race, at least nearly approaches them and owing to the
wealth of knowledge, depth of speculation and systematic
construction, takes an outstanding position in the history of
Oriental medicine"
- S.C. Seal 1971.
* The concept of Public health is as old as the Indus Valley
Civilisation - 2800 to 2500 B.C.
* Health and disease have been given comprehensive definitions.
* The code of Manu (Upanishadic period - 600 B.C.) laid down
guidelines for personal and public health.
* The Buddhist period (600 B.C.) brought in an humane approach
to the developing science and art of healing.
* The Hospital concept of health care emerged during 300 to
200 B.C.
* Patanjali compiled his YOGA SUTRAS (300 B.C.) to help evolve
the spiritual dimension to the physical and- mental dimensions
of health.
* Veterinary medicine and the use of census for health care
evolved.
"We would soon find that scientific medicine has a philosophy
also. We too look at the human body as a microcosm in the
midst of the macrocosm. The same elements that constitute
the organism are -found in the outside world, and the same
physico-chemical forces are acting in both. The physician
thus trained would have a much clearer idea of the task of
medicine and of the part he is called upon to play in society"
- Siegrist 1946
..3
3
In ancient India, a physician graduated to his profession
through one of the following procedures :
- he learnt the art and science of medicine from a
teacher as his apprentice;
- he joined a Gurukula, a residential school situated
in the forests away from the crowded habitations;
- he enrolled himself as an understudy at the University
of Taxila, or Kasi (Varanasi/Benares) or Nalanda.
Some of the characteristics of these Universities were,
1)
students come these seats of learning from all over the
country and also from foreign lands,
2)
3)
the selection of students was rigid,
all the prevailing arts and sciences of the age were
taught here by eminent teachers of the times,
4)
those seeking instruction in medicine were exposed to the
exact sciences like mathematics, algebra and trigonometyy;
the arts like music and dance; the budding fields of
Astronomy and Astrology, in addition to the Philosophical
thought of the age,
5)
the studies were sponsored by the king and the rich of
the area who sent their own children to these centres for
a well rounded education,
6)
great importance was attached to the personal and moral
qualities in both student and teacher,
7)
' '
the instruction was to the individual, and the limited
number of students attached to a teacher lived with the
teacher during their studies as part of his household.
..4
The objective of education was not merely to prepare the
student to earn a livelihood, but also to infuse into him
a strong desire to lead a good and virtuous life.
Fitness of the student wishing to learn was a preliminary
to initiating him/her to studies.
The initiation or Opanayana ceremony was then performed,
where the student took an oath which would be honoured
during the studies.
The course usually lasted six years, or more, if required,
when prescribed texts were learnt and practical training
imparted.
Mastery in all fields of knowledge was considered essential
to pass the final tests.
This was followed by the Convocation ceremony (Samvartana)
and Registration with permission to practice from the King.
Quackery was recognised and condemned.
The qualities of teacher as well as taught were laid down.
MEDICINE DURING AKBAR*S REIGN
159
qualities to it, but no one could persuade the physician: never
theless, he was a good physician.
As I had brought a larg: supply of tobacco and pipes, I sent
some to several of the nobles, while others sent to ask for some:
indeed,all, without exception, wanted some, and the practice was
introduced. After that the merchants began to sell it, so tin
custom of smoking spread rapidly. His Majesty, however, did
not adopt it.
Ain-ul Mulk Hakim Shams-ud-din AU Sherazi.
He was the .
grandson of Jalal-ud-din Mahmood-bin-Asad Siddiqui Dawa’i. He
was born and brought up in Shiraz and had his education under the
famous scholars of the time. Then he went to Mecca where he met
Mirza Aziz-ud-din who brought him to India. Akbar made him one
of his courtiers. According to Muntakhab-ut-Tawarikh of Badauni,
“He bore the name Dawa’i and besides a high rank, a noble
disposition.”
He was a learned,physician and expert surgeon. Eye diseases
and eye operations were his speciality."
In AD 1563, he had the honour of treating the Emperor’s shoul- .
der wound which was caused by an arrow shot by Qutlugh Faulad,
when the Emperor, after a hunt, was passing through the Chaupar
Bazar riding on an elephant. Ain-ul-Mulk extracted the arrow which
had gone upto nine inches deep in the shoulder. The wound healed
in a week’s time.15
Hakim Ain-ul-Mulk Shirazi composed the following four medical
works : (1) Alfzual Adwiyya, (2) Jam-i-ul-Atibba, (3) Sabab-i-Sit:-’
Rishidi, and (4) Fawaid-ul-Insan.
There is a Persian manuscript entitled Zia-ul-Uyoon, a treatise on
ophthalmology by Hakim Dawa’i who was probably the Ain-ul-Mulk 7
Sherazi.” In this treatise, he lists as followS/the qualities that ore
essential for a physician :
1. His body should be proportionately built. Proportionate body
is the sign of moderate temperament. Often, a person of mode
rate temperament performs perfect actions.
2. He should be ignious because the diagnosfs of eye-diseases is
delicate and difficult.
3. He should have completed the course (of study) and become
a master in the art of medicine by serving the aged and truthful
men of the art.
160
MEDICINE IN MEDIEVAL INDIA
4. He should have carried out practical work while he was in
their service.
5. His hands should be soft, deft and suitable for the handling
of delicate operations, such as that of the panus, pterygium and
cataract etc., otherwise, he will commit blunders on account of
fear and lack of experience.
6. It is essential that he should be strong-minded and kind so
that he may look after the body of the patient as it is his own
and treat him with as much kindness as possible.
7. It is also essential for the physician not to mention the faults
of patient near him.
8. The physician’s dress should not be red and white in colour
but it should be blue or green or yellowish black.
9. The eyes of the physician should be free from external and
internal diseases, in order that he may notice the hidden diseases
of the eye, such as. cataract and its different kinds, and the
dilatation and contraction of the eye etc.
10. He should not look with disdain at the patient who is suffer
ing from much excess of dirt, ulcers and tears in the eye.
11. He should not treat the weak and poor people only for the
sake of remuneration.
12. He should never reveal his greed before the people because
the absence of greed in him will raise his prestige and he will
become renowned and the public will have faith in him.
13. Of course, he may expect payment or reward for his treat
ment from the kings, his courtiers and the rich men.
14. But his main aim should be to restore their lost health but
hot gaining of the wealth for himself. For, if his aim is to
make money, his treatment would not bring good result, God
know better^/
Ain-uI-MuIk Sherazi was a constant companion of the Emperor
in the capital and during various royal tours and military campaigns.
In addition to his medical duties, he also played a prominent role in
various political missions and was therefore granted the rank of
Faujdarl.
In the ninth year of Akbar’s coronation, he was deputed to deliver
the Emperor’s injunction to Chinghiz Khan at Ahmedabad where the
latter had spread much terror. The mission was successful.
In the seventeenth year of coronation, he was sent with the
Emperor’s concilatory letter to Itimad Khan of Gujarat; this was
sucessful.
4
Medical Education
Before a student took up medical training, he was supposed to
have been well grounded in the preparatory subjects, about which
al Malaki1 of al Majusi states as follows :
If one wishes to reach the highest level of preparation for practic
ing medicine, he should study books of logic and the four principal
branches of knowledge [the quadrivium] : arithmetic, geomctiy,
astronomy and music. Inasmuch as logic balances our reasoning
and straightens our dialectic approach and utterances and is useful
in every field of knowledge, so are the four principal sciences.^
Al-Zahrawi (d.c. 1013), an eminent surgeon of the Western
Kaliphate in al-Tasrif says that' “when of age, each child should be
sent to a kuttab (elementary school) under the direction of a good,
gentle and compassionate tutor for Quran and religious teaching and
the study of Arabic syntax, reading, writing and grammar. Thereafter,
the child should be sent to another tutor for the learning of arithme
tic and geometry, then astronomy and music. After doing well in
these courses and passing the examinations, the child should study
logic and philosophy. Thereafter, he should specialize in one of the
other sciences such as the healing art.”2/
/'ll was held desirable, that a medical student should also know
geometry in order he might know the shapes of wounds, “for round
wounds heal with difficulty, polygonal with ease”, astronomy so that he
might know the lucky and unlucky quarters of the moon, and music
in order that he might appreciate the subtleties of the human pulse. z
A young student began his medical studies in one of the three
ways. First, he apprenticed himself to a well-known practitioner; those
who had a close relation, a father or an uncle in practice, usually made
their studies under him. This was the method adopted in the wellknown families of physicians like Bakhtishu, Qurrah and Zuhr.
HMM■
medicine In medieval inDia
26
Secondly, there were the private medical schools run by eminent
physicians, for example, that of Yuhanna ibn Masawayh, al-Razi,
Maslamafi al-Majriti in Spain, Abd‘al-Rahim al-Dakhwar etc.
Thirdly, in schools attached to hospitals in big cities.3
As an introduction to the subject, the Masa'il of Hunayn, the
Mansuri of al-Razi and al-Malaki of al-Majusi were taught and then
gradually other texts were added, for example, Sixteen treatises of
Galen, al-Hawi, Qanun, Hundred Chapters of Abu Sahl and Thesaurus
of Sayyid Ismail al-Jurjani.
Many of the teachers composed books specially meant for the
students. Al-Majusi, in the introduction to his al-Malaki, outlined
eight rules to be kept in mind by the author while preparing a book.
These are : ••
To make clear the author’s objectives, and motives for writing
it; to explain the benefits that can be derived from reading it; to have
a title relevant to the subject matter; to spell out methods, concepts
and doctrines adopted by the author; to name the author; to give the
author’s competence, to explain contents and validity of his writings
and to have proper organization.1
The most important part of the training was the clinical
instruction at the bed-side of the patient.
Al-Majusi states :
And of those things which are incumbent upon the student of
this art, are that he should constantly attend the hospitals and
sick-houses; pay unremitting attention to the conditions and
circumstances of their innmates, in company with the most acute
professors of medicine and enquire frequently as to the state of
patients and the symptoms apparent in them, bearing in mind
what he has read about these variations, and what they indicate
of good and evil. If he does this, he will reach a high degree of
this art.,
' Therefore it behoves him, who desires to be an accomplished
physician, to follow closely these injunctions, to form his charac
ter in accordance with what we have mentioned therein, and not
to neglect them. If he does this, his treatment of the sick will be
successful; people will have confidence in him and be favourably
disposed towards him, and he will win their affection and respect
and a good reputation; nor will he lack profit and advantage
from them...”0
KfEBiCAL EDUCATION
27
In addition, discussions and seminars were held wherein the
teachers participated. Herein, while the students who attended
gained practical hints, the teachers themselves won praise or ridicule
according to the knowledge they possessed.
Those who wished to practice surgery were bidden also to attend
at a hospital where well-known surgeons operated, and to be constant
in their reading and in their attendance at operations.
Like the surgeons, the ophtalmologists had to undergo a further
examination. A certain number of physicians gave up practice and
took to teaching or possibly added tutoring of the sons of their
patron to their duty of treating the household. Teaching was consi
dered a very honourable profession.
Most students from well-to-do families took up general medicine
aiming at becoming physicians to a governor or a local nobleman or
even to the Caliph or the Shah himself.
In medical teaching, great'stress was laid on ethics. Al-Majusi
recommends to the physicians adherence to the Hippocratic Oath.
He urged the physician to be honest, skilled, resourceful, kind and
compassionate, to shun evil and cling to what is good. During his
visits, the physician’s only aim should be to relieve the patient’s
suffering and to care for and promote his health and general condi
tion without divulging the patient’s secrets. The physician should
abstain from over-drinking, refrain from vices, and care for the sick
by regular hospital visits. In doing so, he will gain a good reputation
and the respect of all concerned."
Quackery
In every civilization at all times, while on the one hand, ethical
and professional medicine has been practiced, on the other, unethical
medicine and quackery have had their sway among the ignorant and
the less-informed. This was so in the Arab empire also. Al-Razi and
Ibn Sina both wrote vehemently against it. Al-Razi noted down the
various practices that the quacks performed and warned the general
public against them. Writing about quacks and their practices in
Baghdad, he stated :
There are so many little Arts used by Mountebanks and preten
ders to physic, that an entire treatise, had I a mind to write,
28
MEDICINE . IN MEDIEVAL INDIA
would not contain them; but their imprudence, and daring bold
ness is equal to. the guilt and inward conviction they have of
tormenting and putting persons to pain in their last hours, for no
reason at all.
Now some of them profer to cure the falling sickness, and there
upon make an issue in the hinder part of the head, in
the form of a cross, and pretend to take something out of the
opening, which they hold all the while in their hands. Others give
out that they can draw snakes or lizards out of their patients’
noses, which they seem to perform by putting up a pointed iron
probe with which they wound the nostril until the blood comes;
then they draw out the little artificial animal composed of liver etc.
Some are confident they can take out the white specks in the eye.
Before they apply the instrument to that part, they put a piece
of fine rag into the eye and taking it out with the instrument,
pretend it is drawn immediately from the eye. Some again
undertake to suck water out of the ear which they fill with a tube
from their mouth and hold the other end to the ear; and so
spurting the water out of their mouths, pretend it came from the
ear.
Others pretend to get out worms, which grow in the ear, or roots
of the teeth. Others can extract frogs from the under part of the
tongue; and by lancing make an incision into which they clap in
the frog and so take it out.
What shall 1 say of bones inserted into wounds and ulcers, which
after remaining there for some time they take out again? Some,
when they have taken out a stone from the bladder, persuade
their patients that there is still another left; they do this for this
reason to have it believed that they have taken out another.
Sometimes, they probe the bladder, being altogether ignorant and
uncertain whether there be a stone or not. But if they do not find
it, they pretend at least to take out one they have in readiness
before, and show that to them.
Sometimes they make an incision into the anus for piles, and by
repeating the operation bring it to a fistula or an ulcer, when
there was neither before. Some say they take phlegm, of a subs
tance like unto glass, out of the penis or other part of the body,
by the conveyance of a pipe which they hold with water in their
mouths.
Some pretend that they can contract and collect all the floating
humours of the body to one place by rubbing it with winter
cherries which causes a burning or inflammation; and then they
expect to be rewarded as if they had cured the distemper; and
MEDICAL EDUCATION
29
after they have supplied the place with oil, the pain presently goes
off.
Some make their patients believe they have swallowed glass, so
taking a feather, which they force down the throat, throw them
into a vomiting which brings up the stuff they themselves had
put in with that very feather. Many things of this nature do they
get out, which these imposters with great dexterity have put in,
tending many times to endangering the health of their patients,
and often ending in the death of them.
•Such counterfeits could not pass with discerning man, but that
they did not dream of any fallacies, and made no doubt of the
skill of those whom they employed; till at last when they suspect,
or rather look more narrowly into their operations, the cheat is
discovered.’
According to al-Razi
Many a quack is experienced in the treatment of a single comp
laint, or two or three, according to his practice, or because he
has seen the treatment of an intelligent physician. Ignorant
people, therefore, think that he has equal dexterity in everything
and entrust themselves to him. It is a great mistake to think
that because he has a genuine remedy for one complaint, he has
one for all. I have myself learnt remedies from women and
herbalists who had no knowledge of medicine.8
The following story is interesting because it contrasts the duly
qualified physician and the quack. In a certain town there were two
doctors-one of supreme merit and the other, although of not
inconsiderable repute, little if anything more than a charlatan and
quack. It chanced that the king’s daughter became seriously ill. The
two doctors were summoned to the palace and the king asked the
first physician what he recommended. The good physician expressed
his honest and capable opinion concerning the case and stated that a
certain medicine contained in the imperial stores would restore the
princess to health. “But,” said the good doctor, “I am old and weak
in sight, and I fear I could scarcely be able to find it, even were I
permitted to make a search for the medicine.” Then the other
doctor volunteered to make the necessary search. This was permitt
ed, with the result that, not knowing anything about the matter, he
selected a drug which was a deadly poison. No sooner had the princess
swallowed the draught than §he dropped ^ea<^ on tlic spot,
30
MEDICINE IN MEDIEVAL INDIA
In consequnce of this terrible result, and in full accord with the
usual Eastern custom, the careless quack was compelled to drink the
remainder of the drug with the inevitable sequel that he just as rapidly
passed out of the picture.8
In his treatise Upon the Circumstances which Turn the Head of
Most Men from the Reputable Physicians, al Razi lists the factors
which influence people to turn away from intelligent and learned
physicians and place their trust in imposters :
If he inspects the urine or feels the pulse, he is supposed to know
what the patient has eaten and what he has been doing. This
is lying and deception and is only brought about by trickery,
by artful questions of speech through which the senses of the
public are deceived. Many hire men or women to find out all
the circumstances of the patient, and to report what is told by
neighbours and by servants.10
Another circumstance that leads to the contempt of legitimate
physicians is that many diseases are but slightly removed from
the border-line of health and are thus difficult to recognize and
cure, whereas highly serious ones may externally appear trivial.
When a layman with a border-line sickness sees that a physician
is in doubt concerning his diagnosis or cure, he interprets such
doubt as positive evidence that the physician is ignorant of even
simple things and therefore will understand still less of more
severe illnesses. This is a false analogy, for the symptoms of
such diseases are actually less obvious because there is only
slight deviation from the normal and cure is more difficult because
no drastic remedies are indicated. The heart of man is further
turned down from the capable physician and towards fools
because the ignorant and woman sometimes succeed in curing
complaints where this has not been done by the most famous
physicians.11
The causes are manifold : luck, opportunity etc. Sometimes
the qualified physician effects an improvement which is not,
however, yet visible; the patient is then placed under another
doctor who rapidly brings about a cure and obtains the entire
credit. If drastic measures arc employed without knowledge
and they are successful, their effects are plainly visible and are
considered to be the result of great dexterity. If however, they
arc unsuitable, they kill suddenly or lead the patient into danger.
The public, nevertheless, applauds the sudden and visible effects
and neglects those who do not adopt such measures; it talks much
of the wonderful cures and forgets or conceals the failures.
31
MEDICAL EDUCATION
The benefiits of medicine may also be lessened through the fear
that even experienced physicians have for drastic measures whence
they forsake the usual remedies and, if the patient be a king or
an eminent, well-known man, suffering from a serious hidden or
doubtful complaint upon which physicians' opinions are divided,
then the practitioner abandons strong remedies or even all medi
cine and employs foods of various kind in order to avoid the
wrath of princes or the hate of mankind.
It appears that even the legitimate Arabian physicians did not at
ail times refrain from devious and publicity-gathering conduct.
Thus, on one occasion, a man fainted in the street close to a physi
cian of undoubted reputation. The physician, using his cane as a
cudgle and summoning the bystanders to follow his example beat the
sick man upon the soles of his feet and upon his body, until he was
aroused somewhat. Thereupon others were encouraged and followed
the physician’s example. When the sick man, miraculously and
finally came back to senses, everyone among the assembled praised
the cleverness of the doctor.12
Al-Razi wrote that thousands of physicians, for years, have labour
ed on the improvement of medicine; he who reads their writings with
assiduity and reflection, discovers in a short life, more than if he
should actually run after the sick a thousand years. However, he
cautions, that “reading does not make physician, but a critical judge
ment and the application of known truths to special cases” does.13
REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
II.
12.
13.
Al Malaki, Ch III
Al-Tasrif, second book
S. Hamarnah, op.cit. p. 56
Ibid., p. 51
Al-Malaki of al-Majilsi, 1, 2
Ibid., J, 1 and 2
Al-Mnsuri, 7,27, quoted by Elgood C., op.cit., p. 252, 253
Quoted by Gordon B.L., Medieval and Renaissance Medicine, Pater Owen
London, 1959, 162.
Ibid., p. 125.
Ibid., p. 160.
Ibid., 160, 161.
Ibid., p. 125.
Ibid., p. 163.
q
18
SCIENCE IN ANCIENT INDIA
information’. It was a specialized learning directed to the attainment
of a higher stale of being. So this wisdom was guarded zealously and
communicated sparingly. Furthermore, possession of such a wisdom
was one of the most valuable possession of a family heritage. It
was passed on to the sons or to the most deserving pupil and in this
way prestige of a learned family was kept intact from generation to
generation.
yThe Code of Manu, Manu Smrti lays down guidelines for the
conduct of students as follows:8
An Aryan must study the whole Veda together with the
Rahasyas (Upanisads), performing at the same time various kinds
of austerities and the vows prescribed by the rules [of the Veda],
In the eight years after conception, one should perform the
initiation [Upanayana] of a Brahman; in the eleventh year after
conception [that] of a Kshatriya, but in the twelfth [that] of a
Vaisya.
Having performed the [rite of] initiation, the teacher must
first instruct [the pupil] in the rules of personal purification, of
conduct, of the fire-worship [fire-sacrifice], and of the twilight
[morning and evening] devotions.9
Let the Aryan who has been initiated, [daily] oiler fuel in the
sacred fire, beg food, sleep on the ground and do what is bene
ficial to his teacher, until [he performs the ceremony of] samavartana [the rite of returning home].
The student who has been initiated must be instructed in the
performance of the vows [acts of discipline, vrata\ and gradually
learn the Veda, observing the prescribed rules.
... a student, who resides with his teacher must observe the
following restrictive rules, duly controlling all his organs, in order
to increase his spiritual merit.
Everyday, having bathed and being purified, he must offer
libations of water to the gods, sages and manes, worship [the
images of] the gods, and place fuel on [the sacred lire].
Let him abstain from honey, meat, perfumes, garlands, subs
tances [used for] flavouring [food], women, all substances turned
acid, and from doing injury to living creatures.
From anointing [his body], applying collyrium to his eyes,
from the use of shoes and an umbrella (or parasol), from [sensual]
08$$?****^^
UPANISADIC PERIOD
19
desire, anger, covetousness, dancing, singing and playing [musi
cal instruments].
From gambling, idle disputes, backbiting and lying, from look
ing at and touching women and from hurting others. Let him
always sleep alone.
Let him fetch a pot full of water, flowers, cow dung, earth,
and kusa grass, as much as may be required [by his teacher], and
daily go to beg food.
He who performs the vow [of studentship] shall constantly
subsist on alms [but] not eat the food of one [person only] (i.e.,
he will not beg always from the same house) ; the subsistence of
a student on begged food is declared to be equal [in merit] to
fasting.
Let him not pronounce the mere name of his teacher [with
out adding , an honorific title] behind his back even, and let him
not mimic his gait, speech, and deportment.
By censuring [his teacher], though justly, he will become [in
his next birth] an ass; by falsely defaming him, a dog: mid who
lives on his teacher's substance, will become a worm, and he who
is envious [of his merit] an insect.
The teacher, the father, the mother, an elder brother must
not be treated with disrespect, especially by a Brahman though
one may be grievously offended [by them] The teacher is the
image of Brahman, the father the image of Prajapati [the lord of
created beings], the mother the image of the earth, and an elder
brother the image of oneself.
Of him who gives natural birth and him who gives [the know
ledge of] the Veda, the giver of the Veda is the more venerable
father; for the birth for the sake of Veda [ensures] eternal [rewards]
both in this [life] and death. /
REFERENCES
1. Taittriya Upanisad, edited with the commentary of Sankara, Arandasrama
Sanskrit Series, fifth edition, Poona, 1929.
2 Brhdddranyaka, Upanisad, translated nnd edited by O. Bohtilingk, Leipzig.
1889.
3. Chandogya Upanisad, translated and edited by O. Bohtlingk, Leipzig, 18X9.
4. Mundaka Upanisad, I. 1.3.
Indian J. Hist. Med., (197J),
18, 45-49
ine.pp„viii-„ixPR0FESS!ONAL ETH5CS IN ANCIENT
’INDIAN MEDICINE1
hila”, Indo-Asian?=.......
=====
....
In nil ancient civilisntions, the medical
ftnnn. enjoyed an exalted position, His
Superior knowledge, moral behaviour, and
sympathetic service made him an indispens
able personality. At the royal court he
’was the king's preceptor, minister, friend
and guide, all in one. In the society he
K. 11. SRIKANTA MURTHY 1
ilini the benefits shall t>c greater and
valuable than ever before.
was the leader, who could advise and guide
the people to prosperity and happiness.
;fn all these activities, he acquitted himself
■worthily
because his
science
had taught
'him to live nobly and serve all beings with
tkindness and compassion.
Ancient medical
’systems of almost every country and clan
bad formulated their own ethical code
a
set of rules of right conduct. These were
jn turn bused upon philosophical nnd reliJgimts beliefs, customs, traditions—etc. Every
..scientific doctrine had a silver lining of
■philosophy and this philosophy shaped the
’ancient physicians into efficient healers,
pond administrators nnd more than all—ideal
imcn. They were more divine than hitman
in their quality and conduct, attaining
’even Godhood in real life.
With the emergence of ‘scientific medicine’
i in Europe, as an after effect of the
i Renaissance, a great change took place,
• The philosophical fever of ancient medicine
and other sciences came to be considered
. as irrelevant, useless and as hindrance to
progress. Science soon parted company
,with ethics and philosophy with the hope
ancients valued most have been cast to the
winds,
The modern medical man who hits studied
the scientific benefit of philosophy is slowly
becoming a poor caricature • a ‘ healer ’.
Recent surveys of crime carried
nut in
some advanced nations have revealed n
shocking fact, that the medical men a'rc on
the upper rung of the crime ladder, with
high percentage of alcoholics, killer drivers,
adulterers and what not. From the rank
of the Grand Vazir to that of a criminal.
from philosopher to sinner it is a great
fall indeed, a slow but inevitable fall
from the Olympian heights to pacific depths.
allowed
medical
t
1 Based on paper presented at the XXIII' International Congress of Hisloi v of Medicine, Welcome
5-42; Indian i Institute of History of Medicine, London, September l'>72.
’ Professor, Dept, of Basic Principles and History of Ayurveda, Govt. College of Indian Medicine.
Bangalore, India.
Prnfesslnwtl ethics in ancient Indian medicine
47
in than to G< >>.. pninnlion. The pupil and the preceptor,
.3) thou shall enter the patients house
■once in humi then, swore before the sacred fire. the. after due permission accompanied by a
'•sorted that pr former to submit wholeheartedly to the person known to him, bent of head and
shall
conduct thyself with utmost care
best he n.'hirv: nu-Tt-r nn«l the latter to Irnrli lite pupil
mid camion,
lie four piim ip t(1 the best of his knowledge, lest evil may
4) once inside the house thou shall
irth.t. Kama tie" |,c fall him. The pupil stayed with the
devote thy senses, mind and speech entirely
as higher value: teacher under the same roof and learnt
to the patient, his ailments mid things concer
ng or commoner thf science. Theoretical and practical ning him but shall not let them go astray,
or pjMtessiomtl training were given; the student followed
5) thou shall keep nil information about
i'O^^rtiies r, []1C teacher to the forest in search of herbs,
the sanctity o to the sick man’s house to study diseases the paf'ent secret and shall not offend him
by revealing it to others.
fmpathy for th and their treatment and to the wide world
6) even if the patient’s life wore closing
tpectation, con to learn etiquette and manners. The
n all activities1 teacher-student relationship was intimate up, thou shall not announce it cither to
or to his relatives in a manner as would
amc the sou. and affectionate, yet rigid and disciplined. him
injure their feelings.
tach profession Paternal care combined with the watchful
rules of moral Cye, moral and noble behaviour of the
7) no offering of any kind, reward.
as professional teacher moulded the novice into an efficient present, eatables, etc., shall be accepted
| physician, an ideal man and a model for . by thee without the permission of the
head of the family especially from the
„ others in the society.
Indies with the knowledge and consent of
was composed
their masters,
oeriod of the, Ethics, of Professional Conduct:
A. D.) reflect' Having taught the science thoroughly,
hies were for- the teacher administered an AnushasanaStrict ■Charaka a 011th to the disciple, which contained
unhitns
t|ort mid
bear-
the Subject.
■ i.itictly
during
Clinnika Smuhitn
be
fcdlinVed
professional
career.
dont’.s
his
to
8)
thou shall conduct thyself dignified,
respect the traditions and customs of the
house, speak moderately, gently and rightly.
contains one such Antt-
trveda cover ; J], c. ) predating (he famous Hippocratic
latter having ■bears valid testimony to the high level of
nt than the professional ethics in ancient India but
also a third
•ing the Inst I adoption by present day medicine.
tion for _tjie
10) boast not thy knowledge though pos
sessing it,
II) thou shall be clean and modest in
thy attire and appearance,
12) tltou shall not commit adultery even
in thought,
13) thou shall not covet others’ posses
sions, and shall exercise restraint on thy
desires,
} If thou dcsireth success, wealth and fame
; as a physician in this life and heaven after
14) thou shall not associate with sinners,
idoivcd with I your death,
drunkards, criminals and the mean nor
hard work, > 1) thou shall pray for the welfare of shall act as their abettor,
".all
creatures;
day
and
night
thou
shall
study after
15)
reside not in places of ill-repute nor
■ endeavour to relieve their suffering with
approached J.all thy heart and soul,
visit them.
nstructions.
2) thou shall not injure nor desert thy
16)
harbour not jealousy towards elders,
d teacher, patient even for the sake of thine own other physicians and respectables; regard
ter careful ■ ife or living,
them, consult them at times of doubt,
Professional ethics in ancient Indian medicine
nJ is not merely tA|i
f(e who bestows hculth nnd rclicvt-:
Tlii‘. is ln>, illi.'iradwaj i, Alrcya. Ai’.nivcsha,
i< Io it store hc-'i|th«,? pnjn is worthy of every kind of worship
promote health Himj 5lj| the fruits of righteousness shall
nntitml strength Vj.cnje l0 him.
Divodasa,
. , .
22) Physician by relieving the suffering
* science is nterclj5!ajPS heaven without performing sacrifices.
a to those who an
e of disease; it i 231 Practising the profession on the princi5 sho^W not as'-itmgjes of philosophy of life, looking after the
elf o^0> his Sciencftealth of the deserving and the needy.
Rowing kindness and compassion to all
..Brings is the Dharma for the medical man;
e controller of life!tcepting from the rich just enough money
is remover) proper^ n-.ect the minimum needs, his life and
licrapy are the only^e dependents is the Artha ; respecting the
r0*‘
ilders, scholars, professional brethren and
gobies and receiving honours from them.
and Galen. Great men of medicine of present
times like Pavlov, Osler, Shweitzer, Carrel,
were - equally philosopher scientists who
substantiated the ancient truth that sciences
should merge with ethics and philosophy to
bring peace and happiness to man. It is strict
adhciancc to medical ethics that can make
an efficient physician, an ideal man as well.
mid affection of all by
Indian wisdom to achieve Ideal relationships-
’ •d'me t1,1,1 . 11 .'r.mpnthctic service is the Kama; by practii icied as certain.'
(|,us the physician is sure to attain
do not extst.
^ation Moksh'a.^ ____
between the teacher and thc pupil, physician
and patient, physician and society and
above all-science and life.
’
'i.fr '"(iinmng the love
done to the Inst
■ss patient recovers Ayurveda further envisages that the
medical man should spend the last, years
tcrgency adopt all of bis ,ifc in thc Pursuit °r emancipation;
st as redeeming 1° Prepare himself to reach heaven. He is
advised to gradually minimise contact with
. ■ -f
.
Society, devote all his time to study and
vened successes ‘'-achinB> practice yoga, conquer his mind
olhe^method of Md senses, concentrate on higher goal, cat
ptec^Pwith due once just enough to sustain life, pray for
>r his relatives. t)lc well being of all creatures, not to be
■r than saving a carricd !"vay by desires and emotions, and
s waste, |n some lead a simple but noble living like the sages
mo others lame,
ytJtc.
s but with every
he physician.
ild not be used 1
•ney, but should ■
enlures.
quadri - facetted.
npathy and coin- ‘
care and attenble pntient and
(C. S 1/9-26) ;
e a merchandise
i<l casting away
Sushruta,
Chafaltti, Nagnrjuna
mid Vaghliatn lived in India. So 'lid Inhotep,
i\ I; het moil, I lippocraies, Avio'ima, t'clsri'i
Modern medical education shall certainly
derive benefit by incorporating ancient
lU’.l-l PPNr.'PS
I.
Cliaraka Samhita (< • ■'> ) Ed. J.T'.avaji Tricuinji
Acharya Nirnayasajrar Press, Bombay 1941.
2.
Sushruta Samhita lid. (S. S.) Jadavaji Trtciarj,
Acharya Nilniiynsng.ir Press, llm.'hav I'l'l.
Astbonga Hridaya (A. S. H.i - l:d. Annamoreshwar Kunte Ifarishastry I’nr.idkar, Nirnaytis-ipar Press, Boml'.iy-I939.
3.
4 .
Chnrnkn Samhila (C. S.) English Trnnsliitloo
- Vol I. P. M. Mehta et- al. Gulab Kunverba
Ayurvedic Society Jamnagar 1940,
5,
Surgical Ethics hi Avuivotln ■<>, O> Singhnl
IP nl lliitinins 19/1.
Indinti Journal of History of Modicino
Rao, M. N- — History of Public Health in India.
na.la, Awllmi I m.lonh, J*MU).
4i
Published by M. S. Rao, Kanki-
Reddy, D. V. S. — Glimpses of Medicine in the age of Hamayana, Indian M'
■ Research Vol. -13., No. I, 19-13.
1 of
I. )■-. i>. V
,.f II. .ill!, .ini M.-liri n.. in M.-.-nyan Empire.
Qminiind University, Hyderabad; India, I9i.>i>-
Reddy, D. V. S. — Western Epitomes of Indian Medicine. Osmania University,
Hyderabad, 1965.
Report of Simon Commission, Government of India, 1930.
Report of Simon Commission of Wlvlloy Commission, Govornm ml of India,
th
1930.
Report of Simon Commission,
ol IhoSailary Commissioner with Government
of India 1861 onwards. Government of India Press, Calculi.i.
Sand. Ilvim
• Ailvmir.si I.,
M<- I..mm. dl.iphv. In.mu l.on-hm, I• • .
Seal. S. C- ■—• Text Book ol Preventive and Social Medicine, Allied Agency,
Snal.S.C.
History ol Modi'al I diumlion In India. Indian Joyrn.il ol Public
Health Inaugural Issue, Indian Public Health Association, IHlii., Ca)< nlta.
Seal. S. C. ■— Health ol India Souvenir, Indian Public lleallh Am-o -.i illon,
Calcutta, 195G.
4
Sigerist, Henry E. ■ - A History ol Medicine, Volume JI, Oxford University Press,
Oxford, 1961.
Sigorisl. Henry E. - Medicine and Human Wollaro, Yalo'Univor.ilfy Press, Yolo,
Now Haven. 1941.
Sinha, K. P. - Mcihnbluiral the Groat Indian Epic. Calcutta, 1.929.
Smith, V. A.
Oxford, 1909.
■ Anoka 11m Buddhist Emperor of India.
Oxford Univornlly Press,
Shyamasastry, R. — Kautilyas Arlhasastra, 2nd Edition. Translated by Wesleyan
Press, Madras, 1923.
Tewari, T. R. — Contributory Health Service Scheme, Government o! India.
Souvenir XIVth World Health Assembly, Swaslh Hind, New Delhi, 1961.
Wilder, Alexander — A Brief Outline of Medical History referred by D. V. S.
Reddy in his book on " Western. Epitomes ol Indian Medicine, Osnianta Medical
Collage, Hy.hr.ibnd, 19G6.
World Health Organisation
Birst Ten Years' Report, WHO Geneva.
Yoga System of Patanjali — English Translation by J- H- Wood, Harvard Medical
Centro, Cambridge, Mans, 191'1.
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.jAPblfl). VirCTif1.
/^History of Medical Teaching in India from the Pre-literacy
///Period up to Modern Times ». Dro J.N.Banerjee
The Indian Journal Of Medical Education Jan 1966 Vol. V No. 2
ll£)
Dr.S.C.Seal A Short History of Public Health in India
Indian Journal Of History of Medicine Vol XVI Dec 1971 No,2
LESSONS FROM HISTORY, CULTURE, AND TRADITION
Culture and Tradition reflect the stronger and persistent
influences of the past on human behaviour.
'1'hey could help
understand the present better and provide pointers for the
future.
"The history of medicine is both history and medicine.
It is a historical discipline like the history of art or
the history of philosophy. It helps to give us a more
complete picture of the history of civilization, because
it is obviously not unimportant to know what diseases
affected the people in the past, what they did nob- protect
and restore their health and what thoughts guided their
action.
But the history of medicine is also medicine.
By analysing
developments and trends it permits us to understand a situation
more clearly and to act more intelligently. We all know that
success or failure of our medical work depend not only on the
scientific knowledge we possess but also on a great variety
of other non-medical factors, on economic, social religious,
philosophical, political factors that are the result of
historical developments. Unless we are aware of them and
understand them many of our efforts will be wasted".
History provides an essentially broad-based perspective to any
branch of study. The progress of Medical history is seen to
pass through the following phases :
- the mendicants accompanying the wandering tribes,
- its initial association with religion and magic,
- its evolution with development of Philosophical thought
and the rise of new faiths,
- its written history compiled in extracts of the Vedas,
- the evolution into formalised systems like Ayurveda and
Siddha,
- the introduction of Unani or the Islamic system of
medicine with the early muslim conquerors, and
- the coming of the Europeans to India with the European
system of medicine.
When our medical heritage is looked at dispassionately and critically
- not to prove a point or pat ourselves on the back - it is an inval
uable teacher.
One can learn the dynamic process of development
with all its economic, social, political, religious and philosophical
implications, and appreciate the role of medicine and health in
this milieu.
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^Intitau ^Journal
OF
'
JHrstirru nf ^ebirinc
Vol. XVI
No. 2
DECEMBER 1971
A Short History of Public Health in India
br
Dr. S. C. SEAL
*
1.
Early History
Pilot lii Ilits hilvnnl 01 Ihii ItillHh Hid hiciHiun tyi’hfn nt incul:. Inf Won iml luV'Wn
Ifldirt
but th© idea ol public hoalth' oven In i»s present coneotnt on was not absent in tho country, For the
concept of hoalth is as old as the Vedas (6000 B.C.), one of its importan.t i:omfjo«»,,nt bnin.
Ayurveda, At this time, the causes of disease boirg little known or mysterious. H e emphasis
was on tho maintenance of health and prevention of disease and so evolv’d one of tiro best treatiso in Hygiene over written namely, Menu's Laws of Personal and Comm unity Hygiene. Those
laws had the religious sanction and were therefore widely practised and wore handed down from
generation to generation ever since. It was the Hindu philosophers who realized that for the
emancipation of tho soul that reside in the body, both body and mind should be kept in perfect
healthy condition. According to them tlio ideal mode of living was to devote onosulf to the
preservation and promotion of hoalth in which nutrition, evacuation, exercise and roti wore per
fectly balanced. It was, however, a regimen for individual health taking ago, sex, constitution
and seasons into careful consideration.
Sigorist in his Clarke lecture in 1952 observed " Hygiene played a very important part in
antiquity, at least among the upper leisure classes.’’ Another origin of the concept of hygiene
is to besought in ancient culture. "Whomsoever entered tho temple of God was to be clean.
He had to be cleanly dressed in spotlesss clothing." Similarly it was declared that individuals
dinhnsn llkn leprosy. Thus "wo non that the connr»pI d
was rnli-ginie: long before t
wan medical. Il had groai hygienic conforgtioncc; inrr.iiKi people lr. b<» clean phy icatly."
Tho AynrvoJiu Sytilom :
Although tho early beginnings of Ayurveda is shrouded ;•?
n «st of antiquity tho
development of this system was. coeval with the evouithjn of the Indian civili,; ■ ion and cultureThus leaving aside its legendary origin this system had already attained a high stage of develop
. * Dr. S. C. Seal, M.B., D. P. H.; Pb. D., F. b.A., F- A.
Medical Scientist, Indian Council of Mr-dical KeRearch, •
H. A., F. I. P. H. A. Emeritus
Indian Journal ot History of Madicinu
munt during thu period ol l‘un<Hvii:.u Atroy.j (lliOO li. C.) .wlion knowledge flowing from <iilluront
;>puciuiiaud liuld:, ol lund.imoni.il und applied bcluncus wuro ulruedy iniogruiud, gunordljzud and
principles enunciated. Thus tho concept of man in its entirety—physical, chemical, biological
including psychological and uphhcujl, that composou him -became the buaia lor study ol medi
cine, and by this time thu medical science had already developed eight specialized branches
■namely, (1) Internal medicine (Kayachikitsa); (2) Paediatrics (Kaumarabhritya); (3) Psycho
therapy (Bautavidya) ; (4) Oto-rhino-laryngology (Shalakya tantra or Urdhanga chikitsa) (5)
General Surgery (Shalya chikitsa) ; (6) Toxicology (Agada tantra) ; (7) Rejuvenation and Geria
trics (Rasayana) ; and (8) Science of Virility (Vajikarana).
A good training on basic subjects such as, anatomy including direction and physiology
{Sharira vritti), etiology .(Kolu), pathogenesis and pathology (Vyadhi), therapeutics (Karma),
Objectives (Karya), climatology (Kala) pharmacology (Karma), madical and surgical procedure
<Vidhi), and qualifications and equipments of physicians (Katru) formed the essential ingredients
or the study and practice of medicine. In common with the philosophy of natural sciences—
Samkhya, Yoga, Nyaya and Vaisoshika -the study of Ayurveda also was based on rigid scientific
methodology represented by Pratyakhsa or direct observation, Anumana or testing of tho validity
of observed fact with instrumentality of induction and deduction, Yukti or analysis of the outcome
■of Anumana with reasoning and lastly Aptopadosha or testimony of exports and also the utiliza
tion of statistic^ and Pramanas (evidence) io determine truthful knowledge.
tfi.ocion and maintenance of both physical and mental health.
InjiiKi :.ur.u.ii;lui‘y revived now in many parts of thu world.
In the troiitm
with drugs and mor
hygiene rules to the
exorcise, rust sox h
religious grounds a
ger, three distinct ej
namely, (i) Vedicbetween 10th and 1
and dating perhaps
731 hymns, prayers,
ing, woims» and till
fear, recovery of vi
child and relief, fror
( As tWne cc
health1’ also duvolc
Mahenjo Daro (Sin
Those planned citioand cleansod by ho
souk.pits otc. and
pluHuijub, i*oiiC ‘i’“
Ihuiu .wore wull-la.
stralion, a system ‘
Ujjuin, I'iuvjU. Ay
bu tho oru ol litoru
and females in mar
wastha) youth (Yc
wastha) and rules
and mental health,
charyya), dietetic:
postnatal practice
proscribud punish
Infants who^jiru
of ritualisti^Buri
It has stood the tost of time and is
Paediatrics in India :
India had the first manuscript on the management of children many years before the birth
of Christ. Kashyapa Tantra had a chapter on Kaumara Bhritya i. e., service to children. This is
perhaps the first record of paediatrics anywhere in the world. This was followed by Sushruta
who wrote a chapter of Kaumata Bhritya in tho second century A. D. about the time Soraneus in
Greece wrote his treatise.
From ihu history of medicine by Mux Nuuburgur Playfair (1910) retorted to the definition
of health given by the Indian treatise as " Health is an expression of a normal composition of and
a normal quantitative relation in the elementary substances, if those or the primary constituents
are deranged, abnormally increased or decreased disease ensues," and that of Disease as " duo to
natural causes such as faulty mode ol life, or nourishment, climate and weather, psychical affec
tion heredity, poison, plagues, or supernatural influences like wrath of God, or demons and Karina
(errors in previous ux.Monee).'’ It is thus seen that long before Hippocrates, the mituruliatic
prigin of disease was conceived by the Indian sages except that it was partially vitiated by the
inclusion of supernatural influences end knrmu. In Max Nouburyor's languiigo, "Tho medicine in
India, il it 'does not equal (ho bust achievements ol tho race, at least nearly approaches them and
owing <«• ihft v/oalth “I knvWhxlue. <1
* !»
*• ’ 111 Bpacuhl.lion end uyatomhliu niinutruolioii, Icikas an
outstanding position‘in the history of oriental medicine.
(presumably bocai
epilepsy or leprosy
'
Tho two o:
truclions and In)
Shanti Parva it is
nionl lor tho bod
and supporting cl
The Hindu
Buddhism and Ja'
Indian Journal ol History of Medicine
’wing from different
tod, generalized and
chnmjcnl, biological
5 foi^Pdy of1 modi.
pecialized branches
itva): (3) Psycho■nnga chikitsa) (5)
venation and Goria-
ion .and Physiology
srapeutics (Karma),
Surgical procedure
•sontial ingredients
sciences—
nn rigid scientific
Inn nF ihn valfdHy
Sis of I he outcome
< also tho utiliza.
•st of time and ig
before the birth
hildron. This is
wed by Sushruta
Inin Gornmms In
o the definition
^position of and
!>ry constituents
<nnn ns " duo to
psychical alfocnons and Karma
the naturalistic
vitiated by the
The medicine in
aches them and
efion. takes an
27
In tho treatment of diseases hygiene and diet were considered nt least of equal importance
with drugs and morn strictly therapeutic measures, Assiduous personal cleanliness end so'ciM
hygiene rules to tho smallest dotnlls such an, the typo ol food to be conguuwl, rogul.-ition of drinks,
exercise, rost sex habits, clearance of bowels and prophylactic measures worn advocated on
religious grounds and religion and medicine wero in complete acco'd. • According to Neubor
ger. throe distinct epochs of Medicine could bo discerned before the advent of tho western system
namely, (i) Vedic —upto 800 B. C.; (ii) Brahministic—in tho middle ages; and (Hi) Arable —
between 10th and 17th centuries- Atharva Veda which deals w.ith Ayurvnda (science of living),
and dating perhaps earlier than 1200 B. C. is a source of archaic medical his'torv. It contains
731 hymns, prayers, incantations or chnntings to protect people from Gnomics, Witchcraft lightn
ing, worms, and all other kinds of diseases, to provide (or the welfare and long life, freedom fromi
fear, recovery of virility, love of girl and husband. fecundity, successful- pregnancy and n male
child and rollof, from insanity and other diseases.’’
2.
Sanitation and Community Health
health also developed very early in India, ns revealed by tho archaeological excavations of
Mahonjo Darn (Sind) and l-larnppa (Montgomery) in the Indus valley as far back as 3000 B. C.
Those planned cities had well.lnid out streets, 30 40 ft. wide, supplied by fonder streets, by-lanos
and cleansed by house and underground drains. A largo number of houses had wells, bath rooms.
soak.pits etc. and latrines wero fairly common. There was a public bath with many rooms,
platforms, staircases and swimming pool. Houses wero provided with windqws for ventilationThore wore well-laid markets and granaries- ) In short, there was some sort of municipal administration, a system which continued to exist in tho old cities and towns in India, o. g., Varanashi,
Ujjain, Prnyag, Ayodhya and others. \The period between 1d00 and I000 B. C.'is considered to
bo the ora of literary loro and Hindu1 Modicino. ( Tho Ayurvnda dealt with compatibility of males
and fomnlos in marriage, division of life span into four distinct periods namely, childhood (Balya.
wnstha) youth (Yuvnwnstin) or active ago, retiring age (Prnuhrnwnsthn) and old age (Vrldhn-waslha) and rules to guide tho healthy growth of an individual. Emphasis was laid on normal
and mental health. Nnnii Snmliita prescribed ruins and regulations for personal health, »Brahma.
chnryyn), dlpicilm! and mnienihy through the etucihm <>f dal I vary Im’s (Aiurgflh.’t), natal and
postnatal practices. He also laid down rules of public health (Community hygiene) and also
prescribed punishment for infringement of rules except by old persons, propnant mothers and
infants who wero only to bo reprimanded. Menu's regulations also threw light upon the ethics
of ritualistic purity and among persons to bo avoided du-ing offerings to God wore physician
(presumably because they handled Infected patients) end any one suffering from elephantiasis.
epilepsy or leprosy. \
.
3. Epics and Pnranas
Tho two groat epics of India—tho Ramayana and the Mahabharata, a!.?o give advice, ins
tructions and injunctions necessary for the maintenance of public hoali!> and sanitation. In
Shanti Pnrva It is stated that tho king should protect tho kingdom by employing 72 kinds of treat
ment for the body. In Valmiki's Ramayana Rama enquires of Bhnrata whether ho is protecting
and supporting children and tho agod people, mothers and physicians.
The Hindu Medicine reached its peak during tho period between 600 B. C. and 200 A. D.
Buddhism and Jainism predominated over Brahminism and the religious preaching?, included th»
Indian Journal of History of Mudlcfnu
cnviil of providing food. medicine and nursing to i|io ulck mid (ho mifluroru. It I a during thlu
period that medical education was introduced in Taxilia and Nalanda leading to the title of
Pranacharjya and Pranavisharad. Restrictions over medical oaths, binding the students to the
rules of personal hygiene, prevention ol transmission of inlection and obligations to teachers and
patients of both sexes wore enforced. )
4.
Public Health in Mauryan Empire
The first great empire in India was born only in the 4th century B. C.—the Mauryan State
—us a vast centralized state run on dictatorship. Wo know about this state from (I) fragments
r.d'jVlegaBthenes who was sunt by Soluuka as .imbasand practised. In his version the learned men belonging to the highest caste were guardians of
public health, and next in honour to ascetic teachers stood the physicians who applied philoso
phy io study the entire man and cured diseases by diet rather than by medicine. They forewarned
disou>u:. and future. Mogasthunos also refers to six committees in charge of the cities, one of
which v is in of charge foreigners whun triuy wore ill and sunt physicians to attend them. Anolher
concerned itself with births and deaths (vital statistics) and a third one to antenatal care given
to the pregnant women who were placed under the care of old and learned men. Thus social and .
•Planning) find rood
occupations and ev
to be provided wit
to be lei I and def 11
ever was injurious
. Kautilya al
demies, snakes, t
against those dan
vided with moans
to grow groins rvl
nuudy with suuds
under the name S
for his own army.
there were purifi«
removing ^^nons
Census Operatic
The consi
-Officer) through
information colle
OiiOlippilon l'l pa-
forensic Medic
5.
Kciutilya Arthaaastra
It is interesting to notu that Kauxilya in his Arthasaslra gave not only elaborate details
regarding the principles of hygiene for the royalty and royal household (baths, dressing, toilet,
mental and social hygiene, eugenics, royal kitchen, domestic hygiene, sick room and labour room
etc.) but also laid down iuIos and regulations that can now be grouped under the heading " Health
and wulliire of the common people." There wore orphanages whore food was given and children
lor the aged, the infirm and the afflicted. Nu.rsus proyidod for widows, cripples
Thu health of the workers was pro-
sluvus ..nd laooururs. Full facilities, concussions and aids wuro afforded during confinement of
needy prujmml women, and their infants wuro carefully nursed. Drugs wore well classified and
preserved in a herbarium and cultivation of drugs was encouraged.
pioiiioling general
city. 1 here wore st n:t rules and regulations (or prevention of nuisance, pollution and adultera
tion of rood stuffs, for protection of cows and inspection of slaughter houses, for control of
prostitution etc., all indicating early attempt to introduce something like the Public Health Act.
There wu
with inheritance
blind, deaf and i
ing. hunting am
-male and female
sexuality etc.
examination cal
cribed. This f»tlescriplion of c
Votorin^^ Mt
Raising
■ rich also maint
soi t ot vuturib'-
Kautilya
•plan was to bi
■ OOnut»M’»loiit‘
neglect or incifluroncu o>j the part ul diu physician in the treatment was regarded as assault or
violence anc was. punishable. Cleat instructions were laid down for lay out of towns (Town
iparsons sutler
‘.ranking amont
Indinn Journal ot History o! Mnrllclno
ever was iniurrous for health and tor the public.
from (i) fragments
mony of the edicts
demies, snakes, tigers and demons
against those dangers- There were strict rules to prevent fire and public buildings were pro
vided with means of protection. During famines, the king or the state was to help his subjects
to grow grains wherever water was available, permit people to hunt and fish and also supply the
io applied philoso.
They forewarned
lor his own army. Epidemics or Mn
there were purificatory ceremonials
removing demons).
Innatnl e.lia.{)iv„n
Thus social and
modern physician
information collected being number of houses (tax and non tax paying', ago. sox. gotrn, . as
occupation of persons, number of slaves, labourers, cowsheds, biped and quadruped animals.
Forensic Medicine :
nlnhnrnlo derails
. dressing, toilet,
and labour room
heading " Health
iven and children
■ifflictod. Nurses
8ook II, Ch. 27.).
workers was proenefits to female
I confinement of
ell classified and
providing pure
oughfares of the
>n and adultera, for control of
bile Health Act.
cian nnd master
Cnrolnssnona nr
ml as assault or
■f towns (Town
There was nlno n high ‘.Imtrlnrd <>l mmllc.rl jurisprudence II ornnsle Mnrlir.lrm) which dealt
with inheritance nnd disease, testamentary capacity of idiois, ounuche, delormod, lunatics, lepers,
blind, deaf and dumb, lame etc-, defamation and testimony of physicians, laws for touching strik.
ing, hunting and creating wounds, for abortion and infanticide, marriage and remarriage of both
male and female, divorce, adultery, marital and soxunl offence including rape nnd bestiality, homo
sexuality etc. Besides those there worn laws for examination of suicide deaths by postmortem
■examination called 'Judicial Surgery.' For all those crimes varieties of punishment wore pros
cribed. This forensic medicine also had chapters on toxicology and poisoning and oven elaborate
■description of chemical warfare, air-raids and incendiary attacks by employing birds.
Veterinary Medicine :
Raising of cattles was the most lucrative property in ancient times. The kings and the
rich also maintained elephants, and horses which needed treatment for their ailments. So some
sort of veterinary medicine also developed on the basis of empiricism nnd practi'.nl experience.
■ 6. Hospital Service in India
Kautllya mentions about hospitals in India In the 4th Century Bi.o , before Asoka. 1 ho
plan was to build hospital near the Fort which was regularly visited by the king. Privilege and
cnncosslons wore given to tho sick, nflHctnrl helpless pilgrims, ascetics, labourers nnd also to
persons suffering from llunger, thirst deformity rinrl dises'. i Ab.ml this tlm.r thrne worn.pby'm lans
rnnUno among scinntlcln. scholars nml councillors who were attached tn tho snvmmgn. his court
Indian Journal ut History of Mudicina
and warriors, while the ordinary subjects continued to have recourse to private physicians or
healers 01 to priests, exercisers or appliers of leeches. The first inspiration for organising public
service was givun by Gautam Buddha (5th Century B. C.) whose sox Rukul and later King Asoka
history of the world, and also introduced nursing service long before the establishment oi
Christian churches and appearance of Florence Nightingale in the field. It is said that during.
this period the king of Ceylon appointed a public physician for every *10 villages and Buddhist
monks to study medicine to practise in a charitable capacity.
Hospitals and Health Sarvicus in Buddhists India :
Hospitals and dispensaries wore the first organised health service for the care of the sick
in India during Buddhist' o-u. Thu Uuddlmt literature, particularly Mrilmvamsu, mentioned that
during thu king Auoku's tuglmu thu system, tor the curing ul the s.icK, both mun and cuttle, hud
bean brought into practice everywhere and al places where the useful healing herbs were wantinghe caused them to be imported and cultivated, and employed medical mon to give treatment.
Seven hundred years after Mogasthenes Fa-Hien, a Chinese traveller visited India and
found the hospital system of Asoka in full activity. " The nobles and the landholders had found’
ud hospitals in every city," ho declared. " In those the poor of all countries, the destitutes, the
cripples and the diseased may repair for shelter. They receive every kind of requisite helpgratuitously. Physicians inspect their disease and order for then, according to the cases, food
and drink, decoctions and medicine—in fact., everything which may contribute to their benefit.
When cured they depart at their own convenience."
In the year 648 A. D. another Chinese pilgrim, Hiuen-tsang visited India and found the
country abounding with hospitals or "house for doing good." Those houses entertained widows
and orphans ami distributed loud, drink and medicine to (ho poor and tho sick. Hospitality was
carried out in thu lull uonuu ol the term making guests ol " thu poor homo, hull and blind " who
Gould give no recompense, us well as ot the sick and tho injured that needed a physician.
Following this, records wore very scrappy or missing. Between 101 and 77 A. D. King.
Dattagamini, in tho First Century A. D., King Nighovasa of Kashmir, in the 4th Century A. D., King
liu.idlhidi ..i mid in lbw 7th CupKiry A. Di King Ihnnhn of India ware Known tn have mi|iihlhlmd
hospital:, with medicine. physicians and stull for providing lullof to Iho suffering population. As
i.iohiiouoil earlier Ihuon-isaiig and also llhsing who visited India in tho 7th Century A, D , during
the glorious’rorgn of the king Harshn, had given account of hygiene, sanitations and medical
practices of tho time. Since u considerable part ol thu Sanskrit treatise on medicine wore
carried away to licet, China and Eastern
*
I urkistan, it is Quito likely that some of thu lost history
relating to the development of public health in India could be reclaimed by a close search and
study of the Tibetan, Chinese and Indonesian source material. During the 12th Century A. DParakrama Bahu opened a hospital with many hundreds of rooms and was provided with male and
IuiumIu attendants, good treatment and good food. Thus tho few hospitals that wore developed.
in the pre-Christian and early Christian era gave free treatment but it is not known whether a
typical dispensary system was maintained as in the present day. This progress suffered a
Cijiiiploiu .o' M.uJ. following llio occupation of India by thu Modems.- Health cure or rather
■ medical care aga
the other hand,
hygiene —clear1
tho court of Jal
the meantime w
doctors were nit
advisers. But
Dutch, Italians
come In Im gm
few also came
18th Century I
menl of^vil a
mainly to proto
(in the ■
the first instit
in 1825 and v
■bods and out<
Calcutta Modi.same year a s
•Grant Medic.:
College in 19
In India " by
9,
Thu
The fi
Ucijl iidtninlv
CiuwA A-Il
ihlu lu^to n
. mortality aneuyoeaiod ll
.Madras- Tl
improve the
sion of Bent
maintain th"
constrnctloi
■affective fo"
apppinted t
‘Provinces, i-
Indian Journal of History of Medicine
P'ivate physicians or
1 for organising public
■il and£atar King Asoko
,r ,h^prst time in the
the establishment of
It is said that during
villaons mid nuddhlai
*r tho care of the sick
amsa, mentioned that
mon and cattle, had
g herbs were wanting
3 give treatment.
In> visited India and
■ndholdors had found>. tho dostimtos, tho
arl of roqulsilo help
fl tojhn cnsos. food
benefit.
India and found tho
entertained widows
Hospitality Was
alt and blind " who
Physician
and 77 A. D. King
Century A. D., King
o have established
tg Population. As
Tory A. D , during
tions and medical
on medicine worn
Of Ihn lost hlntoiy
cluse search nnd
2th Contury A. Dlad with male nnd
■it wore developed
known whether a
ogress suffered a
th care or rather
31
•medical care again remained confined to private Ayurvedic physicians, quacks and charlatans. On
the other hand, Islamic medicine (Unani system) trickled through tho codofied precepts of
hygienecleanliness is piety,’’ practice of circumcision, prohibition of eating pork, perhaps
to guard against Taenia infection. /
7,
Introduction of Western Medicine :
in the early part of tho 17th Century th<> Hint need ol won torn medicine wen brought to
the court of Jahangir by Sir Thomas Ron, laying tho foundation of tho rest India Company, In
the meantime western doctors also percolated into India with the Portugese governors and a few
doctors wore also employed by the foreign missionaries centres and the Indian chiefs and medical
advisors. But those in early employment in tho court of Indian rulers wore French and also
Dutch, Italians or Armenian doctors
Thus tho doctors trained in western medicine started to
come in larger numbers when the East India Company began its empire building operations. A
few also camo to India for private practice and later absorbed In service.. By the middle of tho
18th Century the recruitment of ship’s Surgeons by tho East India Company led to tho ostablish.mont of civil nnd military medical imrvlcen nnd In Hirn In the ttninlnp of nsnisfnnfa and dressers
mainly to prntaot the health pl tho llrllloh.army and tho Ftimtmei^
8.
Training in Western System of Medicine:
,
( In tho early part of tho 19th Contury tho Ouarnntlnn Act was promulgated in 1825 and
tho first Institution for training tho local Inhabitants In European system of medicine was started
in 1825 anti was known ns tho Calcutta Nature Medical Institute. In a small hospital' with 30
bods and outdoor clinics wore attached to this institute, followed by tho establishment of the
Calcutta Medical College in 1835 for a full-fledged training of Indians in western medicine. Tho
same year a school was established in Madras. The other institutions that followed wore the
Grant Medical College, Bombay In 1845, Hyderabad Medical School in 1846, Madras Medical
College in 1950 and Lahore Medical College in 1860, (For other details see " Medical Education
in India” by Seal, 1956).
9.
The first seed of Public Health Administration in India on modern lines :
The first seed of Public Health Administration in India was sown in 1859 when the political administration of the country was taken over from the East India Company by the British
Crown. A high death rate among the Europeans drew tho attention of the British Parliament and
this led to tho establishment of a Royal Commission to enquire into the reasons of such heavy
mortality amongst both military and civil population. This Commission in their report in 1863
suggested the appointment of a Sanitary Commission of fivo persons each in Bengal. Bombay and
Mnrlrnii. Thane nnmmhndmiN''utiu Ind th<Mi d|ininlhmn lu 1IIII4 in the trhuvo three PitRiIrlanrlos in
improve tho health, primarily of the military and secondarily of the civil population.) The Commis
sion of'Bengal nnd Madras proposed an immediate formation of Public Health Service in India, to
maintain tho health of tho army and that of tho general population by preventing epidemics,
construction of drainage system and provision of water supplies. Those proposals were not made
effective for several yoars till jn 1869 a Sanitary Commissioner and a Statistical Officer were
appointed by the Government of India for tho Presidency Provinces as well as the North Western
•Provinces, Oudh, Punjab, tho Central Provinces and Burma, Their dut;es were purely advisory.
Indian Journal of. History of Modicine
10. Public Health Acta >
woa lollowo
' Batwjon 1873 and 1886 suvoral important Acts of public hoallh hearing were passed. Thes" fticka,d
first was the Bengal Birth and Death Registration Act in |873, followed by the Bengal Vaccina. 1®21. and a
tion Act 1870, the first Indian Factories Act in 1881, tho’Bongal Municipal Actin 1884. Theint0 Na,io,v
Local Self Government Act was promulgated in 1885 under the seal of the Late Queen Victoria.
It created local bodies as the seed of autonomy to the people and the public health services were tll0tj|ca| to
left to them as one of their responsibilities without uny financial assistance. 'In 1886-88 the Medical Re
Mudictil Act was puuuod <hh.I Hi<) pom ul bmhlary Cummiuslunur with tho Govurnmuht ul Indio woo
merged with that of the Director Gunoial, Indian Mudicul Survico.'j The first Pustour Institute lor'
the treatment of Rabies was founded at Kasauli by public donation and it started functioning from
1900. Subsunuoiitly Puutour lnsiiiutou wuiu oulablibhod at Coonoor (South India) in 1907 and
*n
at Shillong, in 1917 at Calcutta and Bombay in 1924.
Health <>i.
(later call!
( Plague broke out in epidemic form in different parts of India starting from Calcutta in ancj munic
lll'Hi .iii<I Hombny in 1896 causing great havoc. This revealed the utter inadequacy and defici desired
encies in tho hoallh organisation, and necessitated tho appointment ol a Plague Coniriiluoiun. I he mlViom
report of this commission in 1904 led to the revival of the of lice of the Sanitary Commissioner to the pr<<
with the Government of India, an office which since 1888 had been merged with that of DGIMS. health-of
(His duties were mainly to advise tho Government on Sanitary manors and to direct research. Tho palities
Sanitary Commissioners of the provinces wore also made the Independent heads of rhe Public partially.
Health Dopartrnoni and wore allowed to communicate their views directly to tho Government and degrees
not through the-Surgeon General oi Inspector Gunoral of tho province. At this time the Govt, ol and antiI
India had practically.the full control over provincial governments in the matter of public healthy nation o
Thu Birth, Death and Marriage Registration Act was passed in 1896 and tho Epidemic momonti
. changed
Diseases Act in 1897. By this Act of 1897 tho Magistrate declares a disease rising in epidemic
form and empowers tho health authorities ths right of entrance to any premises and to remove and pub
tho patient to a hospital and to take any other measure to control the epidemic.^ The year 1897 respons
is particularly notable lor tho epoch making discovery of mosquito as the vector of transmission ture etc
a reserv
of imiluH.i by Sir Ronald Roos ul Calcutta.
f Thu Ci
Public
Laboratories for Medical Research:
work s
In 1899 the Plague Research Laboratory under Dr. W. M. Haffkino was established. This
coordif
Laboratory was renamed as the Bombay Bacteriological Laboratory in 1 06 and finally as the
Haflkine Institute in 1926.
Manufacture of drugs was tho greatest handicap of India. The first pharmaceutical
unturprisj was founded ul Calcutta in 1901 by Sir P. C. Ray in collaboration with others as a
pioneering venture under the name Bengal Chemical and Pharmaceutical Works Lid.
In 1903
xho second provincial Public Health Laboratory was established at Madras under the name
y The King Institute of Preventive Medicine ’, for bacteriological, serological and pathological
work, manufacture of lymph vacino and other immunising agents and to conduct public health
Inburalury tests such as examination of food, waler, milk, drugs etc.
In iNiM f..|i>.wmn I ho lupiiii ihe plugiiu Commission rim Conliul Hono.iich InslitutO; K.rudi-
and pi<
very I
coordi
in Ind
Snpic
Indian Journal of History of Medicine
was followed by the establishment of the Control Malaria Bureau in 1909 at Kamal (Punjab) by
"Oring worn passed. The Sir Rickard Christopher. This Institute was rmimund an ’ho Control Mnlnrla Organisation inby tb^Bong.il Vaccina. 1921, and as tho Malaria Institute of India. Delhi, in 1938. and now it has boon transformed
ipal W in 1884. Th0 into National Institute of Communicable Diseases since'1963,
be Late Queen Victoria.
In 1911. the Indian Research Fund Association was established for tho promotion of
lie health services wore
medical research in India.
In 1948 this organisation was renamed as tho Indian Council of
ance. In 1886-88 tho
Medical Research as a registered body under tho Regulations of Societies Act XXI of 1860.
overnment of India was
st Pasteur Institute for
12. Public Health Policies Since 1912
iarted functioning from
In 1912 tho Government of India created a now department to deal with Education.
□th India) in 1907 and
Health and Lands. L-nch province wns authorised to select its own Sanitary Commissioner
(later called Director of Public Health) and a Deputy Sanitary Commissioner and also a district
rting from Calcutta In
I and municipal health officer grafted according to qualification. The Government ol India.also
inadequacy and doficl. declared that while tho general responsibilities and direction of the policy of public health
’goo Commission. ThoS must remain with the Central Government, detailed control and executive action should bo loft
Sanitary Commissionerr jo the provincial governments. Option was also given to tho provinces to decide whether those
1 with that of DGIMS.
f health-officers should form provincial cadre or remain under tho local authorities iMunici.
direct research. The
polities and District Boards). Tho World War I prevented its implementation except very
heads of rhe Public I
partially. In 1916, Indian Medical Degrees Act was pissed for regulating tho use of medical
i Uro Government and
degrees for registration and practice, in 1917, Uro firs’ pionnming venture in tho production
his time the Govt, of
nnd antibacterial vnccino was started at Calcutta by tho Bengal Immunity & Co. / At tho termi
"m^kpublic health.
nation of tho World War I, the national movement for granting self-government gained fresh
momentum and as a insult tho British Government promulgated Hie 1919 Reforms Act which
*6 and tho Epidemic
changed tho situation. By this Act tho Government transferred tho responsibility for local medical
e rising in epidemic
nnd public health administration to tho Provincial Governments. Popularly olocted ministers
•misos and to remove
nic. ) Tho year 1897
responsible to tho legislaturos for tho transferred subjects namely, Health, Education. Agricul.
ture
etc were keen to develop those services as much as funds po-mitted. Finance was, however
setor of transmission
a reserved subject. There was some expansion of the public health activities in the provinces.
The City and District Municipalities Act containing the legal provision for the advancement of
Public Hoalth under tho local authorities in several provinces war. passed. Tho quality of
work suffered from tho wonk control of tho local bodies and also duo to the absence' of any
s osrabllshod. This
coordination of policies among tho various provinces and the centre.
- and finally as lj)9
13. fnlorn.tlioiml Flonlllf Rnjnlioun -iitcl QtrairinHne :
rst Pharmaceutical
on with others as a
'kn Ltd,
In 19f)3
s under I ho name
I and pathological
iuct public health
H Institute. K?suli
Thn Government of India reserved the right to deal with only few matters. like quarantine
and pilgrim traffic outside India and international hoalth relationship etc. However, there was
vary littlo connultntlon between thn provinces following tho above reforms and this loss of
coordination of policy no doubt proved rathor dotrimontnl to tho development of public health
in India.
From tho available records it appears that quarantine was first introduced in Bombay in
September, 1800. Whole time Port Hoalth officers for Ports of Calcutta nnd Bombay wore
appointed in 1875 and 1884 respectively. Till 1919 Port Hoalth Organisation were undor tho
provincial control. Tho Conlrai Government, however, rxmeisod n good deni of control over
training of quarantine regulations and their practice. Although tho latter took it over in 1919
*
2
hithitn Juuninl ol Illsluty ot Mud! emu
under the Government ul India Act 1919, tho Provincial Governments cuntinuod to administ' powers Which We
*
thu uubjoi.t on itganuy Imaln. Ilin < ontnil Guvmiimmit look uviu Ilia i| Haiti h.Hiuj iidiiihdMHHimi < lh” criticism that
lira Porta ul Bombay and C.ihmiiu in 1937, Coohln and Vljmkhupubium hi 1938, Madrm. hi 1$K.those ul suspomd'
and Kundlu In i'lhn. <!u<ihiiiIiii<> adininluRatlon ol Ili«>. iiilnm |hh|q [iio dolnu'Had hi Ilia rgnimrith ■ hrlllnihin la wall
govorninunt. That ol fivo intornaiionul air ports viz.,’ Bombay, Calcutta, Madras. Pulurn an munf should even
Tiruchhapulli is directly controlled by the Central Government. Thu Indian Air Cruft (Publi; to coordinate ptil
Health) Gules 1954 and the India Port Health Rules 1955 are based on the International Sanitai wore given advi<
Regulation and tho Government of India’s reservation thereto. By mutual agreement, no quarantin periphery. \
Instructors are appointed to trullic between India and Pakistan or between India and Nopal
'
Spacial precautions are taken to prevent entry of yellow fever in India by a antimalaria measure?
aim strict quarantine measures. Yellow (over is also a notifiable disease in all tho Indian States
^The same-
Regulation also demands compulsory inoculate of yellow lover vaccine for those visiting tint Commission wa
passing through African endemic countries.
conditions of w
14
Special institutions and extension of health services and research :
Col. Ram Nath
in lhQ j^^et a
In 1920, the School of- Tropical Medicine was established by the then Government o
Bengal through the efforts of Sir Leonard Rogers, an important step in the advancement-o>
r
Tropica’ Medicine and in improving the quality of medical personnel and services. During the
I In 1933
next five years several Acts were passed namely,^ he Bombay Maternity Benefit Act in 1920, the
ing training of
Indian Rod Cross Act in 1922, tho Indian Minos Act, tho Cantonment Act and the Workmen’s
of the Rockefe
Compensation Act between 1923 and 1924, all lor tho welfare ol the workers. In 1926 the
same year to s
Kdluazar Commission was established lor. tho study ol Kalauiui, (in expanding disease, lor finding
Medical Count:
out the mode ol liunsmission, butler treatment and control measures. In -1929, the Nullitioti?
hubomch gaiiiu l n 11 rm looting In India with the outnbliiihmmil of the Nurltion Rmmriroh lOBtittHQ
at Coonoor under the Indian Research bund Association. This Institution has been tianulunoti
The Go
to Hyde-abad since. 1960. Till 1929 there was practically no public health service worth the
name lor tlm lural are.is ol India which accommodate 80 percent ol her population, A compro- further reformto
bo
brought
.iuiibivi) rural health schemes tor Bengal hud been proposed by Ihu l ain C. R. Da;: and it was
accepted by the then Government of Bengal in 1927. According to this scheme a Public Health ol Central; Cu
Circle in each thana (Police Station) area was inaugurated in 1929 as tho first attempt to extend portion was <
*
public nualth facilities to the rural population. It provided a sanitary inspector and a medicine several modi
carrier mainly io control epidemics, to carry out immunisation work and to improve collection of- experimental
Committee's
vital statistics. The cost was met. by tho State Government.j In Bengal, Health officers and
centrj^^
Sanitary inspectors were also appointed in tho districts and municipalities. They wore employees
of the local bodies although the government provided part of their salaries. But relinquishment
of government control over local bodies as in Bengal during tho early phase of tho scheme proved
unwise. In fact, in other provinces the cadru of district health officers was provinciallisod and
the services of the latter wore lent to the District Boards and subjected to transfer from the
place to place. It would have been wise also for tho Government of Bengal to centralise all
welfare activities for a givon period.
15. The Simon Commission:
Ono important event of 1930 was the enquiry by the Simon Commission.- This Commission
-remarked '' the rosulti, ol the logislulivu mid admini'Bi <Hi vo action token in aucordaneo with the
Scheme ol (lie rofurms was in effect to deprive Hio Ministers ol (he Local Soll-Govurriment of
In th
and the pro:
principles o
functions.
The
■ chemical S
Public Hou
■ expansion
Institute o
Indinn Journo I of History of Mr di cino
35
conthwod to ndminlst, powers which wnro nssonlinl if they worn in parform thnir tasks successfully. Wo have hoard
rernntlno administration c tho criticism that tho only offoctivn powers possessed by tho Provincial Governments namely.
•i in
Mndras in 1.93 those of flusponsion and dissolution, calling for loss drastic troatfnnnt and wn think that tho
■0I09" to tha raspectiv
criticism is woll founded." It therefore; recommended that whatever form of system of Govern
:utta, Madras. Palam am ment should eventuate within the next few years there should bo a strong central Board of health
Indian Air Craft (Publh to coordinate public health matters throughout tho whole of India. Tho Provincial Governments
ho Intnrnntionaf Sanitar
agreement, noquarantint
•atwoen India and Nopal
16. Royal Commission on Labour and Drug Enquiry Committee:
'V a antimalaria measure
'
«H tho Indian Stares
ItIio same year (1930) the Royal Commission on Labour in India known as the Whitley
>e for these visiting one
Commission was appointed tn •advise on the mensiiras for improvement nf hnalth and living
•conditions of workers, j Iho Government of India also appointed a Drug Enquiry Committee under
Col. Ram Nath Chopra 'in go into t|m question of adulterated and substandard drugs being sold
’ An-l rcnMrch ;
In tlio market and (0 tor.ummend ways and mnnmi to control Ibis meniico Io public health.
Iho then Government of
in the advancement of
17 Training in Public jTbnlth :
’'I ‘■'”v 1
During the
( In 1933, tho All-lndia Institute of Hygiene and Public Health was established for facilitat
Benefit Act in 1920, the
Act- and the Workmen’s ing training of public, health workers in India, with the aid of tho International Health Division
’
in 1926 the of the Rockefeller Foundation of Now York. ) The Indian Medical Council Act was passed the
hngWiw.c. lor finding same year to standardise medical education in India and to develop reciprocity with the British
In 1929. the Nutrition Medical Council and similar councils of other countries.
it ion ItiMoiirch' Institute
an has been transferred
aalth service worth tho
K'nu>.»tjon. A comproIf. Das. and it was
I'-hurne a public Health
lirsf attompt to extend
<P«vto, .inrl u medicine
J improve collection of
I. Health officers and
They worn employees
"t relinquishment
of the scheme proved
vas provincialised and
'I to transfer from tho
-ngal to centralise all
3ti.j This Commission
accordance with the
il Self-Government of
18. Government of India Act. 1935 :
The Government of India, on the occasion of the Silver Jubilee of King George V granted
further reforms under the Government of India Act 1935. In this Act tho heal th activities wore
to be brought under three lists viz., Federal. Concurrent and Provincial (State), under the control
of Central, Central cum-ProvIncial and Provincial Governments respectively. Only the provincial
portion was operative from 1937 and tho federal portion was left in abeyances. During this-yonr
several model health units worn also started with tho aid of tho Rockefeller Foundation on
experimental basis. Tho results obtained in this experiment formed tho basis of tho Bhoro
Committee's recommendation for providing health services in tho’rural areas through health
centres, )
In the Indian Independence Act of 1947 the same categories of classification continued
and the present constitution which camo into force from tho 26th January 1950 retained tho
principles of these three lists with some changes in the general pattern of distribution of
functions.
19. Other Public Health Innlitutionn :
Tho same year (1937) throe important institutions wore started in Calcutta: (1) Biochemical fitnndflrdiontlnn I nbnrniory was ornnhlishod at tlm All-India Institute nf Hygiene and
Public Health, Calcutta, as tho nucleus of tho Central Drugs Control Laboratory and its further
expansion after tho passing of the Drugs.Act in 1940 and Drug Rules in 1945; (2) thn Indian
Institute of Medical Research was inaugurated at Calcutta with the support of eminent Indian
Indian Journal of History of Mudicino
In 193/, ihu 'Conlinl Advisory Board of Hunhh was constitutod with the Public Health
The Artic1
(.’<au it:. $ouiol(iiy mid with i‘upi6tnnilalivps horn I ho |)iovhi<-ui> and Indian Piinc<JlY( ai]d liumano
alaloo a9 iiiomboiu .....I wno yna|«d wHll lli« hl|»< Hon n| <.«><"'H11 "Ijiitl ho.llll) UOIV !<}<»»
*
Hi llio
vincos and the centre, though only in advisory capacity.
21. Comprehensive Public Health Act:
^ln 1949 f
the South E»
There was no comprehensive Public Health Act for the whole of India till this time. To blam^kid a
overcome this drawback (Madras was the first province to pass the Madras Public Health Act in
t^^lio C
India in 1939. The period between 1939 and 1946 was greatly disturbed by the’/lst World War|y)ySora to di
which also involved India.
nlia| Drug F
22. Health Survey and Development Committee (Shore Committee) :
tier the admi
During this period, however, an important development took place. In 1943 the Govern
*
inent of InJia appointed a Health Survey and Development Committee under the Chairmanship of
j0 (aaj
Sir Joseph Bhoro to prepare a future plan lor health service in India. The report which is inls t|le con
unique ol its kind, war
*
published in 1946. During the same period Professor Aghaikar made art [.|uU|th as c
emitiiiy regarding the possibility ol a social security pl.rn lor lire people ol the country, y In 1:140, aa a.yuar
another important advancement was made by the inauguration ol the Tula Memorial Cancer Hos- fll() Qovam
pital in Bombay as a private venture for the treatment of Cancer Casos in India which wus severely ann|no con
23. Etiviromnonltil Hygiene Committee,
Employees’ State. Insurance aiid. other Acts:
mu c
In 194/ India utlainud independence. I Iris yum dm Asian Labour Conference Wils belli al 1952 and
Delhi which passed a resolution to establish social security service as an essential condition lor mister and
building up a democratic society. The Indian Nursing Council Act was passed and the Bio- as |^h>wc
chemical Standardisation Laboratory was converted into Central Drugs Control Laboratory. In tdo^ne n
1948, the Employees' State Insurance Act was passed by the Central Government; and the report idor each
of the Environmental Hygiene Committee under the Late Dr. B. C. Diir.gupta as Chairman was itonsivo vi
published. The Indian Pharmacy Act and the Dentists' Act were also passed. In the same year antre at 1
the World Health Organisation camo into existence and produced the Magna Charta for Health, ockefeller
with India joining as a member State.
tied in D6
24. Indian Constituent Assembly :
Tho Indian Constituent Assembly adopted the Constitution for India on the 26th November
id
1949.) According to the Article 246 ol the Constitution 3 lists namely List I (Union) List II loalth to
(State) and List III (Concurrent) wore made out covering all health subjects among other things, igal prov
Indian Journal of History ot Medicine
37
lors as the first non.official, powor t0 make Laws on any health subject included in the Union list was vested in the
over by the Council ofijament, the State List in the legislature and the concurrent in the Parliament cum States
a ln|g.,t0 of Biochemistry|is,atures
orat^^as the first of its
■cientific ssarch as applied ’ Tho Article 41 of the Constitution declares "The State shall within the limit of its
inomic capacity and development make effective provision for securing the right to work, to
jcation and to people’s assistance in case of unemployment, old age, sickness and disablement
I in other cases of undeserved want.’’
. with the Public Health
ti1() Article 42 of the Constitution doalaros " The State shall make provisions for securing
inces and Indian Princplv
...
,
.
, ,
.
yit and humane condition of work and for maternity relief. >
ealth services in the pre
25. WHO Regional Office at Now Delhi :
■> In 1949 New Delhi was selected as the Centre for establishing the WHO Regional office
• the South East Asian Countries, which facilitated direct communication with WHO on health
India till this time. To
sblems and assistance needed for the purpose.') The next year the Planning Commission was
'dras Pubiic Health Act in
t up by the Government of India and the Central Food Technological Institute was established
oed by theTlst World War
Mysore to deal with the different aspects of food science and food technology. In 1951 the
intraj Drug Bnsonrch Institulo, the first of its kind in India, wn« opened nt lucknow (U.P.)
ider the administrative control of the Council of Scientific and Industrial Research.
re Committee) :
:o. hi 1943 the Governidor^p. Chairmanship of
26.
Contra! Council of Health & Planning Commission :
To facilitate coordination of health policies between the Central and the State Govern.
n. The report which in
dels the f'ontrnl Council of llnnllh was stnltjlcully cotr.iHulnd hi Ptb,’ with Ihn Union MIdi-Jh.lessor Agharkar made an
Health as Chairman and the Health Ministers of the States as its members. They meet at least
if the country.') In 1940,
ice a year. The resolutions which are of advisory nature are communicated to the Central and
ta Memorial Cancer Hostale Govurnmontfl for Implementation and now plans mn prepared rind nro submitted tn the
Indla which was severely
tanning Commission for inclusion into the Five Year Plans.
27.
Five Year Plana and Rural Health Sorylcofi:
The operations of the Employees' State Insurance Scheme was started In Delhi and Kanpur
Conferanco was held at I 1952 and in the same year the first Five Year Plan was presented to Parliament by the Prime
essential condition for linistor and the Rural Community Development Programme was started all Over the country. This
n p.sr.sod nnd'tho Bio. as followed by non-intonslvn drive for covering the entire community with rural health centre
Control Laboratory, in nder the name Primary Health Centre,to be reinforced by at least 3 sub-sidiary health centres,
ernment.) and the report rider each C.D.P. unit. One of the deficiencies in India was the absence of facilities for an
upta as Chairman was itensivo virus research work. This gap was filled in 1952 by establishment of the Virus Research
n.nd. in the snmo year ontro nt Poona under the Joint auspices of the Indian Council of Medical Research and the
gna Charta for Health, ocknfollor Foundation of Now York. Also the first Indian Cancer Research centre was inaugu.
itod In December of this year nt Bombay nt the Fata Cancer Hospital, mentioned earlier.
28,
• Other Developments :
on the 26th November
List I (Union) List II
In 1953 the Model Public Health Act Committee was appointed by the Union Ministry of
lealth to draw up a model comprehensive Public Health Act to bring together all the existing
s among other things,
agal provisions and enactments and also to add new provisions including the recommendations of
Indian Jomnul uf lllsluiy id Mi/dn.lii"
38
tho Fnvironmontal Hygiene Committeo for bo l tor and nioru offoclivo public health administration
all tluuuuhuul th ' wtjunlr/
I ho lulluW'iig ullmi phiu>hiihh«u vt/mo aL.o lilur (ml duiiug ih<i year
h.iiii-U/, lli» IHiIihi.iI ! Atoll-ion 'f«ivi<.u Pi ugi
l|io Hui.il Ihmllh Smvluv SgIhjiiio to provide
intognUud health suivibus in ihu iiniil ruu.-BJ <h<I the fhilionyl Mohnl
*
’ i’?id I iluiio Cmiliol piogrammes. the Family Planning Rosuuruli Prugiiiirmiu Coinmiltuo way oho formed and th;? Control
Institute lor Rosoarch in Indigenous system of Modicino was established at Jamnagar by tho
Government of India during this your.
29.
Contributory Health Service Scheme :
In 1954 the Conliibutory Hoalth Service Scheme (later known as the Central Government,
Hoalth Suivicu) w.n. iiistitulrd lor all Govmnmunt umployout; and Ihoir lumilios in Delhi and New
Delhi areas. Tho Alt-India Institute ol Mental Health was induguiatud by Raj Kumuii Amiii Knur
al Mysore lor inipiuvumoni ul mental h.-allh in India
*
In 1955 tho Food and Drug Adulteration
Act camo into forco and tho Central Leprosy Teaching and Research Institute comprising the Lady
Willingdori Leprosy Sanitorium al Tirumani and the Silver Jubilee Children's Clinic at Said.ipot
was established by the Government of India at Chingleput, Madras.
30.
Central Health Education Bureau and Indian Public Health Association :
In 1956 the report of tho'Model Public Hoalth Act Committee was published for circulalion and obtaining opinion of tho States and for final approval ol the Parliament. But (his has
not so far rnateria-ized. The same year lor lullilmont ol the objectives ol social medicine tho
Union IViiiughy »>l Ihmlih eutnl.dlhbod tho Control Health Education Bureau ot Now Delhi with
clmi<|U:> lor ovt-il)lh>hing health mui.ounn», film ship piodimilu.n nnd training In health education
etc.. Im the udvuncomunt ol the public health in India in ill. varh'.us aspects including public
health education- Indian Public Health Association was inaugurated at Cali.ulhi by the Union
Hoalth Minister Raj Kumarrl Amrit Kaur in September, 1956
31.
Indigenous systems of Medicine and Mudaliar Committee:
In 1957 tho Government of India appointed an advissr for fho Indigenous system of Modi.
cino in tho Central Ministry of Hoalth and constituted Advisory Committee or Ayurvedic, Unani
and Homoeopathic modicinos to adviso (ho Government on rusoarch schemas and other matters
joiatud io the development of tho abovu systems
In 1959'tho Central Health Service Scheme for
Medical pursonnul was sanctioned by the Government alter the approval of the Parliament. A
second Health Survey and Development Commiiteo was formed under tho Chairmanship of Sir
Lakshmanaswami Mudahar to review and report on tho health services and health planning in
India'- This report was published in 1963.
32.
Central Bureau of Health Intelligence, Family Planning
and Expansion of Central Health Ministry :
In 1961 tlu> Central Bureau of Health I ntolIigorice was established In tho Directorate
Genorul of Hoalth Services, New Delhi to collect and disseminate all types ol hoalth objectives in
tho country' and to prepare the annual reports, between tho years 1956 and 1966 the Central
Ministry of Health and Family Planning started several field projects of Urban Community Develop.
inynt a counterpart of the Rural C. p. Projects jn dif|pryn| Slates it) India. Ip 1968, the Union
■
I
Ministry
ing and
j.
I
MinisW
wore oc
lolltiwl
!
|
1
Oruar
to
Indian Journal ol History of Medicine
Ministry of Honltli wnfi ronrimnd nr. tho Central Ministry of Hrnilth, Family Plnrining, Works, Mous
ing and Urban Development with necessary expansion ol functions and cabinet ranking of the
Minister.in-charge. During this year three regional centres at Lucknow, Bombay and Calcutta
wore established lor the first time for training in Urban (Municipal) Administration. In 1969 the
following items of works wore transferred to this Ministry.
1.
Urban Development including slum clearance schemes.
2.
Town and country planning and matters relating to the Calcutta Metropolitan Planning
Organisation.
3.
Scheme of largo scale acquisition, development .and disposal of land in Delhi, and
Dflhi Development authority. Improvement Trusts, Metropolitan of Delhi and Coordination of Work
in respect of the niaatbr plan.
4.
Administration of Delhi Development Act 1957.
33.
Indian Medical and Health Services :
During the same year the Ministiy <>l Home Alfalfa notified that the Indian Medical and
iloidth Korvlcnt
bonfi constitutor! with effect from February 1969 alonn with rules for recruit
moot In the
Only the senior entngorios of pornonnnl in tho Cnntiiil Health f.nrvieo would
bo absorbed and would also Include all medical and public health posts al the district level and
oiw>v<». iinilor »hn Sinin Gnvnmmnni, nnd similar posts under the Central Government besides n
email fiuinlmr ol junior level p->hto
The above accounts.of the dovolopmont of health nctivltins in India do not record develop.
nwntn ol public and private hospitals, dispensaries, clinics, sanatoria, nursing and maternity
homes, now numbering several thousands, an well an of the qo 11 egret arid in-uit nt Ions, r.omn of
those nnd the list ol international organisations providing assistance to health work in India have
boon described in a separate chapter of the book entitled " Public Health Administration in India''
by the author.
BIBLIOGRAPHY
Achar. S« T. — Paediatries in India. Souvenir, XIVth World Health Assembly,
Swastha Hind, New Delhi. 1961.
Archaeological Survey of India — Annual Reports 1923—24 to 1928 - 29 Govern
ment of India Press, New Delhi.
Banerjee, D. N. — Antiquity of Hindu and Greek Medicine, Medical Bureau,
Calcutta, 1941.
Bhore, Sir Joseph—Report of Health Survey and Development Committee
Government of India Press, New Delhi, 1946.
BOhh'l-, G — Tin) I.UV/.M of Monti,
( ,ln.-n.l..u I’rn.-n. n-|(ll,|, IfU’.G.
Centenary of lh«> M«-dk',)| Coll.v|n nf P.nnqal (.'Hi;... I'l’.i),
College, 1935.
« !,t|. «n | |.i M,.,||e.i|
a! of History of Modi cino
Central Advisory Board of Health - Publication Division, Government of India,
u Drug Enquiry Committee, Government of
Uh..; iopu. Hi;
i.'. — lii.iraliyu Ikibli/al.i 0 Samtkrili, Calcutta I Ini vi >ria iy
f'.u ji'i'l.., I;. <" -- i; f.,i, i,| Kns'ii'oiiiibailnl Ifyijivnu Commllloo, Oct. 1949.
Government of India Preus Simla, J'JSO.
Dasgupra B. C. — Report of the- Committee for Drafting Model Public Health
Act, 1955. Albion Press, New Delhi.
Delta, P- C. ■ - Medical Relief in India. D. M. Library, Calcutta, 1946.
Datta, P. C. - Social Medicine — D. M. Library, Calcutta, 1948.
Dwarkanalh, C. -- Indian System of Medicine. Souvenir XIVth World Health
Assembly, Swasth Hind, New Delhi, 1961.
Employ. •
Slate insurance Sheme — Report of the E. S- I. corporation, 1952.
Family PI mning — hirst Report, Government of India Piess, New Delhi, 1956.
Mackay, I-. — Early Indi in Civilisation, 2nd Edition, London, 1948.
, Madras Public Health A :l
1.939. Govoriimonl ol Madras, 1940.
Meiumdar IL C. Puitul'.or, B. D. — Vedic Ago, London, 195.1.
l.i.ix Mutlor, I-.
Tin- :;.i -hiiI Books ol llm Emil -- Gautam & Apaslamba. Trans-
I .1-,.! l.g Ci.inmili ., I'r.'i-.u, Q>:L.rd, I'll.'i.
Mudaliar, Sir Lakshmanuswami — Report of the Second Health Survey and
Development Commit to.-, Government of India, 1961.
Nathan, K. — Report ol the Indian Plague Commission Part I. Government ot
India Press, Simla, 1898.
Pandit, C. G. —Medical Research in India. Souvenir, XIVth World Health
Assembly. Swasth Hind, Nov/ Delhi, 1‘Jlil.
Playfair, Ernest — Translation ot History ot Medicine by Max Neuburger. Referr
ed by D. V. S. Reddy in his book on " Westen Epitomes of Indian Medicine. Osmania
Mudic.ll College, Hyderabad, 1966.
Proceeding^ of the World Health Assembly — 1948, World Health Organisation,
Geneva of 11.i .{iVth World Health Assembly, W. II. O., Geneva-
The Ayurvoda., oT> !'he Science of Hife, is the oldest
fVfi-.em op Modi-’inn in >hn world.
The a tody of 1 t.r hWory is
rather difficult, as there is lack of J.n formation regarding dates,
places and authorshin etc.
India, unlike China, enjoys a unique
position, 1’? that India instead of being Isolated culturally and
scientifically ns was the case with China, her been freely exchang
ing itsknowledge for centuries with other countries. According to
Professor Wilson, "In ancient In-'ln, i-.he Hindus kept price with the
most enlightened nations of the world, a ttai'.j ] ng as thorough a
proficiency in Medicine and Surgery as any reople whose achievements
are recorded.
There is evidence, that it was common practice
amongst the ancient Aryans to migrate to different lands., such as
Persia, Arabia, Egypt, 3nbyl.nn1n, Groot
nd oven ;'anndinnvin,
carrying with them their vast knowledge and experience".
In
those days, the oractice of Medicine wns a prerogative of the
priestly class, but they disc"1 ayed a high standard of surgical
end therapeutic, skill.
•
Ayurvedic Medicine goes back to the days, when the Aryans
r-imn to India from Control A".1..‘i about
!OO(.' to .".000 years H.C.
Even in the Provedic period as indicated by the excavations "at
Mohenjodaro and Harappa, hygiene and sanitation had reached a
high level of development, for one finds the existence there of
open streets, drains, baths and wells in tho inhabited area
*
‘'e'Ucine in India have described Medicine as a gift of God.
Ayurveda or the Science of Life is said to be bestowed by Indra
on Bharadwnja, who was deputed to go to him by the assembly of
pnger., who mot. In the Hlmnl'tyns.
At.royri the grunt sag", probably
a pupil of Bha^ndwaja, was a great teacher.of Medicine.
Agnivesa,
the distinguished pupil of Atreya, undertook the Herculean, task
of codifying the knowledge imparted by Atreya, and to-arrange it
in the form of a treatise, which formed, the basis of Chnrnk fam}]
the immortal Medical Classic written by Cherek, one of the greatest
physicians of ancient times. The other great Indian Medical
Classic is Cusruta C-amlilla, which contains a groat dual of Surgery,
in which the ancient Indians specially excel1ed,
They set
fractures, performed amnut.at J one, exci r<°d tumours, repaired hernias,
and did couching for cataract. They were pioneers In doing nlastic
Surgery, nnd did Hhinoplnsty.
Hygiene nlayed a groat n«rt in
Indian Medicine.
The lews of Menu are imrv.r t.-nt from the Medical
I
point of view, aslthey enjoin strict personal hygiene and frequent
ablutions as the basis of religious worship.
■Atreya was the first systematic teacher of Medicine.
There ic evidence to suggest, that he taught Medicine in the 8th
century B.C. before the time of Buddha and prior to the establishnant of the University of Taxila.
Atreya stands first amongst
the teachers of Ayurveda and is often referred to as the Ea.thP.r_of
Indian Medicine,
According to him "All suffering, whether of the.
body or of the mind' has Cor .its basis igno> 'u><-p ; -ill hn-p"1nosf! has
Its foundation in pure sclent t f'.i. c knowledge.
In Surgery, Susruta is rightly regarded as the"Father of
of Indian Surgery1.1
He obtained his knowledge from Dhnnvnntrl,
the natron saint of Surgery.
Susruta became the head of the
departments of Medicine and Surgery at -4he Great University of
Varahasl, hut he assigned a somewhat higher place to Surgery,
regarding it as the first and the highest division of the healing
srt.
He however says, that "both Medicine and Surgery must go
hnnd in hnnd, for he who only knows on > branch of the art of healing
is like a bird with one wing”.
Ayurvedic Medicine is based on th'' humnnr.nl theory of
Tants, Dltta nnd Kafa.
Vnnt.n, Pitta and Knnhn are the supporters
of the human body.
They together contribute .nil the nutrition
fluids derived from Solid, liquid and gaseous food materials
ingested by the human organism. They arc, therefore, called the
Sunnortinp Dh^atus (noshaka Dhaatus).
Vesta, n*
tta and Kapha are considered the most essential
factors in the constitution of the human body.
"hen they are in
equilibrium, the body is healthy.
But any variation in th"m or
vitiation cf any one r>r inom causes ill-health or .dlrcnr-e.
IfPLUETiCE OP BUDDHISM:
Ayurvedic Medicine had reached a hit'll lovC of' development
in tho old days, and buddhism provided an added stimulus to its
advmcement, especially in the establishment of hosoitpls. The
Buddhistic period represents the era. of rational or.scientific
Indian Medicine. It began with Gautam Buddha about GOO years B.C.
By denouncing various sacrificial rites, and the system of caste,
and- bv extolling the qualities of mercy, love, kindness and good
ness as stepping stones to peace - Nirvana, Gautam Buddha was
able to change the entire face of the Art of healing. Although
m^gic spoils and miraculous cures, were practised at tho time, the
individual efforts of greet tc-chnrr of Med .’cine and Sur'gery, were
successful in s uplifting the ancient Medical Science of India
to -> high level of proficiency.
The ancient ’Tnlversi. tles of
Tnxila and Malandii became famous for their tench i.ng ->■' KotHchw,
furgery, Philosophy, Mathematics, religion end ether arts and
Sciences under the guidance of eminent teachers.
Establishment of Hpcnitals;
During the reign of Chandra Gunta
(324 - 300 b.C.) sue: ini attention was naif, to th" establishment of
hospitals and dispensaries end for enforcing r’jles of sanitation.
Ashoka (272 - 232 D.C) who was a sincere follower of Buddha took
active nart in ■this campaign. I” Ashok's rock edict'No.Il It is
t>! r.Cr l.bcd a a fol lows:
"Everywhere’ in the dominions of King Driyadarsi, beloved
of the Gods, and likewise in the bordering territories such ns
those cf the Chodas and Pandyas as well as of the fatiynnutra and
the Keralaputr.i as far south as Tamraparni, and in the territories
of the Havana. King Antiyoka and also the kings who are the neigh
bours of the said Antiyoka - everywhere king r’T’iyndnrsi, Beloved
of th" tods, han nrranr.od- for two kinds of njedicil treatment, viz. ,
’'edicnl treatment; for mon .-'n<l medical ■treatment for animals,
And,
. were no medicine"1 herbs bnnef.i ci' 1 to mon and animal
everywhere they h-.ve been c used to bo imported and planted.
f'herover there were no roots and fruits, everywhere they have been
caused to be dug and trees have been caused to be planted for the
enjoyment of animals and men”.
Jeevaka was the most famous physician in Buddha's time
In the 6th century B.C.
ANCIENT INDI IN HOSPITALS.
The Chinese Pilgrim Fa~Hien, who visited India in the
time of fhnneror Chandragupta states:
"The ciders and gentry of these countries have Instituted
tn their capitals free hospitals, and higher come all noor or
he1.nl ess natients, ornhnns, widows nnd crlpnlon.
Th^y are well
taken care of, a docto” attends them, food nnd medicine being
supplied according to their needs. They are al1 made quite
confortable and when they are cured they go away”.
Fn-Hinn also
mentions "Houses of charity on the road-side whern rooms, couches,
beds, food and drink are sunpl led to trave11 err, whi1 e the rich
end nrosnerous inhabitants, vying with one another in the practice
of benevolence and righteousness establish in the cities houses
for dispensing charily and medic I.no.a”.
It is interesting to note that some of the religious and
Charitable endowments of Southern India
"i«de for ’.lie establishirnnt of Grhools, which ’’ora equinnod with a hostel for the
rr,r.vie-co of students, and.-’-o - hosp.ltal.
The hoswlt.nl attached
to the schools wns known ns Veer-' ~;Jol nri'and was nrovtdel 'ith
IS beds..
The staff and ertn'il 1 shm^nt for ?’•>-. ~ 'bool—hostel .and
hospital comprised one phyrlcl n In whoa-- latcily, the privilege of
administering medicines was herinitary, one surgeon two servants,
who fetched drugs supplied fuel ••■nd did ether services for the
hostel and the hospital.
The nr.lv te charities of‘the day were also applied for
’he establishment of maternity homes.
QF HINOn ML-DXJim-; iFOR-IIGK COWKIES.
Tradition says, that many illustrious mon from Greece nnd
other foreign countries visited India, and took back with them the
Hindu "otencos nnd introduced them In th el” schools. Alexander th”
Gre'-t ts-l'1 to have taken •:1th him '’•m^.Indian r'hy r i •• 1 nns after
his Indian Campaign being attracted by their successful cures of
snake bites. ■ The Buddhist monks, who were sent out. to foreign
countries by ''shokr , preaching Buddhism, practised Medicine as
p-rt of their humanitarian task.
They studied medicine along
with philosophy nnd fortified 'heir -fipirl tiinl. ministry by relieving
the sufferings of people.
: o
Buddhism wen tr.-nnl ant «*cJ from India Into Chinn nhnnt 67
i >.
Emperor Ming T1 (58 - 76 A.D) of the Eastern Has sent nn ombar"./ of
oj.-ht^n men to India to os’- fo- ?n<Mh
st
*
Books and teachers. This
action war- the ontccs’ of a d rerun, whi rh tl.’’ '■'.•hnn-or b ■'! In whi"h
he say a gold image of Buddha, who demanded to bn worshipped In
Chinn.
The messenger s left the cnnitnl (Ln-Yang, now known as
Hnnon-fu) in 6o A.D. Th^y travelled across central Asin, until
they reached Khotan. Th® embassy brought, back with it images of
Buddha, Buddhist scriptures, and two 3u<klhist monk.
*-,
K.nuy'-p.-i
atunga and Goberana from Indie
i*
*
Gradually Buddhism rained a
strong hold until the. Tang Dynasty, when it enjoyed the greatest
prosperityAs the result of the frequent nil grimaces made by
enthusiastic .Chinese duddhists to India, end the arrival of many
Tnili-.n monks in China, the Art, faience and other phases of Indian
'Culture, including ’’od ].c ln.e, exerted n profound influence on the
life and • thoughts rf the Chinese people.
’^he vjews about the
etiology
''•> t.hol ogy of Hirearer ■.•-■no ->f Cocfe-d by Buddhist!"
idea *5.
J;i-,n I'.y suffers from two kinds of afflictions, physical
>,nd mental. Pov nhyuie-1 .•> 1 ln.<»nLf; th" dr iw-r p
„n Ch
l«o
*
'.-.til b"
effect!.ve, but for mental el'fectl ms r'.>. hJv out
1. ••' ru-H '■. j ne■■
1 s rem!red" (Wong end '.'u).
Buddha is s.-i11 to have told Chi POs "
You • ~o and heal his body .first, I will com; Inter to treat his
tnantpi suffering". It seems, that faith'-her ling, hynnotism, auto
suggestion and other nsycho' hem pent i. measures mostly originated
from Buddhism. Ont of this arose the art of medihtldn, a system
of mental exorcise, which aims at developing ’h<> mind to a state
of mental repose or relaxation.
down in Ayurveda.
ETHICAL PrlHCIPLES.
To begin with, in admitting students to the study of
’■!<<■ 1 1 •: 1 nn , n» mu.’h' ’ ’ > nr > r - >ri •« war. ■! t t ■> <h <> ! ! . > 1,1 ■ • r-if >
i
1
f I t non ••
as to the intellectual and physical fitness.of t/ o pupils, for
It «'■'? cone!dornr! axiomatic In thorn a«ys, that morn! excellence
was the basis of all true education, including medical education.
The object of education wan not merely to pr'nnro thn<stndnnt to
earn a livelihood, but also to infuse Into him a strong ■lap.lro to
lead n rood and virtuous life.
Further, there '■ns very intimate
contact bntwonn the tenchor and the student, so much so, that
undergo a neriod of probation for six months to one year. if
after this the teacher was satisfied as to the character and
intelIcctivil capability of thd student, he was allowed to proceed
further and continue his studies. f;~ys, Vaghbhata in Astang
fangraha:
’’ A disciple who is cdnablc and possessed of modesty,
nn"li:v arid .;rts and who was served a Probationary
period of six months should be taught as lone ns he
gains perfection in the theory n’nd practice of- the Helene''
INITIATION CriP.-'SlONY:
A special, initiation ceremony was held, when the student
Commenced his andloci studies.
I shall describe in some detail
the Oath of initiation as <dven in (1) Charak Snmhita.
The teacher instructed the discin’’e in th
**
presence' of
the sacred fire, Brahmans and physicians, saving-:
"Thou shalt lead the life of a bachelor (Brahmachari)
grow thy h»l.v, arid hsprd, speak only the truth, ent not meat,
ent only sure articles of rood, bn fr^e from envy and carry
inot arms.............
"Thou sbnl.t dedicate thyself to rcs and regard© me ns
thy chief. Thou shaft be subject to me and conduct thyself for
ever for my welfare and o’ensure. Thou shall serve and dwell
•'1th me like a son
Thou shalt behave and act without
arrogance, and with care and attention, and with undistmeted
mind, humility, constant reflection, ahd with ungrudging obedience.
Acting either at my Robert or otherwise, thou shalt conduct .
thyself for achievement of thy teacher's purpose alone to
the best of thy abilities.,
"If thou desirest success, wealth and fame as a
physician and heaven after death, thou shalt pray for the welfare
of all creatures.
"No offering of gifts by a woman without the behest of
her husband or guhr-iian shall be accepter) by thee.
While
entering the patient's house thou shall be accompanied by a
men, who is known to the patient, and who has his permission
to -’nter and thou sh-11 bn w«>ll el
nnc) bent of hepd,
sei f-possessM end conduct th; •••ill
*
after related consideration.
Thou shall, thus properly mrke thy entry. Having entered, thy
sneechj mind, intellect and senses shall be entirely devoted
to no other thought than that of being helpful to the patient
and of things concerning him onlv.
’’The peculiar customs of the patient's household shall
not be made public.
Even knowing that the patient’s span of
life has come to its close, it shall not be mentioned by thee
there, where if done so, it would cause shock to the patient or
to ethers.
"Though possessed of knowledge, one should not boast
very much of one’.,a knowledge.
Most people nre offended by the
boastfulness of even those, who are otherwise good and
author a ttn tlve',
On the completion of the Initiation ceremony, the student
was designated as a Hramhschari and he "etained this title till
the end of his student life.
During his student i..i Co, he was
specla'ly irstrreted to observe eelebrey, not to carry weapons,
not to indulge in rebellious or immoral acts.
According” to
Kasyapn, he was advised as a Brahmachnri to keep a liberal and
receptive mind and make his contributions to the growth of
knowledge and progress generally.
THE CONVOCATION 0’.'. C IMAV-UITANA
.
After the conclusion of stud os, the young physician was
advised according to Charak 5nmh.lt-> nn follows
*
"Having, finished his studies and permitted to leave the
school, he should go about wearing white garments with clipped
hair, with undeluded mind and with his eyes looking straight
before him.
He must be genial and take initiative in conver
sation.
He must never resort to the patient’s house uninvited.
Having entered, he must scrutinise the prognostic omens. Ho
should not turn his gaze on anything else in the h'-use but the
nntient. He should not make his entry into a hou'-n without
announcing himself.
He should not broadcast the secrets or the
shortcomings of the patient’s household. Ho should withold from
the patient the untoward prognostic signs, that he may have
perceived. He should continually offer consolation to the pntlenl
* ® ’
He should not administer the' medicine in the wrong order, nor
should he delegate the responsibilities to another. He should
make an al together novel combination and administer it. Hn.
must be versed in the knowledge of characteristics of const!buttons, drugs, disease and age.
lie should always be equipped
with the store af fumi''.’.ng drugs, eye-salvos an-’ other
medicines. He should not incur the hostility of otheT> members
or bls profession. In co-onara i on ’•■1th them, he should prepare
the medications. lie should be given to speech that is bold,
*.hi
unnr
rnicms, prompt, vivid, charming, gentle, persuasive,
compreh'snstve, non-oontrad1 cto-ry 'nd rjehtoons. For Indeed,
the physician who r1"<:1 «•<; the w-11-bc.l ng (-.f peo In eSjoys hnppinei
in fh1 s world as well ng in th" other".
These oaths formed the basis of Ethics of the
Physician.
Hegistra. bl oiv
After finishing one’s medical education, one had to
obtain th? r-m r.l :■■■■•\ on ■ f rhe King
start ine’s professional
careen.
This w«s th
*
nr.->ctice tn ancient India. This is what
Su shru tn. so ys i -
"Having studied the Science, having fully grasnod the
meaning, having acquired practical skill and having performed
operations on dummies, with ability to teach the science, and
with tph "Ing1:’ remission, a Phys I.••inn •.vxmi.I.1 enter into fils
profession".
Sushruta Saffihita.
i
This w?s dona to nrotect the -neonle from quacks and
Sukracharya also states posi'ively that without the
p.,r-r? ecion 'f the King, no physician should be allowed to treat,
Ayurveda is deeply rooted in the aoi1 of India and
a large majority of the people still seek comfort from it. It
has largely contributed to our cultural heritage.
UWI 3Y5TE?' 07
Apart from the Ayurvedic, the other old system of ^licinn
in vogue in the country is the Unani‘. The word annul means G 'nek.
This is the old Greek Medicine, which ’had reached a v^ry hi rh
stage of development.
The rational attitude towards life, which
the Greeks acquired also Influenced their attitude towards
disease and death.
The greatest of the Greek Physicians was
Hippocrates. who is known ns the Father of ''odidn ,
He wag a
contemporary of Plato, and Vivcd fro." 460 *1. ‘ tn :
".c. Jllr.
teachings are contained in the Corpus i'I nnocrntlcum. Ills great;
achievement consisted in having dissociated Medicine from •
'I'heol.ogy and marie. He laid stress on the clinical, examination of
the patient more than anything el re. He Introduced ethical
principles in the practice of Medicine. I. am sure, you all know
the‘Hipnocratic Oath.
Ho raised Modi cine to the status of a
science, and nlaced it on a hi h pedestal by combining it with’
the humanities.
By .the first Century of the Christian era, the centre of
Civi’’iea tion rad shifted from Greece to Alexandria and then from
there to Rome. But medicine in . omo was Greek Medicine, and. all
the great physicinns in Rome were Greeks, The greatest n.ame in
Crseko-Roman Medicine after Hippocrates was Claudius Gnlen
(131.AD to 200 AD) whose influence remained dominant in Europe
for 1200 y«nrs.
He codified, all medicine of the time and made
many contributions of his own. ''hen Roman Emnire broke up, its
culture disappeared from Europe for a thousand years.
But many
of the medical works of Hippocrates, Galen and other Greek
physicians had been safely evacuated to Constantinople. From
others, the knowledge snread to Arabia,'Mesopotamia and Persia.
Medicine in Persia and Arabia Was partly Greek and
partly Indian. According to Professor Browne, "Arabian Medicine
Ip that body of scientific or mndic.nl doctrine, Which Is written
in Arabic language, but which is for the most part Greek in its
origin, though with Indian, Persian and Syrian accr«cions, and .
only in a very small degree the product of the Arabian mind".
Its importance lies not in its originality but in the fact, that
in the long interval which separated the decay of the Greek
learning from the Renaissance It represented the most faithful
tradition of ancient wisdom anil was during the PnrV Ages the
■'onrc<» from whi ch Europe derived —)<;h nhP.osonhl. -nl
'nd , ^:^r*
-4f5 c ide-is, ns she possessed.
This medicine deve'oped
in Persia and Arabia, particularly under the ehl ir/itened
natronage of the AbbaSid Khntifas of Baghdad in the Pth and Pth
centuries A.D.
There are two great names of eminent physicians
of this period, namely Phases and Avicenna, who nlayed an
important part not only in introducing Greek medicine in Arabia,
but also in the revival of learning in Europe’. The principal
service of Islam to Medicine Was th-’ nroservctton of the Greek
culture.
0
It was this system which came to India with the advent of
Mohammadans. During the reign of the Moghul. emperors it Reached
the height .of its glory.
There were many distinguished Hakims,
who taught and practised it in many parts of the country, namely
Lahore, Delhi,Agra, Lucknow, Calcutta, Hyderabad nn.d other places.
Emperor Akbar collected at his court many distinguished
hakims (physicians) such as Hnkirn Abdul Fateh Gilani, Hakim
Putfullah Gilani and Hnkirn Ainu!-Mui Eir-Ji.
According to the ’
advice of Hakim Abdul Patch Gilani, many hospitals were esta
blished in the kingdom.
An accountof these is given in Akbar
Mama (Vol.2, p.3) Munshi Laichand has referred to these hosnitals
in his history of Agra.
After Akbar, when Emperor Jehangir ascended the throne,
he issued the following proclamation at the time of his coronation
in 1014 H.E.
"In. all big cities, hosnitals should be established for
the treatment of the sick and the expenses for running these
hOSpitfllp will b« nA id by Government".
Emncror Shah Jehnn followed the exnmnln set by his
predecessors nnd made special efforts to establish hor.nltnl
He established one hospital behind the Jnmmai Masjid at Delhi
in 1060 H.E. to which he appointed some well-known Hakims.
Emperor Aurangzeb also established several
hosnitals in his kingdom.
Among the very able Unani phvsicians during the Moghul
period, Hakim Ali Gilani occupies a high rank. He wrote a very
fine commentary on Avicenna’s Canon of Medicine. Among others,
I may mention the names of Hakim Hasan Gilani, Hakim Sanaulah Khan
of Farrukhsbad and Hakim Mohammad Akbar, Arzani,who wrote an
important book on medicine.
i
During the Moghul period many books Mere written on
Hnahi Medicine. The well-known book Madanushifa Stkarshahl
contains commentaries on Hnani Medicine and lncort>->rntcs many
ureful things from Ayurvedic Medicine.
Mpcrl?>1 n Mention war.
paid to the medicine! herbs in India and bocks written on then.
Medical schools for giving instruction in ’Jnnni medicine were
established at Lahore, Dedhi-, Arm, Lucknow and Hyderabad
(Deccan).
At Lucknow Mirza All Khan Sahib ranked high. He was the
physician of King Shah Gaziuddin-Hyder of Oudh. It is recorded
that he was known by the title "Ilakim-ul-mulk".
Hakim Abdul Aziz
established tn Lucknow the-well-known institution known as
Tak-mil-u-Tibb.
There were some well-known hakims tn Lahore, Bhopal and
pnmnur.
In Dn,hl, the name of Hakim Ajmal Khan is well-known,
and in Hyderabad (Deccan) Mir Fazal Ali'Khan.
There were also
Hakim Ahmed Syed Ararohi, who was the Direc
*
or of Medical Services
in the Deccan, and Hakim Mohammad Abdul Aziz Khan Sahib, who was
physician to H.H. Mir Mahboob Ali Khan Asafjah, and Hakim Syed
Altaf Hussain Sahib, who was also appointed as the Director of
Medical Services.
It is to be observed, that ns the Mohammedans in
Baghdad had absorbed Greek •>«•. Well nfi Ayi.it’Vfedlc modlclfib. In
India too, they adopted Hindu sciences and art, including Hindu
medicine to a great extent. They translated many Sanskrit and
Hindi books into Persian.
They nald the same attention to
Ayurvedic medicine as they did to Greek medicine n’
an nnr"> 1 er-
period.
So the Unanl Medicine which is prractised today is a
blend of both Greco-Arabian and Ayurvedic medicine■ (Jnnni Medicine, like Ayurveda, is also based on the
Humoural. Theory.
According to it, the world consists of two
types of matter, gross and subtle.
The gross matter comprise
Earth, Water and Air, while the subtle matter consists of Energy
and Soul.
For the medical men energy is of impo”t,ance and it
is symbolized by fire.
All the elements interact with each
other.
In the human body four humours are produced, namely,
Khoon, Sajra, Souda and Balgham.
These are responsible for the
replacement of tissues wear and tear and for supplying energy to
the body.
When the humours become abnormal, they cause 111
! 12
health. There is a view, that under certain circumstances
ufoonath may be caused due to these humours, which nay result.in
diseased conditions. Ufoonath means the occurrence ■■if changes
leading to lowered resistance.
There were schools of Unnni medicine at Lahore, Delhi,
Agra, Lucknow, Hyderabad (Deccan) and other places. It came in
contact with Ayurvedic medicine, from which it imbibed many
important ideas about diagnosis and treatment.
MODERN MEDICINE.
The modern system of medicine which developed during
the Renaissance in Eurone was introduced Into India as a result
of our contact with the Western nations, especially the British.
During this period Medical Services were established for the
Armed Forces as well as for the Civil population.
Medical
Colleges and Medical Research Institutes were started and measures
introduced for the prevention of infectious d i.seas'-s, and the
promotion of public health and hygiene.
CONCLUDING REMARKS;
This is the story of our Mndlcnl Herltag0,
which is of a diverse nature.
'•?« are a nation, possessing a
culture which is composite in nature, and History teaches us
that we have a special genius for bringing about integration and
synthesis of different ideologies.
We should trv to synthesize
all that is best in our ancient Medical Heritage and Modern
Medical Science.
For the knowledge and appreciation of our medical
heritage the study of the history of Medicine is v I tally important.
It is specially helpful at the present day. This study helps us
’.o absorb the high standard of elthics laid down in the past, to.
respect the antiquity of the art of healing, to inspire us with
a love of our profession, and to appreciate and admire our past
traditions.
All this will be a source of inspiration to us in
carrying out our dally task. It will heln us to imbibe the
essential quality of humility arid moderation, while considering
the advancement in medicine, which is taking place in our times.
And what is most vital, it will stimulate our general culture by
"pvlving a closer relationship with History, 1item turn, art and
general science.
As fussy. (BIRR) says '' In the first flush or
opulence and success there is no state of mind so difficult to
to maintain, or so necessary for future services as humility.’*.
This position will be rectified by the study of History, and by
the appreciation of our s^endid medical heritage.
r'urther it will also help us to realise that T’ediclne,
like any other fcience such as Hhysics or Chemistry, is one and
indivisible.
It tiers no!
*.
nd nit of any division .Into so called
"Systems'1.
.This Science is universal in its scope, and outlook,
and many Ciduntrles both in the East and the ''est have made nr.'d
are making contributions to it. It is also vitally important,
that we should realise that Medical Science has made grea.t strides
during the last 300 years and some of the advances have been of a
revolutionary character, so that our efforts in the sphere of
curative and Preventive medi'ine are more effective now than ever
before.
This 1s dun to the fact, that all problems are considered
in an objective manner, and our approach to them is through
observation and experiment, methods which have Indeed furnished us .
with a rich hafest of useful knowledge, and we should pursue'them
vj th all the zeal .and resources nt our command.
This is just a brief account of our past medical
heritage. It is primarily based on the ancient; Hindu medicine
which had advanced a great deal in the past.
cuhseqnently to
1 '■ ■ y<»rp added 'Irpnl Medicine and the Modern medicine
*
If Chnrnk
and busruts, Hi nuocr.a' es ,hm1 Hal en,
and .Avicenna,
and Lister, were alive today, they would have advised ns to con
tinue the task which they had commenced .and make further- contri
butions to the Art of Healing.
They would also impress upo.pz.the
necessity of dedicating ourselves to this Science with a spirit
of service.
In this context, I earnestly wish you, my friends,
the best of luck and success in the task that- lies ahead.
4. Bhatia S.T..
Th a Medical Heritage vf in-.’ia. Souvenir
of Ail India Medical Con faronce,
orc 1
5. Chemi n Wonr K and Wu Men Teh: History of Chinese Medicine,
The Tientsin Mesa Ltd’.,
m'/ln, China 193
6.
Lakshmi Path! A: Ayurveda Ciksha. A Text hook of .Ayu^vodr
Vol. I Section I. histories"' ' (.'i ckf round .•I'M
7.
Lakshmi Path! A: Ayurveda Siksha. A Text Book of Ayurveda,
Vol.IV °rInciples <>f Pathology 194G.
8.
Sircar D.C:
Inscriptions of Ashoka. The •'I’bi.tc-ntlons
I:ivision, Ministry of .Information and
Broadcastingj Government of Indi", Delhi 195
Indian J. Hist. Med., (1973), 18, 1 -11
RENAISSANCE AND THE EVOLUTION OF MEDICINE *
Major General S. L. BHATIA, I.M.S. (Retd.)
I consider it a great honour to have been of the Christian virtue of compassion towards
invited to deliver the Silver Jubilee Oration the sick and suffering led to new departures
on the occasion of the Silver Jubilee Celebra in Medicine, particularly in nursing the sick,
tions of the Indian Association of the His and erecting hospitals for their care and
tory of Medicine here in Madras. I am treatment. There was, however, absolute
sincerely grateful for this. It is a great suppression of experimental science. and
pleasure for me to be with you all and to independent enquiry.
meet so many old friends. At the outset
The influence of Renaissance has been
may I say, that on behalf of the Association
of History of Medicine, Bangalore, as its described by Castiglioni, the medical histo
President, I have great pleasure to convey to rian, in the following words :—
“ In this marvellous period of Renais
you, our sincere greetings on this auspicious
sance, which marks the return to the
occasion. We offer hearty congratulations
ancient concept of Hellenism, in
to you all for the excellent work done, and
Philosophy as in Art, in Medicine, as
pray, that God may grant you all the best of
in Literature, vivid sparks emerged
luck and success in the task that lies ahead.
from the forge in which the new
I have selected the subject of “the Renais
forces of the world were being tempe
sance and the Evolution of Medicine” for
red. Disencumbered from the rigid
the Oration, as I thought that on this historic
structure of scholasticism, the horizon
occasion, a subject of that sort would be
revealed the striking profile of the
appropriate.
new science, founded on the free,
critical and individualistic, philosophy
During the period 1500 to 1700 A. D. a
of Hippocrates, and nourished by the
change took place in Europe, which divides
new investigations and gifted observa
the medieval from modern times. It is
tions of the men of the Renaissance,
called the Renaissance. It was a gradual
guided
no less by ancient traditions
change. An atmosphere, which was hostile
than by the firm desire to engrave
to free enquiry, gave place to one in which
deeply
their
own record in the pages
science could live and flourish. During the
of History ”.
early middle ages, the church was the sole
repository of culture. At that time, the
The 16th Century may be regarded roughly
greatest need of the European society was as the first stage when a change was notice
spiritual uplift, rather than intellectual able, although some indication of the change
development. Under the circumstances, the had occurred in the previous century. The
Christian church with its spiritual appeal close interrogation of nature which was to
made a wonderful contribution. The growth lead to the development of modern science
• Oration delivered on the occasion of the Silver Jubilee celebrations of the Indian Association of
History of Medicine at Madras Medical College on Friday 16 February 1973.
2
S. L. Bhatia
had begun. Painters examined the human
frame, and surgeons dissected it. Verrochi,
the . sculptor was also an Anatomist. The
discovery made . by Copernicus, a Polish
astronomer, that the earth revolved round
the sun, steadily gained adherents. A new
culture, lay in its outlook and aristocratic in
origin, for it chiefly grew in the courts of
Italian rulers, spread widely through the
invention of printing. As Professor H. A. L.
Fisher, the Oxford Historian, says:
necessarily all that was given in ancient
books, but something which should be
ascertained by direct objective study and
observation.
Under such circumstances, when Europe
was kindled by new knowledge, and new
outlook, there came Protestant Reformation.
This was a challenge to the Roman Church.
As a result of this, a religion widely held
and strongly entrenched in the social and
political tradition of Western Europe -was
“ During the Renaissance, Europe turned challenged by new spiritual forces, and over
away from the vast literature of a large part of Europe it was compelled to
,
commentaries and glosses which the accept defeat. • Views of life based on
pedants of the later middle ages had freedom of thought and upon the right of
inscribed in letters of opium on tablets the individual conscience came into promi.
of lead ”.
nence, which in the long run transformed
the institutions of Europe and shaped the
There was a spirit of adventure abroad. life of the modern world. Never was the
The Portuguese conquered Ceuta on the human mind so widely and sensibly affected
African coast in 1415, and then Vasco da as in the 17th and 18th centuries as the result
Gama set sail on 8th July 1497 and by of the Renaissance.
circumnavigation of Africa arrived at Cali
cut in India on 20th May 1498. Christopher
From the point of view of evolution of
Columbus, the Genoese sailor, discovered Medicine, the period which is of the greatest
in 1492 the new world beyond the Atlantic. interest to us in the middle of the 16th
The Mediteranean ceased to be the centre century. It was then, that the Medici, who
of civilized world. By degrees Europe began stood close to the people and -understood
to cater into the new phase of its existence, their needs, were established in Florence.
which is distinguished by the estabilshment The Protestant Reformation was steadily
of colonies and empires beyond the ocean, spreading. Martin Luther was preaching
and by the gradual spread of European his doctrines. The Art was flourishing.
culture and influence throughout the habi The artists like Raphael, Michael Angelo
table globe. In this adventure at first and Titian were infusing the new spirit.
Portugal and Spain, and then the Nether The new learning was everywhere working
lands, France and England took an active like leaven. The old Universities were
expanding and new ones were, springing up
part.
everywhere. Nicholas Copernicus had labou
The discovery of the new world coinciding
red hard to study the ancient Science of
with the printing, taught, that ‘Truth’ as
astronomy. The art of printing was steadily
Roger Bacon said, “ is the daughter not of
contributing its share of pouring forth the
authority, but of time ”. Thus mankind means of knowledge.
acquired a new attitude towards knowledge.
The Renaissance produced the double
Authority no longer went unchallenged.
The past was no longer supreme and genera ■ phenomenon of a return to the classic past,
tions grew up, for whom ‘ Truth ’ was not and revival of the dignity of the individuality
Renaissance and the evolution of medicine
sity there. In 1553 he went to study medicine
at Paris. Here he worked under two eminent
teachers, namely Jacobus Sylvius and John
Guinterious of Andernach. Sylvius at that
time had already achieved great reputation,
The Christian view point, which considered and drew students from all parts of Europe.
disease as the punishment for sin, gave way The teaching of Sylvius, however, still chiefly
to the old Hellenic conception according to consisted of reading of the books of Galen.
which disease is a disharmony in the body, Ocassionally the body of a dog or a corpse
which nature should cure. The sentiment from the hospital was brought into the
which made it a sacrilege to dissect dead lecture room, and barber attendants were
bodies, as they were considered impure, gave employed to dissect them for demonstration
place to the thought that by the actual study to the students. Sylvius himself did not do
of the human body itself could one know its the dissection. Vesalius was not satisfied with
perfect beauty. So there was intensive study this; and one day, he put the ignorant
of it.
barbers on the one side and himself comple
This renaissance appeared in different ways ted the dissection.
in different countries. In Germany and the He says
North, Luther and Paracelsus appeared on
“My study of anatomy would never
the scene. In Italy it was pivoted on men like
have succeeded, had I when working
Machiavelli and Guicciardini, profound
at medicine at Paris been willing that
historians and politicians of the age. In
the viscera should be merely shown to
medicine, it was in Anatomy that the revolu
me and to my fellow students at one
tion was brought about by Andreas Vesalius.
or another public dissection by wholly
The University of Padua was closely associa
unskilled barbers, and that in the most
ted with it.
superficial way. I had to put my hand
to the business ”.
(1) Andreas Vesalius (1514-1564)
Vesalius assisted Guinterious in preparing
It was under such circumstances, that in
his book Institutions Anatomicae.
the year 1543, the printing press of J. Oporinus in Basel published a book “Fabrica
In those days, complete dissection of the
Humani Corporis”, the structure of the human body was impossible, as it was
Human body, by Andreas Vesalius, which has prohibited by the Church. Vesalius used to
been described by Sir William Osler as “ The visit the burial ground attached to the
greatest book ever printed from which modern Church of Innocents in Paris, and there he
medicine dates". It served as the basis of studied bones of the human body for many
medical teaching for centuries afterwards.
hours. He also went with another fellow
student to another burial ground on what is
Who was Andreas Vesalius? He was a
now “ Les Buutes Chaumont" to study the
Belgian born at Brussels in 1514. His father
bones.
was apothecary to Charles V. His mother
After three years he went from Paris back
was probably of English extraction. When
to
Louvain, where he continued to study ana
still young, he was interested in anatomy and
dissected animals like mice, rats, cats and tomy. In 1537 he went to Venice and the same
years
he was given the Doctorate of Medicine
dogs. The young Vesalius went to school at
Louvain and afterwards entered the Univer by the University of Padua. Padua was au
of the human being, in addition to the criti
cal spirit springing up in the Arts, Science
and Literature. There was a desire for the
freedom of thought and expression.
S. L. Bhatia
enlightened seat of learning and it was here
that Galileo Galilei (1564-1642) worked with
his telescope, which he had designed, and
thus laid the foundation of a new era of
experimental scientific studies. Tesalius was
appointed Professor of Anatomy and Surgery
there in 1537, and was entrusted with the
duty of conducting dissections. He began
to teach anatomy in his own way. He did
dissection with his own hands, and ultimately
taught only what he could himself see in the
structure of the body of man, and not what
Galen had written. In Padua the church was
not so strong as in Paris, Louvain or in
Spain. Here he was able to get dead bodies
for dissection. In 1542 after 6 years hard
work, he wrote ‘ Fabrica Humani Corporis ’
(Structure of the Human Body) illustrated
with many diagrams, which was published by
Oporinus in Basel in 1543. It contains
description of the structure of the human
body as he had himself seen. The Artist
Johann Stephen Van Calcar, a countryman
of his, made all the illustrations in this book.
This book ‘ Fabrica Humani Corporis' is
the beginning not only of modern Anatomy,
but of modern medicine as well. It was a
great landmark in the history of medicine.
The subsequent history of Vesalius is rather
tragic. His book raised a great storm. After
publication of the Fabrica, Vesalius, who had
already lectured at Bologna and Pisa,
returned to Basel, where he prepared a skeleten, which is still preserved. A number of
editions of this book appeared.
Sylvius, his former teacher, opposed him,
while Realdus Columbus and other Anato
mists also attacked him.
Under these unhappy circumstances, he
left Padua and became Court Physician to
Emperor Charles V at Madrid in 1546, and
subsequently to bis successor Philip II in
1556. Here, he had no opportunity to pursue
his anatomical studies. In 1563, he undertook
a pilgrimage to Jerusalem. On his return
journey, his ship was wrecked at Zante, and
he was stricken by a severe illness, probably
typhoid, and he died in 1564. He was scarecely 50 years old at the time.
The achievements of Vesalius in Anatomy
were truly great. His book De Humani
Corporis Fabrica is a document of the highest
rank in the history of medical science. Vesa
lius occupies a foremost place in the history
of Medicine both as an inaugurator of the
science of Anatomy and also as the founder
with William Harvey of modern medical
science based on facts rather than tradition.
In addition to Andreas Vesalius, there
were some other pioneers, namely Galileo,
William Harvey, Leonardo da Vinci, Thomas
Linacre, Thomas Sydenham and Paracelsus,
who ushered in the new spirit of enquiry in
the field of Medicine. We shall briefly
consider their contributions.
(a) Galileo Galilei (1564-1642)
He was essentially a mathematician. His
influence on medicine was indirect, as he laid
great stress on exact measurement. For
sometime he studied medicine at Pisa, but
after a time he gave this up, and stuck to
astronomy and mathematics. He constructed
the telescope, and also a primitive micros
cope which assumed great importance in the
study of medicine.
William Harvey was greatly influenced by
the experimental spirit practised by Galileo.
(b) William Harvey (1578-1657)
William Harvey was born in Folkstone in
April 1578. He joined Conville and Caius
College, Cambridge in 1593, and obtained
his degree in Arts in 1597. The following
year he left England to study medicine at
Padua, whieh was a great seat of learning in
those days. He spent about 5 years there,
and in 1602 received the degree of Doctorate
Renaissance and the evolution of medicine
of Medicine there. On his return to England,
he was awarded the degree of Doctorate of
Medicine by the-University of Cambridge.
He set up his practice at St. Bartholomew’s
Hospital. He was then developing his ideas,
by actual experiment, regarding the move
ments of the heart and of the blood. In 1621
his book exercitatio Anatomica de Motu Cordis
et Sanguinis in Animali was published. He
attained great fame and favour at the Royal
Court and became physician to King
Charles I. In 1646, he retired into private
practice. In 1651, he published his treatise,
"De Generations Animalium", andon 3rd
June 1667, he died and thus ended a life
remarkable for its achievements and its
effects on further progress of medicine.
excessive charge of blood, unless the
blood should somehow find its way
from the arteries into the veins, and so
return to the right side of the heart; I
began to think whether there might
not be a motion, as it were in a circle.
Now this I afterwards found to be
true; and I finally saw, that the blood
forced by the action of the left
ventricle into the arteries was distribu
ted to the body at large, and its several
parts, in the same manner as it is sent
through the veins and along the vena
cava, and so round to the left ventricle
in the manner already indicated, which
motion we may be allowed to call
circular ”,
His great achievement was the demonstra
tion of the circulation of blood by means of
vivisection and ocular inspection, which he
described in his famous book “ Exercitatio
Anatomica de Motu cordis et Sanquinis in
Animali ” (1628). .He gave a clear conception
of the work of the auricles and ventricles,
with their respective valves. He gave a truer
conception of the pulmonary circulation and
of general circulation than was ever grasped
before. He conjectured that in the tissues
blood passed from arteries into veins. The
existence of capillaries was not known at that
time. This knowledge came subsequently
with the discovery of the microscope. I shall
quote Harvey’s own words:
Harvey’s idea was that blood in the body
moves in a circle. This was confirmed again
and again subsequently by new facts which
were discovered. Harvey says :
“ I frequently and seriously be-thought
me, and long revolved in my mind,
what might be the quantity of blood
which was transmitted, in how short a
time its passage might be effected, and
the like; and not finding it possible
that this could be supplied by the
juices of the ingested aliment without
the veins on the one hand becoming
drained, and the arteries on the other
hand becoming ruptured through the
“ Since all things, both arguments and
ocular demonstration, show “that the
blood passes throughout the lungs and
heart by the action of the ventricles,
and.is sent for distribution to all parts
of the body, where it makes its way
into the veins and pores of the flesh,
and flows by the veins from the
circumference on every side to the
centre, from the lesser to the greater
veins, and is by then finally discharged
into the vena cava and right auricle
of the heart, and this in such. a
quantity or in such a flux and reflux,
thereby the arteries hither by the
veins, as cannot possibly be supplied
by the ingesta, and is much greater
than can be required for mere purposes
of nutrition ; it is absolutely necessary
to conclude that the blood in the
animals body is impelled in a circle,
and is in a state of ceaseless motion,
that this is the act of function which
S. L. Bhatia
6
the heart performs by means of its
pulse ; and that it is the sole and only
lend of the motion and contraction of
the heart”.
The greatest name after Andreas Vesalius
is that of William Harvey. He was a true
scientist. He adopted the scientific method
for his investigations. The work of Vesalius
and Harvey laid the foundation of anatomy
and physiology, and changed the whole basis
of medical science.
(c) Leonardo Da Vinci (1452-1519)
He was one of the greatest artists, who
was a harbinger of the Renaissance. He was
a great genuis who combined in himself the
qualities of an artist and a scientist, includ
ing sculpter, architect, geologist, physicist,
mechanical engineer and a biologist. It is
said, that “ his was the grandest effort ever
made by any man to explore and interpret the
universe ”. He was the initiator of the new
era in anatomical and physiological studies.
Leonardo performed many dissections on the
human body. He had a marvellous anatomi
cal technique. He used injections into the
veins, liquid wax in arteries and made gross
serial sections to study structures of the body
and above all drew beautiful diagrams of the
appearances he observed. He studied muscles
and bones, made sections of the brain, traced
the cerebral veins, and other aspects of
anatomy.
Although he showed accomplishment in
the subject of anatomy and wrote down all
that he had done, his work did not attract
much attention at the time.
(d) Thomas Linacre (1460-1524)
Thomas Linacre was born at Canterbury in
1460. He was a Greek scholar. On the
advice of his friend William Tilling of Solbing, he went up to Oxford and joint Canter
bury Hall, afterwards known as Christchurch,
and studied classics. At the age of 24 he
went to Italy and visited Florence, where he
met Lorenzo the magnificent. He then
returned to Oxford and took up the study of
Medicine, so that eventually he became a
great classical scholar and a physician. From
King Henry VIII he obtained letters patent
for the establishment of body of picked
medical men, which later became the Royal
College of Physicians of London. This
College, was empowered to examine and to
issue license to physicians and to decide who
should be allowed to practise medicine in the
City of London and its immediate neighbour
hood. The first president of the Royal
College of Physicians was Thomas Linacre
himself, a very suitable person for that posi
tion. He died in 1524.
(e) Thomas Sydenham (1624-1689)
He was a great clinician, and paid great
attention to the observance of signs and
symptoms of disease. He gives very vivid
descriptions of many ailments, which are as
accurate as those of Hippocrates, In fact he
was a great exponent of the Hippocratic
method. He introduced the use of iron in
cases of anaemia, of cinchona bark from
Peru in Malaria, and of mercury in syphilis.
His appearance at this juncture was very
opportune, when physicians were deeply immersed in various theories and philosophical
speculations.
(f) John Caius (1510-15731
He was one of the founders of Gonville
and Caius College, Cambridge. He went to
Padua to study medicine. After his return to
England from Padua in 1546 he was appoin
ted Reader in Anatomy to the Guild of
Barber-Surgeons, and held this post till 1563
He succeeded Linacre as the President of the
Royal College of Physicians, and also become
Master of Gonville and Caius College,
Cambridge, He was a prolific writer, and
raised the status of the medical profession.
"
1
Renaissance and the evolution of medicine
(g) Paracelsus (1493-1541)
observations on capillary circulation in the
There was increasing tendency during the lungs of the frog. This added the missing
item
in Harvey’s otherwise complete account
Renaissance for the authors to write in their
own language (French, German, English and of circulation of blood. He was also a
pioneer
in the study of embryology and
Italian) then in Latin. This helped to get
men’s minds away from scholasticism and made contributions to the subject of the
development
of the vascular and central
turn them towards realities and facts of life.
There were four great leaders of the 16th nervous systems.
century who helped the advance of medicine,
namely Paracelsus, Vesalius, Harvey and (b) Van Leeuwenhock (1632-1723)
Pare, Paracelsus - (Theophrastus Bombast
He was a Dutchman, who developed the
Von Hohenheim) (1493-1541) was the most microscope and confirmed Malpighi’s obser
original medical thinker of the 16th century. vations in capillary circulation. He demons
He was a native of Switzerland (Finsieldeln, trated the movement of blood corpuscles in
near Zurich) and was the son of a learned their passage through the capillary network
physician, with whom he began to study of a tadpole’s tail. He was an expert in
medicine. He got his doctor’s degree at grinding lenses and his microscope was
Ferrara (1515) and also acquired knowledge superior to any invented so far. From the
of alchemy and astrology from the bishops medical point of view his most important
and abbots. He taught medicine at Freiburg discovery was that of bacteria and protozoa.
and Strasburg (1535). In 1527, he was His observations on micro-organisms link up
appointed Professor of Medicine at Basel. He eventually with the brilliant researches of
was a devoted follower of Hippocrates and Pasteur and ultimately with the bacterio
strong opponent of Galen. It is said, that logical discoveries of the 19th and 20th
he began his campaign of reform by burn centuries. Thus we see that no one in science
ing the work of Galen and Avicenna in a of medicine works alone, isolated, as it were,
bonfire, and lecturing in German out of his from the past and future. We are all consti
own experience. He was a picturesque man. tuents of a team work on a vast scale.
He was one of the alchemists, but he also
enquired into the properties of metals, nature V The Study and Practice of Medicine in the
of drugs, vegetable and mineral, and their
Renaissance
actions as remedies in disease.
During the Renaissance, the study and
IV
The Early Microscopists
The microscope which was first invented
by Galileo was not very effective. But it was
subsequently developed with a compound
system of lenses, and was an invention of the
first magnitude in the progress of medicine.
In this connection, I shall refer to Malpighi
and Van Leeuwenhoek.
(a)
Malpighi (1628-1694)
Marcello Malpighi was a Professor at
Bologna University. He is famous for his
practice of medicine passed steadily from the
hands of the clergy to the lay people. There
was great improvement in the economic and
social position of the physicians. The physi
cians received their education generally in
the Universities. The Universities in Italy
were at the height of their fame in the 16th
century. Of these Padua, was the best, and
attracted students from Germany, England,
Belgium, Holland, Poland, Hungary etc.
Here there was complete religious freedom.
Many famous Europeans, as I have
mentioned, studied at that University, namely
8
Copernicus,
so on.
S. L. Bhatia
William Harvey, Caius and
The teaching in the 16th century was still
of the classic type. They all read Galen and
Avicenna, but new orientations made their
headway. Public dissections were practised,
and gradually the teachers did their own dis
sections instead of asking their barber
assistants, to do it. The first anatomical
theatre was built at Bologna and the second
at Padua by Fabricius. The teaching of
Pathology also began in this century in
Padua.
Military medicine occupied special atten
tion. Military hospitals were established at
several places. The great progress in surgery
in France is due to Ambroise Pare, who was
a Military surgeon. The increased use of
firearms gave an impetus to the development
of surgery.
The physicians during the Renaissance
became scholars. Prior to this in the middle
ages most medical practitioners consulted
astrology. Empiricists, charlatans, barbers
and farriers flourished in Europe. But now
a change took place. Now the great physi
cians were well versed in classical literature
and were humanists and very respected
members of society.
The history of Renaissance is closely
connected with art. Anatomical progress
was undoubtedly to a large extent to the
part played by the artists. I have referred
to the work of Leonardo da Vinci in the
respect. There was also Michaelangelo, who
was a pupil of Realdo Colombo. This
anatomical plates in Vesalius’s book were
drawn by Calcar, who was a pupil of Titian.
Raphael himself was a great student of
anatomy.
VI The Renaissance and Modern Age
Thus we see that in Europe a profound
change took place in the 15th and 16th
centuries, when there was a transition from
the middle ages to modern times. The
Renaissance commenced in Italy and spread
over the continent of Europe. It was a new
spirit, a new desire for knowledge and
progress, which affected every sphere of
life. Unquestioning acceptance of authority,
the authority of the written word, gave way
to criticism and experimental enquiry, and
medical science which had scarcely progres
sed since the days of Hippocrates and Galen
was quickly enriched by new discoveries.
Then there followed centuries of progress
due to the work of reformers, who were
inspired by the spirit of the Renaissance.
Thomas Sydenham in London and Her
mann Boerhaave in Leyden. (Holland) were
great teachers of clinical medicine, who
stressed the need for observation and careful
examination of the sick person more than
anything else. On the surgical side there
were William Chiselden, Percival Pott,
William Hunter and John Hunter. Percus
sion was introduced by Leopold Auenberger,
stethoscope by Laennec, vaccination by
Edward Jenner. The most merciful of all
discoveries was the conquest of pain and
the introduction anaesthetics, so that surgery
became painless.
The discovery of the microscope, as I have
mentioned, marks an important landmark
in the history of medicine. It made the
discovery of micro-organisms possible.
Rudolf Virchow using the same instrument
found, that the human body consisted of
cells; and this revolutionised the science of
pathology. But the greatest scientist of
the 19th century was Louis Pasteur a French
man who was born in 1822. He was not
a physician, but a chemist. He discovered
the true nature of the process offermenta
tion, namely that it was caused by living
organisms. He discovered the nature of
immunity and was the first to cure people
Renaissance and the evolution of medicine
bitten by mad dogs. His influence can be
detected even today. His work on micro
organisms has laid an entirely new founda
tion for the practice of medicine and
surgery and has specially made a great
contribution to preventive medicine. Past
eur died in 1895.
I must also mention the name of Robert
Koch, a German, who was born in 1843.
He discovered the cholera vibrio and the
tubercle bacillus. Another Bacteriologist,
Metchnikoff, a Russian, who came under
the influence of Pasteur, discovered the
body’s natural armous against disease - i. e.
leucocytes of the blood. His theory threw
new light on the nature of the infection.
The credit for applying Pasteur’s discovery
of microbes to the domain of medical
science goes to Joseph Lister, who was born
in 1827. By using carbolic acid as an
antiseptic in Operative Surgery he made
surgery safe. He is rightly known as the
father of antiseptic surgery, which has led
to aseptic surgery in our times. Lister was
a great personal friend of Pasteur. I may
narrate the following incident which is well
worth recording:
The scene was Paris (1892) the occasion
the seventieth birthday of Louis Pasteur.
Amid tumultuous applause France’s greatest
scientist was escorted to the platform by the
President of the Republic. Many were the
orations that followed: and extravagant the
praises; but none of these could have meant
more to Pasteur, than this simple tribute
from an Englishman:
Lord Lister said:
“ Truly there does not exist in the wide
world an individual to whom medical
science owes more than you ”.
It was not the words that mattered, but
the man who spoke them. “The future
asserted Pasteur in uplay will belong to those,
9
who have done most for suffering humanity.
I refer to you, my dear Lister ”. Lord
Lister died in 1912.
VII
Introduction of Modern Medicine in India
This took place as the result of our contact
with the nations of the West. Prior to this
we had the Ayurvedic and Unani systems
of Medicine, as I have already mentioned.
They still prevail.
(a) The Portuguese
For the discovery of the sea route to India,
Vasco da Gama sailed from Portugal on 8th
July 1497. His expedition consisted of 4
ships. After navigating round the Cape of
Good Hope he reached Calicut (in India) on
20th May 1498. This was followed by other
expeditions. In due course the Portuguese
established a hospital at Goa. One out
standing medical personality of the early
days here is Garcia da Orta, who was a
doctor of Medicine of the University of
Alcala and Salamanca, and for sometime
Professor of philosophy in the University of
Lisbon. He came to Goa in 1534 and
practised as a physician there for nearly 30
years. He was a great botanist and wrote a
book on “Conversations about herbs and
drugs”. He diedin 1570. The instruction
in medical science was first started in Goa
in 1687. This continued for many years.
This was probably the first institution in
A.sia, where modern medicine was taught.
It was remodelled by Dr. Lima Leitao in
1819 and eventually became the “ Escola
Medico-Cirurgica ” of Nova Goa in 1842.
It trained doctors not only for Goa but also
for other Portuguese colonies overseas.
(b) The French also established hospitals
in Pondicherry and other colonial possessions.
But the main contribution to the introduc
tion of modern medicine in the entire
country was made by the British.
10
S. L. Bhatia
(c) The British ; The first fleet of the 26th January 1950. The achievements of
East India Company under the command of the Corps since World War II have been
Captain (later Sir James) Lancaster set out very considerable. In 1949 the post of
for the East in December 1600 with four Director General, Armed Forces Medical
ships. Each ship carried “Surgeons Two Services was created as the coordinating
and a Barber
These “ Surgeons Two and head of the Medical Services of the Army,
a Barber” were the pioneers who brought Navy and Air Force.
Western medicine to India. They constitu
Prior to the introduction of modern
ted the origin of what subsequently develo
ped into the Indian Medical Service, to medicine in India, the Ayurvedic and Unani
Systems of medicine were taught and
which I had the honour to belong.
practised. This was the case during the
The history of the I. M S. dates back to Moghul period. During the British regime,
the
spirit of the Renaissance came to India
1612, when it was started by the East India
Company under John Woodall as the first from Europe, and medical research was also
taken
up, and many important contributions
Surgeon General. Under him medical Offi
cers (mainly civilian) were recruited. Subse were made by the workers here. I shall refer
quently when the company found it necessary to one contribution only which will serve as
to maintain a regular body of troops in India an example of what was done.
they commenced employing military surgeons
We in the Tropics are specially intereste
from 1745 onwards. It was not until 1764
that these surgeons were organised into a in tropical diseases, the commonest of whichd
regular establishment of the company’s is malaria, which directly or indirectly has
armies. Thus the Bengal Medical Service been the cause of a large majority of deaths,
was formed in 1764, the Madras Medical as well as disability in these regions. This
Service in 1767, and the Bombay Medical disease was known to the ancients. The cause
Service in 1779, for the three Presidency of malaria is a parasite, which was discovered
armies of Bengal, Madras and Bombay. by Alphonse Laveran in 1878, and it was Sir
The head of the Presidency Medical Services Patrick Manson who propounded a theory,
were called the Head Surgeons, and they that it was conveyed from one human being
controlled the civil and military needs. In to another by the mosquito. But the man,
1825, the post of Inspector Genenral was who actually proved that mosquitoes were
created in Bombay and Madras. In Bengal concerned in this transmission was Ronald
a Physician General was appointed in 1842. Ross, who was born in Almora in India in
In 1857 this post was designated as Director 1857. He was an Officer of the Indian
General. The three medical services were Medical Service, and it was while he was
in due course, combined into one medical posted at Secunderabad in Hyderabad State,
service in April 1896, under the Surgeon and later in Calcutta that he carried out
General to the Government of India. This experiments on mosquitoes and proved that
designation was later changed into Director malaria spread by the bite of anopheline
mosquitoes. This was a discovery of vital
General, I. M. S.
importance. Sir Ronald Ross died in 1932.
The Indian Army Medical Corps which I had the opportunity of seeing him when he
was created by the amalgamation of the came to Cambridge in my student days (1912)
I. M. S., I. M. D., and I. H. C. in 1943 was and gave a lecture on the part played by
redesignated “ Army Medical Corps ” on mosquitoes in the spread of malaria.
Renaissance and the evolution of medicine
11
For further history of modern medicine, I applies to both medicine and surgery.
need not detain you much longer. Medicine Fracastorius introduced new concepts in the
has made great strides in the 19th century, field of epidemic diseases. The establish
but the progress in the first half of the 20th ment of the experimental method by the
scientific work of Galileo and others gave a
century has taken place with a rapidity which new impulse to the naturalistic concept of
was undreamt of before. We should recollcet, the Universe.
that after centuries of guess work, we gained
Finally on making a broad survey of the
in the short period of about 20 last years of
History of Medicine one is remainded of the
the 19th century a fair knowledge of the following
words of Walter Moxon :
precise cause of gonorrhoea (1879), malaria
1878, pneumonia (1880), typhoid (1880),
“ A Golden thread has run throughout
the history of the world, consecutive
Tuberculosis
(1882),
cholera
(1883),
and continuous, the work of the best
diphtheria (1880), Malta fever (1889) and
men in successive ages. From point
other diseases. There is the discovery of
to point it still runs, and when near
X-Ray and Radium, the conquest of Yellow
you feel it as the clear and bright and
searchingly irresistible light, which
Fever, the discovery of Vitamins, Insulin,
Truth throws forth when great minds
Sulphononamides,
Penicillin and other
conceive it. (Walter Moxon, PiloceAntibiotics. In this battle against suffering
reus Senilis and Other papers, 1887,
and disease, workers in all parts of the world
p. 4).
are participating. Medicine in the truest
REFERENCES
sense of the word is becoming universal,
and in this process the World Health Organi Bhatia S. L. — Commemoration Address on the Unity
of Medical Science, delivered on the occasion of
sation and other International bodies are
the Silver Jubilee Celebrations of the Govern
ment College of Indian Medicine, Madras, 20th
making a valuable contribution.
VIII
Concluding Remarks
January 1950.
Bhatia S. L. — History of Medicine with a special
reference to India - An address delivered at the
Government Tibbia College, Hyderabad, 13th
October 1957.
Bhatia S. L. Sir Ronald Ross — Presidential Address
delivered on the occasion of the Ross Cente
nary Celebrations at Hyderabad, 13th October
1957.
In conclusion I may say, that during
Renaissance, enormous progress was madeThere was rapid evolution of medical
thought. The rigid Aristotelian system was
replaced by Neo-Platonism. The scholarship Bhatia S. L. — Greek Medicine in Asia. The Indian
Institute of World Culture, Bangalore (1958).
advanced quickly, especially in the sphere
of observation and experiment. There was Bhatia S. L. — The Renaissance and the Evolution of
Medicine. Armed Forces Medical Journal, 21
a return to the Hippocratic concept of
1 (1964).
disease. At the same time, as the result Castiglioni Arturo — A History of Medicine, Alfred
A. Knoff, New York 1941.
of the work of Leonardo, Vesalius, William
Harvey, Fallopius and Cesalpino, Anatomy Donald McDonald, Surgeons Two and a BarberHistory of Indian Medical Service (1600- 1947)
and Physiology advanced as basic sciences.
Williams Heinemann (1950).
But the most important gift of Renaissance Fisher H. A. L. — A History of Europe - Edward
was that of Humanism, consisting in the
Arnold & Co., London 1932.
study of the patient, his behaviour when Garrison Fielding H. — An Introduction to the
History of Medicine - 4th Edition W. E. Saunders
affected by disease and the investigation of
& Co. Philadelphia and London (1929).
the phenomena of disease by objective
Sir William Bart — The Evolution of Modern
methods, a concept interpreted in its most OslerMedicine,
New Haven, Yale University Press,
(1943).
representative form by Paracelsus. This
HISTORY OF PREVENTIVE & SOCIAL MEDICINE:
The goal of Medicine is to keep Men adjusted to his
environment as a useful member of Society, or to readjust
him as the case may be.
Society sets standards not only for the amount of
knowledge that a physician should possess, but also for
his behaviour, through certain regulations, Further the
society took over certain medical functions, which indivi
dual physicians could not carry out by themaselves. And so,
the sanitation of dwelling places and protection against
epidemic diseases hnssm became administrative functions of
the state. It is found, that with the evolution of Medicine
the field/ of public health widened considerably. This
was the case with the care of tuberculosis, mental and
indigent patients etc. This also gave use to the establish
ment of many hospitals, where indigent patients were treated
free of charge. With the onset of the Industrial Revolution
from the beginning of the 19th Century a number of new
medical problems arose. The workers had to be protected
against new health hazards.
While industry developed,
medicine progressed. As aenry Sigerist, the medical
historian says:"Society has become increasingly aware of the economic
burden of illness. Health conditions have improved tremendously
but we have the knowledge enabling us to improve them still
more. We still have in every country countless cases of
unnecessary illness, and many premature deaths. Social
planning is necessary in the medical field just as much as
in other human activities" In the ancient das days medicine was closely related
to religion. Most ancient religious, demanded that when a
man enters a temple he should be clean. Although the clean
liness was taken in a spiritual sense, it had great hygienic
influences. These precepts are very clearly defined in
Leviticus, as part of the old Testament.
Uncleanliness was considered contagious. By touching
an unclean person one becomes impure one's self. Even a
woman during her menstrual periods and child birth was con
sidered unclean. When in the middle ages leprosy became
widespread, and the physicians were unable to control it,
it was the Church that fought the disease by applying the
rules a laid down in Leviticus. Lepers were isolated every
where. The same method of prevention was employed, when
plague broke out.
... 2 /
2
Thus it was through religions ordinances that Preventive Medicine
had its commencement.
Hygiene in Ancient days
Sven in the Early days, Sushrita emphasised the importance
of cleanliness of both body and spirit.
The disinfecting
virtues of water were fully realized.
Outbreaks of epidemic
diseases have been attributed to unpleasant seasons, to the
floating of minute unpleasant,poisonous particles in the air
and to the unrighteous conduct of people - Earthquakes, famines
etc. were described by Sushrita as the usual precursors of danger
ous epidemics such as plague etc.
The hygiene directlai's as- given in Ayurveda are both a
metter of religion & medicine.According to this they advocated
getting up early in the morning before sunrise, the first duty
is to answer nature's call, then to cleanse one's teeth and to
hefre a bath.
Physical exercise gives activity, strength, good
digestion and reduction of fat.
Suitable diets were prescribed
for different seasons of the year for it was strongly xdXEca±H±
advised that for reasons of health one should suitably adjust
oneself to the change of climate by appropriate diet, sleep,
work etc.
Even the people of the ancient Indus Valley Civilization
had the same idea of essential hygienic requirements in dwelling
houses.
As the excavations of Lothal show the houses had paved
baths connected with brick paved drains.
The drains were built
to carry sewage.
Later soakage pits were provided..
The pits
had holes at the bottom to soak away the water while the solids
sewage was collected and removed to prevent blockage of the drains.
The Egyptians, also showed progress in the realm of Public
Health.- They built planned cities, public baths, and underground
drainage systems.
Egyptian Medicine occupied a dominant place
in the ancient world for about 2500 years when it was replaced
by greek Medicine.
The Greeks made a great confctibution to the intorduction
of Hygiene.
Health then was regarded as the highest good and
their ideal man was the harmonious man; who was perfectly
balanced, both bodily and mentally.
They placed great
emphasis on trest, diet, graduated exerices and baths in treating
disease rather than on undue medication.
The greatest
...3/-
3
Greek physician was Hippocrates eften described as the Father of
Medicine.
He stressed the importance of Preventive Medicine as
distinct from curative medicine.
His book Air, water and placed
is considered a masterpiece for he stressed the importance of the
environment on the health of the country.
But it was due to the Romans that public health was developed.
Although they
their Medicine mainly from the Greeks
after conquering them, they were a more practical minded people
than the greeks. They made fine roads throughout the empire and
passed laws that the dead should be buried outside the town.
Water was brought to Rome by means of aqueducts - They estab
lished public baths and every house had its own water cistern.
was an axzxfcxfliing outstanding physician of the time and
contributed much to eur understanding of epidemics. He observed
that disease was due to 3 factors - predisposing factors, existing
factors, and environmental factors, a truly modern idea.With the
onset of the Rennaissance, there was great revival of the ancient
greek ideals. The hygenic conditions during the middle ages
was appalling. There were epidemics of plague, small pox,
diphtheria etc. During the 18th Century a change took place,
and hygien&K was greatly Improved. These improvements were due
to the change in political conditions, and the philosophy of time
which resulted in the French Revolution.
It was during this time that important advances were made.
James
prevention ofScuvey, and Edward Jenner's prevention of
small pox revolutionised the concept of preventive medicine’.
A new era was born, an era of specific disease prevention.
Ramazzini early in the 18th century inaugurated the study of
occupational diseases and became the father of occupational
medicine , while Mendel f founded the science of genetics.
Health problem due to Industralization•
In t he beginning of the 19th century there was the onset
of the Industrial revolution. Health conditions were very
unsatisfactory. When Cholera broke out in thsxiS 1830, there
was awakening of public conscience and a great demand for
improving sanitary conditions - A commission was established
in England in 1843 to study the sanitary conditions of the
country and this led to the introduction of the Public Health
Act of 1848. From England, the Hygienci movement spread all
over the world.
... 4 /
4
International Health;
The
of the International Health work may be
traced back to the 14th century, where seaports in the
Adriatic introduced first quarantine as a protection
against plague imported by ships. Venice set up a
quarantine station called a Lazarette at the beginning of
the 15th Century. Soon other countries followed suit.
This practice caused many inconveneinces.
In 1851 an International Sanitary Conference was
held in Paris and it was at this time that an International
Industrial Exhibition was organised in London. It was shown
that although much industrial progress had been made,
people lived under most unsanitary conditions. Thus the
Confirence in Paris commenced a new Era in promoting
International Health conditions. Several medical Associations
were formed and the First International Medical Congress
was held in Paris in 1867 when Listers work on Antisepsis
was announced.
It was the beginning of the 20th century in 1903
which marked the turning point in the Scientific study of
the epidemic diseases like Cholera, Plague, yellowfever etc.
It was at this time that it became clear that thex country
has a direct responsibility for the health
of the individual.
Mother and child health services were initiated, School
health services were developed concurrently gradually the
idea grew that every healthy individual was a community asset
and every sick person a community liability.
The health organisation of the League of Nation
was established in 1923 and in 1948 it was replaced by the
WHO. These organisations were mainly responsible with the
task of helping countries with information, technical skill
and assisting of the national staff in dealing effectively
with the health problems of the country. Help to erradicate
small pox, tuberculosis, Malaria etc was also given.
Growth of Preventive Medicine:
In the 18th century two discoveries marked the beginning
of a new era, the era of disease prevention by specific
measures a naval officer who advocated
the intake of fresh fruits and vegetables for the prevention
of Survey in 1753 and Edward Jenner who discovered vacination
against small pox 1796.
..
5 /
5
The discoveries of Louis Pasteur and Robert Koch
laid the foundation of Preventive Medicine - Pasteur1 s
work led Lister to his great discovery of Antisepsis During the 19th and early 20th century disease agents
were discovered ene after another in rapid succession.
The ' Germs' theory of disease was firmly established and
Medicine shed the rags of superstition and speculation
once and for all having put on the shining robes of
scientific knowledge. In the wake of these discoveries,
the concept of disease prevention by specific measures
gained momentum. Pasteur's discovery of antirabies vacine
led others to undertake research in innumology - Anti
diphtheria and anti-tetanus sera were soon perfected.
During jua World War I, ALmoth Wright's antityphoid vaccine
was found to be very effective. Soon a number of
other
prophylactic vaccines were discovered.
Preventive Medicine did not confine itself to
vaccines and sera. Discoveries infck the field of nutrition,
the role of vitamins, minerals, proteins and other nutrients
in the prevention of disease and promotion of health
came to be recognised between the 2 World Wars.
In the 1950's the concept of primary and secondary
prevention came into existence. In the meantime the
discovery of sujphan amides, antibiotics, insectisides,
etc have all enriched preventive medicine. Sulphanamides
and antibiotics have cut down the mortality roles of many
infectious diseases. The knowledge of insectisides has
brought about fundamental changes in the control of
borne diseases.
The concept of disease prevention gave birth to
a new concept of disease eradication and today we no longer
talk of prevention but of eradication of Malaria, Small
pox etc.
Preventive Medicine is now taking into its field
degenerative, neoplastic and metabolic diseases, industrial
accidents and disabilities, mental illness and genetic
diseases. There are no specific weapons against these
diseases and so preventive medicine now relies heavily
on periodic health exams, routine' clinical exams,
screening tests and health education of the people.
... 6 /
-
6
-
Preventive Medicine k is currently faced with
the problem of "Population explosion", a problem of its
own creation owing to the successful control and for
eradication of many communicable diseases and improvements
in the standards of
, Family Planning hitherto
considered immoral and inreligious, gained recognition
as a Family Welfare Programme, and an essential community
health service. Juring 1960-70 many countries liberalized
their abortion laws.
Socialization of Medicine
Over the years Medicine has developed into a trade,
sometimes a bad trade purchased by the patient and sold
by the Physician - with the new scientific discoveries,
Medicine has become highly specialized and the cost of
medical care has increased more rapidly than the purchasing
power of the people. Charitable institutions have played a mafc
notable role in providing medical care to the poor.
Socialization of Medicine was thought to be the right
method of providing adequate health facilities to all.
Germany was the first to institute compulsory sick
ness insurance in 1883. This was not complete social
ization of Medicine but a start in that direction. Russia
was the first to socialize medicine and give its citizens
a constitutional right to all heath services.Great Britian
passed a National Health act in 1946. In India the
Smployees State Insurance Scheme (1948 ) is a step towards
socialization of Medicine.
Socialism treats Medicine as public service and
so from a private ownership medicine is becoming a social
institution.
The scope of Medicine has broadened considerably
in recent years and the terms Public Health, Preventive
and Social Medicine are slowly being replaced by the
term Community Medicine which deals not with individuals
but the health needs of the entire community.
8/4/74
Dept, of Preventive & Social Medicin
St. JOHN'S MEDICAL COLLEGE
BANGALORE-34.
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RENAISSANCE AND THE. EVOLUTION OF MEDICINE
SILVER JUBILEE ORATION DELIVERED
BY MAJOR GENERAL S.L.BHATIA, IMS (RETD)
ON THE OCCASION OF
THE SILVER JUBILEE CELEBRATIONS
OF THE INDIAN ASSOCIATION OF HISTORY OF MEDICINE
AT MADRAS MEDICAL COLLEGE
ON FRIDAY THE 16TH FEBRUARY 1973
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RENAISSANCE AND THE EV COTTON OF MEDICINE
I consider it a great honour to have heen invited'to deliver
the Silver Jubilee Oration on the occasion of the Silver Jubilee
Celebrations of the Indian Association of the History of Medicine
here in Madras. I am sincerely grateful for this. It is .a great
pleasure to me to be with you all and to meet so many old friends.
At the outset may I say, that on behalf of the Association of
History of Medicine, Bangalore, as its President, I have great
pleasure to convey to you, our sincere greetings on this auspicious
occasion. We offer hearty congratulations to you pH for the
excellent work done, and" pray, that God may grant you all the
best of luck and success in the task that lies, ahead.
I have selected the subject of "the Renaissance and the
Evolution of Medicine" for the Oration, as I thought that on this
historic occasion, a subject of that sort would be- appropriate.
During the period 1500 to 1700 A.D. a change took place in
Europe, which devides the medieval from modern times. It is
called the Renaissance, It was a gradual change. An atmosphere,
which was hostile to free enquiry, gave place to one in which
science could live and flourish. During the early middle ages,
the church was the sole .repository of culture . At that time the
greatest need of the European society was spiritual uplift,
rather than intellectual development. Tinder the circumstances,
the Christian church with its spiritual appeal made a wonderful
contribution. The growth of the chfistian virtue of compassion
towards the-sick and suffering led to new departures in Medicine,
particularly in nursing the sick, and erecting hospitals for
their care and. treatment. There was, however, absolute suppre
ssion of experimental science and independent enquiry.
The influence of Renaissance has been described by Castiglioni, the medical historian, in the following words
"In this marvellous period of Renaissance
*
which marks
the return to the ancient doncepts of Hellenism, in .
Philosophy as in Art, in Medicine, as in literaturej
vivid sparks emerged from the forge in which the new
forces of the world were being tempered. Disencumbered
from tle rigid structure of scholasticism, the horizon
revealed the striking profile of the new science,
founded on the free, critical and individualistic,
philosophy of Hippocra.tes, and nourished by the new
investigations and gifted observations of the men of
the Renaissance, guided no less by ancient traditions
than by the firn desire to engrave deeply their own
record in the pages of History".
The 16th Century may be regarded roughly as the first
stage when a change was noticeable, although some indication
of the change had occurred in the previous century. The close
interrogation of nature which was to lead, to t^e development
of modern science had be^un. Painters examined the human frame,
and surgeons dissected it. Verrochi, the Sculptor was also an
Anatomist. The discovery made by Copernicus, a Polish Astronomer
that the earth revolved round the sun, steadily grained adherents.
A new culture, lay in its outlook and aristocratic in origin,
for it chiefly grew in the courts of Itallian fullers, spread
widely through the invention of printing. As Professor H.A.L.
Fisherr the Oxford Historian, says:
2
"During the Renaissance, Europe turned away from the
vast literature of commentaries and glosses which
the pedants of the later middle ares had incribed
in lette 's of opium on tablets of lead".
There was a spirit of adventure abroad. The Portuguese conquered Ceuta on the African coast in 1415, and then Vasop da
Gama set sail on 8th July 1497 and by circumnavigation of Africa
arrived at.Calicut in India on 20th May 1498. Christopher
Columbus, the Genoese sailor, discovered in 1492 the new world
beyond the. Atlantic. The Mediteranean ceased to be the centre
of ci•. iliac--’ world. By degrees Europe began to enter into the
new phase of its existence, whch is distinguished by the esta
blishment of colonies and -entires beyond the ocean, and by
the gradual spread of European culture and influence throughout
the habitable globe. In this adventure at first Portugal and
Spain, and then the Netherlands, France and England took an
active part.
The discovery of the now world coinciding with the
printing, taught, that 'Truth' as Roger Bacon said, "is the
daughter not of. authority, but of tine". Thus mankind acquired a
new attitude towards knowledge. Authority no lonre7' wont un
challenged. The past was no longer supreme and generations
grew up, for whom 'Truth'.was not necessarily all that was
riven in ancient books, but.something which should-be ascertained
by direct objective .study and observation.
Under such circumstances, when Europe was kindled by new
knowledge, and new outlook, there came Protestant Reformation.
This was a challenge to the Roman Church. As a result of this,
a religion widely held and strongly entrenched in the social
and political tradition of Western Europe was challenged by new
spiritual force’s, and over a large part of Europe it was compe
lled to accept defeat. Views of life based on freedom of thought
and upon the right of the individual.conscience came into
prominence, which in the long run transformed the institutions of
Europe and shaped the life of the modern world. Never was the
human mind so widely and sensibly affected as in the 17th and
18th centuries as the result of the Renaissance.
From the point of- view of Evolution of Medicine, the
period which is of the gr- otc-st interest to us in the mi-’die
of the 16th century. It was 'then, that the Medici, who stood
close to the people and understood their needs, were established
ia Florence. The Protestant. Reformation was steadily spreading.
Martin Luther was preaching--hsi doctrines. The Art was flouri
shing. The artists like Raphael, Michael Angelo an’. Titian were
infus ng the new spirit. The new learning was everywhere working
like leaven. The old Universities wore expandin'
*
.-.nd new ones
were springing up everywhere. Nicholas Copernicus had laboured
hard to study the ancient science of Astronomy. The art of
printing was steadily contributin'- its share of pouring forth
the means of knowledge.
The Renaissance’ produced the double phenomenon of a return
to the classic past, and revival- of the dignity of the indivi
duality of the human being, in addition to the’critical spirit
springing up in the Arts, Science and literature. There • was a
desire f-c-r the freedom of thought an'3 expression.
The Christian view point, which considered disease as the
punishment for sin, gave way to the old Hellenic conception
according to which disease is a disharmony in the body, which
3
3
nature should cure. The sentiment which made it a sacrilege to
dissect dead bodies, as they were considered impure, gave place
to the thought that by the actual study of the human body itself
could one know its perfect beauty . So there was intensive study
of it.
This renaissance appeared in different ways in different
countries. In Germany aiid the North, Luther and Paracelsus .
appeared on the scene. In Italy it was pivoted on men like
Machiavelli and Guicciardini, profound historians and politicians
of the age. In medicine, it was in Anatomy that the revolution was
brought about by Andreas Vesalius. The University of Padua was
closely associated with it.
(1)
ANDREAS VESALIUS (1514-1564)
It was under such circumstances, that in the year 1543,
the printing press of J.Oporinus in Basel published a book
"Fabrica Human! Corporis", the structure of the Human body, by
Andreas Vesalius, which has been described by Sir William. Osler
as 1 'The greatest book ever printed from which ricUern medicine
dates". It served as the bp.si° of Medical teaching for centuries
afterwards.
Who was Andreas Vesalius? He was a Belgian born at
Brussels in 1514.. His father was apothecary to Charles V. His
mother was probably of English extraction. When still young,
he was interested in Anatomy and dissected animals like mice,
rats, cats and dogs. The young Vesalius went to school at
Louvain and afterwards entered the University there. In 1533 he
went to study medicine at Paris. Here he worked under two eminent
teachers, namely Jacobus Sylvius and John Guinterious of
Andemach. Sylvius at that time had already achieved great
reputation, and drew students from all parts of Europe. The
teaching of Sylvius, however, still chiefly consisted of reading
of the books of Galen. Ocassionally the body of a dog or a
corpse from the hospital was brought into the lecture room, and
barber attendants were employed to dissect then for demonstration
to the students. Sylvius himself did not do the dissection.
Vesalius was not satisfied with this; and one day, he put the
ignorant barbers on the one side and himself completed the
dissection.
He says:-
"My study of Anatomy would never have succeeded,
had I when working at medicine at Pa^is been
willing that the Viscera should be merely shown
to me and to my fellow students at one or another
public dissection by wholly unskillcl barbers,
and that in the most superficial way. I had to
put py hand to the business".
Vesalius assisted. Guinterious in preparing his book
Institutions Anatomicac.
In those days, complete dissection of the human body
was impossible, as it was prohibited by the Church. Vesalius
used to visit the burial ground attached to the Church.of
Innocents in Paris, and there he studied bones of the human
body for many hours. He also went with another fellow student
to another burial ground on what is now "Les Buutc.s Chaumont"
to study the bones.
4
After three years he went fron Paris back: to Louvain,
where -he continued to study xAnatomy. In 1537 he went to Venice
and the sane years he was', given the'Doctorate ;of Medicine by the
University of Padua. Padua'was an enlightened scat of learning
and it was here that Galileo Galilei (1564-1642) worked with his
telescope, which he had designed, and. thus laid the foundation
of a new era of experimental scientific studies. -Vesalius was
appointed Professor of Anatomy and Surgery there in 1537, and
was entrusted with the duty of conducting dissections. He began
to teach Anatomy in his own way. He- did dissection with his own
hands, and ultimately taught only what ho could himself see in
the structure of the body of man, and not what Galen had written
*
In Pauda the church was not so strong 'as in Paris or Louvain or
in Spain. Here he was able to get dead bodies for dissection.
In 1542 aftc-r 5 years hard 'work,’'he wrote ’Fabrica Hum.ani Cor
poris' (Structure of the Hunan Body) illustrate-’, with many
diagrams, which was published by Oporinus in Basel in 1543. It
contains description of the structure of the human body as he
had himself seen. The Artist Johann Stephen van Calcar, a
countryman of his, made all the■illustrations in this book.
This b^ok 'Fabrica Human! Corporis' is the- beginning
not only of modern Anatomy, but of modern medicine as well.
It was a great landmark in the history of medicine. The subse
quent history-of Veaslius is rather tragic. His book raised
a great storm. After publication of the Fabrica, Vesalius, who
had already lectured at Bologna and Pisa, returned to Basel,
where he prepared a skeleton, which is still preserved. A
number of editions’ of this book appeared.
Sylvius, his former teacher, opposed him, while Realdus
Columbus and other Anatomists also attacked him'. .Under these unhappy circumstances, he left Padua and
became C-urt Physician to Emperor Charles V at Madrid in 1546,
and subsequently to his success or Philip II in 1556. Here, he
had no opportunity to pursue his anatomical studies. In 1563,
he undertook a pilgrimage to Jerusalem. On his return j’urney,
his ship was wrecked at Zante, and he was stricken by a severe
illness, probably typhoid, and he died in 1564. He was scarecely
50 years old at the time.
The achievements of Vesalius in Anatomy wore truly great.
His book De Human! Corporis Fabrica, is a dccur.-: nt of the highest
rank in the history of medical science. Vesalius occupies a fore
most place in the history of Medicine both as an inaugur'■tor
of the science of Anatomy and also as the founder with William
Harvey of modern Medical Science based on facts rather than
tradition.
In addition to Andreas Vesalius, there were some other
pioneers, namely Galileo, William Harvey, Leonaro da Vinci,
Thomas Linacre, Thomas Sydenham and Paracelsus, who ushered
in the new spirit of enquiry in the field of Medicine. We shall
briefly consider their contributions.
(a)
GALLILEO GALILEI (1564-1642)
He was essentially a Mathematician. His influence on
Medicine was indirect, as he laid great stress on exact measure
ment. For sometime he studied Medicine 'at Pisa, but after a time
he gave this up, and stuck to Astronomy and-Mathematics. He con
structed Telescope, and also a primitive microscope which achie
ved great importance in the study of medicine.
5
William Harvey was greatly influenced by the experimental
spirit practised by Galileo,
(b)
WILLIAM HARVEY (1578-1657.1
William Harvey was born in Folkstone in April 1578. He
joined Conville and Caius College, Cambridge in 1593, and obtained.
his degree in Arts in 1597. The following year ho left England
to study medicine at Padva, which was a great seat of learning
in those days. He spent about 5 years there, and in 1602 received
the degree of Doctorate of Medicine there. On his return to
England, he was awarded the degree of Doctorate of Medicine by
the University of Cambridge. He set up his practice at St.Bartho
lomew's Hospital. He was then developing his ideas, by actual
experiment, regarding the movements of the heart and of the
blood. In 1628 his book cxerdtatio Anatomic a de Metu Crodis at
Saneuinis in Anima11 was published. He attained great fane and
favour at the Royal Court and became physician to King Charless
I. In 1646, he retired into private practice. In 1651,he publi
shed his treatise, "De Generations Aniraalium", and on 3rd June
1667, he died -nd thus ended a life remarkable for its achievements
and its effects on further progress of medicine.
His great achievement was the demonstration of the circu- •
lati-n of bloo'1 by means of vivisection and ocular inspection,
which he described in his famous bonk "Exercitatio Anatomies
de Motu Cordis et Sanguinis in Animali" (1628). He-gave a clear
conception of the work of the auricles and ventricles, with their
respective valves. He gave a truer conception of the pulmonary
circulation and of general circulation than was ever grasped
before. He conjectured that in the tissues blood passed from
Arteries into Veins. The existence; of capillaries was not knnwn
at that time. This knowledge cane subsequently with the discovery
of the microscope. I shall quote Harvey's own words;
"I frequently and seriously bo-thourht me, and long
revolved in my mih'1, what might bo the quantity of blood
which was transmitted, in how short a time its passage
might be effected, and the like; an'1 not finding it
possible that this could be supplied by the juices of
the ingested aliment without the veins on the one hand
becoming drained, an” the- arteries on the other band
becoming ruptured through the excessive charge of blood,
unless the blood shoal" qromehow find its way from the
arteries into the veins, and so return to the right side
of the heart; I began to think whether there might not
be a notion, as it were, in a circle. Now this I after
wards found tn be true; and I finally saw, that the blood
forced by the action of the left ventricle into the
art: rios was distributed to the body at large- , an/ its
several parts, in the- same manner as it is sent’through
the veins and alon.” the. vena cava, and so rb-und to the
left ventricle in the manner already indicated, which
motion we may be allowed to call circular".
Harvey's idea was that blood in the body moves in a circle.
This was confirmed again and again subsequently by now facts
which were discovered. Harvey Says:
"Since all things, both arguments and ocular demonstration,
show "that the blood passes throughput the lungs an'1
heart by the action of the ventricles, and is sent for
distribution to all parts of the.body, where it-makes
6
its way into the veins and pores of the flesh, and flows
by the’veins from the circumference on every side to the
centre, from the lessor to the greater veins, and is by
then finally discharged into the Vena Cava and right
auricle of the heart, and this in such a Quantity pr in
such a flux and reflux, there by the arteries hither, by
the veins, as cannot possibly bo supplied by the ingesta,
and is much greater then can be- required for merepurposes of nutrition; it is absolutely necessary to
conclude that the blood in the animalh body is impelled
in a circle, and is in a state of ceaseless motion, that
this is the act. of function which the heart performs by
means of its pulse; and that it is the sole and only
tl.-/ motion end contraction of the. heart".
The .greatest name after Andreas Vesalius is that of William
Harvey, He was a true scientist. He adopted the scientific method
for his investigations. The work of Vesalius and Harvey laid the
foundation of Anatomy and Physiology, and changed the whole basis
of medical science.
(d)
LEONARDO DA VINCI (1452-1519)
He was one. of the greatest Artists, who was a harbinger of
the Renaissance. He was a great genius who combined in himself
rhe qualities of an Artist and a: scientist, including sculptor,
architect, geologist, physicist, mechanical engineer and a bio
logist. It is said, that "his was.the grandest effort ever made
by any man to explore, and interpret the? universe". Ho was the
initiator of the new era in anatomical and physiological studies.
Leonardo performed many dissections on the human body. He had a
marvellous anatomical technique. He used injections into the
veins, liquid wax- in arteries and.made gross serial sections to
study structures of the body and above all drew beautiful diagrama
of the apnearances be observed. He studied muscles and bones.
made sections of the brain, traced the cerebral veins, and other
aspects of Anatomy.
Although he showed accomplishment in the subject of Anatomy
and wrote down all that he had done, his work did' not attract
much attention at the time.
(e)
THOMAS LINACRE (1460-1524)
Thomas Linacre was bom at Canterbury in 1460. He was a
Greek scholar. pn the advice of his friend William Tilling of
Seining, he went up to Oxford and. joined Canterbury Hall, after
wards known as■Christchurch, and studied classics. At the age of
24 he went to Italy and. visited Florence, where he met Lorenzo
the Magnificient. He then returned to Oxford and took up the
study of Medicine, so that eventually he became a great classical
scholar and ? physician. From Kinr Henry VIII he obtained letters
patent for the establishment of body of picked medical men, which
later became the Royal College of Physicians of London. This
College, was empowered to examine and-to issue license to
physicians and to decide who should be allowed to practice
medicine in the- City of London and its immediate neighbourhood.
The first President of tt i Royal College of Physicians was
Thoms Linacre himself, a verv ?”itable person for that position.
He died in 1524.
.7
7
(f)
THOMAS SYDENHAM (1624-1689)
He was a great clinician, and paid great attention to the
observance of signs and symptoms of disease. He gives very vivid
descriptions of many ailments, which are as accurate as those of
■Hippocrates. In fact he was a great exponent of the Hippocratics
method. He introduced the use of iron in cases of Anaemia, of
Cinchona bark from Peru in Malaria, and of Mercury in Syphilis.
His appearance at this juncture was very opportune, when physici
ans wore deeply immersed in various theories and philosophical
speculations.
(?) JOHi'i CAITTS (1510-1573')
He was one of the founders of Gonville and 'Gaius Cellerc,
Cambridge. He went to Padua to study medicine. After his return
to England from Padua in 1546 he was appointed Reader in Anatomy
to the Guild of Barber-Surgeons, and held this post till 1563.
He succeeded Linacre as the President of the Royal 'College of
Physicians, and also become Master of Gonville and Calus College,
Cambridge. He was a prolific writer, and raised the status of
the Medical profession.
(h) PARACELSTTS (1493-1541)
There was increasing tendency during the Renaissance for
the authors to write in their own’ language (French, German-,
English air" Italian) then in Latin. This~'helped to ret men's
minds away from scholasticism and turn then towards realities
and facts of life. There were four great leaders of the 16th
century who helped the advance of medicine, namely Paracelsus,
Vesalius, Harvey and Pare, Paracelsus - (Theophrastus Bombast
Von Hohenheim.) (1493-1541) was the most original medical thinker
of the 16th century. He was .a. native of Switzerland (Finsieldeln,
near Zurich) and-was the son .of a learned physician, with whom
he began to study medicine. He got his doctor's degree at Ferrara
(1515) and also acquired knowledge of alchemy and astrology from
the bishops an-1 abbots. He taurh't medicine at Freiburg and
Strassburg (1535). In 1527, he was appointed Professor of Me-dicine
at Basel. He was a devoted follower of Hippocrates and strong
opponent of Galen. It is said, that he began his campaign of
reform by burning the works of p-alen and Avicenna, in a bonfire,
and lecturing in Gorman out of his own experience. He was a
picturesque man. He was.one of the alchemists, but he also
enquired into the properties of metals, nature of drugs, vegetable
and mineral, and their actions as remedies in disease.
IV. THE EARLY MICROSCOPISTS
The Microscope which was first invented by Galileo -was
not very effective. But it was subsequently developed with a
compound system of lenses, and yas an invention of the first
magnitude in the progress of medicine. In this connection,
I shall refer to Malpighi and Van Leeuwenhoek.
(a) MALPIGHI (1628-1694)
Marello Malpighi was a Professor at Bologna University.
He is famous for his observations on capillary circulation in
the lunms of the frog. This added the missing item in Harvey's
otherwise complete account of circulation of blood. He was also
a oioneer in the study of Embroyolory and made contributions to
the subject of tht development of the vascular and central nervous
systems.
8
8
(b) VAN LEEUWRNHOCK (1632-1723)
He was a Dutchman, who developed the Microscope and
confirmed Malpighi’s observations in capillary circulation. He
demonstr ted the movement of blood'corpuscles'in their passage
through the; capillary network of a tadpole's tail. He was an
expert in grinding lenses and his microscope was superior to
any invented so far. From the medical Point of view his most
important discovery was that of bacteria and protozoa. His obser
vations on Micro-Organism. link up eventually with the brilliant
researches of Pasteur an1’ ultimately with the bacteriological
'■’iscoveries of the 19th and 20th centuries. Thus we see that no
one in science of medicine works alone, isolated, as it were,
from the past and the future. We are all constituents of a
team work on a vast scale.
V • THS STUDY AND PRACTICE QF MEDICINE IN THE RENAISSANCEDurin" the Renaissance, the study and practice of medicine
passed steadily from the hands of the clergy to the lay people.
There w-s great improvement in the economic and social’position
of the physicians. The physicians received their education genera
lly in the Universities. The Universities in Italy were at the
height of their fane in the 16th century. Off these, Padua was the
best., and attracted students from Germany, England, Belgium,
Holla, d, Poland, Hungary etc. Here there was complete rcli"ious
freedom. Many famous Europeans as I have mentioned, studied at
that University, namely Copernicus, William Harvey, Gaius and so
on..
The teaching in the 16th century was still of the classic
type. They all read Galen and Avicenna, but new orientations made
their headway. Public dissections were practised, and .gradually
the teachers did their own dissections instead of asking their
barber assistants, to do it. The first Anatomical Theatre w-s
built at Bolorna and the second a Padua by Fabricios. The teaching
of Pathology also began in this century in Padua.
Military Medicine occupied special attention. Military
Hospitals were establish^ d at
several
*
places. The great progress
in surgery .in France- is due to Ambroise Pare, who was a Military
Surgeon. The increased use of firearms gave an impetus to the
development of surgery.
The Physicians during the Renaissance became scholars.
Prior to this in the middle ages most medical practitioners
consulted Astrology. Empiricists, Charlatans, Barbers and Farriers
flourished in Europe. But now a change took-place. Now the great
physicians were well versed in classical literature and were
Humanists and very respected members of society.
The history of Renaissance is closely connected with Art.
Anatomical progress was undoubtedly due to a large extent to thepart played by the Artists. I have
*
referred to the work of
Leonardo da Vinci in this respect. There was also Michao-lanrelo,
who was a pupil of Realdo Colombo. The anatomical plates in
Vesalius's book were l.rr.wn by Calcar, who was a pupil of Titian.
Raphael-himself was a great student of Anatomy.
VI. THE RENI AxSS Axil CH AND MODERN AGE
Thus we see that in Europe e profound change took place
in the 15th and 16th centuries,” when
there
*
was a transition from
the Middle Ages to Modem times. The Renaissance commenced in
Italy and spread over the continent of Europe. It was a new
spirit, a new desire for knowledge and progress, which affected
every sphere of life. Unquestioning acceptance of authority, the
authority of the written world, save way to criticism an
* 1 experi
mental enquiry, and Medical Science which had scarcely progress©
since the days of Hippocrates and Galen was quickly enriched
by new discoveries. ■
Then there followed centuries of progress due to the work
of reformers, who were inspired by the spirit of the Renaissance
Thomas Sydenham in London and Hermann Soc-rhaavc in Leyden
(Holland) were great teachers of clinical medicine, who stressed
the need for observation and careful examination of the sick
person more than anythin? else. On the surgical side there were
William Chiselden, Percival Pott, William Hunter and John Hunter
Percussion was introduced by Leopold Auenbcrrer, Stethoscope by
Laennec, Vaccination by Edward Jenner. The most merciful of all
discoveries was the conquest of pain and the introduction
Anaesthetics, so that surgery became painless.
The discovery of the microscope, as I have mentioned,
marks an important landmark in the history of medicine. It made
the discovery of micro-organisms possible. Rudolf Virchow using
the same instrument found, that the human body consisted of
cells? and this revolutionise
*
1 the Science of
* Pathology. But
the greatest scientist of the 19th century was Louis Pasteur,
a Frenchman who was born in 1822. Ho was not a physician, but
a chemist. He discovered the true nature of the'process of
fermentation, namely-that it was caused by living organisms. He
discovered the nature of immunity and was the first to cure
people bitten by mad dogs. His influence can be detected even
today. His work on microorganisms has laid an entirely new
foundation for the practice of Medicine and Surgery and has
specially made a groat contribution to Preventive Medicine.
Pasteur died in 1895.
I must also mention the name of Robert Koch, a German, who
was born in 1843. He discovered the Cholera Vibrio and the
Tubercle Bacillus. Another Bacteriologist, Metchnikoff, a Russia!
who cane under the. influence of Pasteur, discovered the- body's
natural armous against-disease - i.e. Leucocytes of the Blood.
His theory threw now light on the nature- of the infection.
The credit f or-apn lying Pasteur's discovery of microbes to
the domain of Medical Science goes to Joseph Lister, wh
*'
was
born in 1827. By using carbolic acid as an antiseptic in
Operative Surgery he made surgery, safe. He is rightly known
as the- father of Antiseptic Surgery, which has led to aseptic
surgery in opr times. Lister was a great personal friend of
Pasteur. I may narrate the'following incident which is well
worth recording:
The scene.was Paris (1892) the occasion the seventieth
birthday of Louis Pasteur. Amid tumultuous applause France's
greatest scientist was escorted to the platform by the
President of the Republic. Many were the orations that followed:
and extravagant the praises; but none of these could have meant
more to Pasteur, than this simple tribute from an Englishman:
.10
10
Lord Lister said:
"Truly there does .not exist in the wide world an
individual to when medical science owes more than you".
It was hot the words that mattered, but the nan who bplon~ to
those, who have done most for suffering humanity. I refer to you,
m y dear Lister". Lord Lister died in 1912.
VII. INTRODUCTION OF MODERN MEDICINE IN INDIA
This took place as the result of our contact with the nations
of the West..Trior to this we had the Ayurvedic and TTnanp systems
of Medicine, as I have already mentioned. They still prevail.
(a) THE PORTUGUESE
For the discovery of the sea route to India, Vasco da Gama
sailed from Portugal on 8th July 1497. His expedition consisted
of 4 ships. After navigating round the Cape of Good Hope he
reached Calicut (in India) on 20th May 1498. This was followed
by other expeditions.. In due course the Portuguc-se established a
hospital at Goa. One outstanding medical personality of the
early days here is Garcia da Orta, who was a doctor of Medicine
of the University of Alcala and Salamanca, and for sometime
Professor of Philosophy in the University of Lisbon. He came to
Goa in 1534 and practised as a physician there for nearly 30
years. He was a great Botanist and wrote a book on "Conversations
about Herbs and Drugs". He died-in 1570. The instruction in
Medical science was first started in Goa in 1687. This continued
for many years. This was probably the first institution in Asia,
where modern medicine was taught. It was remodelled by Dr.Lima
Leitao in 181-9 and eventually became the "Escola Medico-Cirurgica"
of Novo' Goa in 1842. It. trained doctors not only for Goa but
also for other Portuguese colonies overseas.
(b) The French: also established hospitals in Pondichery and other
colonial possessions. But the main contribution to the introduct
ion of modern medicine in.the entire country was made by the
British.
(c) The British: The first fleet of the East India Company under
the command of Captain (later Sir James) Lancaster set out for
the East in December 1600 with four shins. Each shin carried
"Surgeons Two and a Barbor". These "Surgeons Two and a Barber"
were the pioneers who brought Western medicine to India. They
constituted the origin of what subsequently developed into the
Indian Medical Service, to which I had the honour to belong.
The- history of the I.M.S. dates back to 1612, when it was
started by the- East India Company under John Woodall as the first
Surgeon General. Under him medical Officers (mainly civilian)
were recruited. Subsequently when the company found it necessary
to maintain a regular body of troops in Indi? they commenced
employing Military Surgeons from 1745 onwards. It was not until
1764 that these surgeons were organised, into a regular establish
ment of the company's Armies. Thus the Bengal Medical Service
was formed in 1764, the Madras Medical Service in 1767, and the
Bombay Medical Service in 1779, for the three Presidency Medical
Services were called the Head Surgeons, and they controlled the
civil and military needs. In 1825, the cost of inspector General
was created in Bombay and Madras. In Bengal a Physician General
was appointed in 1842. In 1857 this post was designated as
Director General. The three medical services were in due course,
combined into on
*
medical service in Anril 1896, under the
. ..11
11
Surgeon General to the Government of India. This designation
was later chanced into Director General, I.M.S.
The Indian Armv Medical Corps which was created by the
amalgamation n’f the l'.M.S., I.M.D.", and I.F.C. in 1943 was redesignated "Army Medical Corps" on 26tn January 1950. The achie
vements of the Corps since World War II have' been very- considera
ble. In 1949 the post of Director General Armed Forces Medical
Services w.s created as the .coordinating head of the Medicaffl
Services of the Army, Havy an1 Air Force.
Prior to the introduction of Modern Medicine in India,
the Ayurvedic and TTnani Systems of medicine were taught And
practised. This was the case during the Moghul period. During
the British regime, the spirit of the Renaissance came to India
from Europe, and medical research was also taken up, an"- man?/
important contributions were made by the workers here. I shall
refer to one contribution only whies will serve as an example
of what was done.
We in.the Tropics are specially interested in Tropical
diseases, - the Commonest of which is Malaria, which directly
or indirectly and has been the cause of a large majority of
deaths, as well as disability in these'regions. This disease was
known to the ancients. The cause of Malaria is a narasite, which
was discovered by /Iphonse Laveran in 1878, and it was Sir
Patrick Manson who propounded a theory, that it was conveyed from
one human being to another by the mosquito. But the man, who
actually proved that mosquitoes were concerned in this transmi
ssion was-Ronald Ross, who was born in Almora in India in 1857.
He was an Officer of rhe Indian Medical Service, and it was. while
he was posted at Secunderabad in Hyderabad. State, an"1 later
in Calcutta, that he carried out experiments on mosquitoes and
proved that Malaria spread by the bite of anopheline mosquitoes.
This was a discovery of vital importance. Sir Ronald Ross died
in 1932. I had the o' portunity of seeing him when he cane to
Cambridge in my student days (1912) and gave a lecture on the
part played by mosquitoes in the spread of malaria.
For further history of Modern Medicine, I need not detain
you much longer. Medicine was made great strides in the 19th
century, but the progress in the first half of the 20th century
has taken place with a rapidity which was undreamt of before.
We should recollect, that’after centuries of guess work, we
gained in the short ner.iod of about 20 last years of the 19th
century a fair knowledge of the- precise cause of Gonorrhoea
(1879), Malaria 1878, Pneumonia (18^-0), Typhoid (1880), Tuber
culosis (1882), Cholera (1883), Diphtheria (1880), MaltaTe^er
(1889), and other diseases. There is the discover^ of X-Ray
and Radium, the conquest of Yellow Fever, The discover of
Vitamins, Insulin, Sulphononamides, Pencillin and other
Antibiotics. In this battle against suffering and disease
workers in all parts of the world are participating. Medicine
in the truest sense of the word is becoming universal, and in
this process the World Health Organisation an-’ other International
bodies are making a valuable contribution.
VIII COuCLTTDIrIG REMARKS
In conclusion I -.may say, that during Renaissance,
enormous progress was made. There was ra-id evelution
of
*
medical
thought. The rigid Aristotelian system was replaced bv NeoFlatenism. The scholarship advanced quickly, especially in the
12
sphere of dbs.ervation and experiment. There was 'a return to the
Hippocratic concept of disease. At the same- time, as the result
of tie work of Leonardo, Vasalius, William Harvey, Fallopius
and Ccsalnino, Anatomy and Physiology advanced as basic sciences.
But the most important rift of Renaissance was that of Humanism,
consisting in the study of the patient, his behaviour when
affected by disease and the investiration of the phenomena of
disease by objective methods, a concept interpreted in its most
representative form by Paracelsus. This applies to both medicine
and surgery. Fracastorius introduced new concepts in the field
of 'epidemic diseases. The establishment of the experimental
method by the scientific:work of Galileo and ethers gave a new
impulse to the naturalistic concert of the TTniverse.
Finally on making a broad survey of the History of
Medicine one is remainded of the’ following words of Walter Moxoh?
MA Golden thread has run throughout the history of
the world, consecutive and continuous, the work of
the best men in successive ayes. From point to point
it still runs, an1 when near you feel it as the
clear and bright and searchingly irresistible
light, which Truth throws forth when great minds
conceive it. (Walter Moxon, Pilocereus Senilis and
Other papers, 1287, p.4).
S.L. Bhatia.
REFE FENCES
1. Bhatia S.L. Commemoration Address on the Unity of
Medical Science, delivered on the occasion of the
Silver Jubilee Celebrations of the Government College
of Indian Medicine, Madras on 80th January 1950.
2. Bhatia S.L. History of Medicine with a special
reference to India - An address.delivered at the
Government Tibbia College, Hyderabad (DrJ) on
13th October 1957.
3.
Bhatia S.L. Sir Ronald Ross. Presidential Address
delivcredon the occasion of the Ross (Centenary
Celebrations at Hyderabad (Dn) on 13th October’1957)
4.
Bhatia S.L. (1958 Greek Medicine in Asia-. The Indian
Institute of World Culture, Bangalore.
5.
Bhatia S.L. The Renaissances and the Evolution of
Medicine, Armed Forces Medical Journal Vol XXI No.l (1964).
6.
Castiglioni Arturo - A Historv of Medicine, Alfred
A. Knoff New York 1941.
7.
Donald McDonald. Surgeons T^o and a Barber - History
of Indian Medical Service 1600 - 1947 - Williams
Heine.man (1950).
8.
Fisher H.A.L (1932) A History of Europe - Edward
Arnold & Co., London 1937.
9.
Garrison, Fielding H. (1929) An Introduction to the
History of Medicine - 4th Edition W.E. Saunders 4 Co,
Philadelphia and London.
10.
Osler, Sir William Bart. (1943). The Evolution of Modern
Medicine, New Haven, Yale University Press.
FIVE HISTORICAL
PHARMACIES
>
\ '■
John Bell’s Pharmacy, Oxford Street, London : c.1820
Hispano-Mauresque Pharmacy : c.1790
Italian Pharmacy : Seventeenth Century
English Pharmacy : c.1680
Arab Pharmacy
The Wellcome Historical Medical Museum
The Wellcome Building, Euston Road, London, N.W.l.
Drug Jars, and the various appliances used by the drug-sellers of
former days, have long been fascinating objects to modern collectors
of antiques and of specialised examples of the ceramic art. Even a
single drug jar of choice design and workmanship is an object of
great beauty, and in the Museum gallery may be seen some specially
selected examples. There are, however, very few museums anywhere
in the world where more than one or two examples of the same type
can be seen together. Hence very few people realise the vivid
impression of rich colours which must have been experienced by the
customers who visited the pharmacies in former days. Among the
attractions of the Wellcome Historical Medical Museum are recon
structions of the five historical pharmacies which are described in
this leaflet. Dating from the seventeenth, eighteenth and nineteenth
centuries, they present a fascinating contrast to their modern counter
parts.
ITALIAN PHARMACY: SEVENTEENTH CENTURY
The design of this pharmacy is based on the layout and furnishing
of the Pharmacy of the famous Hospital of the Santo Spirito at
Rome, which is still in use. All the furniture and fittings of the
reconstructed pharmacy are of Italian origin, most of them dating
from the seventeenth century or earlier. The very handsome
pharmacy counter, with its inlaid figures, was made in Italy during
the seventeenth century. The drug jars are products of many famous
Italian maiolica potteries. Although the majority are of seventeenth
century workmanship, some of the most beautiful were made in
the late sixteenth century. A few were probably made in the
eighteenth century, but they follow seventeenth-century designs. The
beautiful figure in the niche in the background should be especially
noted. It is the work of an Italian woodcarver of the sixteenth
century, and represents either the Madonna or, more probably, St.
Catherine of Alexandria.
HISPANO-MAURESQUE PHARMACY: circa 1790
So far as the furnishings and fittings and most of the woodwork
are concerned, this is a genuine Andalusian pharmacy of the end of
the eighteenth century. In 1928 Sir Henry Wellcome purchased the
whole of the woodwork and contents of the Pontes Pharmacy in
Granada. This shop was said to have been continuously used as a
pharmacy since 1492; but not unnaturally changes in the layout
and contents had gradually occurred during the intervening period,
and in 1928 these had been practically unaltered since the close of the
eighteenth century. On the doors of the large cupboard are four
painted representations of Adam, Solomon, Theophrastus (c.
380-287 B.c.), the Greek father of botany, and Dioscorides (1st cent.
a.d.), the father of materia medica. On the panels of the smaller
cupboards are painted portraits of Albrecht von Haller (1708-77),
the great Swiss savant and physiologist; Hermann Boerhaave
(1668-1738), great Dutch physician and the first to teach clinical
medicine in the modern sense; Antoine Baume (1728-1804), the
French chemist and pharmacist; Robert Morison (1620-83), the
Scottish botanist who was physician to Charles II and held the
Botany Chair at Oxford; George Louis Leclerc, Comte de Buffon
(1707-88), the great French naturalist; and Jose Quer y Martinez
(1695-1764) author of Flora Espanola (6 vols. 1762-84) and first
Director of the Botanical Gardens in Madrid. Note should be made
of the fine run of hand-painted drug jars of unusual type and all
in the same style, which fill most of the shelves. On the shelves in
the left foreground is a fine selection of jars made of HispanoMauresque lustre ware. Note should be made of the portrait in the
left background. It is of Gabriel Martin de Otero, Doctor of
Pharmacy, ‘visitor and founder of this shop’. The date—1790—on
the portrait can just be made out. No further information is extant
regarding this man, but he presumably purchased the shop about
that time.
English pharmacy: circa 1680
This pharmacy has been reconstructed from various sources.
Owing to lack of space it has not been possible to reconstruct an
entire shop. The front of the shop is, however, shown as it would
have appeared, together with sufficient of the interior to give some
indication of the probable contents. The interior contains drug jars
of the period made of London delftware. (Many further examples of
English delftware and of its Dutch counterpart may be seen in the
Museum.) In the window of the shop is hung a pill-tile in mono
chrome bearing the arms of the Society of Apothecaries of London.
These tiles were sometimes used for rolling pills, but those bearing
the Society’s arms were possibly used as signs hung in the windows
of pharmacies as trade signs and to indicate the fact that the owners
were members of the Society. This example dates from about 1700.
(An example of the very rare tiles bearing the Society’s arms in
polychrome is shown in the Museum.)
ARAB PHARMACY
This is a reconstruction using genuine Arab material, and shows
an Arab pharmacy as it might have existed some centuries ago, and
equally as it might be found today. The structure, fittings and
contents are all of Arab workmanship. The craftsmanship should
be noted, especially the ceiling, the inlaid mother-of-pearl work, and
the glass mosaic work of the windows. The decoration of some of the
cupboards is not simple carving, but consists of inlaid work and the
intricate interlocking of individual pieces of wood. Even the copying
of this work would be beyond the capabilities of most craftsmen
today.
JOHN BELL’S PHARMACY
This well-known pharmacy, formerly situated in Oxford Street,
London, was founded in 1798 by John Bell (1774-1849), the father
of Jacob Bell (1810-1859), founder of the Pharmaceutical Society of
Great Britain. The old front of John Bell’s pharmacy in Oxford
Street was dismantled in 1909, and was acquired by Sir Henry
Wellcome. Some of the contents of the windows had previously
been purchased. The original shop-front is here rebuilt, and in the
limited area available an attempt is made to give an indication of
the contents of an English chemist’s shop and of its windows,
using contemporary material, about the middle of the nineteenth
century.
Coloured postcards of the pharmacies are on sale in the Museum.
The Wellcome Historical Medical Museum is open to the public
from 10 a.m. to 5 p.m., Monday to Friday, and 9.30 a.m. to 4.30 p.m.
on Saturdays.
CP. 11I67 $oM.
Printed in England
12th Programme on
MEDICAL AUDIT
2004
Programme Director
Dr. P.H. RAO
Administrative Staff College of India
VERVIEW
itltra'pid advances in medical science and technology, hospital service are becoming
more and more complex and also competitive. On one hand awareness and
expectations of consumers are increasing and on the other the number of health care
managers realizing the need for improving the Quality of Care is growing. It is important
to make the health care provider effective, economical, and accountable. Health
Managers need an enabling system to ensure that people associated with delivery of
health care at different levels are able to monitor, evaluate and account for their work
themselves, and thus provide quality care to patients on an ongoing basis.
Medical Audit facilitates in-house assessment of current medical practices, comparing
them with set standards on medical care, and suggest changes for implementation
leading to improvement of the quality of services provided.
PROGRAMME OBJECTIVES
The main objective of the programme is to empower health care providers with
practical and implementable knowledge and methodology to implement medical audit.
PROGRAMME CONTENTS
Introduction to Quality of Care
Medical Audit - definition, scope, framework and organisation
Management of patient, clinical and financial data for objective evaluation
Components of Medical Audit
Morbidity audit, mortality audit, tissue audit, infection control/audit,
prescription audit, equipment audit, cost audit, material management/
audit etc.
Implementing Medical Audit
Critical Paths
WHO WILL BENEFIT ?
Hospital administrations, Medical Superintendents from Central, State, Public^
Sector hospitals
Hospital Managers from corporate and voluntary hospitals
Programme Managers from NGOs involved in the delivery of health care
Other health care managers and researchers interested in Quality of Care
and related issues.
.
WHAT WILL YOU GAIN ?
INDIVIDUALS
Appreciate the importance of Quality of Care and understand the role of
Medical Audit in improving Quality of Care.
Familiarity with Systems Framework for conducting Medical Audit.
Understand different components of Medical Audit and its implementation.
Knowledge of relevant legal aspects and ethical issues.
Organisational Sponsorship is Essential.
,
ORGANIZATION
Human resource who appreciate and understand the scope and applicability of Medical
Audit. They will be invaluable in improving Quality of Care provided by their
organisations by means of Medical Audit.
PROGRAMME DURATION AND VENUE
The programme will be held at ASCI Center for Management Education (CME), College
Park Campus, Banjara Hills, Road No. 3, Hyderabad. The programme will be held
from August 16-18, 2004.
PROGRAMME FEE
The programme fee is Rs. 15,000/- only. It includes the cost of board and lodging
charges, fee for instruction and courseware. The crossed demand draft should be
made out in favour of "Administrative Staff College of India", Hyderabad. The College
is exempt from income tax, therefore, please do not deduct tax.
PROGRAMME DESIGN
The programme pedagogy emphasizes participatory learning approach. It includes
lectures, discussions, group work, exercises and case studies. The participants are
encouraged to share their experiences. A step-by-step approach will be adopted to
enable the participants to attempt Medical Audit as a method of practical management
in their organisations.
IMPORTANT DATES
Last date for receiving nominations
August 2, 2004
Last date for withdrawing nominations
August 9, 2004
CERTIFICATE OF PARTICIPATION
The college issues a certificate of participation on conclusion of programme.
Programme Director
DR. P.H. RAO, M.Pharm, Fellow (IIMB)
Holds a doctoral qualification in Health Management from nation's premier
management institution, Indian Institute of Management, Bangalore. He has
extensive experience in designing and conducting Management Development
Programmes for programme managers, trainers and other professionals from
health and family welfare services. He was trained in Indonesia on Quality
improvement in Health Care and Advances in Health Communication and
Advocacy at JHLJ/CCP., Baltimore, USA.
ASCI Campuses
Administrative Staff College of India
Administrative Staff College of India
Bella Vista
Raj Bhavan Road, Khairatabad,
Hyderabad - 500 082.
College Park Campus
Road No. 3, Avenue No. 8,
Banjara Hills, Hyderabad 500 034.
Tel : 2331 0952
Tel : 2335 1514
Administrative Staff College of India
New Delhi Centre
C-24, Institutional Area, South of IIT
Behind Qutub Hotel, New Delhi 110 016
Tel : 2696 2204
For further details, please contact:
Dr. P.H. RAO
Programme Director
E-mail: drphrao@asci.org.in
Mr. T. SHESHAIAH
Programmes Officer
E-mail: poffice@asci.org.in
Programmes Officer
ADMINISTRATIVE STAFF COLLEGE OF INDIA
Leadership through Learning
Bella Vista, Raj Bhavan Road, Khairatabad,
Hyderabad - 500 082, India.
Telefax (Programmes Office) : 0091-40-23324365
Phone : 0091-40-23310952, Cable : BELLAVISTA
Fax : 0091-40-23312954
Please visit us at:
hzed
IJME First NATIONAL BIOETHICS CONFERENCE
Conference registration
Collaborating organisations
Registration fees are inclusive of conference
• Tata Institute of Social Sciences, Mumbai
material, lunch and tea/coffee for the three
• 5ree Chltra Tlrunal Institute of Medical Sciences
days of the conference.
and Technology, Trivandrum
Registration fees for participants from India
• 5ama, Mew Delhi
and other 5AARC countries are Rs 500 if paid
• Rational AIDS Research Institute, Pune
before July 51, 2005 and Rs 800 thereafter.
• MA5UM, Pune
Registration fees for participants from other
• L0C05T, Baroda
resource-poor countries are: U5$ 25 if paid
• Lokmanya Tllak Municipal General Hospital and
before July 31, 2005 and U5$ 40 thereafter.
The First
NATIONAL BIOETHICS CONFERENCE
Indian Journal of Medical Ethics
Hovember 25, 26 and 27, 2005
YMCA, Mumbai Central, Mumbai, IHDIA
Medical College, Sion, Mumbai
Registration fees for participants from the rest
• REM Hospltal/G5 Medical College, Mumbai
of the world are 05$ 75 if paid before July 31,
• Jaslok Hospital, Mumbai
2005 and 05$ 100 thereafter.
• Institute of Legal Medicine, Chennai
Accommodation
• Independent Ethics Committee, Mumbai
For outstation participants, accommodation at
• Gujarat Institute for Development Research,
Ahmedabad
the venue (YMCA International Guesthouse,
Mumbai Central) Is available in double occupancy
'
rooms for Rs 1,000 per day per person In
• Forum for Medical Ethics Society, Mumbai
• Christian Medical College, Vellore
air-conditioned rooms, and Rs 500 per person
I
per day per person in non-air-conditioned rooms
I
(both inclusive of breakfast and dinner).
• Centre for Studies In Ethics and Rights, Mumbai
• CEHAT, Mumbai
• All-lndia Institute of Medical Sciences, Delhi
Conference Coordinator
Amar Jesanl
Organising Committee
Secretariat
Ramesh Awasthl, Sunlta Bandewar, Shallnl Bharat,
Anant Bhan, Hobhojlt Roy, 5andhya Srinivasan
.
SuJIt Chandy, Suneeta Krishnan, K Mathlharan,
Heha Madhiwalla, 5anjay Mehendale, Sanjay Hagral,
Amita Pitre, Mala Ramanathan, K Srlnath Reddy,
Please send abstracts/concept notes and all
H B SaroJInl, 5 Srinivasan, Avlnash Supe,
inquiries to: bioethlcs2005@yahoo.co.ln
For updates see www.i5sue5inmedlcalethlc5.org
I
Urmlla Thatte, Leela Vlsaria, Jagrutl Waghela.
Ethical challenges in health care:
global context, Indian reality
• Ethical challenges in HIV/AID5
• Ethics of life and death in the era of
hl-tech health care
Contact address:
national Bioethics Conference
IJME c/o C5ER, Candelar, 4th Floor, 26 St. John
i
Baptist Road, Bandra (W), Mumbai 400 050IHDIA.
■
Tel.: (91 22) 2640 6703, Fax: (91 22) 2667 3156
;
• Ethical responsibilities In violence,
conflict and religious strife
• Ethics and equity In clinical trials
and other Issues
The Indian Journal of Medical Ethics completed
Interconnections. Further, in India, they are strongly
as Is the question of researchers' ethical
12 years of publication in 2004. During these
associated with an Increase in violence, conflict and
responsibilities when undertaking studies in
years. It has contributed to and benefited
fundamentalism. It is in this general context that
from the emergence of bioethics as a distinct
one must view the emerging ethical challenges in
discipline In India.
health care.
IJME hopes to build upon this relationship
Focus sub-themes: Within this broad theme
such situations.
♦ Ethics and equity in clinical trials and other
issues: This section will include presentations
on issues related to the growth of clinical trials
through the national Bioethics Conference.
providing the framework to deliberations at the
The conference alms to establish a regular
conference, In-depth discussions will be held on the
take up papers on Issues not covered In the
platform for coming together, sharing
following focus sub-themes.
other themes.
Individuals, organisations and institutions
concerned with bioethics in India.
♦ Ethical challenges in HIV/AID5: The advancing
While the conference is planned to cover these
epidemic of HIV/AID5 and the extremes of
sub-themes, submissions will be accepted on
cultural, religious, professional and other
other subjects as well.
Conference theme and focus sub-themes;
social responses to it have posed severe
'Bioethics in India has developed In response
ethical challenges In clinical practice, research,
to multiple Influences. The community health
public health and health policy. Stigma and
movement has demanded universal access
discrimination In social and occupational settings,
to basic health services and offered a critique
of professlonallsatlon, mystification and
and the Intervention of people living with HIV/
bureaucratisatlon in health care. The patients'
shaped both the ethical challenges and the
and consumers' rights movement has drawn
response of health care providers.
attention to commercialisation in health care and
medical malpractice. The movement for rational
therapeutics and drug price controls has analysed
the conduct of the pharmaceutical Industry and
doctors' prescription practices. The women's
movement has exposed the politics of population
control and documented ethical violations in
contraceptive trials. While these and other
significant movements emerged from the specific
political reality of India, they were - and still are
AIDS In defence of their human rights, have
♦ Ethics of life and death in the era of hi-tech
health care: The Increased Investment in hltech health care has posed ethical challenges
In public policy, resource allocation and
addressing inequity. It has also highlighted ethical
complexities In specific areas such as organ
transplantation, artificial reproduction, euthanasia,
palliative care and the use of sex selection
technologies.
- also a response to global changes in the health
♦ Ethical responsibilities in violence, conflict and
sector. The process of opening up the economy
religious strife: What are the tensions between
for global capital, the accelerated development
health professionals' religious, caste. Ideological
of the corporate health sector, the phenomenal
and other affiliations and their professional
increase in cheap drug trials, the decline of the
obligations, and how may they be resolved?
public health sector and the rise in inequities
The subject of health professionals' ethical
- all these have complex national and global
responsibilities In conflict situations is crucial,
Cross cutting themes: Each sub-theme will be
discussed In the context of clinical practice,
research and public health. Discussions will also
be informed by several cross cutting themes
such as equity and access; culture and religion;
laws and regulations; provision for ethics reviews
and consultations, and so on.
Structure ©? the conference
The conference will be structured around
morning plenary sessions with presentations
by experts; parallel sessions for each focus
sub-theme; and late afternoon/evenlng satellite
sessions consisting of lectures, discussions,
role-plays (such as mock ethics review boards or
clinical consultations), films and cultural events.
The last date for sending abstracts is June 30,
2005. Writers will be Informed of the programme
committee's decision by July 31, 2005.
‘ h —JU
experiences, and fostering cooperation among
in developing countries. This section will also
Nominee’s
Photograph
to be affixed
here
Nomination Form
(To be filled in by the Nominee)
Please return the completed form, along with the demand draft towards programme fee to:
Programmes Officer, Administrative Staff College of India
Bella Vista, Raj Bhavan Road, Hyderabad-500 082
LATEST BY:
August 2, 2004
Phone: 23310952; Telefax: (Programmes Office) 0091-040-23324365
Fax: 0091-040-23312954; Email: poffice@asci.org.in
Website: http://www.asci.org.in
Twelfth Programme on
MEDICAL AUDIT
[Period |
August 16 to 18, 2004
Nominee’s Personal Information
Name (Mr./Mrs./Ms./Er./Dr.) I
Designation
I A§e |~
Date of Birth
Organisation
Address
Phone(s)
Fax
E-mail
| Home |
Business |
Nominee’s Academic Information (Graduation onwards only)
Title/Degree
Institution
Nominee’s Experience - Present Organisation
Year
Subject
Nominee’s Experience - Previous Organisation(s)
Position
Organisation
Reporting to
Years
Responsibility
i
i
Present Training Programme
What does the participant expect to learn?
What does the participant expect to contribute to the learning process?
Health of the Nominee
Good I
Specify chronic ailments if any
Date
Signature of Nominee
(To be filled in by the Sponsor)
Sponsoring Organisation : Business Information
| Sector |
Name
Address
Phone(s)
E-mail
Range of Products/
Services
Size (Rs. in Lakhs) Revenue |
| Asset Base]
| Employees |
Programme fee payable to Administrative Staff College of India
Amount of Payment
Instrument Number
Name of the Bank
Mode of Payment (DD/Ch)
Date of Instrument
Date :
Signature of Sponsoring Authority
Name :
Designation:
M-3
ADMINISTRATIVE STAFF COLLEGE OF INDIA
Leadership Through Learning
Bella Vista, Raj Bhavan Road, Hyderabad - 500 082, A.P. (India)
Grams: “BELLAVISTA", Phones: 0091-040-23310952 13 Lines
Telefax: (Programmes Office) 0091-040-23324365, Fax: 0091-040-23312954
email: poffice@asci.org.in; URL: http://www.asci.org.in
Dr. P. H. Rao
Fellow (IIMB)
Programme Director
June 4, 2004
TWELFTH MANAGEMENT DEVELOPMENT PROGRAMME
ON MEDICAL AUDIT
August 16 to 18, 2004
Dear Sir/Madam
I am happy to inform you that ASCI, The College for Practicing Managers, is
offering the Twelfth Management Development Programme on “Medical Audit” from
August 16 to 18, 2004. I am enclosing herewith a brochure giving details of the
programme fof your information. A nomination form is also enclosed for your use.
Our earlier programmes on Medical Audit were attended by health professionals from
central, state governments and local bodies, private and corporate hospitals, NGOs
and others. I am enclosing a list of participating organisations for your perusal. The
Seventh Programme was organised exclusively for the “Maharashtra Health
Systems Development Project”, in September 2002 at Khandala. The Eleventh
Programme was organized exclusively for the Orissa Health System Development
Project at Hyderabad from March 4 to 6, 2004.
Feedback from the earlier participants indicate that it will be useful to send a team
of administrator, nursing superintendent and a member of medical records, who are
likely to be involved in the Medical Audit process in the organisation.
As the last date for receiving nominations is August 2, 2004, you are requested to
send the nomination form at the earliest, so that we can reserve the number of seats
required by your organisation. The total number of seats is restricted to 25 to facilitate
close interaction and better learning.
We look forward to the nominations from your organisation. You are welcome to call
or write to me in case you need more information about the programme.
Thanking you,
Encl: a) List of participating organisations of the earlier programmes
b) Brochure & Nomination Form
PROGRAMME ON MEDICAL AUDIT
Organisations participated in the earlier Programmes
Government of India and Government Undertakings
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
BHEL Hospital, Hyderabad
Heavy Water Plant Hospital, Department of Atomic Energy, Andhra Pradesh
Konkan Railway Corporation, Navi Mumbai
Directorate General-Medical Services (Air), Air HQ, New Delhi
Ordnance Factory, Varengaon
Planning Commission, GOI, New Delhi
NTPC, New Delhi
Western Coalfields Ltd, Nagpur
Safdarjung Hospital, New Delhi
Survey of India, Dehradun
GJ Hospital, Port Trust, Visakhapatnam
HWP Hospital, Khammam, AP
BHEL Hospital, Bhopal.
Northern Coal Fields Ltd., Singrauti, M.P.
Directorate General of Health Services, New Delhi
Sail Hospital, Durgapur, West Bengal
ESIC Model Hospital, Hyderabad
Singareni Collieries, Kothagudem, A.P.
Health System Development Projects and State Governments
1.
2.
3.
4.
5.
6.
7.
8.
9.
AP Vaidya Vidhan Parishad, Hyderabad
Punjab State Health Systems Corporation, Chandigarh
Orissa Health Systems Development Project, Bhubaneshwar
West Bengal Health Systems Development Project, Kolkata
UP Health Systems Development Project, Lucknow
Maharashtra Health Systems Development Project, Mumbai
Department of Public Health and Family Welfare, Madhya Pradesh
Department of Health & Family Welfare, Rajasthan
Department of Health & Family Welfare, Himachal Pradesh
Local Bodies
1.
2.
3.
Municipal Corporation of Hyderabad, Andhra Pradesh
Municipal Corporation of Delhi, New Delhi
Bangalore Mahanagar Palike, Bangalore
Private & Corporate Hospitals
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
KEM Hospital, Pune
Prince Alykhan Hospital, Bombay
Shankar Nethralaya, Chennai
SDA Hospitals, Hosur
Advanced Medicare & Research Institute, Calcutta
Poona Hospital & Research Centre, Pune
RD. Hinduja Hospital, Mumbai
Dhanvantri Hospital, UPPC Nagar, Auraiya
Bhailal Amin General Hospital, Vadodara
PSB Hospital, Coimbatore
BKTPP Hospital, Calcutta
Dhirubai Ambani Hospital, Maharashtra
Jagadguru Sri Shivarathreeshwara Hospital, Mysore
Puri Sadar Hospital, West Bengal
Tata General Hospital, Mannur, Kerala
Orange City Hospital & Research Centre, Nagpur, Maharashtra
: 2 :
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
Kasturba Gandhi Hospital, Delhi
JW Global Hospital & Health Centre, Mount Abu
Medwin Hospital, Hyderabad
Apollo Hospital, Hyderabad
Apollo Hospital, Chennai
Max Healthcare Ltd, New Delhi
The BD Patil Parsee General Hospital, Mumbai
National Institute of Opthalmology, Pune
Peerless Hospital and B.K. Roy Research Center, Kolkata
Sri Jayachamarajendra General Hospital, Arsikera, Hasan District, Karnataka
Lokamanya Medical Foundation, Pune
The B D Petit Parsee General Hospital, Mumbai
Tata Main Hospital, Jamshedpur
Tapadia Diagnostic Center, Hyderabad
KG Hospital, Coimbatore
BKF - Chande Nephro - Urology Center
Ashwini Kidney and Dialysis Center, Nagpur
Goodricke Group Hospitals, Calcutta & Jalpaiguri
Tinplate Hospital, Jamshedpur
Kamineni Hospital, Hyderabad
Medical Colleqe/Traininq Institutes
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Gandhi Hospital, Secunderabad
Gandhi Medical College. Hyderabad
Guru Tej Bahadur Hospital, New Delhi
Sri Ramachandra Medical College & Research Centre, Chennai
Dr Panjabrao Deshmukh Medical College, Amravati
Vinayaka Mission Medical'College and Hospital, Pondichery
Post Graduate Institute of Medical Education and Research, Chandigarh
Nizam's Institute of Medical Sciences, Hyderabad
Urban Health Research and Training Institute, Bangalore
St. John’s Medical College Hospital, Bangalore
NIMHANS, Bangalore
Al - Amein Medical College Hospital, Bijapur
Amrita Institute of Medical Sciences, Kochi
Dr P D Medical College, Amravati
Dr R P Medical College Hospital, Dharmasala, H.P.
AllMS, New Delhi
L.V. Prasad Eye Institute, Hyderabad
Kasturba Medical College Hospital, Manipal
NGOs & Others
1.
2.
3.
4.
5.
Parivar Seva Sanstha (PSS), New Delhi
Aware Hospital, Hyderabad
Rubber Board, Kerala
Family Planning Association of India, Mumbai
Christian Medical Center, Pittapuram, A.P.
- Media
RF_MP_9_SUDHA.pdf
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