SCHOOL OF HAPPINESS

State Medicine and Epidemic Diseases

The countrymen of Manu, Confucius, Zoroaster and Mahomet cannot be
said to be mere imitators. Philosophy, literature and the sciences and arts
are not unknown to them. The difference between them and the nations
of modern Europe is a difference of degree and number … When we
descend, however, from the concrete to the particular, the difference by
no means appears to be so great as it would at first sight.

This was the observation of  S. C. G. Chuckerbutty (1826-74), who, in 1855, was the first Indian medical graduate to join the Indian Medical Service (IMS). Sir Ronald had been tackling Malaria in Sierra Leone. The disease had killed English colonists in the country. In December 1899 he gave a lecture to the Liverpool Chamber of Commerce about his experience. He said “in the coming century, the success of imperialism will depend largely upon success with the microscope.”Born in India, a child of empire, he foresaw that his work would help expand the British rule.

The historiography of medicine in India has seriously debated the subject of ‘public health’ in recent years. In general, two main trends characterize the existing literature.

The first addresses the colonial legacy in public health, debating the extent of progress made by the British in this field. Perspectives on this issue vary widely, ranging from assertions that public health thrived solely under British influence to arguments contending that successive British administrations primarily aimed to safeguard the health of colonial enclaves. Some scholars have gone so far as to question the suitability of the term ‘public health’ in the Indian context, favoring the use of ‘state medicine’ instead.

This leads to the second trend in historiography. This Foucaultian analysis scrutinizes ‘public health’ measures in the context of colonial power. This perspective views such measures as tools through which the state sought to understand and exert control over its subjects.

Medical Gaze

Foucault develops the concept of ‘the medical gaze’, describing how doctors modify the patient’s story, fitting it into a biomedical paradigm, filtering out non-biomedical material. A ‘gaze’ is an act of selecting what is considered to be  relevant out of the total available data. Hence, medicine creates an abusive power structure.

The trajectory of public health in British India during the 19th and early 20th centuries offers valuable insights into a period marked by the emergence of new trends in medical systems. It signifies a shift from conventional surveys to the advent of microscopic studies in medicine, housing the earliest laboratory endeavors and groundbreaking achievements in microbiology and immunology. The rise of infectious diseases and tropical medicine was a direct consequence of colonialism.

Establishment of Medical Services

The history of western medicine in India dates back to 1600, with the arrival of first medical officers  India along with the British East India Company’s first fleet as ship’s surgeons. In 1757, the East India Company established its rule in India, which led to the establishment of civil and military services. Deepak Kumar in Science and the Raj says that Colonial hegemony rested upon baring the differences, real or assumed, and stamping one’s supremacy. Narratives of medicine were employed as effective tools to build this idea.

Colonial hegemony, therefore, acted as a double-edged weapon. It sought to widen the gulf between the colonizer and the dispossessed. Secondly, it established the supremacy of western medicine, while undermining folk practices and indigenous systems of medicine. 

There  were exceptions, of course. Works of people like Johnson (1813), B. Heyne (1814), H. Wilson (1825), W. Ainslie (1826), W. Twining (1832), G. Playfair (1833), J. R. Martin (1837, 1856), J. F. Royle (1837), T. W. Wise (1845) and many others showed appreciation of indigenous medicine too.

While there was glorification of ancient Hindu culture by some people, viz,.

a full and continued stream of light, which shows that the ancient Hindoos, with great acuteness and philosophical discernment, turned their attention successfully to almost every department of human knowledge…(J. F. Royle, An Essay on the Antiquity of Hindoo Medicine. London, 1877: 190)

But practices of Medieval India came in for sharp criticism. Synonymous with poverty, decadence and backwardness in colonial narratives, Medieval India became a part of medical discourse through terms like ‘sudden’, ‘severe’, ‘decline’, ‘decadence’, ‘deterioration’, ‘degeneration’ and, worst of all, ‘putrefaction’. N. Harish in his  ‘Poisons, putrescence and the weather: a genealogy of the advent of tropical medicine’ describes this phenomenon in detail.

In the mid-nineteenth century, the Indian perspective was also embracing new opportunities and the acquisition of new knowledge. The agenda was one of syncretism rather than revivalism. Even within the ranks of British officials, there were proponents advocating for a government initiative to fuse “both exotic principles and local practices, European theory and Indian experience.” The aim was to ‘revitalize’, ‘invigorate’, enlighten, and liberalize the native medical profession in the ‘mofussil’.(W. Adams, Report on Vernacular Education. Calcutta, 1868: 322–3).

In this regard,  views of three Indians from three different presidencies stand out.

Read more on this in Social History of Public Health in Colonial India-Part 2