Projit Bihari Mukharji

Structuring Plurality: Locality, Caste, Class and Ethnicity in Nineteenth-Century Bengali Dispensaries

Dispensaries in colonial South Asia have received scant attention in the historiography on colonial medicine in India. Those who have touched upon them have remarked on the pluralism and hybridity of the medicine practised in them. Yet these studies remain trapped within binarisms such as coloniser/ colonised, science/tradition or Occident/Orient and fail to ask further questions about the structure of this medical pluralism. Why did colonial officials collaborate with some strains of indigenous healing while they rejected others outright? Asking this question also forces us to disaggregate categories such as 'indigenous medicine,' 'colonial medical establishment,' 'indigenous practitioners of western medicine' etc. I try to investigate here how categories such as locality, ethnicity and class structured the pluralism of the colonial dispensary practice.

Since the appearance of David Arnold's Colonizing The Body in 1993, an impressive body of scholarship has developed on the medical history of South Asia. Yet there remains very little work on specific medical institutions. The little that is available in this regard tends to focus on Hospitals and Asylums.¹ Dispensaries, on the contrary, have hardly been investigated by historians of medicine. Arnold provided a brief sketch of the role of dispensaries with special reference to those of the Madras Presidency.² In the following year Mark Harrison commented on the dispensaries of Bengal, albeit briefly.³ Recently, Christian Hochmuth has engaged with these in greater detail.⁴ The dispensaries of Bombay have been investigated by Mridula Ramanna and Jennifer Blake, both in 2004.⁵ Arnold had pointed out that '[t]he "ablest and most experienced" physicians could not afford the time and energy needed to attend dispensary outpatients.'⁶ Hochmuth has thus rightly suggested that the Bengal dispensaries provided a unique glimpse into the colonial public health establishment due to the significant role it afforded to 'indigenous practitioners.' In other words, analysing dispensary practice in South Asia allows us an unprecedented insight into the interaction between western and indigenous medicine.

Because he framed his glimpse in terms of a negotiation between 'scientific' medicine and 'indigenous practice' Hochmuth fails to disaggregate the hierarchies of power that are immanent to these categories. Waltraud Ernst has pointed out, that, by counter-posing 'scientific western medicine' to 'indigenous practice,' Euro-centric prejudices which tend to 'automatically impugn' the 'validity of [the latter's] knowledge base and the integrity of [its] practitioners' have been perpetuated despite an absence of 'explicit denigration.' Ernst has further pointed out that by 'dichotomising a multi-faceted reality,' even while arguing for 'pluralism,' the perpetual internal flux of these categories is overlooked and 'western/scientific medicine' and 'indigenous practice' posited as discrete and clearly defined terms.⁷ Claudia Liebskind, for instance, has shown how not only did practitioners of indigenous medicine refuse to admit any pregiven definition of 'scientific medicine,' but even differed amongst themselves on its redefinition.⁸ Gyan Prakash's work has also drawn attention to the politically loaded connotations of 'science' in colonial South Asia and the bitter contestations over its definitions.⁹ Moreover, the nature of 'scientific medicine' changed quite dramatically between the early years of the nineteenth century and its closing decades, especially after the rise of the germ theory. It is doubtful hence that practitioners of 'scientific medicine' from the closing years of the nineteenth century would agree with Hochmuth in calling the medicine practised by their forebears in the early 1800s 'scientific.'¹⁰ Even more crucially, the indigenous participants in this medical world were a diverse group. They included people like Soorjo Goodeve Chuckerbutty and Gopaul C. Roy, who were educated at the best British medical schools of the time and occupied important positions in the colonial medical bureaucracy, as well as lowly vaccinators and compounders who occupied the lowest echelons of that bureaucracy. It would be unfair to speak of them in the same vein merely because of their skin colour. They differed from each other drastically in their training, attitude and influence. Relations of power remain crucial to the definition of terms such as 'western/scientific medicine' and 'indigenous medicine' as well as in defining the interactions between them. While Hochmuth is right in noticing the plural nature of colonial medicine in dispensaries, we need to go beyond plurality alone and see how hierarchies of power inflected and shaped the precise form that such plurality took. Narratives of indigenous participation, thus, need to be synchronised with hierarchised models of the colonial medical bureaucracy such as those suggested by Mridula Ramanna or Sanjoy Bhattacharya.¹¹

The colonial medical bureaucracy was a multi-layered and hierarchic institution in which the dispensary system occupied a unique position. Sir Henry Burdett, writing in the 1890s, singled it out as the most characteristic feature of Anglo-Indian medicine¹² in India.

The Dispensary system of India forms the most striking feature in its medical history. The dispensaries not only supplement the hospitals, in many instances, but they are also separate establishments with distinct administrations, and possess the attributes of hospitals on a small scale.¹³

It is this distinct position of the dispensaries that has often passed without comment in the existing historiography. While scholars such as Arnold and, more recently, Hochmuth have remarked upon the differences between hospitals and dispensaries, no in-depth study of the nature of the colonial dispensaries are available. While they were definitely an integral part of the medical establishment at large, they were seen by many (such as Burdett) as being a distinct set of institutions with its own unique identity. It is only by understanding the nature and characteristics of these institutions that we can seek to unpack the various hierarchies of power that informed indigenous participation in them.

Early development and uniformity of statistics

The first public dispensary in Bengal was opened on Chitpur Road in Calcutta in 1792, on the initiative of Mr. Wilson, a member of the Medical Board, and certain other eminent gentlemen of both European and Indian origin. In 1794 it was moved to Dharmatala Street and attracted a mere 216 patients in the year 1794–95. Subsequently, two subordinate dispensaries were established at Park Street and Garanhata. In 1841 a third was opened once again at Chitpur. In 1803–04, liberal subscription combined with government aid allowed dispensaries to be opened in Murshidabad and Dhaka. Soon afterwards, others were opened in Patna, Bareli and Benaras. These dispensaries remained ad hoc institutions and were not thought of as a unified 'system' or 'network.' The first attempts to form them into a recognisable system commenced with the calls for half yearly reports from 1842 onwards. That this was clearly a new way of seeing these institutions can be well brought out by comparing the call of 1842 to the Medical Regulations of 1838. Published only four years earlier, these regulations, while including an entire section on 'vaccinations,' had said nothing explicitly about the dispensaries apart from a broad, and almost off-the-cuff comment that all reports on 'Bazaar, City, Native or Pilgrim Hospitals' were to be forwarded quarterly to Superintending Surgeons for the information of the Medical Board, in the same form as those sent in for the Jail Hospitals.¹⁴

Ironically, even this minimal attempt at collating information was discontinued after 31 March 1852. Yet, the number of dispensaries kept growing: from 1 in 1792 to 6 in 1842, 142 in 1868 and a whopping 471 by 1917.¹⁵ Hochmuth has argued that this exponential rise in their numbers resulted in a laxity of supervision, especially in the period after the 1860s.¹⁶ Significantly, the nature of the information that was sought from these dispensaries through the institution of annual reports changed quite radically after the 1860s. Faced with a staggering increase in their numbers, the government once again introduced the system of reports. The nature and structure of these new reports were significantly altered from the earlier reports of the 1840s. In December 1865, the principal inspector general of the Medical Department was instructed to send in annual reports, showing the 'state of the funds of each, the receipts and expenditure for the year, [and] the detailed medical statistics.'¹⁷ Though the reports of the 1840s had already started showing a trend towards greater standardisation of the format and the inclusion of standard tables to show expenses and patient statistics, they were nothing like the 1865 reports. David Arnold has already drawn our attention to the increasing tendency, at this time, to represent health and illness in terms of numbers.¹⁸ These new reports were a product of that very tendency. In the post-1865 reports, standard forms are sometimes supplied with a bold superscript in red saying 'Not to exceed 25 pages.' Whereas in the earlier reports the individuals in charge of the dispensary concerned were at liberty to elaborate upon whatever they wanted (and many such as Rameshwar Awasthi, Ishwarchandra Ganguly and Nabinchandra Pal did indeed take the opportunity to elaborate upon their concerns), later reports were mostly statistical tables appended with a short covering letter, merely summarising the statistical results. The early reports were fascinating texts which, at times, included detailed descriptions of local herbal potential and, at other times, of interesting individual cases. Occasionally, they even narrated communications with representatives of 'indigenous' medicine.

Ian Hacking has commented upon the epistemic transformations after 1815 that sought to represent illness and health through numerical tables. Hacking argues that this was a new mode of objectivity through which absolute chance was tamed and recast as a degree of probability. From around 1825, Hacking continues, there emerged a new category of 'biological' law which could be derived from numerical regularities. It was around this time that statistical laws started informing legislative practice. The quantum of sickness thus was to become the rationale for legislation.¹⁹

As the nature and modalities of legislation changed from the rather ad hoc approach of the company years to a firmer commitment to public health under the crown, the nature of information sought changed as well. Sickness was increasingly quantified in an attempt to discover statistical laws which would supply the definite grounds of legislation. What changed thus was the administrative logic of public health. The quantification of sickness and healing emerged as more crucial questions than narratives of affliction and treatment.

The need for comparable data and the difficulties in representing data from dispensary practices in uniform and comparable formats was commented upon by Dr. F.P. Strong of the Bhowanipur Dispensary as early as 1843. Dr. Strong wrote that, 'I may only allude to the difficulties of arriving at the result of Dispensary practice in general, and to the different modes made use of in different Dispensaries for the purpose.'²⁰The dilemma of producing standard comparable data from institutions whose very localised and adaptable nature made them rather diverse continued to haunt the colonial government. Even after the reports were standardised in the 1860s, Surgeon Major J.T.C. Ross reported that native doctors, sixty-seven of whom held independent charge of their respective dispensaries, were being encouraged to write detailed reports in the vernacular and get them translated.²¹ It is quite plausible then that there was a significant gap between the medicine actually practised by these Bengali-speaking physicians and the reports submitted, which were written by someone else who had sufficient English proficiency. This possibility that indigenous doctors may not have been reporting the extent of their innovations in official reports is further strengthened by the fact that the medical establishment was thought to look with suspicion upon 'originality and special ability,' holding these to be detrimental to promotions.²²

Though the voices of these physicians were lost in the government reports of the period through translations and statistical tables, they emerge vigorously in the burgeoning world of vernacular journals of the period. In the 1860s and 1870s, a series of journals emerged which dealt with illness, health and healing. Many of these were edited and run by 'native' doctors. The Chikitsha Shommiloni was among the most successful. It had a large number of contributors as well as subscribers who practised Anglo-Indian medicine. By its third year in 1887, 15 of its 57 paid-up subscribers, one of its two editors and at least 11 of its 23 contributors were practitioners of Anglo-Indian medicine. A substantial number of these would undoubtedly have been employed in the many dispensaries of the Presidency such as one of the editors, Annada Charan Khastagir, who was attached to the Malda Dispensary.

Figure 1: Dr. Annada Charan Khastagir, Medical Officer Malda Dispensary and editor of the Chikitsha Shommiloni. [Source: Chikitsha Shommiloni IV (1887): 37.]

The stated goal of the Chikitsha Shommiloni was to promote dialogue and collaboration between the various medical traditions. It published separate sections on 'Allopathic,' 'Homeopathic' and 'Ayurvedic' medicine. Occasionally some of these physicians also published treatises which incorporated an eclectic mix of treatments and medicines drawn from a variety of traditions. Hara Charan Sen, medical officer-in-charge at the Sherpur Dispensary for instance, writing in 1881, gave both 'western' as well as Ayurvedic prescriptions for all the venereal diseases he discussed.²³ Another medical officer, Amritalal Bhattacharya, in turn proposed a new typology of fevers from the one he had been taught in D.B. Smith's lectures to the Bengali Class²⁴ as a student. Bhattacharya's new scheme, perhaps not surprisingly, greatly resembled the classical Ayurvedic scheme with three basic types, three binary combinations and one triplicate combination.²⁵ Doyal Krishna Ghosh, Assistant Surgeon at the Sultangachhi Dispensary, while writing on malaria in 1878, not only opposed the official wisdom of the clearance of jungles as an antimalarial measure, but moreover showed the extent of the intellectual as well as emotional distance from the regime he served, by adding that

when we were independent or under Muslim rule local custom was respected and hence water bodies and marshes improved and cleaned regularly, now such is no longer the case and this is one of the reasons for the increase of Malaria.²⁶

Evidence of the persistence of the pluralistic medical culture of the dispensaries, plentiful in the journals, also occasionally cropped up in the later set of reports, such as the reference to Amar Chandra Gupta's use of a large number of indigenous remedies at Rajshahi or the statement of the medical officer at the Krishnanagar Dispensary that most of the remedies he used were learnt from local Kavirajs and Hakims.²⁷ Yet these references were much rarer and less detailed than those from the 1840s reports. The standardisation of the reports only created an illusion of growing uniformity. On the ground, the world of the dispensary was managed and run by people who were both intellectually and emotionally only tenuously integrated into the world of Anglo-Indian medicine.

Locality and plurality

The dominant character of the dispensaries was their localised nature. Because they were essentially seen as organised in response to local needs and circumstances instead of having been designed according to a well-thought-out blueprint, they reflected the varied forces that shaped them even in their physical form.

The local variety among dispensaries is amply reflected in the physical sites in which the dispensaries were situated. At the royal Bengali capital city of Murshidabad, for instance, the establishment was housed in a building belonging to the Nawab²⁸ himself. On the other hand, in the imperial capital of Delhi, where the Mughals still tenuously held onto symbolic power, the dispensary was housed beyond the city centre, on the precincts, making it difficult for poorer patients to visit it. In Patna, where British interest had been sporadic and blatantly commercial for a long time, the dispensary was perennially housed in a building almost on the verge of collapse with two branch dispensaries: one in the heart of Patna's white town, Bankipur, and the other in the Catonment, Dinapur. In Puri it was housed in a charitable hospital for pilgrims, maintained by the precolonial government. In Calcutta, attempts were made to start two early dispensaries with support of native reformers, as an example of 'enlightened' British rule. On the tumultuous border lands of Chittagong, it was housed in the insalubrious periphery of the town, next to the regimental lines in an old forsaken Mosque.

The variety of sites reflected the varied relationships of the dispensaries to the local people of the area. There was no uniform character to this relationship. Murshidabad and Delhi, both included in the reports on the Bengal dispensaries in the 1840s, provide a good contrast. Though both cities were still home to the vestiges of the precolonial aristocracy, their response to the local dispensary was quite different.

At Murshidabad, after the committee set up for the purpose had failed to obtain a good house for the purpose, the Nawab provided rent free accommodation in one of his own houses. In fact, part of the building continued to house the Nawab's establishment.²⁹ In Delhi, on the contrary, the 'Mussulman Physicians' through their influence in the court of the Mughal Emperor prevented people from attending the dispensary and forced it to be situated outside the city. It is even said that not only were rumours spread about the use of human body parts in dispensary medicine, but agents were posted by the Hakims outside the dispensary, with the intention of keeping people away from it.³⁰

Being essentially local institutions, these diverse local circumstances resulted in dispensaries being very different from each other. A plethora of forms developed by way of ad hoc responses to local circumstances made it difficult for them to be recognised as similar institutions at all. Unlike the big urban hospitals, these dispensaries often had very little in common with each other. Describing this truly Byzantine complexity, Surgeon General W.R. Edwards wrote in 1917 that the Presidency Division had a total of fourteen dispensaries. Of these several were maintained by zamindars, at their costs on their estates. The Raja of Chanchal in Malda district for instance maintained three on his estate and planned on opening another one shortly. Medical Missionaries also contributed substantially and returns had been submitted from seventeen such institutions, many of which were in particularly 'out-of-the-way places.' The Manikcheri Dispensary in Chittagong was built and handed over to the government by a Buddhist tribal chieftain, who continued to pay for it. Besides these, there were further a number of temporary dispensaries, displaying even more varied characteristics. In Bardhaman district for instance, there was a mobile dispensary on a boat that traversed up and down the Khari River which remained afloat for three malaria-prone months a year. Up to fifteen special dispensaries were opened up at various local rural fairs in the Dinajpur and Bogra districts. Twelve special malaria dispensaries were also opened in Birbhum. Apart from these again several district boards, especially in the hills, employed itinerant doctors, who visited weekly village markets (hats) to treat patients.³¹ The extreme informality and adaptability of this network is surprisingly at odds with the more formal, and at times arrogant, world of the hospitals.

The financial support for dispensaries were partly the result of local negotiations. As Arnold has pointed out, it was 'partly because the government was unwilling to put more resources into local services, the number of institutions remained small compared to the size of the population and the scale of its needs.'³² It was as a consequence of this lack of governmental commitment at the local level that a number of strategies were developed by local administrators to meet the needs of the population in the area. It was often the district magistrate's personal pressure upon the local elite that secured the funding. What masqueraded as the voluntary philanthropy of public-spirited Rajas and Chiefs in Edward's description was often in fact a response to a combination of inducements and threats from colonial officials. This is not to deny that colonial Bengal did indeed have an idiom of elite philanthropy derived from both an English tradition of elite philanthropy through public works as well as the indigenous notions of charity. While zamindars would often support dispensaries, named after departed relatives, on their estates, that there was definite informal governmental encouragement for this kind of philanthropy is almost certain.³³

In areas where a single patron could not be found, district magistrates would use their influence to coax and cajole moneyed residents of the area into setting up a subscription fund and a management committee.³⁴ The financial arrangements for each dispensary were thus arranged in a unique way. In some cases, such as in the Dispensaries of Azimganj (Rai Dhunput Singh Bahadur), Raiganj (Rani Shyam Mohini), Kakina and Batashim (Babu Mohima Ranjan Roy and Rai Lutchmeepat Singh Bahadur), Doolye (Azim Choudhury), and Alipore (Maharani Shwarnamayi), there was a single patron or a family who patronised the dispensary. In other cases there was a local committee comprised of the local members of the elite known variously as the Local or Managing Committee.³⁵ The latter were often marked by irregular contributions and nonpayment of subscriptions by members who had been induced to commit. This often led to straining of relationships between the elite and government officials. For instance, the dispensary in Bandipur in the district of Hughli was finally closed down in December 1889 after the tension between local authorities and the board reached such proportions that government funding was completely withheld.³⁶ But even before that, such occurrences were on no account rare. In the early 1840s, for instance, Chittagong was perpetually plagued by nonpayment of subscriptions.³⁷ In the 1850s and 1860s similarly Bahrampur³⁸ and later still dispensaries such as the one in Bakerganj³⁹ and Kandee⁴⁰ faced similar problems.

As the drive for uniformity that was reflected in the new statistically oriented reports of the 1860s gained ground, calls were made to standardise the nature of funding and administration of the dispensaries. These calls resulted in proposals for a common dispensary manual by the 1870s. Commenting on a draft for such a manual prepared by a Surgeon H. Cayley, C. Bernard, officiating secretary of the Judicial Department of the Bengal Government, expressing the views of the Lieutenant Governor, clarified that the proposed manual must lay down clear directions about Managing Committees, buildings, medical staff, subordinate staff, both in-patient and outdoor patients and diets.⁴¹ According to the scheme, 'Dispensaries and small charitable hospitals [were to] be divided into three classes.' The Class I dispensaries were virtually independent of governmental financial aid and had the best qualified medical officers, whereas at the other end Class III dispensaries received extensive government aid including a part of the salaries of the medical officers. The qualifications of the physicians to be employed at these Class III dispensaries were left open to the extent to which the 'supporters' were willing to contribute and the best that could be obtained at that salary.⁴²

While such manuals were partially effective in finally recognising that the dispensary network was quite different from the large city hospitals and had distinct needs and features, it did little to homogenise the nature of practice in these institutions. The very nature of these institutions was such that they had to be responsive to local pressures. Moreover, one of the main reasons for this plurality was the government's refusal to take complete financial charge. In the absence of any change to the nature of the financial arrangements, the manual became an attempt to merely regulate the nature of cooperation with local elites. This recalcitrance on the part of the government to take on the burden of financing the dispensaries by itself was forcefully reaffirmed in 1874, when the government decided to add an additional clause into Rule III of the Dispensary Manual. According to this new clause, a prior legal guarantee for minimum subscription needed to be executed by either a single patron or a committee of subscribers before a new Class III dispensary could be opened. It was stated that the move was intended to 'protect the Government from loss ... from persons failing to pay up the promised subscriptions.'⁴³

Multiple pedagogies, diverse medicine

On the issue of the medical officers employed, the 1870 manual proved largely ineffectual. In 1874, for instance, we find the following categories of medics employed in the dispensaries of Bengal:

Rank	Number
1^st Grade Asst. Surgeon	3
2^nd Grade Asst. Surgeon	4
3^rd Grade Asst. Surgeon	15
1^st Grade Hospital Asst.	4
2^nd Grade Hospital Asst.	4
3^rd Grade Hospital Asst.	4
Vernacular Class Native Doctors	20
Apothecary Class Native Doctors	32
Locally Entertained Native Doctor	9
Private Practitioner	1
Total	92

Table 1: Categories of medics employed in Bengal dispensaries. [Source: Home (Medical) Proceedings (1874), India Office Records, British Library, London, 175.]

Assistant Surgeons were graduates of the Calcutta Medical College and received an education in which coverage of the various indigenous learned traditions was very limited. Moreover, the limited opportunities that did exist for the introduction of indigenous medical traditions, as pointed out by Hochmuth, was dependent on learned Pandits, giving it a classical rather than contemporary flavour. The Vernacular Class on the other hand commenced in 1851 with a view to meeting the huge deficit of qualified medical practitioners. The course was for three years, unlike the five year courses for the MB and LMS degrees, and according to a report in the Indian Medical Gazette on 2 November 1868, due to a paucity of Bengali text books, teaching in this class depended principally upon class lectures.⁴⁴ The most amorphous category was that of 'locally entertained Native Doctors.' In 1873, Dr. Barker wrote that they 'were in fact mere compounders, and were employed simply because government native doctors were not available and better could not be found.'⁴⁵ Many dispensaries, moreover, were entrusted to the charge of 'Native Doctors,' a designation even more notorious for its imprecision. It could mean a graduate from any of the three year courses or a graduate of the School for Native Doctors abolished with the founding of the Native Medical Institution, a graduate of this later institution, or even an apprentice who had been certified by the medical officer-in-charge at various dispensaries.

The wide variety of educational backgrounds obviously militated against any uniform approach to treatment. The 1868 report on the Lalpur Branch dispensary in Rajshahi district, for instance, mentions that, 'The Native Doctor in his report details at length several prescriptions of Native medicines which, he says, he finds useful in various forms of disease.' Similarly the report on the Tripura Charitable Dispensary in the same year also mentions that, 'indigenous drugs have been used freely during the year in the treatment of different diseases which came under observation.' In contrast, the report on the Kamrup Dispensary stated that 'No particular indigenous drugs have been much used, as the nature of the cases generally require active and certain remedies.' The Chakdighi Branch Dispensary in Bardhaman district went further and reported that, 'the people ha[d] great faith in the English system of treatment, and the unusual demand for practitioners is now-a–days met by a large class of ignorant and self-styled Doctors whose knowledge of the medical science consists in treading the threshold of the Medical College, or being a compunder to his own class.' In the Barasat Dispensary too a similar disjuncture was seen between the public's desire for European medicines and the sub-assistant surgeon's preference for indigenous drugs. The dispensary report mentions that, '[t]he Sub-assistant Surgeon uses indigenous drugs largely in his practice; he finds them useful ... [and] better borne by patients than expensive European drugs. Their use, however, was not introduced without 'strong opposition from the inhabitants, even intelligent persons,' who reported the matter to the civil authorities as a great grievance.'⁴⁶ The great variety of backgrounds from which the medical officers were drawn as well as the exigencies of their local circumstances affected the treatment they offered. The local medical market too influenced the medical officer's choice. In the case of the Dinajpur Charitable Dispensary, for instance, it was said that, 'indigenous drugs are not easily procurable in this place, and they are sold at a high price, and for these reasons are less used than in many other dispensaries.' Similar was the case of the Sadar Dispensary of Rangpur. Branch dispensaries of Jangipur and Jamoakandi in the district of Murshidabad, on the other hand, reported chronic shortages of European medicines.⁴⁷

A wealth of material on the precise treatment followed by this varied set of medical officers can still be found in the numerous medical journals that appeared from the second half of the nineteenth century. The Chikitsha Shommiloni, for instance, regularly carried case histories sent in by physicians from all over the province. One such report sent by Dr. Bipin Bihari Ghosh from Pingla, Midnapur mentions how a mixture of palm candy, butter and pollens from Serpent's Hood flowers, as recommended by Charak, stopped bleeding in cases of piles in a couple of days, whereas the prevalent 'daktari' (Anglo-Indian) treatment took up to two weeks.⁴⁸ Dr. Bhagwan Chandra Rudra, MD, sent in another case history in which he advocated the use of Shnekobish (arsenic) for the treatment of Pernicious Anaemia, instead of the better known treatment with Iron compounds.⁴⁹ Perhaps not surprisingly the Chikitsha Shommiloni also carried a serialised article by Jadunath Mukharji, a graduate of the Bengali Class and a prolific author of Bengali texts on Anglo-Indian medicine, in defence of quacks. Mukharji argued that, given the extreme shortage of qualified medical men, as well as the expensive fees charged by such men, there was sufficient reason to allow quacks to practice, since they knew a few useful medicines and provided the poor with a modicum of much needed medical care.⁵⁰

The standard of medical care available at these dispensaries was therefore clearly variable. As Hochmuth points out the popularity of the dispensary therefore varied widely depending on the stature of the medical officer in charge.⁵¹ Rev. Shepherd, for example, wrote of Sub-Assistant Surgeon Nabinchandra Pal of the Dhaka dispensary in the 1840s that

his kindness, attention and professional success in the treatment of diseases have gained the confidence of the inhabitants, and to these excellent qualities and his good conduct in every respect, I have no hesitation is [sic] ascribing the progress which the Institution is daily making in popularity and usefulness.⁵²

Similarly, about Umacharan Set of Agra it was said that, 'the most perfect confidence...[was] placed' upon him by the people and they came from 'great distances.' Many were even said to return with their 'sick comrades' after being cured.⁵³ Rajakrishna Dey was similarly credited with the popularity of the Delhi dispensary. When he died suddenly, numbers dwindled 'very considerably' and though the dispensary remained open it got few patients.⁵⁴

Several reports mention the personal charisma of the physicians as being crucial to the popularity of the dispensary. Yet popularity was seldom universal. What was popularity and charisma to one was often notoriety to another. Since professional standards of achievement were not enforced at the level of the dispensary, and reliance instead placed on lay popularity, difficulties arose when a medical figure was very popular with a particular group but exactly the opposite with another group. The question then arose as to whose opinion was to count.

While the dispensaries were undoubtedly very responsive to local opinion, exactly whose opinion mattered was always a contentious matter. In the Jamoakandi Branch dispensary in the 1870s, for instance, complaints were received against the Sub-Assistant Surgeon Hari Narayan Banerji. Civil Surgeon Major Shircore, who investigated the matter, found Banerji to be an extremely conscientious and popular man. Not only was Banerji a good doctor, but he often paid for the medicine and food of poor patients from his own pocket. Shircore suspected that it was a 'party spirit' amongst the local elite spurred perhaps by Banerji's meteoric popularity amongst the poor that was behind the complaints. Shircore while noting all this was still forced to transfer Banerji to another station merely to placate the local elite and keep them contributing.⁵⁵

Caste, apprenticeship and dispensary education

The search for legitimacy and local popularity were also institutionalised into the system of accepting local apprentices to be attached to the dispensary.⁵⁶ These apprentices were often paid a small stipend and encouraged to learn Anglo-Indian medicine through practical engagement.⁵⁷ They often played a significant role in the care of the sick who attended the dispensary. Sub-Assistant Surgeon Kalachand Dey of the Bhowanipur Dispensary for instance, mentioned how the two apprentices, Sannyasi Das and Ali Baksh had shouldered most of the responsibility when the compounder and an older, more experienced apprentice, Jadab Chandra, fell ill at the same time.⁵⁸

The ambit of the apprentices' education as well as the procedure of their appointments were ad hoc at best and depended on both local circumstances as well as the views of the superintendent. The candidates were often chosen on the basis of their family. The first report of the Kanpur Dispensary in 1841, for instance, describes the three apprentices as being of 'good caste and good family.'⁵⁹ Such considerations also meant that families with close contacts with the government were more likely to be chosen; two of the three Apprentices at Kanpur were thus sons of native commissioned officers.⁶⁰ At the newly opened Mutra Dispensary in 1843, of the three apprentices, Seo Gobind was the son of the 'Dawk Moonshee' (native post-master), Suroop Sing Rajpoot was the son of an invalided Cavalry Trooper, and Sookha Nund was the son of the local Shroff (money changer).⁶¹ Kishenprasad at Kanpur in 1843 was the son of a native doctor.⁶²

Considerations of caste were important not only in the selection but also in the later advancement of the apprentices. In 1842, Suraj Baksh was dismissed from his position as apprentice at the Allahabad Dispensary due to objections raised against him for being of the 'Bearer caste.' In contrast another high caste apprentice, Chunni, was kept on at the same dispensary despite being 'negligent' and unwilling to approach corpses or dress ulcers.⁶³ In a similar vein Jubbroop, an apprentice belonging to the lowly Chamar caste at the Kanpur Dispensary, despite being intelligent and attentive was said to make little effort to educate himself further since he knew that his caste would prevent any further promotions.⁶⁴ In Farrukhabad, on the other hand, the apprentices were ex-students of the Government School, who were initially taken on in a private capacity by the superintendent and given a stipend from his own pocket, until they had acquired sufficient knowledge to be recommended for government stipends.⁶⁵ But in Chittagong, despite repeated efforts and inducements the government failed to interest any of the students of the Government School or the Roman Catholic School.⁶⁶ The two candidates finally obtained were ignorant of the English language and therefore encouraged to attend the Government School in their spare time. Since linguistic competence enabled or obstructed access to certain medical traditions, the widely divergent linguistic competence of the Apprentices was also likely to have influenced the medicine they practiced.

The actual training that these apprentices had received varied greatly with their own educational backgrounds as well as the interest that was taken by the sub-assistant surgeons. In Kanpur, since both the apprentices were Urdu scholars, they had been encouraged to translate the 'Persian Pharmacopoeia.' Sub-Assistant Surgeon Sadhu Charan Mullick also used to lecture them daily on other aspects of medicine. The apprentices were also encouraged to write down lectures in the form of a practical manual and used it to treat the 'simpler forms of disease' with 'most of the common European medicines.'⁶⁷ Dr. Barker at the Siuri Dispensary in the district of Birbhum, writing in 1873 mentioned a class of between eight to twelve students, whom he lectured in his 'leisure hours.' 'Practical hints [were] imparted daily' and the students taught the rudiments of 'medicine and surgery' and given a general overview of anatomy.⁶⁸ At Puri they were taught to compound medicines first and subsequently given a rudimentary education in anatomy. At Jabbalpur a similar course was followed, teaching first European and Native names and properties of the medicines, followed by compounding 'pills, powders etc.' and finally an overview of anatomy.⁶⁹ On the basis of their aptitudes they were promoted first to compounders and subsequently encouraged to sit for an examination to qualify as Native Doctors.⁷⁰ In 1842, for instance, the annual report informed that three apprentices, Najaf Ali, Mohammed Baksh and Sheikh Jahangir Baksh of Kanpur dispensary, had been certified as being qualified to become Native Doctors.⁷¹ The following year we again hear of two apprentices from Kanpur and one from Delhi being recommended as being fit to join service as Native Doctors.⁷²

Occasionally, apprentices were themselves practitioners of indigenous medicine. At the beginning of 1845, for instance, we learn from Sub-Assistant Surgeon E.J. Lazarus of Dhaka that, of the four persons who had applied for an apprenticeship, one was an elderly man who had 'been practising as a native Cabrauz [sic] [Kaviraj- a term used in Bengal to refer to practitioners of Ayurvedic medicine] for many years.'⁷³ A few years later Neem Chand Das Gupta, the descendent of one of the best known medical families of Bengal travelled to Dhaka to work as an apprentice and learn Anglo-Indian medicine. It was through him that Thomas Alexander Wise, one of the earliest and most prolific English writers on Ayurveda, gained much of his knowledge of the ancient practice.⁷⁴

Many of these apprentices became agents for the further dissemination of Anglo-Indian medicine. Some left after having attended the dispensary for a while to set up independent practice, while others carried on an independent practice while still attached to the dispensary. Chaddalal, an apprentice at Mutra, for instance, is reported to have resigned to pursue 'private employment,' while Mahabir Prashad, who was attached as compounder at Agra and was very likely the same person who had earlier been an apprentice, failed to return from a six month leave of absence and it was believed that he had found employment elsewhere.⁷⁵ Barker's report in 1873 also mentioned that those Apprentices who had made good progress were either appointed as compounders or set up their own 'Chemist Shops' in the district.⁷⁶ There were also numerous cases of the theft of medicines from the dispensary by apprentices, pointing perhaps to a clandestine private practice. In July 1842, for instance, we learn that at Murshidabad, '[s]ince November [1841] two Apprentices ha[d] been attached to the institution, but one of them having been in the habit of carrying off medicines etc. has been dismissed.'⁷⁷ Similarly at the Bhawanipur Dispensary too we hear of the urgent need for a watchman, since drugs were regularly being stolen, a complaint repeated by Patna as well.⁷⁸ At the Kanpur Dispensary in 1844 an apprentice named Nookha was dismissed for 'theft of medicines.'⁷⁹

Figure 2: Neem Chand Das Gupta (left) and an unnamed Barber-Surgeon (right) both were apprentices at the Dhaka Dispensary under T.A. Wise. [Source: Thomas A. Wise, A Review of the History of Medicine (London: J. Churchill, 1867), preface.]

Ethnicity and the structure of pluralism

Scholars such as Hochmuth have rightly pointed out the plural nature of the medicine practised at the colonial dispensary. In a limited number of cases he has also suggested that the medicine practised could truly be referred to as 'hybrid.' Yet this is only part of the story, because Hochmuth, like many others before him, has consistently failed to disaggregate the category of 'indigenous medicine.' In the light of this failure, 'plural' or 'hybrid' medicine has been assumed to have been created through the parallel use or admixture of two or more clearly defined medical systems or traditions. Hochmuth indeed goes even further and seeks to find a truly 'hybrid' medicine in the 'development of a new medical system' that is sufficiently 'estranged' from the 'hegemonic scientific medical discourse.'⁸⁰ Thus not only are the parent traditions from which 'pluralism' or 'hybridisation' is expected to proceed seen to be unitary and mutually coherent, but indeed even the hybrid product is narrated as a 'new ... system,' possessing undoubtedly the systemic attributes of internal coherence and consistency. As Kavita Sivaramkrishnan's recent work on Punjab has amply demonstrated, indigenous medicine was a highly differentiated and diverse category that often appeared to be infinitely pluralised.⁸¹ In order to understand the pluralism or hybridity of the colonial dispensary we need to ask why some strains of 'indigenous medicine' were accepted and utilised while others were rejected by particular members of the medical establishment.

One of the most important factors to affect the nature of hybridisation was the linguistic or regional identity of the medical officers. The areas included under the administrative unit of the Bengal presidency included numerous ethnic and linguistic groups. A majority of the medical officers though were Bengalis. This often led to them being suspicious of indigenous physicians in the area where they were posted, while being very open to collaboration with indigenous practitioners from Bengal. One of the first reports in 1843 had opened with a reflection on the alienation of the Bengali doctors, writing that,

as almost all of them [sub-assistant surgeons] are natives of Bengal, and consequently strangers both in point of customs and language to the people of the Western Provinces, among whom many of them are appointed to labour, some time must be allowed for the softening down of mutual prejudices.⁸²

A classic example of this trend could be found in Iswar Chandra Ganguly, the sub-assistant surgeon at the Benares Dispensary in the 1840s. Benares enjoyed an almost mythic reputation for high learning in all matters including Ayurveda. In fact Susruta, thought by many to be the pre-eminent author on Ayurvedic surgery, was believed to be a resident of Benares. Ganguly, though, wrote of the indigenous practitioners of the region with disdain and called them 'superstitious quacks.' Yet this was not symptomatic of a general antagonism on Ganguly's part towards indigenous medicine. According to his reports he made widespread use of another medicine called the Lallgoonra for Diarrhoea which was developed by 'a very respectable Byed, residing at Kanchrapara, in Bengal, some 30 or 35 years ago.' Similarly, Ganguly's reports were also full of praise for another medicine called Nas, described as 'an invaluable stimulant, developed by Babu Ramgopal Bose of Calcutta.'⁸³

The Bengali doctors moreover were predominantly Hindus and occasionally betrayed their antagonism to Muslim patients in the garb of medical wisdom. Shyama Charan Dutta of the Jabbalpur Dispensary for instance, wrote in 1845:

There is another class of ailments to which the men of this part of the country like those of the Provinces are frequently subject, and on the successful issue of which depends their social honour and domestic happiness. I allude to derangements of the generative function. The Mahomedans are more subject to them than the Hindoos for reasons I need not mention. Seminal weakness, catarrhus vesicae, and impotence are frequent complaints among them. That these are generally brought on by over action, there can be no doubt...⁸⁴

Nearly thirty years later, in 1870, the predomination of Bengali doctors and their alienation from the locals can still be clearly seen in the annual reports. The report of the Native Doctor at the Garbeta branch dispensary in the district of Midnapur, for instance, referred to the local population as 'Sonthals and other savage people' and went on to mention that their religion was unlike that of the Hindus and they worshipped a god called Baram. He also mentioned that they had little faith in the European or Ayurvedic medicines and largely treated themselves. In Dibrugarh in Assam it was reported in the same year that the in-patients were mostly 'foreigners to the province' comprising of Bengalis and 'Hindustanis' [Upper Indians], while referring to the Assamese as an 'ignorant and prejudiced race.' Contrarily, the Kukis and Tripuris in Tripura and the Bhutias, the Nepalis and the Lepchas in Darjeeling were said to hold the dispensary in high esteem and to make good use of it.⁸⁵ Despite the imprecision which plagues these reports while referring to tribal groups, it is undeniable that different ethnic groups viewed the local dispensary differently and in many cases the Bengali medical officer was as alienated from his patients as any other foreigner.

Occasionally, the lack of awareness of the local medical ideas by the Bengali doctors led to conclusions which reflected and confirmed their prejudice towards the local population. Sadhu Charan Mullick of the Farrukhabad Dispensary for instance wrote in January 1844 that, 'formation of maggots in the nose' was a common affliction in the area; in a majority of the cases, he felt, it was the result of syphilis and was found mostly among the 'lower orders who never take the trouble of washing their bodies or seek medical advice.'⁸⁶ What Mullick saw to be a result of the unsanitary habits and callousness of the underclass, was actually a well-known affliction in the region that was referred to separately by Jadab Chandra Seth of Bareilly in 1840 and again in the report of Delhi five years later in 1845.⁸⁷ Seth also clarified that it was an affliction never seen in Bengal. It was known as Nuzlah by the Hakims of the region and was treated by Tobacco leaves and, contradicting Mullick's views, affected the rich and poor alike. Mullick's mistake was the result therefore, in equal measure, of his lack of acquaintance with the medical culture of the region as well as his thinly disguised disgust of the 'lower orders,' who formed the bulk of his patients.

At times though, the Bengali doctors would take advantage of their postings outside Bengal to add to their knowledge of local medicines. Jadab Chandra Ghose of the Mirzapur Dispensary, for instance, mentioned in his report that he had laid out a medicinal garden in the 'Hospital compound' with plants used by the 'Byeds and Hakims in this part of the world' and not mentioned in the Bengal Dispensatory and therefore 'unknown to many in ...[the] profession.'⁸⁸ Unfortunately as our evidence from the 1870s suggests, even after thirty years the 'softening of mutual prejudices' was still far from achieved. Ethnicity therefore continued to impinge upon the nature of the 'medical pluralism' that was offered at the colonial dispensaries. Moreover the awareness of ethnic difference within South Asia forces us to also unpack the category of 'indigenous medicine.' Not only were there more than one learned tradition, but there was also substantial regional variations among practitioners of these traditions. Furthermore, there were several nonclassical, nontextual and local traditions. 'Indigenous medicine' comprised of all of these and, as we have seen, the pluralism of the colonial dispensaries was not equally open to all.

Apart from the regional differences, many other factors influenced the decision to exclude certain strains of indigenous healing while accepting others. Faith healing, for instance, was an important aspect of indigenous healing culture that found no place in the medical pluralism of the dispensaries. The very first dispensary reports written in January 1841 mention that attendance at Murshidabad suffered due to immense crowds of patients flocking to the east of the district where an 'incarnation of an Hindu divinity' was said to have arisen and was believed to be able to cure all diseases. Though the sub-assistant surgeon is said to make widespread use of 'indigenous medicine,' no interest is expressed in finding out about the healing practised by the incarnation.⁸⁹ Other strands of indigenous healing that were rejected outright include the Rarees of Dhaka. Dismissively referred to as a 'class of native quacks,' they were said to treat 'eruptive fevers' with 'cold water.' On rare occasions despite the disinterest in learning from such strains of indigenous medicine, these nonlearned forms of healing could still elicit praise from individual physicians. A. Ross, the civil surgeon of Delhi for instance, wrote to Superintendent Surgeon George Playfair about a 'Native Oculist' who had come to acquire a great celebrity in the city. Ross wrote that 'putting aside a good deal of quackery' he considered the Oculist an 'expert' in the use of his 'rather clumsy instruments.'⁹⁰ The oculist is likely to have been a member of the group referred to in Tara Chand Pyne's report on the Moradabad Dispensary in 1845 as being known as Settias. These were itinerant oculists popular in the region and said to use 'Munturs or incantations' as part of their operations. Pyne, a Bengali medical officer, was extremely dismissive of them and wrote of them as being quacks and charlatans.⁹¹

Conclusion

A study of the medical culture at the colonial dispensaries, in particular those of the Bengal Presidency, show that crucial to the plural nature of the medicine practised at these dispensaries were issues of caste, class and region. Just as there was not one but several major as well as minor healing traditions within what is commonly known as 'indigenous medicine,' so too there were diverse and varied groups that practised Anglo-Indian medicine. Just as the learned Hakims of Delhi, the Kavirajs of Kanchrapara and the Sethias or Rarees were very different groups, so were Soorjo Goodeve Chuckerbutty and Mahabir Prashad of Agra or Bipin Bihari Ghosh of Pingla medical practitioners who were quite different from each other. Binary models such as those seeking to narrate the medical history of the region in terms of binary oppositions between the coloniser and the colonised, or between 'scientific medicine' and 'indigenous practice' are therefore inadequate. As suggested by authors such as Jean Langford, we need to get beyond histories knit around an encounter between two clearly demarcated 'systems' and look towards more localised stories of complex negotiations between a diverse and vertically stratified medical bureaucracy, on the one hand, and a complex milieu of indigenous healing praxes, on the other.⁹² Plurality too needs to be rewritten in this light as a constant process of reification and negotiation where caste, class, region, and other indices or power are crucial, thereby avoiding what Waltraud Ernst has called the 'conundrums of dichotomously arranged categories.'⁹³ From amongst the multiple strands of healing available in any given locality, precisely what to accept and what to reject as bunkum and quackery was a decision arrived at through the prisms of a variety of factors that marked out the distribution of social power.

University of Southampton

Acknowledgements

I thank David Arnold and Waltraud Ernst for their comments and encouragement. Their suggestions have been crucial to my argument. I must also thank the two anonymous referees whose comments went a long way in helping me bring out my argument with greater clarity. I remain solely responsible for whatever inadequacies persist.

Notes

^1. See for example P. Kutumbiah, "Public Medical Service and the Growth of Hospitals in India," Indian Journal for the History of Medicine 15 (1969): 37–45; Kenneth Ballhatchet, Race, Sex and Class Under the Raj: Imperial Attitudes and Policies and their Critics, 1793–1905 (London: Weidenfeld and Nicholson, 1980); Waltraud Ernst, Mad Tales from the Raj: European Insane in British India 1800–58 (London: Routledge, 1991); S. Hodges "'Looting' the Lock Hospital in Colonial Madras During the Famine Years of 1870s," Social History of Medicine 18 (2005): 379–8.

^2. David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley, CA: University of California Press, 1993), 246–54.

^3. Mark Harrison, Public Health in British India: Anglo-Indian Preventive Medicine 1859–1914 (Cambridge, UK: Cambridge University Press, 1994), 88–90.

^4. Christian Hochmuth, "Patterns of Medical Culture in Colonial Bengal, 1835–1880," Bulletin of the History of Medicine 80 (2006): 39–72.

^5. Mridula Ramanna, Western Medicine and Public Health in Colonial Bombay, 1845–1895 (New Delhi: Orient Longman, 2002), chapter 2; Jennifer Blake, "The Dispensary Movement in Bombay Presidency: Ideology and Practice 1800–1875," M.Phil Thesis, University of London, 2004.

^6. Quoted from James Ranald Martin's letter dated 29 April 1837 (Arnold, 248).

^7. Waltruad Ernst, "Plural Medicine, Tradition and Modernity Historical and Contemporary Perspectives: Views From Below and From Above" in Plural Medicine, Tradition and Modernity, 1800–2000, edited by Waltraud Ernst (London: Routledge, London, 2002), 3–4.

^8. Claudia Liebeskind, "Arguing Science: Unani Tibb, Hakims and Biomedicine in India, 1900–50" in Plural Medicine, Tradition and Modernity, 1800–2000, edited by Waltraud Ernst (London: Routledge, London, 2002), 58–75..

^9. Gyan Prakash, Another Reason: Science and Imagination of Modern India (Princeton, NJ: Princeton University Press, 1999).

^10. For a comprehensive review of the changes in the principles of medicine in the nineteenth century see W.F. Bynum, Science and Practice of Medicine in the Nineteenth Century (Cambridge, UK: Cambridge University Press, 1994).

^11. Ramanna; Sanjoy Bhattacharya et al., Fractured States: Small Pox, Public Health and Vaccination Policy in British India, 1800–1947 (New Delhi: Orient Longman, 2005).

^12. I use the phrase 'Anglo-Indian medicine' here in the sense it has been used by Mark Harrison, i.e. western medicine in India.

^13. Henry C. Burdett, Hospitals and Asylums of the World: Their Origin, History, Construction, Administration, Management, And Legislation (London: J & A Churchill,1893), 318.

^14. J.T.C. Ross, General Report on the Lunatic Asylums, Vaccinations and Dispensaries in the Bengal Presidency, 1868, V/24/664, India Office Records (hereafter IOR), British Library, London, 53, 49.

^15. Reports, V/24/664, IOR; Appendix B, No 32, Home (Medical) Proceedings, January 1870; Reports, V/24/749, IOR. Harrison has mentioned only 61 dispensaries in 1867, the discrepancy results from Harrison's having taken account of only the main dispensaries and not the totality of main, branch and sub-divisional dispensaries (Harrison, 89).

^16. Hochmuth, 58

^17. Ross, 52.

^18. Arnold, 66.

^19. Ian Hacking, The Taming of Chance (Ideas in Context) (Cambridge, UK: Cambridge University Press, 1990), 47–54.

^20. Half Yearly Reports, 1842–43, V/24/ 733, IOR, 148–9.

^21. Ross.

^22. Mark Harrison, 13.

^23. Hara Charan Sen, Venereal Disease in Bengali (Calcutta: Gupta Press, 1881).

^24. In 1851 a separate Bengali Class was started to meet the shortage of government doctors. The course was almost the same as the one followed for the Hindustani Class which had been started in 1839 for similar reasons. Proficiency in Bengali was compulsory for admission to the course and successful students were called Vernacular Licentiates in Medicine and Surgery (VLMS).

^25. Amrita Lal Bhuttacharya, A Practical Treatise On Malarious Fevers With Their Complications and Sequelae (Calcutta: (publisher unknown), 1897) 43.

^26. Doyal Krissen Ghosh, Malaria, (Calcutta: (publisher unknown), 1878), 17.

^27. Report of the Charitable Dispensaries under the Government of Bengal for the Year 1868, Appendix B, No 32, Home (Medical) Proceedings, January 1870, P/ 432, IOR.

^28. The Nawabs of Bengal had originally been governors of the Mughal emperor in Delhi, and from the early–eighteenth century they largely became independent rulers and the post became hereditary though formally Mughal authority was not repudiated by the Nawabs. The British came to acquire more and more political power after the Battle of Plassey in 1757, but they too continued the fiction of ruling in the name of the Mughal emperor, with the puppet Nawab officially being the emperor's governor. The power of the Nawab's were from then on successively attenuated until they were, by the beginning of the nineteenth century, converted into petty local landowners, though they continued to use the title of 'Nawab Nazim.'

^29. Reports 1840, V/24/732, IOR, 30.

^30.Ibid, 156–7.

^31. W.R. Edwards, Triennial Report on the Working of Hospitals and Dispensaries, V/24/749, IOR, 7.

^32. Arnold, 249.

^33. See for instance Superintendent Civil Surgeon Purves' comments regarding the Guwahati Dispensary (Report of the Charitable Dispensaries 1868).

^34. See for instance, Extract from the General Report for the Dacca Division, No. 111, 8 May 1863, Home (Medical) Proceedings, May 1863, IOR.

^35. Orders on the Rajshahi Dispensaries, File No. 86J, No. 23, General Dept., Judicial Dept. Medical, Calcutta, 22 September 1873, Home Medical Proceedings No. 24–8, September 1873, IOR.

^36. Burdett, 325.

^37. Reports 1840, V/24/732, IOR.

^38. Orders on Rajshahi.

^39. Extract From The General Report Of The Dhaka Division For 1862–63, No. 111, 18 May 1863, Home (Medical) Proceedings, May 1863, IOR.

^40. Orders on Rajshahi.

^41. C. Barnard, Offg. Secy. Government of Bengal (Judicial) to Inspector General Civil Hospitals, Indian Medical Department, No. 1301, dt. Calcutta, 28 March 1872, Home Medical Proceedings No 24–28, September 1873, IOR.

^42. Manual of Rules For The Management Of Charitable Hospitals and Dispensaries, West Bengal State Archives (hereafter WBSA), Calcutta, 1.

^43. Proceedings for the Government of Bengal Home Dept. (Medical Branch), January 1874, No. 5–6, WBSA.

^44. Cited in Subrata Pahari, Unish Shotoker Banglaye Shonatoni Chikitsha Byabosthar Sworup (Calcutta: Progressive Publishers, 1997), 172.

^45. Report on the Endemic Dispensaries in Beerbhoom District for the Year 1873, Medical Dept. (Proceedings) 1874, P/ 175, IOR.

^46. Report of the Charitable Dispensaries 1868.

^47.Ibid.

^48. Bipin Bihari Ghosh, "Chikitshito Rogir Biboron," Chikitsha Shommiloni 2 (1885): 194–6.

^49. Bhagwan Chandra Rudra, "Chikitshito Rogir Biboron," Chikitisha Shommiloni 2 (1885): 34–5.

^50. Jadunath Mukharji, "Hathurey Chikitshok," Chikitsha Shommiloni 2 (1885): 32–4.

^51. Hochmuth, p.59.

^52. Reports 1840, V/24/732, IOR, 202.

^53.Ibid., 146.

^54. Reports 1842, V/24/732, IOR, 159.

^55. Proceedings of the Medical Dept, Bengal, 1874, WBSA.

^56. An informal system of taking on apprentices had existed amongst the regions European physicians from the late–eighteenth century. Known as 'Native Dressmen,' 'Black Doctors' or 'Native Doctors,' they were employed both in the military as well as in the early dispensaries. By 1807 their numbers were already close to a hundred (See Pahari, 165). There was also an indigenous institution of medical apprenticeship in Bengal. See for instance, Poonam Bala, Imperialism and Medicine in Bengal: A Socio-Historical Perspective (New Delhi, Newbury Park, CA: Sage Publications, 1991).

^57. Taking on this educational role also made the dispensaries resemble hospitals. This also refuted opposition by those such as Duncan Stewart who had opposed the development of dispensaries on the grounds that they only alleviated disease without studying or curing it (See Arnold, 248).

^58. Reports 1844, V/24/734, IOR, 7.

^59. Reports 1841, V/24/732, IOR, 7.

^60. Reports 1840, V/24/732, IOR, 134.

^61. Reports 1842, V/24/733, IOR, 196.

^62. Reports 1842, V/24/733, IOR, 178.

^63.Ibid., 76.

^64.Ibid., 82.

^65. Reports 1844, V/24/734, IOR, 77. Such instances are by no means rare and cast doubts on the actual number of Apprentices attached to the dispensaries at any time, since obviously not all names were entered into the government records.

^66. Reports 1842, V/24/732, IOR, 193.

^67. Half Yearly Reports 1844, V/24/734, IOR, 78.

^68. Report on the Endemic Dispensaries in Beerbhoom District for the Year 1873. Medical Dept. (Proceedings) 1874, P/ 175, IOR

^69. Reports 1842, V/24/733, IOR, 110–17.

^70. Reports 1844, V/24/734, IOR, 72.

^71. Reports 1842, V/24/733, IOR, 82.

^72. Medical Board to W.W. Bird, Deputy Governor of Bengal, Letter No. 13 of 1842–43, V/24/733, IOR, 147.

^73. Reports 1844, V/24/734, IOR, 33–4.

^74. Thomas A. Wise, Review of the History of Medicine, (London: J. Churchill, 1867), 'preface'.

^75. Reports 1845, V/24/735, IOR, 106; Reports 1844, V/24/734, IOR, 94.

^76. Report on the Endemic Dispensaries 1873.

^77. Reports 1842, V/24/733, IOR, 24.

^78.Ibid., 3.

^79.Ibid., 178, 181.

^80. Hochmuth, 67.

^81. Kavita Sivaramakrishnan, Old Potions, New Bottles: Recasting Indigenous Medicine in Colonial Punjab (1850–1945) (New Delhi: Orient Longman, 2006).

^82. Reports 1840, V/24/732, IOR.

^83. Reports 1840, V/24/732, IOR, 162–6.

^84. Reports 1845, V/24/735, IOR, 125.

^85. Report of the Charitable Dispensaries 1868.

^86. Reports 1844, V/24/734, IOR, 8

^87. Reports 1842, V/24/732, IOR, 271; Half Yearly Reports 1845, V/24/734, IOR, 112.

^88. Reports 1848, V/24/736, IOR, 86.

^89. Reports 1842, V/24/ 732, IOR, 24.

^90. Reports 1840, V/24/732, IOR, 161.

^91. Reports 1845, V/24/735, 135.

^92. Jean M. Langford, Fluent Bodies: Ayurvedic Remedies for Postcolonial Imbalance (Durham, NC: Duke University Press, 2002).

^93. Ernst, 3.

Content in the History Cooperative database is intended for personal, noncommercial use only. You may not reproduce, publish, distribute, transmit, participate in the transfer or sale of, modify, create derivative works from, display, or in any way exploit the History Cooperative database in whole or in part without the written permission of the copyright holder.