How Calcutta became the centre of colonial medical studies

One account, as quoted in P Thankappan Nair’s Calcutta in the 18th Century: Impressions of Travellers, paints a dramatic picture of the situation:

“The climate of Bengal is perhaps as bad as any in the universe and remarkably fatal to our countrymen. It abounds so much with standing water and earth is so much impregnated with saltpetre…the air becomes absolutely putrid and this occasions the frequency of agues and putrid fever. Of the eighty-four…we had but thirty-four remaining in three months—a convincing proof how fatal this climate is to Europeans.”

From the 17th to the 19th centuries, malaria was the predominant concern, followed by plague, typhoid, cholera, tuberculosis, typhus, and smallpox, many of which continued well into the 20th century. These persistent health crises earned colonial territories a notorious reputation and prompted the British crown to view tropical disease as a societal, rather than personal crisis.

The hot, humid climate in Calcutta was a breeding ground for parasites and pathogens unknown in Europe. (Wikimedia Commons)

Roy emphasises, “The stakes were high: not only were British citizens suffering, but there was also the looming threat of these diseases spreading to Europe. This anxiety drove urgent studies and interventions.”

In her book Western Medicine and Colonial Society: Hospitals of Calcutta, Srilata Chatterjee highlights that Calcutta’s rise as a medical research hub is intricately linked to its growth as the colonial capital with a cosmopolitan culture.

The East India Company brought medical officers with its first fleet in 1608 and established facilities to care for its troops. Over time, hospital boards were set up, and by 1785, medical departments were established in the Bengal, Madras, and Bombay presidencies, staffed by 234 surgeons. Among their early efforts was a military hospital at Fort William in Calcutta, where Indian soldiers were among the first to receive care from British surgeons. Though some high-caste soldiers were wary of European medicines due to caste norms.

Meanwhile, the British were not only advancing medical care but also deeply involved in researching Indian medicinal plants. In 1786, they founded the Royal Botanic Garden in Calcutta, the first of its kind in the region. With a near-monopoly on Western scientific activities in India, the East India Company meticulously safeguarded its commercial interests. The company rigorously controlled scientific expeditions to ensure that only its servants and experts conducted research.

Medical care, too, was exclusively reserved for British soldiers. However, by the late 18th century, the swelling European population in Calcutta demanded more medical facilities. Enter the Presidency General Hospital, Calcutta’s first hospital to step outside the fortress walls. It wasn’t just a place for European civilians and military personnel to get treated; it was also a tropical disease training ground for newly arrived English surgeons. The hospital’s exclusivity was so stringent that it was staffed almost entirely by Europeans, with only a few token local positions. Meanwhile, the native population continued to depend on traditional practices such as Ayurveda and Unani medicine.

The Presidency General Hospital, now known as the SSKM hospital was Calcutta’s first hospital to step outside the fortress walls. (Express photo by Nikita Mohta)

At the same time, the colonial government’s military medical administration set about creating asylums to address mental illness, blaming the tropical heat and physical strain for European lunacy. One of Bengal’s earliest institutions was the Bhowanipore asylum.

A fascinating turn of events in the latter half of the eighteenth century was the rise of hospitals for the local populace, spurred by the civic-mindedness of European residents, surgeons, and local elites. This philanthropy, driven by the pursuit of social prestige and political favour, led to the founding of the Native General Hospital on Chitpore Road in North Calcutta in 1794. Although supported by Bengali leaders like Ramkamal Sen and Dwarakanath Tagore, the hospital was managed by nine British governors along with Armenian and Portuguese officials.

Building on this philanthropic momentum, the British set up the Native Medical Institution (NMI) in Calcutta in 1822 to ensure a steady stream of “native doctors” for the East India Company. The NMI offered instruction in local languages and blended indigenous and Western medical teachings. Ayurveda found a home at Sanskrit College, while Unani medicine was taught at the Calcutta Madrasa, established in 1781 by Warren Hastings. As history enthusiast and blogger Rangan Dutta notes, “Although training in indigenous methods like Unani and Ayurveda existed before the British, it was informal. It was the Europeans who introduced formal degree education in medicine through a structured syllabus in India.”

The Eurocentric shift in Indian medical practice

The brief spotlight on indigenous medical training was dimmed by the 1830s. British administrator John Grant’s 1834 report criticised the NMI’s methods, and Thomas Macaulay’s 1835 push to cut funding for institutions using native languages dealt a serious blow to traditional practitioners. Historian Deepak Kumar notes in Science and the Raj, 1857-1905 that by early 1835, the closure of medical classes at Sanskrit College, Madrasa, and the Native Medical Institution led to the founding of the Calcutta Medical College, which mandated that students “learn the principles and practice of medical science in strict accordance with the European model”.

He suggests, “This was an important event, for henceforth, through syllabi and language, was to be fostered a ‘dependent science,’ and Indians were made to look for Western models in every field of medical science.”

The Calcutta Medical College (Express photo by Nikita Mohta)

Aligned with this view, Mark Harrison, in his essay Racial Pathologies, highlights that the College emphasised on anatomy from the outset. Encouraging Indians to engage in dissections was seen as a bold move against superstition.

“For this reason, the first dissection performed by an Indian—which took place at the college in 1836—was celebrated as a major event and received widespread coverage in the press in India and Britain,” Harrison writes.

Between 1835 and 1858, the college trained 456 “native doctors”. While some served the East India Company, others took roles with Indian princely states or started practices for the city’s elite. With an eye on creating a blueprint for future teaching hospitals, the Medical College Council, led by Secretary David Hare, proposed the construction of a new hospital.

In tandem with Calcutta Medical College, Madras Medical College opened its doors in 1835. It was followed by Grant Medical College in Bombay in 1845, Agra Medical School in 1854, King Edward Medical College in Lahore in 1860, and King Edward Medical School in Indore in 1878. These institutions transformed the colonies into hubs of medical innovation, particularly in tropical medicine, with discoveries that even made waves in Britain. Meanwhile, British techniques like Joseph Lister’s antiseptic methods, Sir Henry Thompson’s lithotripsy, and the Wasserman test for syphilis found their way into Indian medical practice.

After the Crown took over administration in 1858, the British presidencies’ medical departments merged into the Indian Medical Service (IMS). The IMS made headway against diseases like cholera, plague, leprosy, smallpox, and malaria. Pointing to a plaque inside SSKM, Roy proudly declares, “Here is where Surgeon Major Sir Ronald Ross, a pivotal IMS figure, revolutionised malaria research!” Ross’s groundbreaking work earned him the Nobel Prize in Medicine in 1902.

At first, medical efforts in India were all about tackling tropical diseases, but soon they turned their attention to overhauling traditional midwifery. Historian David Arnold, in his book Science, Technology and Medicine in Colonial India, describes how traditional midwives, or dais, were often painted as “wizen hags” responsible for high maternal and infant mortality. In Calcutta, Western medical practices began reshaping childbirth management. Driven by utilitarian principles and Victorian ideals, the government introduced new health and sanitation measures.

By the late 19th century, Western medicine became a symbol of modernity for the upper-caste Hindu bhadralok. Madhusudhan Gupta, a leading advocate, took aim at native childbirth practices and pushed for a maternity hospital. His dream materialised in 1840 with the establishment of a lying-in hospital affiliated with Calcutta Medical College. But Gupta was not alone in his scientific zeal. Rammohun Roy’s well-known petition to Governor Amherst called for improved science education, and in 1833, the Derozians launched Bignan Sar Sangraha, a bilingual monthly for spreading scientific knowledge. By 1842, missionary J Long observed that Calcutta had a touch of Cambridge or Oxford.

The first medical efforts in Calcutta were all about tackling tropical diseases. (Wikimedia Commons)

The training of Indian women in medicine and nursing also gained significant momentum, fuelled by social and religious reforms. This was bolstered by the Dufferin Fund, set up in 1885 by Irish vicereine Lady Dufferin to provide medical aid and education to women in India.

“Western medicine in India was no longer merely a colonial project,” notes Arnold. Echoing this, Chatterjee points out, “Although it began with a political aim to secure the health of the European army, by the 19th century, considerations of public health and dangers of epidemic outbreak led to the foundation of institutional medical care for the local population.”

Race and Gender Politics in Colonial Healthcare

Despite growing faith in scientific principles, British racial superiority persisted, as evident in hospital conditions. The Presidency Hospital for Europeans was clean, with regular whitewashing and nutritious meals served in spotless utensils. In stark contrast, native hospitals faced severe neglect. As Chatterjee describes, “The reeking stench, dirt, and uneven ground with pits filled with stagnant water and rubbish undermined efforts to present the hospital as a hygienic place for medical care.”

At hospitals like Calcutta Medical College, which catered to both European and Indian patients, strict racial segregation was enforced in both male and female wards. Until 1859, the lack of separate wards for European women discouraged many European families from using these facilities.

Discrimination in care quality

The European ward was better equipped, with dedicated nursing staff for bedridden patients and higher-quality diets compared to those provided to their native counterparts. The cost of these enhanced diets often exceeded the budget, with the additional expenses covered by reducing allowances for native patients, as noted by Chatterjee.

The Government of Bengal, unlike Bombay and Madras, enforced segregation in its asylums. As Chatterjee notes, there were “separate asylums for the local Hindu and Muslim population and another for the Christian European and Eurasians”. Despite this, the upper classes continued to disdain public hospitals, preferring expensive home care.

Arnold highlights how prejudice was reflected in the racial and professional exclusivity of institutions like the IMS, situated in remote hills away from the local population and diseases. Kumar adds, “Since 1878 Indians in the higher grades were getting only two-thirds of the pay of their English colleagues doing the same work.” This pay disparity impacted prominent Indian scientists like Jagadish Chandra Bose and P C Ray, with Bose refusing a reduced salary.

Biswamoy Pati and Harrison, in their engaging work The Social History of Health and Medicine in Colonial India, shed light on the ever-present, though sometimes subtle, role of race in colonial health policy. “Race was sometimes present in explicit ways, such as in medico-bureaucratic categories and segregated medical institutions, but just as often in unspoken assumptions about the needs of Indian people, their susceptibility to different forms of illness, and the role of their habits in the production of disease,” they write.

Racial divisions have long marginalised ordinary Indians in medical policy. Despite efforts to “Indianise” the Indian Medical Service in the early 20th century, Europeans continued to dominate top positions. This historical exclusion has left a lasting imprint on current practices. Recent calamities have exposed glaring safety and rights issues within the system. As we strive for fairness in medical care and administration, it is essential to address these long-standing imbalances and ensure that healthcare is not just an exclusive club for the city’s elite.

Further reading:

Western Medicine and Colonial Society Hospitals of Calcutta, c.1757-1860 by Srilata Chatterjee

The New Cambridge History of India Science, Technology and Medicine in Colonial India by David Arnold

Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India by David Arnold

The Social History of Health and Medicine in Colonial India Edited by Biswamoy Pati, Mark Harrison

Science and the Raj, 1857-1905 by Deepak Kumar

Western Medicine and Public Health in Colonial Bombay, 1845-1895 by Mridula Ramanna