NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
224
the other (quinine) exerting its influence through some defence mechanisms
of the body. Owing to its slow excretion atebrin appears to exert a more
prolonged action than quinine.
The treatment of chronic intestinal amoebiasis presents many difficul-
ties in the tropics and none of the treatments recommended are satisfac-
tory . Chemotherapeutic s tudies were conducted both in the laboratory as
well as in the hospital with the alkaloids of Holarrhena antidysenterica
(Kurchi), an organic arsenic derivative called carbarsone, yatren and other
drugs. A preparation of the total alkaloids from H. antidysenterica called
kurchi-bismuth-iodide and an organic compound of arsenic carbarsone gave
encouraging results:
VII. Biological standardisation of drugs on the Indian market.
A large number of drugs on the market were biologically assayed in the
department of pharmacology and were found not to possess the thera-
peutic activity that they are alleged to have. The high atmospheric tem-
perature, combined with a high degree of humidity, produces deterioration
during storage. Those manufactured in India, including some of the potent
compounds of arsenic and antimony, are subject to no control whatever by
the State and consequently they vary a great deal in strength. In 1930,
the Drug Inquiry Committee was appointed by the Government of India
to go fully into the question of drug adulteration in India. This committee
recommended the urgent need for the standardisation of drugs and for legis-
lative measures to control the drug trade and industry. In the absence of
any legislation the Indian market is glutted with products of inferior quality
and this constitutes a serious menace to the public health. It is gratifying
to note that as a result of the recommendations of this committee, the
Government of India have taken steps to introduce a bill to control the
import of adulterated drugs into India. A laboratory consisting of Bio-
assay and Pharmaceutical sections has also been recently established under
the direction of Brevet Colonel R. N. Chopra to analyse and assay the
purity and potency of medicinal preparations in the Indian market. It is
hoped that the provincial governments will now bring in legislation to
control the manufacture of drugs on the 'lines recommended by the Drugs
,Enquiry Committee.
CANCER.
The extent to which Cancer prevails in India has been the subject of
considerable speculation. .Most writers on the subject have indulged in
assertions based on little or no investigation and have tried to account for
the supposed rarity of Cancer in India according to their pet theories.
Mortality statistics in India except in Presidency towns are not based on
proper death certificates. Even in Presidency towns the certification is
often of a perfunctory and misleading nature. Death rate due to many
infectious diseases, which have disappeared from most civilised countries,
is still very high in India and expectation of life very low. The anemia
Contributed by Dr. Vishwa Nath, M.D., B.S. (Punj.), F.R.C.P. (Ireland).
226
the oral cavity, the penis, skin or the gastro-intestinal tract, the factor of
irritation seems to excel all other possible causes and brings the problem
of this fell disease within the scope of Preventive Medicine.
7 The following papers published as the result of this survey will afford
a detailed view of the information collected:—
(i) Malignant disease in the Punjab; Indian Medical Gazette, March
1933.
(ii) Cancer in India; Indian Journal of Medical Research, July 1935.
(iii) Cancer in India; Indian Journal of Medical Research, January
1937.
The final paper in connection with this survey is under preparation and
will be published shortly.
8. Although this survey cannot fix decisively the relative position of
Cancer amongst the causes of mortality in India, it affords sufficient
evidence as to this position being not insignificant. It should at least per-
suade foreign writers on the subject to be less dogmatic about the rarity of
this disease in India. The writer of this note believes that if vital statistics
were as carefully collected in India as they are in the West and proper
allowance made for the number of individuals living per thousand at a
given age, the incidence of Cancer will be found to be independent of
geographical and racial variations.
6. HISTORY AND ACTIVITIES OF IMPORTANT INSTITUTIONS
CONNECTED WITH MEDICAL RESEARCH IN INDIA.
• (i) THE CENTRAL RESEARCH INSTITUTE', KASAULI.
When proposals were put forward in the earlier years of the present cen-
tury for the establishment of a Bacteriological Department for India an
essential part of the scheme was the formation of a Central Institute for
Medical Research. In 1904 the Government of India with the sanction of
the Secretary of State approved the proposals and work was commenced on
what is now the Central Research Institute. It was decided to locate it at
Kasauli in the Simla Hills, some 6,000 feet above sea level. A large bunga-
low and its site was adopted for the purpose, extensive additions being made
to provide the necessary accommodation and the Institute was opened in
1906. The first Director was Lt.-Col. Semple, later Sir David Semple, who
had established and been the Director of the first Pasteur Institute in
India in the same station.
2. It was intended that the Institute would form a centre for research
and a basis from which field inquiries would be conducted and that it
should also undertake the manufacture of sera and vaccines for which there
was an increasing demand. The scheme for the Institute included pro-
posals for sections dealing with bacteriology and immunity, malarial
research, medical entomology, sera and vaccine manufacture and other sub-
jects. Its functions in regard to such lines of work have varied from time
Contributed by Colonel J. Taylor, C.I.E., D.S.O., V.H.S., I.M.S.
227
to time and the Institute has been the centre for research on a variety of
medical and public health problems. Bacteriology and immunology have
always been the main subjects of study. Malaria on which much work was
done in the earlier years was later taken over by the Malaria Survey of
India (now called the Malaria Institute of India) accommodated in the same
buildings but designated as a separate organization. Work on medical
entomology has been done on a large scale but conduct of research in this
line has varied with the inclination and experience of successive members
of the staff of the Institute.
3. The manufacture of sera and vaccine has constituted an ever growing
part of the routine work of the Institute and during the War years the
Institute was almost entirely devoted to the preparation of T. A. B. and
cholera vaccines and later on influenza vaccine for the use of the Army.
Production on an unprecedented scale was necessary for the prophylactic
inoculation of troops in India, Mesopotamia, Egypt, East Africa and else-
where. The research activities of the Institute were largely in abeyance
until 1920 but when resumed much valuable work was done on malaria,
entomology, dysentery, cholera, relapsing fever and other subjects.
4. The Institute conducts research work on its own resources on pro-
blems associated with the vaccine and other products issued and in addition
houses inquiries financed by the Indian Research Fund Association which
are carried out by its own staff or by attached workers. During the last
five years an extensive basic investigation has been in progress in relation
to cholera problems and a fruitful Inquiry ha recently been completed on
the venoms of the principal Indian snakes. This latter work has been
partly in relation to the properties of the antivenene prepared against the
venoms of the Indian Cobra and Russell's viper, for which the Institute is
the sole source of manufacture and supply in India.
5. The Institute fulfils also the functions of a Bacteriological Laboratory
for the Central Government and carries out such routine work as may be
required including the testing of disinfectants for the Stores Department
and other procedures. It also acts as a bureau of information and advice
on medical and public health problems and its extensive specialised library
is made available for the use of accredited persons.
6. The Institute houses the Library and Stores of the Indian Research
Fund Association. The Director is ex-officio Editor of the Indian Journal
of Medical Research and the Indian Medical Research Memoirs which he
conducts on behalf of the Indian Research Fund Association.
7. The Central Research Institute is administered by the Director-
General, Indian Medical Service, for the Department of Education, Health
and Lands of the Central Government. The Director of the Institute is
usually the senior member of the Medical Research Department and the
permanent staff includes three other officers of the same Department. Sir
David Semple, the first Director, was followed in succession by Lt.-Col.
W. F. Harvey and Colonel Sir Richard Christophers. The present Director
is Colonel J. Taylor, I.M.S. 0 2
228
(ii) THE SCHOOL OF TROPICAL MEDICINE, CALCUTTA.
The School of Tropical Medicine is the only centre in India for post
- g r a d u a t e t e a c h i n g i n t r o p i c a l d i s e a s e s . T h e i n s t i t u t i o n o w e s i t s e x i s t e n c e
to the efforts of Sir Leonard Rogers, whose work in connection with cholera,
dysentery and other tropical diseases is so well known. The idea of estab
-lishing a research centre for tropical medicine in Calcutta definitely formed
itself in his mind in 1910 and after working indefatigably for nearly 10
years, he achieved his object. The foundation stone of the School was laid
by Lord Carmichael, the then Governor of Bengal and the institute began
to function from 1921. The School has attached to it a special research
hospital for tropical diseases. This was built, equipped and endowed by
public subscription at a cost of Rupees 3¼ lakhs and enables the workers
at the School to carry on clinical research under strictly controlled condi
-tions. This is one of the unique features of the institution and the facilities
that it offers for research and investigation of obscure cases of disease are
available in few other places. In the Out-patient Department attached to
this Hospital patients are examined: and from among these, selection is
made of those suitable for post-graduate teaching and research work.
2. The Endowment Fund which Sir Leonard Rogers raised has since
1921 frequently come to the rescue of research work at the School when
official funds were not forthcoming and it stood at a sum of just over Rs. 9
lakhs. The Endowment Fund and the grants from the Indian Research
Fund Association are the very core of the research activities of the School.
3. In addition to the Government of India, the Government of Bengal,
the institution, with its all-India interests and importance, has received
very considerable financial support from other sources, as the following
figures will show.
The capital cost of the whole scheme was as follows :—
Rs.
Government of India . . .
5,00,000 =32 per cent.
Indian Research Fund Association . . .
2,00,000 =13 "
Government of Bengal . . .
4,82,853 =31 "
Endowment Fund of the School . . .
3,84,000 =24 "
Total . . .
15,66,853
4. The sources of income may be illustrated from the combined budget
of the School and the Carmichael Hospital for Tropical Diseases for 1932--
33. The figures were as follows:—
SCHOOL.
Rs.
Government of Bengal . . .
2,80,838 =43 per cent.
Indian Research Fund Association . . .
2,05,829 =32 "
Endowment Fund of the School . . .
1,63,488 =25 "
Total . . .
6,50,155
Contributed by Colonel R. N. Chopra, C.I.E., K.H.P., I.M.S.
229
HOSPITAL.
Government of Bengal .
.
.
Rs. 1,28,051 =100 per cent.
These figures show how very important is the financial aid received from
the Indian Research Fund Association who receives very good value for the
money so expended: if Simla and Kasauli are the "spiritual home" of that
Association, a very large part of the valuable work which it carries out is
done in Calcutta.
5. As indicated above the School serves the double purposes of post-
graduate teaching and research work in Tropical diseases. Three classes
are held annually, one from October to April, terminating in the examina-
tion for the Diploma of Tropical Medicine (D.T.M.); one from July to
October terminating in the examination for the Licentiate of Tropical Medi-
cine (L.T.M.), and one in conjunction with the All-India Institute of
Hygiene and Public Health, lasting nine months and terminating in the
examination for the Diploma of Public Health of the Calcutta University.
Students in these classes come from all parts of India, and from many
countries overseas such as Ceylon, Burma, America, China, Siam,
Australia, New Guinea, Egypt and Kenya. The teaching staff consists of
nineteen professors, assistant professors and lecturers. The following
departments are in existence in the School:—(1) Department of Tropical
Medicine, (2) Department of Pathology, Bacteriology and Helminthology,
(3) Department of Protozoology, (4) Department of Entomology, (5) Depart-
ment of Pharmacology, (6) Department of Chemistry and Physics, (7)
Department of Serology and Immunology, (8) Department of Tropical
Hygiene, (9) Department of Public Health Laboratory Practice, (10) De-
partment of Tropical Surgery and (11) Department of Infectious Diseases.
The research staff composed of workers under the Endowment Fund of the
School and Indian Research Fund Association are 50 in number who are
carrying on various investigations on medical and public health problems
and also give special teaching in their own subjects.
6. The following are the special Research Departments and Inquiries: —
(1) Hookworm and Helminthological Research (2) Respiratory Diseases
Research, (3) Leprosy Research, (4) Bowel Diseases Research„ (5) Diabetes
Research, (6) Filariasis Research, (7) Indigenous Drugs Inquiry, (8)
Dermatological and Mycological Inquiry, (9) Malaria Transmission Inquiry,
(10) Cholera Inquiry, (11) Anaemia Inquiry, (12) Epidemic Dropsy Inquiry,
(13) Drug Addiction Inquiry and (14) Medicinal Plants and Food Poisons
Inquiry (financed by the Imperial Council of Agricultural Research).
Besides the above the School has a large department of Radiology and a
Pasteur Institute attached to it.
7. In the field of Research, the work of the School has been outstanding
and has gained both local and international reputation. From the very
inception of the institution, emphasis was laid on applied and clinical
research and many of the problems studied have a direct bearing on the
practical aspects of diagnosis and treatment of diseases. It will not be
237
a highly satisfactory operation for the removal of the adult female worm
from the subcutaneous tissues and have enabled investigations to be carried
out in selected villages in the Deccan with the object of destroying the water
cyclops, a minute crustacean which harbours the infective stage of the.
guinea-worm.
(d) Pharmacology.—Synthetic anti-malarials like Atebrin and plasmo-
quine have been in use for some years but their pharmacology had not been
.fully worked out. Researches in this . subject are in progress. A. consi-
derable amount of work on the pharmacology of indigenous drugs has also
been carried out.
(e) Nutrition.—The biochemical department is engaged in researches in
nutrition. In addition, basal metabolic rate and other normal physiological
constants are being worked out for Indians.
Studies in Sprue, Schistosomiasis, Anaemia of Pregnancy and Malaria
have been conducted.
II. MANUFACTURE OF VACCINES.
(a) Plague Vaccine.—Since the founding of this Institute 40 years ago,
41 million doses of Haffkine Plague vaccine have been issued to all parts of
India and the Middle East. The Institute is the largest producer of plague
vaccine and stocks are maintained to meet demands for almost any quantity
at a moment's notice.
(b) Other vaccines.—Large quantities of other prophylactic vaccines also
are manufactured, e.g., T. A. B., Meningococcal and Cholera ,vaccines.
More than seven lakhs doses of cholera vaccine alone have been issued
.during the year 1937.
III. ANTI-RABIC DEPARTMENT.
The Institute is the chief Anti.-rabic centre for the Presidency.
A large
and increasing number of out-patients from the city of Bombay attend daily
for antirabic treatment. In addition to the treatment afforded at the
Institute, a number of "out-centres" have been established in. different
parts of the Presidency and the neighbouring Indian States.
The vaccine adopted is the carbolised fixed virus vaccine put up in
different doses for treatment of five different classes of cases according to the
severity and site of bite. It is stored in the cold storage and issued to
out-centres as required. During the five years 1931-1935, 1,983,680 c. cs.
of anti-rabic vaccine were manufactured and issued and 46,597 cases
treated. Statistics show very low case mortality which may be ascribed
to efficient cauterisation of wounds and to prompt and early treatment
afforded at the many out-centres now established under the decentralisation
scheme for treatment for rabies.
IV. DIAGNOSTIC DEPARTMENT.
This department conducts routine bacteriolog ical and pathological investi-
gations for the hospitals in the Presidency employing most recent methods
and modern apparatus. More than 3000 Wassermann Tests are done
yearly in addition to cultural examinations of blood, faeces, sputum, urine,
etc..
The section of pathology is at present conducting research on the
238
pathology of plague in experimental animals in addition to routine sections
of pathological tissues for histological examination.
V. SNAKE VENOM.
The . Institute maintains a large number of poisonous snakes from which
venom is collected for the manufacture of anti-venomous sera and the
process of venom extraction is counted as one of the principal attractions
to the visitors. At present the animals from which venom is extracted
are Cobras and Russell's Vipers, but it is hoped that in the near future.
other varieties of poisonous snakes will. also be tackled and attempts made.
for the production of curative sera against their bite.
The Institute maintains a large library with 150 current monthly and
weekly journals and a collection of recent scientific publications and books
to afford suitable assistance to the workers. Facilities have been afforded
to private individuals for conducting research.
(v) PASTEUR INSTITUTE OF INDIA, KA SAULI.
The Pasteur Institute of India, Kasauli, was founded in 1893 mostly
with the aid of public subscriptions and incorporated as a charitable concern
in 1901. The principal objects of the Institute were:—
1. The treatment of persons suffering from injuries inflicted by rabid
animals.
2. The study, diagnosis, practice and teaching of bacteriology in all
its branches, especially with reference to the diseases of men,
animals and plants.
3. The investigation of tropical diseases and the practical application
of bacteriological methods to the prevention and cure of disease.
2. Antirabic treatment was begun on the 9th August 1900 by Major
D: Semple, R.A.M.C. (later Sir David Semple) in a small building called
Manor House which enlarged again and again is the building still occupied
by the Institute.
During the first year of its existence the Institute
treated 321 patients.
The popularity of the Institute is evident from the
fact that 36 years later in 1936, 18,620 patients received the benefit of
treatment with vaccine manufactured 'in this Institute.
This Institute
besides preparing antirabic vaccine also originally manufactured antivenene,
anti-tetanic and anti-diphtheritic serum.
In 1906 the latter part of its
activities was transferred to the Central Research Institute. Kasauli.
3. The success of this Institute not only led -to the opening of the
Central Research Institute but also of other Pasteur Institutes in India at
Coonoor, Shillong, Bombay, Rangoon, Calcutta and Patna.
4. Researches on rabies mainly with a view to produce a more efficient
vaccine was one of the main functions of this Institute since its inception.
Generous contributions towards this object were received from the Indian
Research Fund Association from 1926 onwards.
These researches have.
now made it possible to decentralize the treatment. The Institute has
atpresent more than 140 centres in the Punjab, United Provinces, Delhi
Province, North-West Frontier Province and Indian States where anti-
rabic treatment is administered. Much time has therefore been gained in
Contributed by Dr. R. O. A. Smith, I.M.D.
239
starting the treatment of a patient at risk and this factor combined with the
improvements made in the vaccine has resulted in a considerable diminution
in the mortality rate from hydrophobia which has reached the low figure
of 0.52 per cent of the treated cases.
A vaccine is also prepared at this Institute for the treatment of animals
which has rapidly grown in popularity. The number of animals inoculated
during 1936 was well over 1300.
5. In addition to research on rabies the Institute is at present also con-
ducting researches on Typhus Fever with funds provided by the Indian
Research Fund Association.
6. The Institute is now run on a commercial basis and though small
grants are contributed by the Government of India and certain local bodies
and Indian States, the bulk of the income is derived from the sale of anti-
rabic vaccine.
(vi) PASTEUR INSTITUTE OF SOUTHERN INDIA, COONOOR.
The establishment of the Pasteur institute of Southern India for the
treatment of persons bitten by rabid animals was rendered possible by the
allotment by His Excellency the Viceroy, (the late Lord Curzon), of one
lakh of rupees out of the sum placed at his disposal by Mr. Henry Phipps
of the United States of America.
2. The plans of the main building and out-houses were drawn by the
Government Architect, the construction was begun in 1905, and completed
in 1907. The Institute was opened for the reception of patients on April
1st, 1907.
3. The present site covers an area of 12.53 acres of land. The cost of
the buildings to date has been about rupees 2½ lakhs of which one lakh
was contributed by Mr. Henry Phipps, Rs. 83,000 by the Government of
Madras and the balance was met from revenue. In addition to the main
building which contains the laboratories and the inoculation and waiting
rooms for patients, there are free quarters for the indigent patients, medical
staff, clerks and servants and a limited number of houses for patients who
can afford to pay a small rent.
4. Ample accommodation for animals has also been provided. An
extension to the original building was constructed in 1921 at a cost of
Rs. 27,000. The first floor forms a library which is equipped with 3,500
volumes of scientific and medical books and journals and the ground floor
an up to date room for animals. Electric installation was put up in 1914.
5. The Institute is an Association registered under the Societies Regis-
tration Act of 1860. The objects of the Society are :—
(1) to afford treatment at the central or any branch establishment
of the Society by inoculation against rabies or any other disease
so far as the Society may be in a position to afford such
treatment ;
(2) to spread the knowledge of such treatment and inoculation among
the public by means of printed pamphlets ;
(3) to undertake research work with the ultimate object of discovering
the causative agent of rabies and of elaborating a cure for the
disease, with the immediate object of improving the present
system of treatment, and, incidentally, to follow up any
Contributed by Dr. G. L. C. Philipsz, I.M.D.