This exhibition on the College and India highlights the many links that the Royal College of Physicians and Surgeons of Glasgow has with India - in its many Fellows and Members, examinations taken, international conferences and also in our library and archive holdings.

The first international conference organised by the College in India was in November 1988 in Madras. 'An Update in Medicine and Surgery' was attended by 750 delegates and was the first occasion on which a United Kingdom Royal College had mounted a venture of this kind. At that date there were around 155 Fellows and Members of the College practising medicine in India (by May 2013 this number had grown to 600). A second international conference was held in Madras in 1992 entitled 'Medicine and Surgery 2000 AD'. In 2012, the College supported an international conference in Pondicherry run by the Sri Balaji Vidyapeeth University and Medical College and, in October 2013, an international conference run by the International Medical Science Academy in Bangalore.

In addition to supporting conferences, the College has been offering examinations in India since the mid 1990s. The primary FDS examination was held at the College of Dentistry at Dharwad in May 1995. Surgical examinations followed shortly afterwards with the Part A Surgical Fellowship examination, also in Dharwad, in September 1997. The number of examinations and examination centres offered by the College in India has grown considerably since that date and in 2013 the College undertook examinations in Ahmedabad, Bangalore, Chandigarh, Chennai, Dharwad, Hyderabad, Kolkata, Mumbai, New Delhi and Pune.

We hope that you take time to explore subsequent sections of this exhibition which includes items from our extensive historical collections.

For further information on any of the items described in this online exhibition please email library@rcpsg.ac.uk

Glasgow Faculty Connections

In 1820, the East India Company recognised the diploma for licentiates of the Faculty (now Royal College) of Physicians and Surgeons of Glasgow as a qualifying examination for service with the Company. James Adair Lawrie, who became a Member of the Faculty of Physicians and Surgeons of Glasgow in 1830 used the experience gained in the East India Company to good use when he returned to Great Britain. Lawrie had gained a licentiate's diploma from Faculty in 1822 and had also graduated M.D. from the University of Glasgow the same year. Following graduation he was able to secure an appointment with the East India Company and went out to Bengal. He returned to Scotland in 1829. He came across cholera first when he was in Calcutta in 1823 and once back in Great Britain subsequently investigated it in Sunderland, Newcastle and Gateshead. The results of his investigations were published in 1832 in an Essay on Cholera. He used the experience gained in India in his treatment of cases in the United Kingdom but with some modifications. He recommended mercury in the form of calomel for treatment and also opium (although not in the large amounts given in India). He was subsequently appointed professor of surgery at Anderson's College in 1829 and in 1850 became Regius Professor of Surgery at the University of Glasgow.

Entries in the register of licentiates show that by the mid 19th century British-Indian students were coming to Glasgow to take the examinations of the Faculty. Some, such as James Lennox (licentiate April 1859) studied in Glasgow; others such as John Green (licentiate April 1869) or George Currie (licentiate April 1871) studied in India (Madras) and then came to Glasgow to sit their examination.

The first college of European medicine was founded in Calcutta in January 1835 and was followed closely afterwards by the foundation of Madras Medical College in Chennai in February 1835. The foundation of Grant Medical College in Bombay in 1845, Lahore (1860), Nagpur (1867) and Patna (1874) widened the scope of European medical training in India.

For many Glasgow practitioners, the first introduction of the practice of medicine in India may well have been from a paper "On the Past and Present State of Medicine in India" read by Indian surgeon Gopaul Chunder Roy to the Glasgow Medico-Chirurgical Society on the 3 February 1871. The paper was subsequently published in the Glasgow Medical Journal, 3, 1871, pp. 538-551. Roy had trained at Calcutta Medical College and then subsequently came Scotland to become the first Indian student to graduate from the University of Glasgow, graduating with an MD in 1871. The first part of Roy's paper was an explanation of the Hindu system of medicine, noting that many of the drugs that formed part of the British pharmacopoeia were well known and used. The second part was a description of the beginnings of Western medical education in India and he appealed to members of the Society to use their influence in obtaining the full recognition of the qualifications granted by the Indian Colleges. Roy's paper was very well received by the Society and at the following meeting, on the 3 March 1871, he was elected a corresponding member. For more information on Roy, see the University of Glasgow website

It was another graduate of Calcutta Medical College, Yamani Sen, who was born in Bengal who became the first female Fellow of the Faculty of Physicians and Surgeons of Glasgow in 1912.

For further information on any of the items described in this online exhibition please email library@rcpsg.ac.uk.

Medical Books in India

Medical books on India

For many medical practitioners in the United Kingdom, India was known through the spices and medicinal plants that were brought back by seafarers and subsequently utilised by medical men in their prescriptions.

From the mid-sixteenth century, Portuguese physicians and travellers began to write about medicinal plants in India and aspects of medical practice. Portuguese physicians Garcia de Orta (1501-1568) and Cristóbal Acosta (c.1540-1599) described the simples and spices and their various properties.

Garcia de Orta practised medicine in Goa on the west coast of India. He developed and maintained botanical gardens in which he grew medicinal plants which he used for his own practice and also sold commercially in Goa and Bombay. He collected information about plants from local people and visited a number of places in India where certain plants were grown. His work, Coloquios dos simples, published in Goa in 1563 was the earliest description of plants and drugs found in India in a foreign language. In addition to information about Indian plants, the work also includes the first account of Asiatic cholera by a European. The College Library has a Latin epitome or abridgement of this work by Carlos Clusius, published by the famous Dutch printer Christopher Plantin, in 1567.

Cristóbal Acosta summarised the materials described by de Orta along with some additions. Both works seem to have been aimed at European practitioners, widening the scope of the materia medica then available and were subsequently widely cited by other authors.

The first work primarily aimed at those practising medicine in the East Indies was De medicina Indorum, by Jacob Bondt, or Bontius (1592-1631), first published in 1642. Bontius was employed as head surgeon at the Dutch East India Company at Batavia (Jakarta, Indonesia). His work contains detailed descriptions of a range of fevers and diseases including dysentery, hepatitis, cholera morbus and a disease called barbiers which was similar to beriberi. De Orta and Acosta had ascribed diseases primarily to an individual's behaviour such as over-eating and too much drink. Bontius, too, felt that some diseases were caused by such factors, but he also laid more emphasis on meteorological conditions such as the heat and moisture in the air at Batavia which he believed accelerated putrefaction. From observations made during post mortem examinations he concluded that the liver was particularly likely to be a seat of disease for Europeans in tropical climates. This he felt was due to heat and also the large consumption of alcohol.

By the mid 18th century a whole corpus of works on tropical diseases had arisen for travellers. James Lind's Essay on diseases incidental to Europeans in hot climates, first published in 1768, became a standard work of reference. Heat and moisture continued to be important factors in causing disease leading to putrefaction. Lind identified climate as the principal factor in causing disease. Bengal was considered a dangerous place for Europeans with diseases raging from July to October during the rainy season. Bombay was more 'wholesome' with Madras being the most healthy place. Reflecting perceived opinion of the day, Lind felt that Europeans could become acclimatised after a few years residence in a hot clime.

For further information on any of the items described in this online exhibition please email library@rcpsg.ac.uk.

Western medicine's response to disease in India

Bleeding, purging, vomiting and sweating were used during the 16th century and beyond to reduce fevers. These were used in conjunction with mild and easily digested foods. By the 1760s, however, there was a shift away from bloodletting for illnesses encountered in the Indies on the grounds that bloodletting did not suit Europeans who had spent some time in a hot climate. Alternative treatments were given such as purging with antimonial drugs followed by the administration of Peruvian bark. This change in treatment arose from the belief that diseases originated in disturbances of the liver and other internal organs which led to rapid putrefaction. Purging was considered to be vital in the removal of corrupted bile and bark was considered as an 'antiseptic' in preventing or stalling putrefaction. Of all the treatments available, the most popular right up to the 19th century were Dr James's fever powders made to a secret recipe including antimony which was believed to purge the patient of all poisonous matter.

Mercury in the form of calomel pills came to be used by East India Company surgeons from the middle of the 18th century for patients suffering from inflammatory diseases of the liver. Up until this time mercury had generally only been used in Europe for venereal disorders. The practice may have arisen from the local use of mercurials by Indian practitioners. Gradually calomel and other mercurial preparations came to be used for a wider range of diseases. The first British-Indian writer to recommend mercury for fever was Dr Francis Balfour who was based in Calcutta. Balfour attempted to devise a therapeutic regimen for those with fever in accordance with the lunar cycle, publishing a Treatise on the Influence of the Moon in Fevers in 1784 (the influence on the moon in fevers had been noted by other authors including Lind). At this time, Balfour placed a great emphasis on the use of bark. In a later work, however, Treatise on Putrid Intestinal Remitting Fevers published in 1790, he advocated the expulsion of putrid matter with emetics and purgatives, believing mercury to be especially helpful. By the 1790s mercurial remedies were employed as a matter of course.

By the early 19th century changes in perceptions of disease led to the alleviation of the causes and symptoms of nervous debility rather than just the evacuation of putrid matter. This change is exemplified in the work of Madras-based surgeon, James Annesley. Annesley's Researches into...the more prevalent diseases of India, and of warm climates generally, published in 1828 with its detailed case histories, collected over many years of service, provided the most complete treatment of diseases in India to date. His work was widely read by military surgeons, for whom it was intended and copies were sent to all the regiments in India. Annesley's dissections led him to believe that the increased secretion of bile in fevers was a consequence rather than a cause of such diseases. He followed a two-stage method when treating fevers with bleeding to prevent paroxysms followed by the use of emetics, calomel and bark to stage off any reoccurrence. His work was later published in a condensed volume as a practical work of reference for medical officers in India.

Quinine was isolated from the bark of the cinchona tree in 1817 and gradually became a major therapeutic tool for the treatment of fevers. Charles Morehead in his Clinical Researches on Disease in India, 1856, noted that "the use of quinine in the treatment of malarious fevers has during the last twenty years been gradually gaining ground in India, and may be said to be now universally adopted". The discovery by Ronald Ross in 1897 of malarial parasites in mosquitoes heralded new attempts to eradicate the disease by preventative methods. A search for a vaccine for malaria continues to this day.

Information on 19th century attempts to manage health and disease in India, including access to a large amount of papers written at the time can be found on the website of the National Library of Scotland, Medical History of British India web pages

For further information on any of the items described in this online exhibition please email library@rcpsg.ac.uk.