{"id":770,"date":"2013-07-13T01:30:18","date_gmt":"2013-07-13T01:30:18","guid":{"rendered":"http:\/\/localhost\/?p=770"},"modified":"2013-07-13T01:30:18","modified_gmt":"2013-07-13T01:30:18","slug":"30-medical-department-vol-27-supplement-volume-27","status":"publish","type":"post","link":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/01-works-of-sri-aurobindo\/01-sabcl\/27-supplement-volume-27\/30-medical-department-vol-27-supplement-volume-27","title":{"rendered":"-30_Medical Department.htm"},"content":{"rendered":"\n\n
\n


\nMedical
\nDepartment<\/font><\/b> <\/font>
\n<\/b>
\n<\/span>
\n
\n<\/span><\/b>
\n<\/font>I<\/font>NTRODUCTORY<\/font><\/b><\/p>\n

 <\/p>\n

\n                               
\n<\/font>O<\/b><\/font>NE
\nof the peculiarities of administration in India is the extent to which the
\nprovision of medical aid for the people rests on the shoulders of the
\nGovernment. In a healthy community the sphere of Government action outside
\ncertain recognised spheres tends always to contract; in one which is feeble or
\nunsound it tends always to expand. Judged from this standpoint there are few if
\nany countries which show such a miserable lack of robustness as India. Normally
\nGovernment action is limited to the management of only such affairs as cannot be
\nconducted by local or private enterprise either at all or with sufficient
\nefficiency and organised power. Foreign affairs and the maintenance of national
\ndefence, legislation and the administration of justice and maintenance of order,
\nthe imposition and raising of the revenues necessary for public administration
\ncomprised under the old theory of politics the main sphere of Government. In our
\nown times all matters of public or national concern are held to be a fit
\nprovince for Government action; but chiefly in the way of assistance, general
\nregulation or the maintenance of a certain standard of efficiency or public
\nmorality. Government for instance assists national trade and industry by a
\nbureau of statistics and information, protects it by tariffs, regulates it by
\nseeing fair play in essential matters between employers and employed or by
\nenactments regulating navigation. Similarly it may exercise a watch and light
\ngeneral control over all forms of local self-government. In one sphere
\nespecially State action is being everywhere more and more imperatively called
\nfor, in all civilised nations; it has become an axiom of modern politics that
\nthe provision of universal education is the duty of the State. Yet even here the
\nnecessity is rather a result of the circumstances of modem national life than a
\npermanent principle. The action of certain nations driven by their comparative
\nweakness to find a counteracting force to the superior individual energy of
\nother nations in<\/p>\n

<\/font><\/p>\n

 
\n<\/font>
\nPage-109<\/font><\/p>\n

\n

\nthe
\nuniversal education of the community by the State and the success with which
\nthey have used this lever to raise themselves to preeminence in commerce and
\npolitics has made it an essential condition of self-preservation to all
\ncivilised countries. Without universal education a nation nowadays is
\nself-condemned to stagnation and decay. But it is conceivable that when all the
\ngreat nations stand on an equal level in this respect, the grip of the State on
\neducation may again relax and the duty of Education will again gradually devolve
\non local and private effort, the State confining itself to its fundamental duty
\nin all matters of public concern, assistance, general regulation and the
\nmaintenance of a high standard. Even now a large element of private and
\nvoluntary enterprise is a healthy element in the provision of education, as
\nnecessary for variety, life and progress as State control for generality and a
\nhigh standard of efficiency. <\/p>\n

<\/span><\/font><\/p>\n

               
\nThere are at least two departments of medical activity in which the State may
\nclaim a predominating voice, Sanitation <\/span> <\/span>and
\nMedical Education. But the peculiar circumstances of this country have enforced
\nit to take up a third burden which in wealthier, better-educated or more
\nadvantageously circumstanced countries is undertaken by individual enterprise
\nand private charity, the provision of medical assistance. The utmost that could
\nusually be expected of the Government in this line would be the establishment of
\nState Hospitals in large towns where there existed a large and congested mass of
\npoverty. But in India the State provides not only these but covers the land with
\nskilled medical help and dispensaries, bringing assistance to the doors of the
\npeople gratis or at a nominal price. The reason of this state of things does not
\nlie altogether in the poverty or helplessness of the people.<\/p>\n

<\/span><\/font><\/p>\n

               
\nPrevious to the British rule medicine was practised in India as in Europe by a
\nclass of skilled physicians using their knowledge as a means of independent
\nlivelihood. The princes and nobles of the land might maintain a family Hakim or
\nVaidya, but there was no idea and probably no great necessity of providing State
\nor charitable help in any systematic shape to the mass of the population. The
\nfees of the local physicians were not beyond the means of an ordinary income,
\nand the great mass of<\/p>\n

<\/span><\/span><\/font><\/p>\n


\nPage-110<\/p>\n

<\/font>
\n<\/p>\n

<\/span><\/font><\/span><\/p>\n

\n <\/p>\n
\n <\/span>\n<\/div>\n

the
\npeople living healthy open-air lives and observing rules of life which the
\nexperience of generations had established as suitable to the climate, enjoyed
\ngreater immunity than in these days from ordinary diseases and trusted more with
\njustification to the vigour of their natural constitutions for recovery when
\nattacked. The great epidemics which sanitation and prophylactic measures combat
\nwith so large a measure of success, were regarded, in India as in mediaeval
\nEurope, as divine visitations borne with terror perhaps, but without any idea of
\norganised resistance.
\n               
\nWith the British rule came a marked change. There was in this country an ancient
\nand indigenous system of medicine, which had shared the fate of the other Hindu
\narts and sciences both in the comparatively high degree of scientific knowledge
\nand intelligent practice it had reached in astonishingly early times and in the
\npremature blight which had subsequently come over it. In surgery, in pharmacy
\nand in sanitation its knowledge was sound and masterly; it conducted
\nsuccessfully surgical operations which would have been far beyond contemporary
\nscience in Europe; it had amassed a pharmacopoeia from indigenous drugs, which,
\nhowever imperfect, was possessed of considerable merit and efficacy; and its
\nrules of sanitation were exhaustive, sound and in consonance with the scientific
\nopinion of today. Its theory of the human body was, it is true, rather in
\nagreement with ancient opinion than the more enlightened modern ideas, but its
\npractical science was superior to its theory. Upon this promising science as
\nupon almost everything else in India there fell a curse of stationariness and
\ndecay. Its practice became mechanical; its science fell into desuetude; the old
\nauthorities couched in the learned tongue came to be repeated by rote; its
\npharmacopoeia was ministered without intelligence or original research and
\nanalysis and therefore with only a fitful efficacy; surgical knowledge ceased to
\nexist except in a rudimentary form, and sanitary rules once invested with a
\nreligious sanction came to be flagrantly violated in the daily practice of the
\npeople. Mahomedan medicine, a mediaeval science based on the Greek, did not tend
\nto
\ncorrect this state of things; it only added another imperfect system to the
\nexisting one. To a country thus circumstanced, Western civilisation came with a
\nmedical science which, recovered<\/span><\/span><\/font><\/p>\n


\nPage-111<\/font><\/span><\/p>\n

\n

from
\nits old stagnation, was making immense strides, with a vastly superior pharmacy,
\nan ever bolder and more subtle surgery and organised and living grasp of
\nsanitation.<\/p>\n

<\/p>\n

<\/span><\/span><\/font><\/p>\n

            
\n<\/span>When the British Government finally established itself throughout the
\ncountry, its enlightened and benevolent instincts left only one course open to
\nit. The epidemics which yearly devastated filthy and insanitary towns and
\nvillages must be in some measure combated. A population scattered through the
\ncountry in innumerable small villages without any means of adequate medical
\nassistance, must be familiarised with the more advanced science of the West. But
\nthere was no body of men in the country itself who could replace as an
\nindependent profession the old Vaidyas, Kavirajas and Hakims by the application
\nof the new science, nor could the Government wait for the necessarily far-off
\ntime when such a class, in sufficiently large proportions, could be elaborated.
\nThe necessary consequence was the development of the Indian Medical Service one
\nof the most beneficent institutions of the British rule; and with this
\ndevelopment came, as an obvious corollary, the establishment of Government
\ndispensaries all over the country. One of the latest minor developments in this
\nline, the action by which small quantities of quinine are sold at the Government
\nPost Offices as a remedy for malarious fever, is a characteristic instance alike
\nof the curiously paternal nature of the British rule and of the unique state of
\nthings prevailing in this country. Of this state of things great poverty is a
\nnecessary feature, otherwise Government assistance might be gradually replaced
\nby the class of professional men with diplomas from the Indian Universities who
\nare now to be met with in increasing numbers in every considerable town. But
\nsuch men have small chance of success in the rural districts among a population
\ntoo poor to pay for efficient medical assistance. The great bulk of the
\npopulation must for long depend upon the gratuitous assistance which the
\nGovernment has placed at their doors.<\/p>\n

<\/span><\/p>\n

<\/span><\/span><\/font><\/p>\n

   <\/span>     <\/span>         <\/span>
\n<\/span>In Baroda the old system prevailed almost until the year of my accession.
\nAt that time the only public provision of medical aid on modern lines was one
\nhospital at Baroda under the Residency Surgeon, two small military hospitals in
\nKathiawar and<\/p>\n

<\/span><\/font><\/span><\/font><\/p>\n


\nPage-112
\n <\/font><\/span><\/p>\n

\n

three
\ndispensaries in various parts of the State. At the same time a number of Vaidyas
\nand Hakims, about 25 in all, were maintained by the State for the benefit of the
\nTroops, the prisoners in the jail and the State officials. These had their
\ncharges in a manner farmed out to them, for they were expected in lieu of a
\nregular remuneration to provide drugs and other medical necessaries from their
\nown resources. One State Hakim drew the immense salary of Rs.5000 a month; the
\nothers, though not so fortunate, had certain advantages within their grasp.
\nThese physicians were attached to different Departments and in some cases the
\nsame man held charges in two, three or more departments, thus drawing a multi
\nfold salary and farming out each branch of his work to someone else at perhaps a
\nthird of the stipend attached to it. These easy and profitable posts descended
\nin practice from father to son, and often had privileges attached to them of
\nconsiderable pecuniary value. The medical expenditure on their salaries amounted
\nto about \u00a320,000, and their privileges to at 1east 10,000 more. In 1876-77 this
\nsystem was swept away, the whole staff being pensioned off for an aggregate sum
\nof Rs.545 per month and a regular Medical Department instituted. Dr. Cody, a
\nmedical officer of the British service, was appointed Chief Medical Officer and
\n4 hospitals and 9 dispensaries were opened in Baroda, Nowsari, Sidhpur, Kadi,
\nPattan and other important places in the territory. These were added to in
\nsuccessive years and in 1880-81 there existed 11 hospitals, 23 Dispensaries and
\none Veterinary Hospital. A Vaccination Department had been organised under the
\nsupervision of the Residency Surgeon several years before and this under the new
\nregime was greatly strengthened; 3 inspectors, 31 vaccinators, 6 probationers
\nand 34 peons formed the staff. The strength of the regular Department numbered
\nbesides the Chief Medical Officer, 10 Medical Officers, 46 Hospital Assistants
\nand 34 Medical pupils; the Veterinary Hospital was in the charge of a Surgeon
\nand one veterinary pupil; a midwife was also maintained by the State for the
\ncity of Baroda. During the five years from 1875-1880, Rs.858,550-5-6 had been
\nexpended by the State on its Medical Department.<\/p>\n

<\/font><\/span><\/p>\n

              
\n<\/span>The work done up to this date could only suffice for the most urgent and
\nimmediate needs of the principal towns of the Raj.<\/p>\n

<\/font><\/span><\/p>\n


\nPage-113
\n <\/font><\/span><\/p>\n

\n

The
\ntwenty years from 1880 to 1900 have accordingly been devoted not only to
\nexpansion on the lines already laid down, but to the inception of larger work in
\nthe sphere of Sanitation and the introduction of improved methods and
\norganisation in the Department. Of the 35 institutions already existing, several
\nhave been discontinued owing to the cessation of the special need for which they
\nwere created; for instance the military dispensaries at Deesa and Manekwada came
\nto a natural end with the cessation of the contingents there stationed. On the
\nother hand, 24 new institutions have been established, 20 dispensaries, 2
\nveterinary dispensaries, and one Lunatic and one Leper Asylum, raising the total
\nnumber to 54. Most of the towns of the Raj which are at all considerable have
\ntherefore been provided with these facilities for medical assistance.
\n               
\n<\/span>It
\nhas not been found necessary to increase the number of,
\nHospitals, the provision already made being sufficient for the present and
\nliberal in proportion to the extent and needs of the territory. In the city of
\nBaroda itself there are as many as three Hospitals. The oldest, once known as
\nthe State Hospital, dates back to the times of the Maharaja Ganpatrao and was
\nfrom its inception till 1881 under the supervision of the Residency Surgeon. So
\nlong as there was a lack of- qualified medical talent in the country, such an
\narrangement was no doubt advisable and necessary, but by this time the
\nconditions which necessitated it had ceased to operate, and after assuming
\npowers I appointed Dr. R. H. Nanavati to be in charge of the Hospital; it has
\nsince been under the management of different State Medical Officers. The housing
\nand accommodation had ceased to be sufficient for what was intended to be the
\nfirst Hospital in the State; accordingly in 1882-83 the old building was pulled
\ndown and a new one erected in its place, the Hospital being temporarily
\ntransferred elsewhere. The new building is a fine red brick building just
\noutside the city, graceful in architecture and sufficient in accommodation. It
\nis now called the Countess of Dufferin Hospital as a compliment to a lady whose
\nname will always be remembered in India in association with high benevolence,
\nactive sympathy with suffering and an earnest desire to ameliorate the condition
\nof Indian women. Another and smaller building was added to the<\/span><\/font><\/span><\/p>\n

 <\/span><\/font>Page-114
\n <\/font><\/span><\/p>\n

\n

Hospital in 1898-1899 for the accommodation
\nof women of respectable families and styled the Victoria Jubilee Ward and a
\nfinal addition for the use of patients from the army, called the Sayajirao
\nMilitary Ward, completed the building as it now stands. The hospital is well
\nequipped with instruments and appliances; in 1893-1894<\/span>
\nRs.5000 worth of instruments were
\nordered out from <\/span>England and in
\n1900 after visiting the Paris Exhibition I sent many of the latest scientific
\nappliances from Europe to be kept
\n<\/span>for use in this Hospital. Besides the
\nMedical Officer in charge who daily visits the Hospital and the Hospital
\nAssistants working under him, there is a House
\nSurgeon in constant attendance upon the sick and, since 1899<\/span> a<\/span>
\nLady Doctor with a nurse to as<\/span>sist
\nher, in charge of the Victoria Jubilee Ward. A Lady Doctor was first appointed
\nin 1893 at the Jumllabai Hospital<\/span> to attend
\nto female out-patients; but the appointment has, I believe, benefited the public
\nof the city more widely than the sphere of her purely official duties would
\nindicate, as many families are glad to secure skilled female assistance for
\ntheir ladies when it is available. There is a greater field in India than in
\nother countries for the services of female physicians and nurses, but the supply
\nis insignificant. The abundant provision of trained nurses is a great element in
\nthe comfort and efficiency of hospitals in Europe. The State has made some
\nattempt to supply the need of nurses for women in sickness by sending four
\nfemale students to the Cama Hospital in Bombay to learn midwifery and nursing;
\ntwo of these returned after passing their final examination in 1887-1888 and
\nwere
\nappointed to the State Hospital and the Jumnabai Hospital. The other two also
\nwere entertained in the State service in the next year. A regular midwife has
\nalso been maintained whose duty it is to attend cases of childbirth in the city.<\/p>\n

<\/font><\/p>\n

               
\nOf
\nthe other hospitals in Baroda the Jumnabai Hospital named after H.H. the
\nMaharani Jumnabai is confined to out- cases; it was originally a dispensary
\nafterwards turned into a Hospital, by attaching a girls’ school building in the
\nvicinity as a ward. For in-cases the accommodation in the Dufferin Hospital is
\nsufficient and the site healthier, accordingly since 1899 the admission of
\nin-patients into the Jumnabai Hospital has been discontinued. The Sayajirao
\nMilitary Hospital was, as its name<\/font><\/p>\n

\nPage-115<\/font><\/p>\n

\n


\nimplies, meant not for the use of the general public but for the Army, of which
\nby far the larger part is stationed at the capital; originally built to
\naccommodate 40 people, it was increased as necessity arose by two further wards.
\nIn 1899, it was amalgamated with the State Hospital by the addition of the
\nSayaji Military Ward to that building and placed under the same supervision. In
\nspite of the superior development and scientific accuracy of Western medicine, a
\ngreat portion of the people of this country still cling to their belief in the
\nold systems, and it has been thought advisable to make a certain concession to
\ntheir preferences. Two Hakims have been appointed by the State to treat cases at
\nthe Hospitals in which patients might express a greater confidence in the
\nMahomedan system of treatment and the State Balvaid was attached to the Countess
\nof Dufferin Hospital in 1899-1900 for the benefit of those who preferred the
\nAyurvedic treatment.
\n               
\n<\/span>The city of Baroda has therefore been amply supplied with medical
\nfacilities; nor have the districts been neglected. There are Hospitals in the
\nchief town of each Division, the large division of Kadi having two to its share;
\nbesides this several of the district dispensaries are in all essential respects
\nhospitals, admit- ting in- and out- patients as well as dispensing medical aid
\nto out-patients and being placed under the supervision of an Assistant Civil
\nSurgeon, notably Mehsana, Petlad, Dabhoi and Visnagar. There are also Assistant
\nCivil Surgeons at Sidhpur, Anusuya and Dwarka. This large development of medical
\naid in the districts has taken place mainly since 1887.The regular strength. of
\nthe Medical Establishment numbered, in 1899,21 Medical Officers, 62 Hospital
\nAssistants and 75 medical pupils, besides the Hakims, Balvaid, midwife and
\nnurses already mentioned.
\n<\/font><\/p>\n

\nPage-116<\/font><\/p>\n<\/td>\n<\/tr>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

Medical Department INTRODUCTORY                                   ONE of the peculiarities of administration in India is the extent to which the provision of medical aid for the…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-770","post","type-post","status-publish","format-standard","hentry","category-27-supplement-volume-27","wpcat-16-id"],"_links":{"self":[{"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/posts\/770","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/comments?post=770"}],"version-history":[{"count":0,"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/posts\/770\/revisions"}],"wp:attachment":[{"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/media?parent=770"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/categories?post=770"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/worksofthemotherandsriaurobindo.org\/index.php\/wp-json\/wp\/v2\/tags?post=770"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}