Bull. Ind. Inst. Hist.Med. Vol. XXIX - 1999 pp 71 to 82

GLEANINGS FROM THE TRAVELOGUE OF THETRA VELLER NICHOLAS SENN

P.K.J.P. SUBHAKTHA *

ABSTRACT

The Traveller Nicholas senn, visited India in the early part of this century, tomake detailed enquiries about the development of medical science, generaleducation and to obtain proficiency in the professions and arts. According to himrevolutionary changes were taking place day to day in research and discoveries inthe fields of science and also in the practice of medicine and surgery at that time.Scientific work was no longer confined to a favoured institutions, it may be seenin all parts of the civilized globe. A personal acquintance with men who haveearned a well-merited reputation in the advancement of medical profession is asource of great gratification and excites a new interest in the work he hasaccomplished.

Introduction:Traveller Nicholas senn, M.D., Ph.D.,

L.L.D.I.M was professor of surgery inUniversity of Chicago, professor and headof the surgical Dept. Rush Medical College,Surgeon-in chief in St.Joseph ' s HospitalSurgeon General of IIIionois, Liectenantcolonel and chief of the operating staff withthe ~y in the field, during the spanishAmerican war, etc. He travelled differentparts of the world via INDIA and wrote abook entitled "Around the world viaINDIA" (A MEDICAL tour) which wasmore especially intended for medicalinformation of all sorts general andprofessional. Author Nicholas senn in hisexplanatory remarks at the begirining ofthis book denoted that "This book is moreespecially intended for his travels indifferent parts of the world, and to whomhe was chiefly indebted for manycourtesies and much information. The text

consists of a series of articles published inthe journal association. Many illustrationshave been added which the author hopeswill enhance the value of the book."

Certainly this book consists of handfulinformation related to the establishmentand development of Medical schools andHospitals during the period oflatter part ofthe 19th century to early part of 20thCentury. Nicholas senn left San Franciscoon July 7th in the year 1904 on the steamer"SIERRA" and reached Harbour of NewYork on I Ith october exactly 3 months 3days. He travelled thousand of miles fromSan Francisco to Hawaian islands Soma,Newzealand, Australia, Cylone and finallyreached to madras on 30th August 1904.At that time India with its 300,000,000 in -habitants had only four medical collegeslocated at Madras, Calcutta, Lahore andBombay. These four medical schools wereaffiliated to the respective universities. The

• Asst. Research Officer, (Ay) Indian Institute of History of Medicine. OMC Buildings, Putlibowli, Hyderahad.

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following information is based on theexcerpts from his 'travalogue' about hisobservations on the medical and scientificenvironment prevalent at that time in India.Although all ofthese medical schools wereaffiliated to the respective universities, onrecommendation of the medical facilitiesthe universities confer degree but themedical schools receive no financial aidfrom the universities and set their ownstandards of requirements for admissionand graduation. All the medical schoolsare patterned after those of the U.K. as torequirements for admission, graduation andmethods of teaching.

According to Nicholas senn the greatstumbling block of the Indian Medicalstudent of that time was language. aknowledge of Latin was a rara avis andthe meaning of ordinary English words washard for them to express and comprehend.The teachers were fmding this imperfectknowledge of the English language as thegreatest drawback ingrafting their ideas into the minds of students. the total numberof medical students in the differentinstitutions present at that time was about2,000. The classes have increased in sizevery rapidly indeed that space andequipment in all of the medical schoolsmaking them entirely inadequate. Nicholassenn has seen the students in the differentmedical colleges and was impressed withtheir lively, cheerfull dispositions and theirdevotion to their work.

The teaching force -as a rule wasinadequate in number in all the schools andas a consequence the men were 'over-worked'. He mentions one strikinginstance of this about Lt. Colnel Dimmockof Bombay who was the director of the

Bull. ind. Inst. Hist.Med. Vo/.J(XiX - /999

Jamsetjee Jeejeebhoy Hospital, principal ofGrant Medical College, and professor ofObstetrics, Gynecology and Pediatrics. Themen of the Indian medical service who wereengaged in medical teaching were overburdened and under-paid.

Nicholas senn has given a briefdescription offollowing account of variousmedical colleges and hospitals of india.Madras Medical College:

The Madras medical college wasoriginally established as a medical schoolin 1835 (Fig. I). The classes received theirinstruction at first in rooms adjoining thequarters of the surgeon general of thegeneral hospital. The main building of themedical school was opened in 1836. Themedical school commenced with a teachingforce of seven, ten medical apprentice andeleven native medical pupils. Privatestudents were first admitted in 1838. Theyobtained free education in common withgovernment students. In 1851 it became acollege and in 1857 it was placed in the listof affiliated institutions. The buildingswere altered and enlarged in 1867. In 1885separate anatomic buildings were esteemedto which were added a theatre with adissecting unit and a museum in 1887-88(Fig.2). Separate buildings for biologic andhygienic laboratories followed.

In 1875 the college admitted on lis rollsthree new classes of students - viz.,candidates for the degree of Licentiates inmedicine and surgery for the new grade ofcivil apothecary and female students. Theprincipal of the college at that time (1903 -1904) was Lt-coJ. J.Maitland, M.D.,I.M.S., F.M.U. The teaching staff consistsof 23 professors and assistant professors,and the number of students 400. The

Gleanings from the Travelogue - Subhaktha

calender for 1904 - 1905 contains thefollowing regulations.Dress for Natives Only:

I) The Typical Dress : The turban along or short coat buttoned up to the neck,trousers socks and English shoes.

2) Modifications Permissible:a) Students who wear a turf or whoshave the scalp must wear a turban.b) Students who dress their hair afterthe European fashion may wear capsbut indoors if their dress in otherwise-European the cap must be removed.c) Mohammedians may be allowedto wear the fez on ordinary occational,but not at cermonial observes.

d) Any student may wear a dhote ormunda, but he must then go bare foot-ed indoors or wear socks and Euro-pean shoes.3) All articles of dress, whatever the

material must be clean.The students for the M.B. and C.M

section must pass the first examination inarts of this university or an examinationaccepted by the syndicate as equivalentthere to. The course of training for thisclass extends over five years and the feescharged for tution are :

For the first year study - 100 Rs.For the second year of study - 155 Rs.For the third year ofstudy - 155 Rs.For the fourth year of study - 100 Rs.For the final year of study - 100 Rs.or if paid in one sum on joining college,500 Rupees.

The course for the L.M. & S degreeextends over four years and the feescharged for the whole course if paid inadvance amount 470 rupees, Thecandidates for these degrees are obliged to

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pass only three examinations. The firstexamination included one course in eachof the following branches: Anatomy,physiology, chemistry, practical chemistrypractical pharmacy & Histology. Thesecond includes one course in medicine,surgery, materia medica and therapeuticsgeneral pathology and bacteriology,hygiene, pratical hygiene, medicaljurisprudence, minor surgery. The thirdand final examination includes medwiferyand diseases special to mental diseases andsurgery. The exam ination test for thedegree of M.B. and CM. is much moresevere. Provision is made for the educationof military pupils for the Indian subordinatemedical dept., colonial apprentice,apothecaries, male and female chern ists anddruggists. The Madras Medical collegeoffers nine medals, eleven prizes and tenscholarships annually.Madras Government General Hospital:

This institution is intemately connectedwith and infact is, the clinical part of theMadras Medical college, all of theattending Physicans and surgeons beingmembers of its faculty. The hospital ismade up of two story pavilion buildings~und capacious square court ornamented~ithtropic trees, shrubs and flowers. Itcan accommdate 450 patients. The amountand variety of clinical material in thisinstituion .is simply enormous and one ofthe best in India. N.Senn found a greatmany emergency cases in this hospital, likefractures, accidental wounds, number ofcases of abscess of the liver and hernia etc.,Elephentiasis of the scrotum is veryfrequently operated here. An unusualnumber of cases ofthe mouth find their wayin to this hospital. Carcinoma of the cheek

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alone accounts for almost one third mostcommonly affected in Hindus andMuslims, male and females.

The nursing in the M.G.H. is inchargeof 28 trained female nurses, male wardattendants and 21 female ward attendants.During the year 1903 - 1904 the institutioncared for 60,842 out patients and 7,177 in-patients. The total number of deaths were644. The total number of operationsperformed 6,28] with a mortality of only1.9 percent.Bengal Medical College and CalcuttaGovernment General Hospital:

The medical interests of calcutta a cityof great commercial importance with nearlya million of inhabitants, centre is the BengalMedical college and Go vt. GeneralHospital, its clinical department andhospital are located on the same spaciousgrounds artificially laid out intersected bywell made and well kept walls ornamentedwith trees shrubs and flowers (Fig.3). Bothinstitutions are managed by offices of theIndian medical service, who constitute thefaculty of the college and attending staffof hospital thus cementing togeather thedidactic and clinical teaching and unitingthem practically under one administration,and securing uniformity in the methods ofteaching and a systematic progression ofthe courses from year to year.Bengal Medical College:

The Bengal Medical College wasfounded in 1830, and from a smallbeginning has gradually developed into agreat medica! school with an attendance atthe present time (1904) of about 600students. The college as well as the hospitalwh ich in reality forms an integral part ofit, had to be enlarged from time to time in

Bull.lnd.l nst. Hist, Med. Va/XXIX - 1999

order to accommodate the rapidlyincreasing number of students. Separatelaboratory buildings have been intendedand fairly well equipped.

Then there are special provisions madefor female medical students and militarypupils, Admission to female medicalstudents regulated by principal and formilitary pupils by the Director general ofthe I.M.S. Female medical studentsentering as regu lar or female certificatestudents are eligible for a governmentscholarship 20 rupee~ per month and arenot charged any fees (FigA).Midwives and Dias :

The Bengal Medical college hasundertaken the education of midwives avery commendable extension of its widefield of usefulness. The regulations for thisdept. are formulated under this heading.

Women who have a fair knowledge ofEnglish, but also have not passed theentrance examination or its equalents willbe admitted into Eden hospital to learnmidwifery. The Government grants 20rupees a month towards the board, washingetc. with free of quarters. After years tutionand beside practice, if found proficient,they will obtain a qualifing certificate. Thefee for each certificate is 5 Rupees only.Calcutta Government GeneralHospital:

The calcutta govt. General Hospital isvertually the clinical part of the BengalMedical college. The Eden Hospital(Fig.5), a seperate new modem buildingin the maternity in which about 600 womenare delivered every year. The strictestcleanliness prevails here. The originalhospital building is an old fashioned whichcan accomdate 450 patients and has a few

Gleanings from the Travelogue - Subhaktha

private rooms for which a charge of 22rupees a day. The operating room has asmall amphi theatre which affords standingroom for the students as in all hospitals inIndia, chloroform is the favourite anestheticand the binioded of mercury takes the firstplace as antiseptic.

Abscess of the liver appears to beextremely common in this part of India, asprofessor Bird operated on twenty cases intwo years. As in Europe carcinoma in allits forms is met with here with the samefrequency almost in all hospitals in India.N.Senn found the greatest variety ofMalaria and its multitude of complications.The out-patient department is utilized to thegreatest advantage and it is here that thesutdents are given the best opportunities tocome in touch with the patients. Theaverage medical student in india has akeener taste for practical work than forScientific research and consequently makesgood use of his clinical opportunities. Thefemale medical students are no exceptionto this role.Jaipur Mayo Hospital:

The Mayo hospital, so called inmemory of a former governor of this partof India is the government General hospitalof Jaipur and is the largest out of the twentysix hospitals of this state. It has a superblocation, building, beautiful garden and thefine state of the governor name itcommemorates.

The hospital has accomdations for 160patients into the capacious wards welllighted and ventilated but the furniture isscanty and of the simplest kind. Duringthe year 1903, 24648 out patients and 2, 124in patients were treated here. During thesame year 696 major minor operations were

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performed.Grant Medical College And TheHospitals of Bombay:

Bombay with the 800,000 inhabitants,is the commercial metropolis and medicalcentre of India. The city has many andvaried medical institutions that awaken theinterest of the professional visitor. Themost important among these is the Grantmedical college the largest medical schoolin India, opened its doors to medicalstudents in 1845 (Fig. 6), from a modestbeginning it has developed into a greatmedical school with an attendance of morethan 600. The female medical studentsnumber about sixty and with exception oftwo or three white women students. Somereceive hospital positions with smallsalaries Rupees 100 to 200 month, othersenter private practice but seldom meet withgreat success.

The professors are selected from theI.M.S. with special reference to theiraptitude to teach the different branches.The principal chairs, medicine surgery andobsteitrics, are occupied by men who havehad an extensive experience, while theprimary branches, especially pathology andbacteriology are usually taught by thejuniors.

The original Grant Medical college, socalled in honour of the former governor ofBombay in a substantial venerable, twostory stone buildings with the increasingdemand for space, additional buildingshave been erected with massive stone andmarble floors for dissecting room, chem icaland pathological laboratories.

The Curriculam of study for the M.B.and B.S. degree extends over five years andincludes the following studies.

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FIRST YEAR : Biology, Botany,Chemistry, Practical Chemistry, Meteriamedica and Practical Pharmacy.SECOND YEAR: Anatomy, Botany,Chemistry, Practical Chemistry, Meteriamedica, practical Pharmacy andPhysiology.THIRD YEAR: Physiology, Histology andpractical Physiology and Anatomy.FOURTH YEAR: Medicine, Surgery,Pathology, hygiene, diseases of women andchildren, demonstrations in Pathologyclinical practice and female O.P. rooms &pathology rooms.FIFTH YEAR : Surgery Medicine,Diseases. of women and children,Operative surgery, clinical practice inmedical, surgical, obstetric and surgicalwards attendence at pathologic room.Jamsedjee and Jeejeebhoy Hospital:

This hospital is one of the oldest andbest known ofthe many Bombay hospitals.it bears the name of Parsee who built it athis expense and presented it to thegovernament in 1845.

Mr. J.J. was a poor man but made afortune by buying and selling bottles.Hence the hospital is still known as "BottleHospital" A full sized statue of stone halfreelining position in the main entrance hallof the hospital does honor to the memoryof its founder. The hospital is for theexclusive use of the native sick poor and ismaintained entirely at government expense.

Three new-story stone pavilions wereopened in 1892, The Sir. Dinshaw PetitHospital for diseases of women andchildren, The Bai Motlaibai Meternityand the opthalmic Hospital each with acapacity for 40 patients. About 800 women

Bull.lnd.lnst.Hist,Med. Va/.xXIX - 1999

are delivered annually in the metemityhospital and two students attend the eachcase. The nursing of this intitution leavesmuch to be desired. The trained femalenurses are inadequate in number.Homeless Leper Asylum, Matunga,Bombay:

It is in the largest leper asylum in Indiaand at present it is in the home of370 lepers.The inmates are wellcared for. Mr. H.A.Acworth. I.C.S, C.I.E., Municipalcomm issioner for the city of Born bay from1890 to 95 is the founder of this modelinstitution, as it was through his influencethat the necessary funds were obtained.

The report of the asylum shows aboutthe following proportion of the variousreligious beliefs of the in mates.Hindus (Marattas) - 66.43%Mohammedans - 9.32%Christians - 10.61 %Hindus (Low Caste) - 13.41 %Others - 23.00%The Plague Research Laboratory of theGovt. Of India Parel, Bombay:

This institution owes its origin to Mr.W.M. HaftKine, C.LE. a Russian Scientistwho has rendered India such signal servicesince 1893, first by his prophylactictreatment of Cholera by serum inoculationsand later by his discovery of serum thePlague. According to many scientists ofthat time, the serum treatment in theprevention of the Bubonic Plague, devisedby Haftkin is reliable and specific in itsresult. The immunity thus obtainedremains throughout an epidemic and hasbeen known to last two years. Haffkinereceives a salary of 2000 Rupees a month.

Gleanings from the Travelogue - Subhaktha

Bombay Bubonic Plague Hospital:This hospital is located outside of the

city limits and consists of a row of one storybrick buildings which serve as wards.During the height of the epidemic as manyas 30 patients a day were admitted fromthe city and near by villages. The mortalityhas been very great.

At the time of Nicholas Senn visitabout 25 patients remained in all stages ofthe diseases. Three heroic trained femalenurses take care of the sick, aided by maleand female helpers. One of these nurseshas been on constant duty since theepidem ic commenced more than four years

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ago, and not withstanding the arduous andtrying duties that she has so faithfullyperformed her general health has notsuffered.

These are the excerpts from theNicholas senns travelogue who madedetailed enqueries about the developmentof medical science, general education andin obtaining proficiency in the professionsand arts. According to him revolutionarychanges were taking place day by day inresearch and discoveries in science and inthe practice of medicine and also in surgeryat that time.

Madras Medical College and Government Hospital

78 Bull.lnd. Inst. Hist,Med. Va/.xXIX - 1999

Another view of Madras Medical College andGovernment Hospital along with separate anotomic buildings

Bengal Medical College, Calcutta

Gleanings from the Travelogue - Subhaktha 79

Quarters for military pupils

The Eden Hospital, Calcutta

80 Bull. Ind.lnst. Hist, Med. Vol.XXIX - 1999

Grant Medical College, Bombay

Gleaning from the Travelogue - Subhaktha 81

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