Registered with the Registrar of Newspapers for India under R.N.I 53640/91
Vol. XXVIII No. 11, September 16-30, 2018
The physician’s accomplice, undertaker’s benefactor and grave worm’s provider, an apothecary…
– American satirist A.G. Bierce
The Madras Medical School (MMS) was formally established a few days after the Bengal Medical School in Calcutta in 1835. From the start, MMS offered formal training to personnel to be called either ‘Apothecaries’ or ‘Dressers’. The training offered for both Apothecaries and Dressers was the same. Europeans and European descendants (referred to as ‘Indo-Europeans’ by the Government and ‘East-Indians’ by themselves and as ‘Anglo-Indians’ at present) were entitled to use the title ‘Apothecary’, whereas Indians (particularly those from the Madras Army) were to use the title ‘Dresser.’ Before the start of MMS, these personnel, irrespective of whether they were Europeans or East Indians or Indians, attended army hospitals as voluntary trainees and, after a period of such training, were recognised appropriately.
In Europe, training as apothecaries was popular from the late 18th Century. Among the many examples, the English Romantic poet John Keats (1795-1821) features prominently in the list of European apothecaries. Keats qualified for an apothecary’s licence in 1816, although he did not practise as an apothecary during the remainder of his short life.
One key reason for the founding of MMS was to formally train Apothecaries for military and civil service. The Government at Fort St George determined that a school for instructing and training candidates as Apothecaries was necessary to improve medical help to people. MMS started as a private medical ‘hall’ on February 2, 1835, and was superintended by William Mortimer, who held it as an additional responsibility, as he was already superintending the General Hospital, Madras. Mortimer was assisted by George Harding (some references say ‘Hardinge’) in teaching at the School. Apothecary D’Beaux and Dresser P.S. Muthuswami Mudaliar were subordinate assistants. Through an ordinance promulgated by Governor Frederick Adams, MMS was appended to the General Hospital and was to be financially supported by the State. At this time, MMS existed in temporary sheds close to the Surgeon’s quarters in the General Hospital (GH) precinct, Hog Hill. A new building was to be built in the GH precinct in the next two years. This building eventually included four apartments, a theatre, lecture room, a museum, and a library, and was built at a cost of Rs.10,000. The earliest documentation announcing the launch of MMS occurs as a news item in The Asiatic Journal.
A decade-and-a-half later, the management council of MMS sought the status of a college. MMS was renamed ‘Madras Medical College’ on October 1, 1850 and from this time the academic title awarded was ‘Graduate of the Madras Medical College’ (G.M.M.C). With the establishment of the University of Madras in 1857 and the College being affiliated to it, the G.M.M.C. title was withdrawn and the award of M.B.,C.M. was installed, which was later modified as M.B.,B.S. Award of the ‘Apothecary’ and ‘Dresser’ title continued beyond the 1870s, but was restricted to army personnel only.
The Madras Journal of Literature and Science, which refers to the ‘first’ public examination of pupils competing for the Apothecary-Dresser titles held in December 1837, reports grandiosely, “The erection of an edifice at Madras especially devoted to the cultivation of the different branches of the science of Medicine and the instruction of the Natives of India in that most useful and highly important department of knowledge, is too grand and interesting an event to permit of its being unnoticed by the local scientific journal.” This report uses ‘Madras Medical School’ formally for the first time. This report also reiterates the purpose of MMS, stating:
“… Government and the public enjoy the positive and immediate benefit of having a well-trained and well-instructed set of subordinates in the medical department and public service.” The public examination of the first batch of pupils was held on December 13, 1837 in the ‘new’ building. The event confirms that Apothecary-Dresser training was over two years. The Governor of Madras, John Elphinstone (the 13th Lord Elphinstone) accompanied by members of the Medical Board, viz., Peregrine Maitland (Commander-in-Chief, Madras Army) and John Sullivan (Judge, Faujdari Adalat and Member, Board of Revenue), besides many other persons of distinction, both from Medicine and otherwise, witnessed this first, formally held, public examination. Before the examination, Elphinstone inspected the new building and the anatomy laboratory, which was to house the medical museum in the near future. The room where the examination was to be held, this report describes, as an “elegant” apartment with a gallery, built after such rooms in Europe. The examination was conducted by Mortimer and Harding in the presence of the dignitaries. Mortimer examined candidates in Materia Medica and Harding in Anatomy (based on the prescribed syllabus). Further to examining the candidates in the subjects taught, Mortimer and Harding also examined ‘promptitude’, ‘clarity’, and ‘precision’ in them. Governor Elphinstone was ‘highly gratified’ with the result of the examination. Whether MMS issued the title ‘Licentiate of the Society of Apothecaries’ (L.S.A.), similar to many of its contemporaries in the UK, or some other academic title, is not clear.
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Eleven students were admitted into the first Apothecary (and Dresser) instruction programme, with half of them being East Indians and the other half Hindus and one Muslim. With this course Madras had an early start in the organised and formal medical education of Apothecaries, and the other Presidencies followed Madras practice with a structured syllabus and regular examinations coupled with appropriate clinical training. Mention of ‘two women apothecaries’ occurs with no further explanation in Colonel M. Taylor’s report on the Mental Hospitals of Madras, appended to the 1946 Joseph Bhore Report on Health Reforms in India. This notation probably derives from what Satthianadhan had indicated in his History of Education in the Madras Presidency, that trained women Apothecaries served Madras hospitals in the 1940s.
The hospital-assistant training was further extended to include more medical subjects by 1870. MMC preferred to extend academic training for Hospital Assistants to three years. The grade of Hospital Assistant was created to replace Dressers, but MMC’s Principal considered the training of Hospital Assistants to replace Dressers was inadequate.
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The Medical Department, all over pre-independent India, particularly in the later decades of the 19th Century and early decades of the 20th Century, was administered overall by the Army Medical Corps, with the Presidency governments of Madras, Bengal, and Bombay maintaining their freedom to administer the Department’s respective local branches. The Medical Board, which included three of the senior-most surgeons, each holding the rank of a Colonel, presided over the destiny of the Medical Department in each Presidency. Superintending Surgeons, at the rank of Lieutenant Colonel, followed by Surgeons at the rank of Captain, and Assistant Surgeons at the rank of Lieutenant reported to the Medical Board. The Medical Board reported to the Governor.
The Subordinate Medical Service of Madras, which was established in 1812 – the earliest department of this nature in India – included non-commissioned medical servants of European descent referred to as ‘Apothecary’, ‘Second Apothecary’, ‘Assistant Apothecary’, and ‘Medical Apprentice’; the non-commissioned Indians were referred as ‘First Dresser’, ‘Second Dresser’, and ‘Medical Pupil’. The Bengal Subordinate Medical Service included ‘Stewards’ and ‘Assistant Stewards’, in addition to the Apothecaries, the term ‘Dresser’ was specific to the Madras Presidency. Dr M S Valiathan, former Vice Chancellor of Manipal University told the authors, “The Madras story is different from that of Calcutta, where two schools for natives for Hindus and Muslims were merged to make a medical school. While anatomy, medical botany, pharmacology, and other subjects taught were translated from English and to all students, Hindu students were taught Charaka and Susruta from the second year and Muslims were taught Avicenna. This was later abolished to open a medical school under the Governor General’s order. In the Madras Presidency, before the formal launch of training programmes for the Apothecaries, only those who volunteered as apprentices in hospitals were certified as either Apothecaries or Dressers and none was paid any scholarship as the Bengal Presidency Government did. After 1835, in the newly established Bengal Medical College and in MMS in Madras, the lectures for Apothecary trainees in Anatomy, Chemistry, Surgery, Materia Medica, Physic, and Practical Dissection were taught in English. The process adopted in Madras, to subject the Subordinate Medical Personnel in the ranks of Assistant Apothecary and Assistant Dresser to an examination (whether written or oral, is not clear) during promotion to Apothecaries and Dressers, influenced the Bengal Presidency Government in Calcutta. Formal instruction for hospital apprentices was introduced in 1847 in Bengal following the system that had previously been trialled and found effective in Madras.
The Indian Medical Gazette (1968) states in an article “The European Apothecary, to whom the European soldier naturally, as to a fellow countryman, looked, in illness not only for sympathy but for skill, was in truth an empty vessel. Whilst his brother in Madras, and even the native doctor in Bengal, were acquiring, the former an excellent and the latter very fair, education, the hospital apprentice was receiving, except what the kind-hearted medical officer or apothecary of his regiment might give him, absolutely none.”
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Apothecaries in Madras Medical Service published scientific papers in professional journals, although the frequency of their publication was far and few between, compared with those made by Assistant Surgeons and Surgeons, for example, a paper entitled ‘Case of chylous urine’ by George Davis, an Assistant Apothecary attached to the Primary Medical School of the Madras Medical College, is found in the Madras Quarterly Journal of Medical Science. A few other papers, mostly referring to single-case studies by Madras Apothecaries, occur in various medical journals published from Madras.
The Madras Apothecaries launched the Madras Apothecaries Society (MAS) in 1864, which aimed at promoting and advancing medical science and knowledge. At the first business meeting of MAS, a paper on ‘Cholera, its etiology – prophylactic and therapeutic management’ was presented by a member of MAS. This was followed by shorter presentations on ‘Dog bite and hydrophobia’ and ‘Relationship between nerve force and electricity in cholera management’ by two other MAS members. The Society existed until 1871.
The MAS was a novel initiative, since no record of a similar society elsewhere in India occurs. That the MAS aimed at promoting and advancing medical science and knowledge speaks volumes of professional commitment of the Madras Apothecaries and Dressers.
It is notable that from 1869 until the founding of the King Edward VII College of Medicine in 1921, apprentice Apothecaries for placement in Singapore were trained in MMC, this training playing a key role in enabling better health management among Singaporeans.
In Madras, formal training of Apothecaries ceased by the later decades of the 19th Century, although informal training continued, especially for army cadets and women.