:: Genesis of the Grant Medical College and J. J. Hospital ::

Background

The education of native medical practitioners prior to 1826 was haphazard. In most instances, the practice was handed down from father to son. Apprenticeship was the other route. The student entered the household of a reputed practitioner and started off by performing all the menial tasks of the establishment. After attending to his master thus for some years, he was permitted to learn, over a period varying from six to twelve years, all that the teacher had to offer. Books were scarce. The literate vaid possessed some shastras in Sanskrit. The majority of native practitioners were illiterate. There was an almost total absence of any knowledge of human anatomy, physiology, pathology, chemistry, surgery or botany other than that picked up by sheer experience. Palpation of the pulse was an important test but was based on principles not acceptable to the European physician.

As practice was handed down from generation to generation without modification, the progress of medical science had long been suspended. Original thinking and innovation were not only deemed unnecessary but were discouraged.

Dr. William Mackie and The Bombay Native Dispensary

When Dr. Mackie, a private practitioner, set up his clinic in Bombay he was soon besieged by large numbers of Indian patients. Most of them were abjectly poor. His empathy for them made him approach wealthy Indian merchants with the object of setting up a dispensary where such patients could be treated free of cost. After struggling for two years he was able to collect a subscription of three thousand rupees. 

Following a public meeting in October 1835, several subscribers and donors came forward to help the Bombay Native Dispensary. Sir Jamsetjee Jejeebhoy donated Rs. 500 and promised an annual subscription of Rs. 100. Nana Sunkershett donated Rs. 250 and offered Rs. 50 per month. Mr. James Farish donated Rs. 300. The total donation on 7 October 1835 amounted to Rs. 9,000. In addition Rs. 5,000 were promised as annual subscriptions.

This institution was started on 1st January 1836 and was historic in that it was the first Indian dispensary endowed by funds principally contributed by native public charity and was intended 'to provide medical advice and medicines to the poor classes of the native inhabitants gratis'.

It continued to serve poor patients till Sir Jamsetjee Jejeebhoy's Hospital started functioning. After Dr. Mackie's return to England on grounds of ill-health, the dispensary appears to have faded away.

The Native Medical School

In January 1826 the Medical Board in Bombay, having studied a plan for the Calcutta Medical School, suggested the creation of a similar institution in Bombay. Later, in the same month, Assistant Surgeon John McLennan was appointed as Superintendent of the Native Medical School at the salary of Rs. 500 per month.

Governor Mountstuart Elphinstone had founded this medical school with the objective of general diffusion of medical science among Indians, by educating native youth to a knowledge of the European system and then sending them into the district to practice.

Due to a variety of causes – principally flowing from lack of support for Dr. McLennan by government officials – this school failed and was disbanded. Elphinstone's successor, Sir John Malcolm and other officials openly voiced their strong feelings that Indians were incapable of learning modern medicine.

Sir Robert Grant
- conceived the project
- battled odds to get it sanctioned

Sir Robert Grant had to overcome these sentiments to win approval for the medical college he so ably championed.

He took up the question of medical education of Indians in the western system of medicine. In his historic minute dated 14 February 1837, he stated ‘When I was at the Mahabuleshwar Hills in the year 1835, I suggested to Dr. Morehead, then the Acting Surgeon there, the formation of a Bombay Medical Society.” The suggestion was warmly received by Dr. Morehead who took up the challenge.

‘Grant told Morehead later “one result to which I looked forward from the institution of such a society was the general improvement of medical and surgical science and practice among the native practitioners in these departments.”

‘The subject has since been frequently in my thoughts and I have now to propose that we call upon the Committee of the Medical Society to enquire into the best means of effecting such improvement and how far and in what way the aid of Government can advantageously be offered to the object in view and to report on the result of their enquiries fully and in detail.”

‘I am aware that an experiment of an institution for the medical education of native practitioners has already been made at a great cost in this Presidency and has failed. But having read with care all the proceedings relating to the abandonment of the plan, I am not at all satisfied that the object is of hopeless attainment…’

Dr. Charles Morehead
- researched and executed the project
Accordingly, Grant made a proposal to the Governor-General, Reade; but he was not in favour and wrote ‘…I cannot agree in the propriety of commencing an investigation of this nature, nothing appearing to call for it and it being on that account likely to be misconstrued as an interference with their prejudices and usages which, in my opinion, had better not be agitated. Large sums of money might be expended and new places be created eventually without, as it appears to me, the hope of a corresponding benefit or any permanent good effect.’

In reply, Grant noted: ‘The Society in question (Bombay Medical and Physical Society) is, in some sense, a child of my own. The idea of such an institution was not suggested to me by anyone nor was it communicated to any person but the Medical Officer attached to my own staff…’

He then referred to the previous medical school. ‘…It failed by reason of defects in its system involving expenses and inutility. I never heard that the object or design of the institution was impeached. On the contrary, I believe both were highly approved by the Home Authorities and the public in general. Its abolition therefore could form no reason why an attempt should not be made to accomplish the same ends by better means… The medical and surgical practice of the Natives… and especially the former… I believe to be very defective and erroneous. The consequences must be the existence and mortality of diseases, which a better system would prevent or assuage. The idea of supplying European practitioners sufficiently numerous for the wants of the swarming people of India is obviously and utterly preposterous. It is the duty of Government to use its best endeavour to improve the Native Medical Practice.’

He then quoted from the Bombay Durpun edited by Bal Gangadhar Shastri Jambhekar: ‘We have every reason to believe that vast numbers die on this island for want of proper medical attendance and due to the ignorance of the native medical practitioners to whom, in general, the native inhabitants are obliged to resort when overtaken by sickness. Our object, however, is to suggest to some of our own countrymen to study medicine according to the European system and by that means, while they secure a livelihood for themselves, contribute to the savings of the lives of numbers who for want of regularly brought up medical men are obliged to entrust their lives to inexperienced practitioners…’

Grant continued: ‘…If this appalling statement be true, if even on this island vast numbers die through the ignorance of native medical practitioners what must we suppose to be the case in the interior of the country? What ravages — how much suffering — must take place in the crowded towns and villages and even in the rural districts — where European assistance is scarcely attainable…? And can it, I would ask, be otherwise that the duty of Government to employ the best means in its power to remedy this state of things? I may rather say, ought any means to be left untried, which may afford us even a chance of ameliorating a state of things as deplorable? What is a government worth if it can sit still and calmly behold its subjects fall victims not to remote, contingent, problematical or inevitable evils — but to physical sufferings, diseases and death, which the introduction of European methods of healing would, in all human probability be the means of immensely diminishing, though no mortal power can entirely obviate…’

John Reade accepted Grant’s arguments though he had some reservations about the “ultimate good to be expected of it”
The Medical and Physical Society thereupon made an enquiry and reported to the Government on 6th July 1837 that the establishment of a medical school for the education of the natives of this Presidency … to the extent of qualifying them to become safe practitioners of medicine and surgery is quite practical and highly advisable…’   The report then listed the three main benefits that must follow the establishment of a medical school for Indian students: decrease in demoralising and irrational superstition; a drop in the level of morbidity and mortality from illnesses and the study of medicine as it was practised in a modern western hospital.

‘We would now express our firm belief that medical education can only be conducted by approximating as nearly as possible to the systems of instruction followed in the schools of Europe: by teaching in detail Anatomy, Physiology, Materia Medica, Chemistry, the Principles and Practice of Surgery, the Principles and Practice of Medicine, Midwifery, Legal Medicine and a general knowledge of Botany… 

‘Without a course of well-directed study in a practical school, no person, howsoever well versed in the theoretical and elementary knowledge of medicine can be qualified to practice either surgery or medicine with safety or utility. The only practical school for the surgeon and the physician is the bedside of the sick in the wards of an extensive and properly regulated hospital…’

As regards the medium of instruction, the report stated: ‘…We would rest our opinion (that English should be the medium) upon the simple facts that the English language is rich in stores of medical knowledge, that the vernacular languages of the East are absolutely barren of all such literature. English is the language of those who must be the teachers…’ Bell and Henderson’s report was cited to prove that Indian students could and did gain proficiency in English.

The report emphasised that the prospective students should possess a very considerable knowledge of English as of their own vernacular and should have cultivated and exercised mental faculties. Furthermore, throughout the medical course, the teachers must continue to improve the students’ familiarity with the language and their mental faculties.

The report saw the role of the proposed College thus: ‘…We have had in view the education of natives to fit them for the useful and safe practice of surgery and medicine and not the training of hospital servants of the public service. It is the more necessary to make the statement because much of the inconclusiveness of the previous school proceeded from the neglect of a distinction so very plain and so absolutely essential…’

On 5 March 1838, Sir Robert Grant wrote on the Committee’s report

 ‘…Having given my best attention to the propositions of the committee I have to state my perfect concurrence with them in all material respects. I am of opinion that a seminary should be established for the education of the natives with a view to qualify them to practice medicine and surgery; that the pupils admitted should, however, possess a considerable amount of preparatory education; that the several branches of medical knowledge should be thoroughly taught in the seminary, the medium of instruction being the English language; that the practical study of anatomy should be particularly thorough and that a hospital for natives and a vaccinating department should in some way or other be connected with the establishment. I approve of much of the details of the plan recommended by the committee…’

Sir Jamsetjee Jejeebhoy
- made munificent donations including the total cost of the hospital
Jamsetjee Jejeebhoy learnt of the plans regarding the establishment of a new medical college for the inhabitants of the city of Bombay. At the meeting of the committee of the Bombay Native Dispensary on 16 March 1838, he proposed the establishment of a hospital to be attached to the College. ‘…I am willing to make an immediate donation of one lakh of rupees in furtherance of the establishment of a Native Hospital and Dispensary in Bombay on an extended and efficient scale provided the Government will give an equal amount of capital (Rs.1,00,000) independent of its present subscription to the existing dispensary and will allow interest at 6% on my donation—or, in other words, will appropriate Rs. 6,000 per annum to be paid to the committee of management as the hospital may require as the produce of Jamsetjee Jejeebhoy’s fund in aid of the new establishment, the principal to remain untouched forever…’

On 16 June 1938 Sir Robert Grant instructed the Secretary to the Government ‘to inform that liberal minded gentleman that the Government highly appreciate his generous compassion for the sufferings of his countrymen and his munificent effort to relieve their sicknesses and promote their welfare and that his request will be strongly recommended to the Government of India… The committee (of the Bombay Native Dispensary) may also be informed that the proposal of Jamsetjee Jejeebhoy sufficiently meets the general plan of establishing a medical college and native hospital which has, for some time, engaged the earnest attention of Government.’

This was the last official minute on the subject by Sir Robert Grant. As the prospect of creating the institute appeared feasible, he grew strangely impatient. In a minute dated 20 April 1838 he urged Mr. Farish to communicate with Jamsetjee Jejeebhoy and obtain a detailed proposal regarding his donation. Realising his abruptness, he explained in what must be one of the most premonitory statements on record: ‘…I should be sorry to seem impatient or precipitate. But all is full of casualty in this country and I own I am very anxious to bring it quickly to the test whether the Government will or will not be pleased to sanction our design; as in the latter event we must encounter the further delay and hazard of a reference to England. Let us once be empowered to proceed and we can then take all due time to mature details.’

‘The further delay and hazard of a reference to England’ referred to the time it took for a message from Bombay to reach Calcutta, then to England and the time for the reply in the reverse direction.

On 9 July 1838, Sir Robert Grant succumbed to cerebral apoplexy at Dapoorie, near Poona.

The citizens of Bombay convened a meeting at the Town Hall on 28 July to honour Sir Robert Grant and consider the best means of erecting a memorial unto him. Juggonath Sunkershett proposed that a medical college be built in memory of this great friend of Bombay and that it be named after him who had so ably and enthusiastically planned it and so zealously advocated its cause.

On 18 July 1838, the Secretary to the Government of India replied to the government in Bombay, conveying the sanction of Governor-General George Eden, 1st Earl of Auckland

‘…His Honour in Council (President) is so convinced of the benefits that must result from any well organised plan for communicating to the native youth instruction in practical surgery and medical science, according to the approved systems of Europe, that notwithstanding the calls on the Government of India for increased economy, he would not withhold his sanction to the expenditure of a sum equal to the amount stated (Rs. 1,00,000) under the condition that this scheme of appropriation be such as to afford reasonable hope of success. His Honour in Council is further satisfied that for the efficiency of a seminary in medical science the annexation of a hospital is essential…’

The Court of Directors in London replied to the Government in Bombay on 22 May 1839: ‘…Under the circumstances and in compliance to your strong recommendation we cordially adopt your views and sanction a sum to be disbursed by your Government equal to the amount of public subscription…’

The Government decided to name the building that was to be erected The Grant Medical College in honour of the late Sir Robert Grant and the hospital after the munificent donor, Sir Jamsetjee Jejeebhoy.

Describing the college under construction, The Bombay Times and Journal of Commerce, 8 March 1845, reported: ‘…This large and beautiful building bids fair soon to be completed and to be opened for the reception of medical classes. Together with the hospital in the rear it presents an imposing appearance and is one of the most interesting objects which Bombay has … Under proper management it cannot fail to provide a rich blessing to the people of this land. Knowledge of medicine, as now taught in the schools of Europe, will do much to dispel the vain and foolish superstitions and the miserable quackeries… The better educated of the native community in Bombay have watched with considerable interest the progress of the institution…’

On the 15th May 1845 (Thursday), in the evening, the respectable members of the European and Native communities gathered at the Sir Jamsetjee Jejeebhoy Hospital to do honour to its founder at the opening ceremony of his hospital.

The Grant Medical College building was completed in October 1845, and was then handed over to Dr. Morehead, Superintendent of the College and Hospital. Entrance examinations were held on the 20th of the same month and the first lectures were delivered in November.