PREFACE The project entitled The Dissemination of Modern Therapeutic Practices in Travancore (18111939) is a Minor Research Project undertaken

n with financial assistance from University grants Commission in the faculty of history. The work was done with help of the primary data collected from National Archives of India, New Delhi, United Theological College Seminary Archives, Bangalore and Kerala State Archives, Trivandrum. The secondary sources collected from Kerala University Library and many other regional libraries have tremendous helped in completing this project. I am deeply thankful to the Staff of University Grants Commission South Western Regional Office, Bangalore in sanctioning financial assistance to undertake this project. I am greatly indebted to Dr. Sr. Soosamma Kavumpurath, Principal, Fatima Mata National College, Kollam for extending all help for the completion of this work. I am also thankful to Dr. C. Stanley for his sincere support and cooperation in finishing this project. I also extend my heartfelt thanks to the staff of National Archives of India, New Delhi, United Theological College Seminary Archives, Bangalore, Kerala State Archives, Trivandrum and various libraries.

Dr Sathiyaraj Principal Investigator/ Associate Professor Department of History Fatima Mata College Kollam, Kerala

National

INTRODUCTION
The project entitled Dissemination of Modern Therapeutic Practices in Travancore (1811-1939) is study on the activities of the agencies involved in the process of disseminating modern medicine in the erstwhile native state of Travancore which forms a part of present Kerala State. There were primarily two agencies who undertook this cause. The initiative in this direction was undertaken by the South Travancore Medical Mission managed by the London Missionary Society. The prime motive behind the great interest shown by this organization in this kind of humanitarian activity was evangelization, indirectly it opened doors to dissemination of the achievements of allopathic medicine in Travancore. Gradually the Government of Travancore also came forward to patronize the medical missionaries. Rani Lakshmi Bai, Rani Parvathi Bayi, King Swathi Thirunal and king Uthram Thirunal took special interest in spreading western medicine in this area. A note worthy feature is the role played by women in the great
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task. The dissemination of modern therapeutic practices brought in a revolution in medical science and triggered of an era of social transformation. No comprehensive study has been yet made in this area excepting some fragmentary constructions in the form of articles. And that also pertains particularly to the south Kerala region. A systematic research remained to be made on the dedicated work undertaken by the indigenous physicians, which finally fructified in the establishment of medical colleges and hospitals and the patronage advanced towards the internationally appealing indigenous medical system. This is a novel attempt to recapture the whole structure of the problem. REVIEW OF LITERATURE

M. Martin Daniel Dhas book Missionary Medical Work in Travancore, A Brief History of south Travancore Medical Mission ,1838- 1959 ( 1981 ) is a macro level study on the medical work of the South Travancore Medical Mission. It is the first and perhaps the only book on this theme. The scholars narrative is mainly based on the primary missionary reports collected from The United Theological College Archives, Bangalore. The author has presented the monograph following a strict chronology of the medical missionaries starting with Dr. Ramsay and ending on Dr. G. Moses. He also elaborates the establishment of Neyyoor Medical School, Nursing, X ray and Library and many other miscellaneous aspects. The book discusses the native resistance against the alien medical system and how allopathic medicine triggered of an era of social change which finally resulted in the waning of caste untouchability. It focuses mainly on medicine and evangelism, but does not go into the depth of colonial questions involved in the

shift from indigenous medicine to western medicine. Again the area of study is limited to the role played by the medical missionaries alone and doesnt pay attention to the role played by the Government of Travancore in spreading allopathic system of medicine. K.N.Panikkar in the chapter Indigenous Medicine and Cultural Hegemony of the book entitled, Culture, Hegemony, Intellectuals and Social Consciousness in Colonial India (1995 ) argues that western medicine initially introduced for the benefit of Europeans in India and latter made accessible to the Indian population was a tool of the empire. He has concluded that western medicine became an officially preferred system during the 19th century; it was accorded the status of official medicine and the attitude of the state towards other systems became discriminatory, even hostile. Panikkar asserts that P.S. Variar was the pioneer in the field of retrieval of Ayurveda and has narrated it with sub title Kottakkal initiative. He introduced the Paradigm revitalization movement for the retrieval of indigenous medicine, with which many subsequent researchers like Sunitha Nair and Anil Kumar have looked into the problem of and diseases medicines in Kerala. These works are helpful to conduct a comprehensive study of the problem.

Koji Kawashimas book, Missionaries and a Hindu State Travancore 1858-1930 (1998), has devoted one chapter on the history of medicine subtitled The Charitable State and the Missionaries. In this chapter the author investigates how the state and the missionaries

maintained their relationship in the area of medicine. The book examines how the government of Travancore co-operated with the Rockefeller Foundation. Koji Kawashima concludes that the influence of missionaries in the area of medicine was much less than that in the area of
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education. Again, it is pointed out that the number of patients treated in government institutions increased far more rapidly than in the L.M.S. institutions.

Sunitha Nairs article, Social History of Western Medical Practice in Travancore: An Inquiry into the Administrative Process (2001) also treats the subject within the geographical limit of Travancore attempted by Martin Dhas. But she steps forward to analyse the question of western medicines hegemony over the indigenous medicines. Again she analyses the role played by the state machinery which Martin Dias has left recaptured. She also makes a peep into the process of colonization through the trajectory of western medicine. K. Rajesekharan Nairs Evolution of Modern Medicine in Kerala (2001), gives biographical sketches of the pioneers in medicine. Though the work cannot be taken as the product of the skill of a professional historical researcher it is a marvelous contribution to the study of diseases and medicines in Kerala. Rajesekharan Nair, a neuro - surgeon has made a truthful and scientific analysis on the diseases and medicines in Travancore, manifesting the medical exploitation made by the so called medical quacks. The book has covered the long history of diseases and medicines in the beginning from The arrival of the missionaries of the South Travancore Medical Mission in 1838 to Dr. Mahadevan Pillai (1932- 1987), one of the superb clinician, excellent teacher and capable researcher in Trivandrum Medical College. We can have from this study a clue to the process of medical development in Travancore which culminated in the inception of Trivandrum Medical College. But this book limits the area of study to Travancore and the author has not observed methodology pursued in historical research.

STATEMENT OF THE PROBLEM

A historical delve on the advancements made by the western as well as the indigenous systems of medicine in Travancore and their attempts to eradicate contagious diseases. RELEVANCE OF THE STUDY The study reveals how the adivasi groups which depended on nature treated the physical and mental ailments. It analyses the process of continuity of the herbal medicine through the indigenous medical systems like Ayurveda and naturopathy. It is a debate on the confrontation between the indigenous system of medicines and the western medical practices and how former assumed a scientific character. It exposes the beginning of the process of eradicating the superstitions linked with treating of diseases. It examines the co-operation between the Government and medical missionaries alleviating the ailment of the people. AREA OF STUDY. The proposed study covers the geographical area of the erstwhile native states- Travancore which integrated into the present of Kerala in 1950. OBJECTIVES OF THE STUDY 1. To examine the condition of the people living in the areas prone to infectious diseases. 2. To find out the inadequacy of indigenous system of cure 3. To expose the medical exploitation that existed prior to the arrival of western medicine
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4. To bring out the merger of the herbal system of the adivasi groups with Ayurveda 5. To articulate the contribution of the missionaries to Health care 6. To link the eradication of untouchability with the spread of western medicine 7. To see whether modern medicine brought in a scientific examination of superstitions 8. To analyse the role of Government in disseminating modern medicine 9. To signify the local participation in the health improvement 10. To manifest the context of the establishment of the first medical college in Kerala 11. To debate on the question of equality of medical facilities 12. To evaluate the different aspects of medical education HYPOTHESIS The study was conducted on the basis of the following hypotheses 1. Traditional medical system in Travancore was not able to address all the medical needs of the people. 2. Superstitions formed the main block to adapt the modern medicine 3. Medical was used as a tool to evangelization 4. Colonial control also acted a strong force in spreading modern therapeutic practices 5. The dissemination of medicine followed the Travancore
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spread of protestant Christianity in

6. Many marginalized groups were empowered. 7. Government patronage subsided the native resistance to the missionary medicine 8. Gradually the natives were also trained in the modern therapeutic practices 9. Participation of women missionaries created awareness among the native women 10. The net result was the establishment of Trivandrum Medical METHODOLOGY 1. Survey of literature 2. Diagnostic study 3. Interview with Practicing Physicians 4. Case study 5. Content analysis 6. Historical Analysis The Project consists of five chapters. Chapter I analyses the social and cultural background of Travancore and the traditional system that prevailed in the state. Chapter II deals with the advent of the London Missionary Society and the activities of Medical Missionaries like -Dr.Archibald Ramsay, Dr. Charles Clader Leitch, Dr. John Lowe, Dr. Thomas Smith Thomson, Dr. Sargood Fry, Dr. Arthur Fells and Dr. Samuell Hickman Davies. Chapter III accounts the new phase in the history modern therapeutics in Travancore with the arrival of Dr. Theodore Howard Somervell. The contributions of his successors are given due importance in this part. Chapter IV
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brings to light the laudable patronage extended to allopathic medicine in the state. Due space has been accorded to the work of Travancore rulers like Rani Lakshmi Bai, Rani Parvathi Bayi, King Swathi Thirunal and king Uthram Thirunal in establishing dispensaries, hospitals, arranging health awareness programmes and extending support to vaccination. Chapter V is an attempt to highlight the commendable services rendered by women like Mrs Paul, Mrs

Thomson, Ann Martha Baylis, Mrs Fry, Miss M.E. MacDonnell, Mrs Greene Wilson, Mrs Mead, Mrs. Jessie Fells, Mrs. Jessie Fells, Mrs Davidson, Miss Schaffter, Miss Edith Annie, Mrs Somervell, Miss Edith Florence, Miss Eileen Alice and Miss Mills in disseminating modern medicine in Travancore. the process of

CHAPTER-I BACKGROUND OF MODERN MEDICAL PRACTICE To quote the post modern writer Foucault and the author of the book Birth of a Clinic, Medicine arose out of the primal sympathy of man with man; out of the desire to help those in sorrow, need and sickness. Modern anthropologists argue that medicine took its origin in magic. If Greek physician Hippocrates is regarded as the father of medicine, the credit for paternity its in modernized form has been attributed to Avicenna, a Persian Scholar. Sigerest, the renounced writer of the history of medicine has stated that the history of medicine must be first of history, but always medicine as well. Its objective must be to serve the physicians vocation by stimulating him, enlightening and serving him as a tool and as a system. The prmitivity of the medicine can be traced back to the starting days of human existence. Dr. P. Vinaya Chandran claims that first man could be the first physician and the first woman the first nurse.1 The progress in the field of medical science is closely associated with the growth of philosophy and sciences.

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India also has in fact a long tradition to its credit in the field of diagnosing and treating the diseases, beginning with Charaka and Sushrutha (Charaka Samhita mentions that Bharadhwaja received the science of Medicine from Indra but Sushrutha says that it was Dhivodhasan who received it from Indra,2 who produced many treatises on medicine. It is often argued that the rudimentary principles of every science had its origin in India and the fundamental principles of the science of medicine were first preached in Arabia by Indian professors and physicians. The advocates of this view hold that from Arabia Ayurveda was carried through Egypt into Greece, and then to Rome, and from there, it spread all over Europe and gradually throughout the world.3 Adhivasi medicine The roots of the indigenous medical systems, which in due course comprised of Ayurveda, Siddha and Unani, in Keralam can be traced out as a legacy of the adhivasi heritage. The adhivasis attributed mental disorders to be the afflictions inflicted by the evil spirits and they believed that favors from evil spirits could be received employing witchcraft and magic. They also believed that they could cast out evil spirits by massaging certain medical ointments and chanting mantras. It was claimed that they could make these spirits manifest themselves in the form of different animals. Nevertheless, Adhivasis like Mannan, Vedas and Panan had some knowledge about the medicinal value of herbs.4 But their medical knowledge was kept as a secret and its application manifested as merely a means of livelihood of certain people5. Hence it did not make any further progress in tune with the advances in the field of medical technology. But it would be baseless to argue that this system of treatment of the adhivasi has become extinct as it is still resorted to by the adhivasis in Keralam. The Ayurveda system of medical treatment which

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received wide popularity in Keralam is in fact a combination of herbs and treated herbs. So it can be argued that the Ayurvedic system developed as an advanced type of the adhivasi medicine. Ayurveda The Ayurveda system of medical treatment seems to have set its foot in the eighth century A.D in Kerala. Ashtanga Hridhaya, medical treatise by Vakbhata, became very popular among the Buddhist community Kunji Kuttan Thampuran refers to the knowledge of Brahmins in Ayurveda.6 The Manipravalam works refer to Alathur Namboodhiri, one of the Ashta Vaidhyas or Eight Physicians. These works mention that the physicians had boasted of their ability to heal the sick. The Manipravala Champus point out that the people had gone outside and studied Charaka Sutra.The Alathur Manipravalam points to the local texts on medicine in Malayalam and the Angadikal (markets) which contained the Pachamarunnu (herbs) and Angadimarunnu (treated herbs). The indigenous literature signifies that during the age of the Manipravalam, knowledge on medicine and treatment was popular among the village communities in Keralam.7 The Medical system that prevailed in Keralam was not completely rational and it was combination of superstitions. Mark Harrison attributes five phases to the course of medical history. The beginning of the first phase has not been mentioned but has fixed the ending at 1670. He commends that during this period both Europeans and Indians also continued to believe in supernatural causes of disease, as well as the influence of planets and stars; astrological and demonic magic being a prominent feature of medicine in both cultures. 8 Feria Y Soosa, a Portugese writer who wrote "Asia Portuguese" in 1649 refers to the system of treatment that prevailed in Keralam. The magicians and not the physicians were first consulted when a person was afflicted with any disease. The magicians would usually suggest that it was

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afflicted by the devil that had entered the body of the sick and that certain magical chanting was to be offered for driving away the evil spirit. The disease was thought to be healed when the evil spirit was cast out.9 Even the rulers were in no way exempt from this sort of superstitions. Rani Lakshmi Bai in a letter to Col. John Munro expreesed her anxiety over a rumor that Dewan Ummini Thampi, deposed Dewan of Travancore, in association with his friends were attempting to kill the Rani resorting to occult.10 It was believed that Bhadrakali, the tutelary deity of the Nadar community and the malignant aspect of the wife of Siva, inflicted epidemics such as smallpox and cholera. All nonBrahmin castes offered human and animal sacrifices to propitiate her so as to save themselves her afflictions. Mutharamman which means the mother of pearls was regarded as the personification of small pox upon the bodies of human beings. 11 Another superstitious act was the devil dancing that was performed annually in front of the idols of the so called primitive gods in the Pekovils or devil temples. In the course of the dance bystander consulted the devil dancer to know about the causes and solutions of his disease.12 In cases of sickness , the diviner and not the physician was first consulted and sacrifices were offered to the demon as per the instructions of the diviner.13 The Sudras and Shanars frequently employed sorcerers who slightly with a few medicines professed to cure snake bite.14 People believed that the spirit of the dead remained alive to do all kinds of mischief. The devils were of different categories such as male, female, Brahmin, Sudra, Christian, Pulaya and Paraya, native and foreign. 15 The irrational people believed that the devils would bring diseases to men and cattle and frighten the timid in the dark nights.16 The spirits of the deceased persons are supposed to become demons and wander about seeking to do ill, especially the spirit of those who have died of small pox or fever or child birth. Samuel Mateer.17 In 1847 the Missionaries reported that the people in western part of Travancore
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took no medicine, but rub ashes on the forehead and drink cold water as the cure for all their diseases.18 No serious attempts had been made to look into the reason for the diseases. The scientific inquiry into the causes of illnesses was focused with the advent of the medicals missionaries of the London Missionary Society. The researches conducted by the medical missionaries brought out the reality that diseases were contracted because of frequent and restless work in the agricultural fields and standing for hours in the water. The working classes communities like the Pulayas, Parayas and Vedas, were exposed to rheumatism, fevers, cholera and other diseases which carried off men in their very youth itself. In old age, being unable to work many died of hunger. 19 Slave women were obliged to labor hard for their daily support and sometimes had nothing to eat on the days without work.20 At night they generally slept on the floor and rarely bathed or washed. They wore cloth, purchased in harvest times, till they worn out.21 Consequently they bodies were easily prone to any kind of contagious disease. 22 Further in 1928, the Mission made an investigation into the outbreak of cholera and found that it was caused by the failure of crops and rains. 23 But the medical ignorance and superstitions of the people subjected them to all kinds of medical exploitation.

The hereditary Vaidhyas, Sadhus, apothecaries and quasi allopathic quacks were indulged in all sorts of medical practices. The quasi-allopathic quacks, the compounders, dressers and hospital assistants who had learned certain medical procedures from the qualified doctors, often engaged in this deceitful medical enterprise.24 It was in such a situation that modern medicine

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started disseminating in south Keralam. It received legitimacy with its introduction in the court of the king. But Allopathic medicine had to face much resistance from the people. Some people argued that vaccination would lead to other diseases like leprosy and syphilis. 25 But the hostility later subsided and in 1876 the L.M.S. Missionaries vaccinated 488 people.
26

In the initial stage

the new method of treatment was confined to the members of the ruling family and to then to the general public. So it took much time for the government to step into the health welfare of the common man. Before that the medical missionaries commissioned by the L.M.S launched the dissemination of modern medicine in Travancore area. References 1. Vinaya Chandran, Keralathinte Chikitsa Charitram, History of Treatment in Kerala (Malayalam), Kottyam, 2001 p.15 2. N.V. Krishnan Kutty Varier , Ayurveda Charithram 2 ( The History of Ayurveda ), Calicut,1980 , p.7.) 3. Jaminibhushan Roy Kavirathna's Pesidential address at the All India Ayurvedic Conference Seventh Session, (Madras, 1915), Calcutta. Vol. 2, No. 2,p.6.Quoted by K.N. Panikkar in Culture, Ideology, Hegemony, Intellectuals and Social Consciousness in Colonial India, Thulika, New Delhi, 1995,p.154. 4. (Certain magical arts like Odi, Kolam Thullal and Velan Thullal developed from such beliefs. P.K.Gopala Krishnan, Keralathinte Samskarika Charithram 4(The Cultural History of Kerala), Trivandrum, 2000, p. 17.

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5. Raghava Varier and Rajan Gurukkal, Kerala Charithram (History of Kerala ), 1996, Kottayam, p. 259. 6. Kunjukuttan Thampuran, Keralam ( Kerala ), Canto No. 2 , Slogam 105.

7. Ibid. 8. Mark Harrison Medicine and Orientalism: Perspectives on Europes Encounter with Indian Medical Systems, Health, Medicine and Empire, Perspectives in colonial India, Biswamoy Pati and Mark Harrison(ed), New Delhi, 2001,pp.42-43. 9. Velayudhan Panikkasseri, Sancharikal Kanda Keralam , 7( Malayalam ) Kottayam, 2001, p. 298. 10. Col. John Munro to the Chief Secretary to Government, Fort. St. George, 6 October 1813, Political Consultations, No. 73, F.3599. 11. Our Home in the Wlderness- Recollection of North Thirunelveli, Church Missionary Gleaner, London, Vol. 7, April 1879,p.40. 12. Samuel Mateer, Land of Charity,pp.214-18. 13. Samuel Mateer, " Paraiah Caste in Travancore ", Journal of Royal Asiatic Society, Vol. 16, 1884, p.188. 14. Ibid. 15. W. H. Dalton, Missions in India, London, 1854, p. 97.

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16. Ibid 17. Gospel in South India , 1882, p. 20. 18. L.M.S. Report for 1847, p. 89. 19. Samuel Mateer, Land of Charity, Op. cit.p.143. 20. P.E. Conner," Extract from the General Memories of the Survey of Travancore", Journal of Literature and Science, No. 1, October 1833, p. 5. 21. Samuel Mateer, Native Life in Travanacore, pp. 207- 208. 22. P.E.Conner, Op. Cit. 23. L.M.S. Report for 1929, p. 6. 24. The government was forced to do something about quackery and the Royal Decree prohibiting quackery came into existence in 1943. K. Rajasekharan Nair,12 Evolution of Modern Medicine in Kerala, Trivandrum, 2001, p. 11. 25. T.K. Menon, Keerivekkunnathu kondulla Chila Dhoshangal, (Malayalam),

Mangalodhayam, No.3, 1088 M.E. (A.D.1933), Pp. 29-60, quoted by Sunitha B Nair in "Social History of Western Medical Practice in Travancore, An Inquiry nto the Administrative Process ", Disease and Medicine in India, A Historical Overview, Deepak Kumar (ed), New Delhi, 2001, p. 219. 26. L.M.S. Report for 1878, p. 49.

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CHAPTER - II PARTICIPATION OF TRAVANCORE MEDICAL MISSION: DR. RAMSAY TO DR. PUGH The London Missionary Society was founded in 1795 as an interdenominational endevour through the efforts of David Bogue, a congregational minister of Gasport, and of Thomas Haweis, the Evangelical Rector of Aldwinkle. The inspiration for the formation of the Society came from the letters of the first Bengal Missionary, William Carey and the first missionaries were sent to the South Islands in 1796. The Rev. William Tobias Ringeltaube, the first Protestant Missionary Travancore came to Tranquebar by travelling in the Danish vessel Kings Packet in December 1804. He came as one of the first three missionaries of the London Missionary Society in India. While the other two came to study Telugu and go Northward, Ringeltaube was drawn to the South and began to

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learn Tamil.1 When he was at Tranqubar, Vedamanickam, a native of Travancore met him and requested him to come to Travancore. Vedamanickam was a converted Christian and his original name was Maharasan. On his return from a pilgrimage to Chidambaram with his nephew Sivagurunathan was miraculously converted while listening to sermon preached by Rev. J.C. Kohlhoff at Tanjore. After conversion, Maharasan asked for baptism, and he and his nephew Sivagurunathan were baptized and christened as Vedamanickam ( gem of the Bible) and Masilamani ( blameless gem) respectively. Thereupon they took up the task of preaching Christianity to their people in Travancore. On a subsequent visit to Tanjore Vedamanickam was providentially led to meet Ringeltaube at Tranquebar. There Vedamanickam invited Ringeltaube to come to Travancore as missionary. Ringeltaube took it as a call of God and decided to go to Travancore.2 Ringeltaube crossed the Aramboly Ghaut on 25th April 1806 and entered Travancore where he labored in Travancore from 1806 to 1816 and established the London Missionary Society there under the auspices of Col. Macaulay and Col. Munro, the British Residents in Travancore during his time. He settled at Mylaudy, the village of Vedamanickam , where he founded the first Protestant Church in Travancore in 1809 after getting permission from the government with great difficulty. During his stay in Travancore he founded six more congregations at Pitchaikudiyirupoo, Thamarakulam, Puttalam, Atticadu, Eathamozhi and Kovilvilai. He earned more than hundred converts to Protestantism, but only three or four of them, he says, had a longing for salvation. Ringeltaube wrote, The rest have come from all kinds of motives which we can only know after years have passed 3 As result of his hard work, his health broke down and he left Travancore in 1816. Just before his departure he wrote to the Directors of the Society, I am fast decaying and am unfit for active service, My work is done and finished, so as to bear the stamp of permanency. Your money cannot be said to have been

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lost. You will find it in heaven and in the annals of the church of Travancore. 4 After leaving Travancore by a ship, Ringeltaube was finally heard of at Malacca and disappeared from view. During the next two years Ringeltaubes seven congregations fell under the pastoral supervision of Vedamanickam. Ringeltaube before his departure from Travancore. He ordained Vedamanickam as the Native Priest and authorized him to administer the mission. Accordingly, he conducted pastoral tours, settled the local disputes among the Christians and administered the mission properties faithfully. In 1813, Ringeltaube , with the help of Col. Munro paddy, received paddy lands at Thamarkulam as a royal grant to the Mission. Vedamanickam was entitled to administer these lands and other lands on which the seven churches stood.5

The long and eventful period of the mission in Travancore began in 1818 with Charles Meads taking over of his charge. He changed the head station of the mission from the little

village of Mylaudy to Nagercoil which soon became a Christian village. Under Mead the station attained rapid growth covering almost all the parts of south Travancore. At the end of 1819 Ringeltaubes seven congregations had increased to fifteen. Mead was further encouraged by the arrival of the Rev. and Mrs. Charles Mault in 1819. Many Nadars came under the influence of the Gospel and many churches were established between Koodankulam in the east and Thenkapatanam in the west.6 The work grew further when more and more missionaries of the London Missionary Society came to Travancore. DR. RAMSAY

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The first missionary party with a complete medicine chest furnished with an extensive variety of the best drugs to India reached Tranquebar in 1706 to accompany Bartholomaus Ziegenbalg and Heinrich Pluetschau the pioneer Protestant missionaries to India. 7 The

Tranquebar Missionaries had some time requested to have a physician, both for their own establishment and for the surrounding natives. They hoped also, by means of his service, to conciliate the favour of the Rajah of Tanjore who was not in terms with the missionaries. Therefore Dr. Schlegemilch was sent to Tranquebar by the men who steered the Tranquebar Mission in 1730.8 Dr. Schlegemilch was the first Christian Medical Missionary ever sent from Europe to India. But this prospect soon became overcast when Dr. Schlegemilch died at Tranquebar on the 30th of August 1730. The next medical missionary to India Mr. Samuel B. Cnoll who arrived at Tranquebar in 1732 was blessed by his Master to save more souls to Him through his healing ministry. Rev. James Hough describes the medical missionarys usefulness in evangelism as, This intelligence was soon spread throughout the settlement, and his patients soon amounted to two hundred and fifty of whom he lost none. This auspicious beginning established his reputation at once. The natives placed implicit confidence in his skill, and his dispensary became the constant resort of the sick. The success of his practice operated, as was expected in favour of the general objects of the mission; for it impressed the poor people more deeply with a conviction of the missionaries charitable regard for them, and many who came for the relief of their bodies found a blessing for their souls. 9 The first British Medical Missionary to India was William Caseys colleague, Dr. John Thomas, who was the means of bringing the first caste convert of north India, Krishna Pal, whom healed. 10 Dr. Ramsay reached Neyyur on 6th April 1838with his wife and step daughter Miss Paul who later came to be known as Mrs. Daly. 11 He was the second Missionary sent by the London Missionary Society and the first to come over

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to Travancore. The Societys first medical missionary was Dr. John Taylor appointed for Surat in 1804. Apart from the military doctors, Dr. Ramsay was the pioneer of western medicine in Travancore. In the same month of his arrival he established the South Travancore Medical Mission. As there was no suitable building for carrying on this humanitarian work, Mead put temporary thatched sheds and helped the patients to come and stay. As a result there was a steady flow of patients who were able to get regular treatment. At morning and evening times, Mr. Ashton and catechist Thoma read out scripture lessons concerning the medical science. 12 Originally Mead did not intend to establish the Medical Mission at Neyyur on a permanent basis, for Neyyur was neither a thickly populated area in those days, nor was it a centre of nonChristians among whom the Medical Mission was expected to bring better results. Therefore Rev. Mead selected Fort Udaygiri, close to padmanabhapuram as the centre for the Medical Mission. It was Hindu stronghold. Padmanabhapuram was an ideal place as it was surrounded by thickly populated villages with people belonging to various castes and creeds. It was indeed a great and happy period for the Mission when the missionaries and the doctor stayed together in Neyyur carrying on the divine work. But soon a change in the charge of the missionaries was effected in the year 1839, which resulted in the removal of the Medical Mission from Neyyur. Rev. Charles Miller was transferred to Nagercoil and along with him went also the seminary which was in his charge. Since Ramsay was conducting a medical class in the seminary he too went to Nagercoil. Therefore the Medical Mission was also transferred to Nagercoil.
13

Ramsay' s work at Nagercoil was closely associated with Rev. Charles Mault. The

latter often introduced patients to the new doctor in his station. The verandha of the doctors

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house at Nagercoil soon became asylum in which patients always accommodated. It seems that free food was supplied to those who waited there. Bible texts both in Tamil and Malayalam were kept there so that the patients could know about the Great Physician Jesus Christ. One of those who was benefitted by reading a part of the New Testament in Malayalam was a young Brahmin, Subbian by name, who later became the native pastor of the Nagercoil Home Church with the new name Devadasen.14The people who observed Dr. Ramsays work in Medical Mission saw that some novel things were going on and brought to him people suffering from various diseases. For the sake of those who wanted to stay there and continue their treatment, Ramsay soon set up small thatched huts with the help of Rev. Mault. But the huts proved inadequate to accommodate all the patients who wanted to stay there. There to erect a better hospital he made an appeal for funds which was liberally responded by both Europeans and natives in Travancore. He began the building with the money thus collected on a site where the present Womens Christian College is situated. The building was planned by Col. Horsley and the basement was soon completed. Unfortunately, at this stage there arose a difference of opinion between Dr. Ramsay and the other missionaries. Therefore he left the Mission in 1840 and entered into the government service at Trivandrum. Later the building he began to construct for the hospital was completed and used for the seminary by Rev. J.O.Whitehouse. In Travancore Dr. Ramsay found a people very willing to accept his treatment, as is seen from the fact that he treated as many as 1500 cases. He wrote: People of every caste, even the Brahmins, flock to me for advice. I have free access to all, and have reason to believe that good will be done15 His name became famous not only through out Travancore, but also in the neighboring provinces. He was invited to Palayamkottai when the C.M.S. missionary working

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there, Rev. Rhenius fell ill. Despite Dr. Ramsays best efforts Rhenius succumbed to his illness in June 1838. 16 DR. LEITCH Charles Calder Leitch was born on 31 October 1822 in Scotland. After education he joined a job in the Western Bank of Scotland. While working int at Biggar, he took active part in the Sunday School of the Church there. He wanted to become missionary. Soon he was transferred to Gasgow where he got an opportunity to join the university there for higher education. He also studied theology of the United Presbyterian Church in Divinity Hall. While studying there he wrote to the London Missionary Society that he wanted to work as a

missionary in India. In July 1851the London Missionary society requested him to move to India and ordained him on ordained him on September 4, 1851at Greyfrairs Church, Glsagow. He set sail for India from Portsmouth on September 17th and he reached Madras on 17 December 1851. He stayed at Madras for five months and learned Tamil language and studies the types of diseases in India.17 When Leitch reached Nagercoil on 21 June 1852 the missionaries there advised him to stay with them at Santhapuram. Leitch accepted the advice and he studied Tamil well and helped those who approached him for medicine. He stayed there for eight months and came to Neyyur to take charge of the Neyyur Mission on 15 February 1853. He worked there as a missionary and doctor for one year. But when Frederic Baylis took charge of the Neyyur Mission, he concentrated his attention on the Medical Mission.18 Dr. Leitch opened his first dispensary on March 7,1853 at Neyyur and Neyyur began to become the headquarters of the South Kerala Medical Mission. When the number patients increased Dr. Leitch began to think of erecting a hospital at Neyyur. He collected Rs. 800 by public donation and completed its

24

construction in 1854.19 During the eighteen months of his service at Neyyur, Dr. Leitch treated more than seven thousand patients of which 2069 were in-patients. He also performed many operations.20 Mr. Samuel Zachariah the Catechist greatly helped Dr. Leitch in his evangelical work. He spent the morning hours in preaching the word of God tp the patients who go there for treatment and converse with them on the merits of Jesus Christ. Many tracts and scripture portions were also distributed among those who could. Both worked hard to create an awareness about the evils of drunkenness.21 But he could not see the newly built hospital at Neyyur opened. Dr. Leitchs health began to decline due to restless work. On August 25, 1854, he was drowned while bathing at Muttom, a small fishing village about seven miles from Neyyur. In spite of serious efforts his body could not be recovered. The present Leitch Bungalow at Muttom stands as memorial to Dr. Leitch. 22 After the death of Dr. Leitch Rev. Frederic Baylis was put in charge of providing medicine for the Eurpeans and the natives who came for treatment. He had some medical knowledge of medicine while employed in a medical shop.23 DR. JOHN LOWE John Low was a born on 2 March 1832 at Banchory. He passed F.R.C.S was qualified as a surgeon in Edinburgh. Motivated by missionary zeal, he studied theology in Badford and was ordained as a medical missionary at Queen St. Hall, Edinburgh on 1 July 1861. He reached Neyyur on the 18 November in the same year.24

25

Dr John Lowe took over the charge from Frederic Baylis of the medical mission which was in difficult situation. He opened a hospital built by Dr. Litchi and stayed there itself. He made the Medical Mission a self sufficient unit. All the expenditure of the Medical Mission including that for the medicine was met by Dr. Lowe through sources other than the aid received from the London Missionary Society. The King of Travancore was pleased to sanction an annual subscription for the support of the Medical Mission. This encouraged many people to come forward and financed the missions activities in the state. 25 Dr. Lowe treated 2,629 patients, operated 11 tumors conducted 134 operations and 338 minor operations. In 1862 he spent Rs. 835 for the mission.26 Gradually the medical activities prospered and people belonging to

different castes, creeds and religions came to Neyyur Hospital for treatment. He wrote Throughout the past year, it was customary to see from time to time, sitting side by side under the same roof the Brahmin, the Sudras, the Shanar and the Parayas, devil worshippers, the worshipper of Siva, the Mohammedan, Roman Catholic andand the Protestants, men, women and children of all caste and creed listening attentively to the word of God and preaching of the Gospel and hundreds during the past years have heard this sweet story of redeeming love. There lived together in the same room in the hospital for nearly two months a young Brahmin and his mother, a Sudra, his wife and brother and a Shanar boy and his mother. The Brahmin had a compound fracture of the thigh. For the time being , at least, broken bones leveled their caste distinctions and created as a bond of sympathy between them.
27

In 1864, Dr. Lowe read a

lecture entitled, Health How to Preserve it in s meeting of the Maharaja, the Diwan, his government officials and others including the teachers and students of the Maharajahs Free School, Trivandrum. The appreciated the lecture and ordered to print it in English, Tamil and

26

Malayalam so that his subjects could get benefit by reading it. Accordingly the letter was printed and distributed among the people. 28 The number patients from far and wide increased and Dr Lowe felt the necessity of opening branch dispensaries in each mission district. But trained medical men were not

available to be put charge of the dispensaries. So he started a medical class in the Central Hospital in November 1864. In addition to the hospital assistant Mr. M. Daveedu, eight young men were admitted in this training class. Dr. Lowe taught them medicine and surgery while Frederick Baylis of Neyyur gave instructions in Latin and Chemistry. The medical students were allowed to attend minor case so as to get practical knowledge in medicine. After training these medical assistants, Dr. Lowe opened three branch dispensaries in three important localities of the mission, viz., Agasteeswaram in the Kottaram district, Santhapuram in the nagercoil district and Attoor in the Neyyur district. 29These medical assistants were later known as Dressers and they labored much for the dissemination of modern medicine. In 1864, there broke out an epicdemic of smallpox in South Travancore. Dr. Lowe gave special training to Daveedu in vaccination and sent him mainly among the lower cast people. Daveed went from house to house vaccinating a large number of people. It was estimated that during Dr. Lowes entire period of seven years as many as 11,000 people were vaccinated. 30 The climate of Travancore was hostile to Mrs. Lowe and he was go on furlough to accompany her to England. He resigned his connection with the Society in 1871. Later he became the Secretary and Superintendent of the Dispensary and Training of the Edinburgh Medical Missionary

Society. In spite of his retirement from Travancore, he did not forget the South Travancore Medical Mission. He continued to help it by sending medicines, equipments etc., from England

27

till another missionary doctor came to Neyyur. It was mainly due to his influence that the two medical missionaries came to Neyyur. Nearly 50,000 persons passed through the dispensaries during his work in Travancore. The Maharaja of Travancore was very much impressed by his medical activities and started paying annual grant for its support. Many native gentlemen also came forward to offer support to the mission following the example of the king. 31 T.S.THOMSON Dr. T.S.Thomson set sail for India on 20 November 1872 in the vessel Dhoolia and reached Madras on 4 January 1873. Mrs. and Mr. Thomson stayed in Madras a little more than a week. Mrs Thomson and Dr Thomson spent more than a week in prayer for the blessing of in this great work. On 13 of January he left madras for Trivandrum where he was received by Mr and Mrs, Mead. He had an interview with the Maharajah of Travancore at Trivandrum and explained the benefits of the Medical Mission to him. The king was very much impressed with his mission and offered all assistance for medical work. For eight years the king took much interest in his work and helped his work materially. After the death of the king the new king also continued to encourage Dr Thomson and appreciated him for the good work the Medical Mission was doing among his poor and suffering subjects. 32 Mrs. and Mr. Thomson started their work from Neyyur from 30 January 1873. His knowledge and experience in Medical Science attracted the people towards him. He found the old hospital inadequate to meet the needs of the increasing number of people seeking medical help and so he decided to build a second hospital at Neyyur. But he had only 200 rupees offered by some people and the foundation was laid with that amount. He sought the help of the King

28

who asked the details of the expenditure amounting to Rs. 2000. Dr Thomson wrote the details and the king sanctioned the whole amount. 33 The new hospital building was very useful and the number of patients seeking medical aid inceased to Rs. 20000 every year. It became very difficult to manage everything himself and decided to a new batch native assistance. He found that many young people who studied in Nagercoil Seminary were interested in learning medical science. Thomson could not go ahead with the project of training them because of financial difficult. But the British Resident G.N. Ballard came forward to support two students. Thus Dr Thomson started his first Medical Class at Neyyur in 1873. The trained young people were of great help to him in his medical activities. He commenced the second batch of medical class in 1881. Y. Henry. Immanuel, G.James, Edward, Yacob, S.G. Manuel, N.Abel, R. Asirvatham, Jacob Jesudasan and Alfred were some of the native assistants trained by him. 34 While the work was progressing his wife died on 12 June 1876 and was buried at Neyyur.35 In spite of the heavy family responsibility of caring his two children, he carried on his work with great joy and devotion. After two years, he married Mrs. Baylis on 26 September 1878. She had been immense help to him in medical and missionary work. The native assistants were given charge of the branch dispensaries. He also opened a new dispensary at Thittivillai about fifteen miles away from Neyyur in a government building offered by the King of Travancore. On 30 September 1879 Dewan Seshia Shastri declared it opened and a native assistant was put in charge of it.
36

Another dispensary was opened in 1881 at Kulasekharam,

sixteen miles North of Neyyur in an unused government building. But it had no much facility for accommodating the patients and so Dr Thomson requested the king to permit to move it to the

29

nearby unused salt store. The government sanctioned it and it was moved to the salt store 0n 27 July 1881. Dewan Rama Iyengar opened it in the midst of a rejoicing multitude of people. After opening this dispensary during the period from 1881 to 1884 between 12000 to 17000 people received medical help. Another branch dispensary was opened at Marthandom in 1883. According to I.H. Hacker during the period of Dr Thomson not less than 29.433 people received medical aid and his work extended to 700 square miles inhabited by 350, 000 people.37 The medical work under Dr Thomson also helped to cast away the superstitions among the people. Once a person whose wife was supposed to be demon possessed came to him with a recommendation letter from his master who was a local magistrate for curing the woman. Dr Thomson admitted her in Neyyur Hospital and treated her disease which was in no way connected with demon possession. The woman also realized the real cause of her disease. This incident helped her and family members to get rid of superstition regarding disease. 38 Dr Thomson left Neyyur with his daughter Flora on 7 February 1884 to meet his parents who were spending their old age in Australia. He spent three months there and returned to neyyur on 11 June 1884. On 18 July he visited his three outlaying dispensaries, Kulasekharam, Attoor and marthandom and gave helped to many poor patients and exhorted the people who flocked to see him with words of encouragement. But soon after his return from the visit, he was attacked with fever. When his illness became severe, Dr. Hudson, the Durbar Physcian was brought from Trivandrum to treat him. Despite Hudsons efforts, Dr Thomson passed away on in the early morning of 31 July 1884. He was laid to rest in the Neyyur Mission compound. Dr Sargood Fry

30

For two years the South Travancore Mission remained with a missionary doctor. During this period Rev. I.H. Hacker of Neyyur supervised the Medical Mission and hospital works were managed by Dr. R.P. Packianathan, the Chief Medical Evangelist of the Neyyur Hospital.39 Later Dr. Sargood Fry was appointed to take over the charge of medical mission. He started voyage on 23 December 1885 and reached Neyyur on 11 February 1886. In the next year of Dr Frys arrival at Neyyur witnessed the Jubilee Celebrations of Queen Victoria and the south Travancore Medical mission decided to erect a Jubilee hospital and a lepers asylum in Neyyur connection with the celebrations. The work began in 1889 and the new hospital was opened by Mr.Ormsby. 40 The most important activity during the period of Dr. Sargood was the work among the lepers. While he had a journey along a road in Travancore, a leprosy patient begged for help. Soon the doctor decided to do something to alleviate the suffering of the victims of leprosy. He took the matter to the Mission to Lepers in England. Mrs. Charles Pease, a noble lady in Dublin donated 250 s for this noble cause and promised to support the work with her further subscription. With this money a separate leper asylum was erected at Allencode near Neyyur in 1890. Both men and women lepers were admitted here. Dr P.J. Cornelius, Medical Evangelist was put in charge of the aylum. Also a Childrens Home was opened in the same year. Later the asylum developed into Charles Pease Memorial Leprosy Hospital, Colachel. Another important development during the period of Dr Fry was the appointment of Miss Macdonnel as the superintendent of the Neyyur Hospital. She was the first lady superintendent to serve the South Travancore Medical Mission. It was she who began to train nurses in the Neyyur Hospital for the first time. In those days the trained nurse and midwives were not available in India. People

31

looked down upon the nursing profession. Much of the nursing had been done by the relatives of the patients. Dr. Packianathan, the Chief Medical Evangelist of Neyyur Hospital died on 20 December 1892 at the age of 56 and Dr. G. James was appointed as the Chief Medical Evangelist in his place. Dr . Fry extended his medical work to new areas. He began a medical class in 1889 in fourteen students were selected by different district missionaries. He received help from India and abroad for conducting the classes. Dr. Fry was greatly helped by Mrs. Fry and Dr. Martin, a medical missionary to Ceylon who had been learning Tamil at Neyyur. 41. Dr. John Lowe the Secretary and Superintend of the Edinburgh Medical Missionary Society died on 8 May 1892 and Dr. Sargood Fry was asked to take charge of the Edinburgh Mission Drs. FELLS, BENTALL AND DAVIDSON Soon after the resignation of Dr. Sargood Fry, the London Missionary Society took steps for sending another doctor to take over the charge of the missionary medical activities. Arthur Fells, M.B.C.M. (Edin) made a long vaoyage in the vessel R.M.S. Ophir with Mrs.Fells started on December 31st 1892 from England and reached Colachel on January 30, 1893. The first task which Dr. Fells had to take up and finish in Neyyoor was to continue the medical education left by Dr. Fry and to make them capable and efficient medical practitioners. He fulfilled the task with great dedication. After their training was over Fells opened new branch dispensaries at Quilon, Kottarakara, Nedumgolam, Nellikaikuzhi, and Palukal putting each under a Medical Evangelist.42 Fells also took steps for betterment of the Leper Asylum. The leper asylum begun during the period of Dr. Fry was extended with erection of a separate home for the female leapers at Neyyoor. Mrs. Charles Peace donated Rs. 1,709 for this female leper home through the Mission of leapers. Dr. Fells opened the new home for the lepers in 1901. 43 After working for

32

nearly seven years in Travancore, Dr. Fells thought of furlough and requested the board at home to send another medical man to Neyyoor to look after the Medical Mission during his absence. Accordingly the Rev. S H Davis, L R C.P. & S.E. & C who had been retiring from the Medical Mission service in Samoa was appointed temporarily to Travancore. He arrived at Neyyoor on 31st January 1901. Miss MacDonnell who had gone to England on furlough also came back on 11th of January 1901. Dr. Fells handed over the charge of the Medical Mission to Dr. Davis and left for England on March 5, 1901. 44 But the Medical Mission had to endure a severe shock in death of Dr. G. James, Medical Evangelist, in 1901. Dr. James was born in Kotticodu in 1853. After completing his education in the seminary at Nagercoil, he was admitted to the very first medical class of Dr. Thomson which commenced in 1873. After completing his training in Neyyoor, Dr. James worked in the Mission dispensaries at Agasteespuram, Santhapuram and Kulasekaram. When Dr. R.P.Packianathen, the Chief Medical Evangelist of the Neyyoor Hospital, died in 1892, Dr. James was appointed in that place. 45 Dr. James died on May 13, 1901 at the age of forty. In the same year his cousin, Dr.R.Asirvatham, was appointed as the Chief Medical Evangelist in the Neyyoor Hospital.46 Thus medical practices went ahead uninterrupted. During his stay in England, Dr. Fells convinced the Medical Board authorities at home about the need for more missionary doctors in Travancore. The home authorities therefore becoming aware of the prospects of the Medical Mission, appointed William Charles Bentall, L.R.C.P & S. to south Travancore. Dr. Bentall arrived at Nagercoil in January 1902. He realized the inevitability of learning the local language in the performance of his duties. So he began to learn Tamil.47 In November Dr. Fells returned to Neyyoor from furlough and in December Dr. Davis left Travancore.48 In the next year Miss. Macdonnell left the Medical Mission and her place was taken up by Miss Wilson Greene who arrived in the same year.49
33

Another notable event during this period was the opening of a new building for the Mission dispensary at Nagercoil in 1904. The Nagercoil dispensary was originally opened during the period of Dr. Thomson but the work there suffered a lot for lack of a good building. Dr. Y. Henry who had been working in this dispensary for a long time attempted to build a good building for it and collected some money. With the money collected, he completed the basement for a new building in 1903, but further work was delayed for want of funds. When Mr.E.D.Pochin, the father-in-law of Rev. George parker who and his wife were already missionaries in Travancore, visited Nagercoil and gave Rs. 3,000 to erect the building for the dispensary. Thus the construction of the building was completed and Mrs. George Parker (daughter of Mr.E.D.Pochin) opened it in February 1904 in the function presided over by Dr.N.Subramonya Iyer, a high official in the government of Travancore. The new building was used for in patients while the old one was used for out-patients. Attingal was opened on November 9, 1905.51 In 1905 Dr. Fells resigned and the left the Medical Mission on account of his family circumstances. He ably managed the affairs of the south Travancore Medical Mission for thirteen long years. As his co-worker Dr. Bentall wrote, under him the annual number of patients went up from 26000 to 70,000 and the expenditure from Rs. 6,000 to 20.000, while the branches increased from seven to thirteen. 52 He was the first surgeon in the whole of India to make a scientific observation on the problem of oral cancer. He attributed high frequency of this disease in Travancore to the chewing of areca nut, betel leaf, lime and tobacco and noted that the cancer arose at the spot where the quid lay.53
50

The newly built dispensary at

34

After the retirement of Dr. Fells, the Medical Mission came under the superintendence of Dr. Bentall who had been working with Dr. Fells since 1902. He carried forward the work until 1907. The reader will probably be pleased to have an account of working of the Medical Mission under Dr. Bentall in his own words. Today there are two of us in charge (one being Dr. Bentall himself and the other J. Davidson, M.D. who joined in 1905), and a temporary vacant post of lady matron (since the resignation of Miss Wilson Greene in 1906). A staff of seventeen trained assistants, who in many cases should be called fellow medical missionaries, all passed through our school, six native nurses, a school of nine students taking a five years course based on the lines of the Edinburg school, and being examined annually by outside examiners. The annual list of sick treated numbers 79,000, with 5,000 surgical operations, and we read in Prof. Currie Martins book on Foreign Mission that this is the largest medical mission in that world. Dr. Bentall also writes of the way in which he managed the expenditure of the Medical Mission: The cost of each patient, calculating all expenditure save that of the missionaries salaries, works out at 2 d. per head, and of this only d comes from the Board at home. Our expense are kept so low by what I would call a method of self supply, sawdust, coming as packing for the drugs and costing nil, taking the place of expensive wool, by being made into small bags or pads; expensive hot-water bottles are replaced by the tins some medicines come in; our compounder is a trained from our orphanage; our hospital painter and tailor likewise; the whole staff is trained within the Mission, and therefore salaries are not high, and the men better known and more reliable. The income is largely kept up by the charge of small prices for medicines to those who can offord it the poorest getting food, medicine and everything absolutely free. No fee for operation or consulting is ever charged in the Mission
35

Hospital, though we charged for outside visitations, otherwise folks would always fetch us to their homes, and we should have time for naught else.54 Dr. Bentall resigned due to the ill

health of his wife and returned to England where he took a practice at South port. His missionary experience in Travancore exerted a powerful influence on the Home Board, and then as its Chairman. He revisited Travancore in his capacity as the Chairman of the India committee of the society in 1932 and was much pleased to see the progress of Medical Mission which he had once stewarded. Dr. Bentall left the Medical Mission under the superintendence of Dr. James Davidson who had come to Neyyoor in 1905, just one and a half years before his retirement. Dr Davidson continued to work in the Medical Mission till 1913. During all this time the number of patients who received treatment in the Medical Mission had increased and the Mission maintained its status as the biggest medical mission in the world. Dr. Davidsons period was memorable for the erection of a separate eye ward in the Central Hospital at Neyyoor and the erection of a hospital at Kazakutam.55 In 1910, Dr. Davidson started training a batch of medical students. This training course was completed only under Dr. Pugh, his successor. Under Dr. Davidson the scope of the Medical Mission became widened registering a rapid increase in the number of branch dispensaries existing at: (1) Kottarakara, (2) Kundara, (3) Nedumgolam, (4) Attingal, (5) Kilimanur, (6) Kazakutam, (7) Pallode, (8) Paruthapalli, (9) Nellikaikuzhi, (10) Ravananchirai, (11) Kulasekaram, (12) Martandam, (13) Santhapuram, (14) Nagercoil, (15) Attoor, (16) Thittivilai, (17) Agasteespuram and (18) Kottaram. With special reference to Neyyoor. Dr. Davidson wrote that it required:

36

 a). Development of major surgery b). Development of higher medical education c). Building of more pay wards for Europeans,.56 But before any of these schemes could be implemented he too had to leave the Medical Mission due to unfavorable family circumstances. He resigned from the Medical Mission in 1914, followed by a furlough in 1913. In 1915 he became the Medical Officer at the Mission House in London and he held that post till 1927 in addition to his other services to the Society. During the period of his leadership at Neyyoor, doctors Herbert Charles Orrin, F.R.C.S. (1909-1910) and Oswald Huntly Bulloch, M.B.Ch B. (1911-1913) also worked for shorter periods in the South Travancore Medical Mission. One of the notable features of the growth of the Medical Mission during these years was the increase in the size of the European staff. But this increase was a natural consequence of the overall the growth which the London Missionary society had registered in its medical work. By 1880 there were only six medical missionaries in the whole of the societys work- one of them being in Travancore (Dr. T.S. Thomson). In the next fifteen years the number of doctors under the society grew more than three times. The number of medical missionaries in Society service in 1895 was 22 (19 doctors and three nurses). But the figure for Travancore was only twice more by the addition of Miss. MacDonnell as the lady superintendant. In 1905 the 1895 figures of the society doubled and naturally the number in Travancore also doubled. For nearly ten years these figures remained constant everywhere, excepting in Travancore where the figure became trebled in 1912 (Drs. James Davidson, O.H. Bulloch and S.H. Pugh). The

37

London Missionary Societys increase in the size of European medical staff during these years could perhaps be best summed up by quoting Dr.Norman Goodall: In spite of the strength and quality of the Societys pioneer medical service, it was some time before there was any considerable increase in the number of doctors sent abroad by the L.M.S. By 1880 there were still only six medical missionaries in the whole of the Societys work: one of those being in India, and three in Chine. In the next fifteen years the number more than trebled and in the opening year of our period (1895) out of 258 missionaries (excluding wives in Societys service 22 were in China and four in India. Ten years later (1905) the 1895 figures had been more than doubled. The total missionary staff had only risen to 277, but 45 of these were medicals (38 doctors and 7 nurses), China claimed thirty of this forty five; India eleven. For nearly ten years these figures remained fairly stable.57 DR. S. H. PUGH Soon after the retirement of Dr. James Davidson Neyyoor in 1913 the Home Board sent Stephen Horatio Pugh, M.B.Ch.B, F R.C.S, to the south Travancore Medical Mission. Dr. Pugh assumed charge of the Medical Mission, felt that the entire staff trained within the Mission were hopelessly underpaid though they were rendering better dedicated and reliable services. The Medical Evangelists without whose service the Medical Mission would not have widened its scope were paid Rs. 12 or 14 per month. Dr. Pugh having come to know of their poor standard of living on account of their meager salaries raised it up to five or six times. Similarly, he revised the salary of all the members of the Medical Mission and their standard of living became better, much better than it was before. When the salaries and the standard of living of the servants became better than the type of person who came for training as a nurse or a compounder also

38

became far superior to those who had been coming before. Nursing profession which was once considered a shameful job in India was gradually getting to be honoured and trusted. Well educated boys and girls began to apply even when a single vacancy arose in the Medical Mission. But all these advances in the payments made by Dr. Pugh increased the expenses of the Mission. The total expenditure of the Medical Mission which was only Rs. 20,911 in the year 1910 rose to Rs. 61900 when he left the Medical Mission in 1926. This increase in the expenditure of the Medical Mission necessitated charging patients for operation and consultations, a principle introduced by Dr. Pugh. Later Dr.T.H. Somervell justified Dr. Pughs action as follows: Much as we should like to treat all our patients fee of charge, we could only do so if we gave them thoroughly inferior treatment and bad inadequate nursing. To keep up our standard which is the highest we can give with the skill funds at our disposal. We have to charge for it, and we consider it is no charity to give free treatment to those who can well afford to pay, especially if by so doing we would of necessity deprive the poor of any attention at all.58 Dr. Pugh was the first surgeon in India to realize that dyspepsia that is so common in south India and Ceylone is due to duodenal ulcer. This disease in a village community cannot be satisfactorily treated except by surgical operation; and Pugh was the first surgeon in India to operate for it. Bradfield in madras was a close second.59 Opportunities of the medical mission for service multiplied at an alarming rate inspite of the fees charged for operations and consultations. As we have mentioned above, the major portion of Dr. Pughs service in Neyyoor was single-handed. Therefore the patients for operations had to wait many weeks, in great pain, for their turn to come. This lack of European doctor was painfully expressed in one of his annual reports as follows: We have known years

39

when three European doctors have staffed our medical work and been fully employed, but during the past year Dr. Pugh has had to meet single handed work which three doctors would have found heavy. We are further unfortunate in being without a European nurse owing to being understaffed for the past six years it has not been possible to carry on a medical class to train new workers and we are now feeling keenly the lack of medical evangelists. Three branch hospitals have had to be closed and the work in one or two others has been inefficient as we have no men to replace the present workers.60 Therefore Dr. Pugh made arrangements to get his

men trained in the American Presbyterian mission medical school at Miraj in Bombay. The entire cost of education of those candidates was met by the medical mission. The minimum cost for each student for the four years. Including their one years probation at Neyyoor was Rs. 1,800 an expense which could have been avoided if the medical class at Neyyoor had been properly equipped to train its own students with the arrival of the newly trained doctors from Miraj the outlook of the existing medical Evangelists became widened through their contact with the well-trained new comers. The missions work on the womens side was greatly affected with the retirement of Miss Schaffter in 1922. Miss Schaffter had been steering the nursing department from 1916 in an efficient manner. But with her resignation the medical mission went without a European nurse and the absence of a lady superintendent lowered the standard of nursing and gave additional work to Dr. Pugh. In spite of fact that Miss Ferguson, a European nurse who was making a tour in India volunteered to serve the hospital for a period of two years, without a permanent nursing superintendent there was no chance to train any fresh candidates as nurses and the result was a shortage in the nursing department. 61 But this state of affairs in the nursing department came to be remedied in 1923 when Miss E.A. Hacker, after completing her training as a nurse in guys
40

hospital, London, joined the Medical Mission. The benefits of her work from 1923 to 1927 became well appreciated by the mission. She was an exceedingly capable nurse. She spoke Tamil like a Tamilian, being born and brought up in Neyyoor itself when her father Rev.I.H.Hacker, was a missionary there. She began to give training to freshmen and women in nursing. The efficiency of the men and women whom Miss Hacker trained was highly spoken of by the doctors. From now onwards the Medical Mission never suffered for lack of nurses.

The South Travancore medical mission entered into an era of marvelous changes with the arrival of Dr.T.H.Somervell of Mount Everest fame. Dr.Somervell first visitor the Neyyoor Hospital in September 1922 when Dr. Pugh was in the helm of affairs. Dr. Somervell stayed with Dr. Pugh for a fortnight and the two doctors together were able to perform a number of surgical operations.62 Being impressed by the great at Neyyoor. Dr.Somervell decided to come to Neyyoor medical missionary. Later Dr.Somervell himself wrote of as follows: in fact It was due to a ten days sojourn at Neyyoor in 1922, that I had decided to spend the best part of my life at that very place, where the need seemed to be great, and the supply seemed hopelessly inadequate. 63 Dr. Somervell joined the staff of the medical mission in 1923. At the very outset what he noticed in the Neyyoor Hospital was the inadequacy of doctors in relation to the number of patients there and also the inadequacy of the accommodation for the patients already existing. While his arrival solved the first problem it only intensified the second. For while Dr. Pugh Working Full time Was able to fill the Hospital of eighty beds and to keep them full, now two famous doctors working full time, simply dealt with twice that number. This brought in the need
41

for doubling the patients accommodation. The hospital capacity at this time began to look so woefully inadequate that not only all the beds were full but even an extra patient was put under each bed, besides a few between the beds. The verandas were also filled with patients. This made the two doctors to think seriously on the question of finding additional accommodation.

Apart from the overall inadequacy of accommodation, there was also a bad arrangement in the Neyyoor hospital, by which the womens ward became situated on the roadside in the front portion of the hospital, in a public place. This arrangement was not one suitable to the Indian custom of segregating women. Because of this bad arrangement many of the upper class women patients would not willingly come to the Neyyoor Hospital. For years Dr. Pugh was brooding over this problem, and he rightly thought of building a separate ward for women. It was at this juncture that Dr. Somervell brought with him an x-ray apparatus. The need for installing this apparatus together with the necessity for increased accommodation brought the issue of a separate ward for women to the forefront. And so, shortly after the arrival of Dr Somervell in 1923. Work for additional accommodation was started in right earnest. In the new construction, the x-ray room and a large medical ward were on the ground floor, the former opening outwards into the mens compound, the later into the womens . Above these were two wards, one for midwifery and the other for surgery. To the south-west were to be three wards with six or eight beds each: two for septic cases, and one to function as an isolation ward. Mrs. Parker gave ten thousand rupees towards the cost of these buildings from her embroidery industry at Trivandrum. Later two rows of kitchens and a maternity room were added to this fifty bed womens ward. The total cost of the building came to about rupees twenty thousand and it

42

was Mrs. Parker who opened the new womens ward in 1924. From now onwards Neyyoor hospital began to attract almost every class of women including Mohammedans. The visiting hours was fixed from twelve to two, during which time alone men were allowed to visit their sick ones. After the opening of this new womens ward, former womens ward was used as mens abdominal ward and some 300 or 400 gastric cases every year were treated in it. These new accommodation facilities and the introduction of modern techniques like x-ray apparatus etc. attracted a large number of people from all over Travancore and even from the neighboring provinces. In spite of the continuation in multiplication of government hospitals throughout Travancore in those days, the south Travancore medical mission dealt with 134,000 new cases in the year 1926 alone- a record number in the history of the Medical Mission. This was also, as far as we could ascertain, a number larger than that which had been dealt with in any other medical mission in the world. The annual report of the Medical Mission for the year 1926 says: Considering the continued multiplication of government hospitals in Travancore, the fact that our patients are more numerous than ever is one which speaks well for the efficiency of the Mission and the confidence it inspires in the country. Neyyoor Hospital is now the largest hospital in Travancore, and its equipment is thoroughly up-to-date: in consequence we often have cases sent to us which the government hospitals have been unable to treat, but which find Neyyoor ready and able to give them all the benefit of modern surgery, aided in its diagnosis by X-rays, and I its practical side by diathermy. During 1926, the major operations done at Neyyoor have totaled 1,032, a greater number than ever before.64 Again, what prestige the Neyyoor Hospital under Dr. Pugh had attainted in the whole front of Christian missions would appear from the following lines taken from the One Hundred

43

and Thirty-first Report of the London Missionary society published in the year 1925: Visits were paid during the year by three medical missionaries who came for surgical experiences before beginning in their own Hospitals. One of these was Dr. Cecil Gill, who was on his way from England to Papua where he will be a medical missionary under the Australian Board of Missions. It is significant of modern missionary fellowship that a medical missionary of another Society commissioned for work in Papua should study for his lonely work in a friendly hospital near the south most point of India.65 The growth of the Medical Mission during all these became manifest not only in the Central Hospital at Neyyoor but also in its various branches. Martandam Hospital, for example, one of the largest of the branches, opened four new private wards in 1922. The cost of their erection was entirely defrayed by Mrs. Sinclair from the Martandam embroidery industry owned by the London Missionary Society in Travancore.
66

The branch

hospital at Kulasekaram was running successfully and had dealt with 7,000 patients during the year 1926 alone. The Tittivillai branch which had been closed for some time was also ready for reopening in 1926. 67

During this period, through Dr. Somervell was in Neyyoor from 1926 onwards, it seems that he not able to focus his whole attention towards the Medical Mission, through he had decided to be a medical missionary at Neyyoor. In April 1924 he went off to Everest and was away from Neyyoor for a few months, leaving Dr. Pugh to himself once again. However, he returned to Neyyoor in August and worked in double harness. In 1925 he went back to England where he did the best thing by marrying Miss Margret and soon returned to Neyyoor with his wife. In 1926 he once again went for a Himalayan holiday in the region of Nanda Devi with his

44

wife. All the recorded growth and advance of the Medical Mission in these days therefore are to be attributed mainly to the efficiency and painstaking work of Dr. Pugh. Early in the year 1926, Dr. Pugh became very tired and overworked and was therefore recommended for furlough. By the time Dr. Somervell returned to Neyyoor from his Himalayan holiday in 1926, Dr. Pugh had already left Neyyoor on furlough. A few months later, much to the dismay of all, Dr Pugh wrote that he did not intend to come back. He arrived in Neyyoor in 1912, and had a longer period service there than any of his predecessors. Moreover, For many of these years he was working single-handed. In one of his reports, Dr. Somervell pays him the following tribute: Dr. Pugh, who did not more than any single individual to increase the efficiency and the influence of our Medical Mission, left us during this interval. He it was who substituted the miserable pittance our staff were receiving in the old days, by a reasonable living wage. He developed the surgical side of the Neyyoor Hospital enormously, and greatly improved the business arrangements of the Mission. And as a personal note may I add that he was an ideal colleague to serve under and to serve with; patient, yet efficient; high in his standard and strong in his sense of right; yet understanding and sympathetic, and extremely painstaking with every patient who consulted him.58 Throughout his service in Travancore Dr. Pugh was ably supported in his work by Mrs. Pugh who took upon herself not only the responsibility of caring for an overworking husband, but also the oversight of the womens leper home and the orphanages and the management of the hospital linen besides endearing herself to the many with whom she came across. References 1. William Walker, A History of the Christian Church, p.472
45

2. 3.

S.A.Azariah, Ringeltaube the Apostle of S. Travancore, pp.71-72 Rev. Samuel Mateer, Native Life in Travancore, p.417

4. Ibid. 5. 6. 7. Martin Daniel Dhas , Missionary Medical Work in Travancore, Marthandom1981 p.3 Samuel Zacharaiah, The London Missionary Society in Travancore, p.88. James Hough, History of Christianity in India,III,.p.156.

8. Ibid.,p.230 9. Ibid., p. 234. 10. George Smith, Short History of Christian Missions, p.182. 11. Ibid. 12. Samuel Zachariah, op.cit,, p.86. 13. Forty Fifth Report of the L.M.S. for 1839, p.65. 14. Rev. A. Vethecan, The Life of the Rev. Devadasan,p.18. 15. Rev. Samuel Mateer, The Land of Charity, p. 285. 16. C.M. Agur, Church History of Travancore, p. 874. 17. Samuel Zacharia, The London Missionary Society in South Travancore, p.228. 18. Memories of C.C. Leitch, p.54.

46

19. Ibid. 20. C. M. Agur, op.cit., p. 917. 21. Samuel Zachariah, op.cit., p.245. 22. C. M. Agur, The Progress of Christianity in Travancore, p.73. 23. Samuel Zachariah, , op.cit. 24. Martin Daniel Dhas, p. 26. 25. I. Hacker, Memoirs of Thomas Smith Thomson, p57. 26. Samuel Mateer, op.cit., p. 312. 27. Report of the Medical Mission, 1862. 28. Health, How to Preserve it, Nagercoil, 1864. 29. Address to Lord Napier by the L.M.S. Missionaries of Travancore, 1 October 1868,Nagercoil. 30. Samuel Zachariah, op.cit.,, p. 32. 31. I.H. Hacker, op.cit., p.56 32. Ibid., p.49 33. Ibid., p.58 34. Ibid 35. Ibid., p.68
47

36. Rev.Samuel Zachariah, op.cit., p.106 37. Ibid., p.104 38. I.H. Hacker, op.cit., p.99 39. Ibid., p. 166. 40. Rev.Samuel Zachariah, op.cit., 145 41. Ibid., p.151 42. Ibid.,p.166. 43. Ibid.,p.200. 44. 45. 46. 47. 48. Report of the Neyyoor District for the year 1899, P.5. Report of the Medical Mission for the year 1901, P.6. Rev.Samuel Zachariah, op.cit.,p.204. Ibid.,p.205. Ibid.,p.207.

49. Ibid.,p.204. 50. Ibid.,p..219. 51. Rev.I.H.Hacker, A Hundred Years in Travancore,p.80. 52. Norman Goodall, A History of the London Missionary Society 1895-1945, p.50. 53. Rev.I.H.Hacker, op.cit.,p.80.
48

54. Report of the L.M.S. for the Year 1910, p.99. 55. J.Romanes Davidson, M.D. (Dr.J.Davidsons son) in his letter dated 23-8-2963 to Dr.Jeyasekaran, published in the Neyyoor Hospital 125th Anniversary Souvenir. 56. Norman Goodall, A History of the London Missionary Society 1895 1945, p.509. 57. T.Howard Somervell, Knife and Life in India, p.15 58. Ibid., p.15 59. Report of the Medical Mission for the Year 1922, p.10 60. Report of the Medical Mission for the Year 1922, p.11 61. Report of the Medical Mission for the Year 1922, p.1 62. T.Howard Somervell, Knife and Life in India, p.2, 63. Report of the Medical Mission for the Year 1922, p.12. 64. The One Hundred and Thirty-first Report of the London Missionary Society, 1925, p.53 65. Report of the Medical Mission for the year 1922, p.11. 66. Report of the Medical Mission for the Year 1926, p.14. 67. London Missionary Society: Ten years of Church and Mission in Travancore 19211930, p.30

49

CHAPTER - III PARTICIPATION OF TRAVANCORE MEDICAL MISSION:

50

DR.T.H.SOMERVELL AND AFTER

Theodore Howard Somervell, M. A., M. B. B. Ch, F. R. C. S, who was destined to steer the course of the South Travancore Medical Mission for the next twenty years, was born in Kendal, in the United Kingdom in the year 1880. His father W. H. Somervell was an honorary Treasurer of the London Missionary Society from 1918 to 1930 whose dedicated Christian character can be known from a book of prayer that he wrote and distributed to many during his deputation to Travancore in 1914. His mother was also an equally pious Christian lady. After finishing his early education, Somervell was sent to famous Rugby School where he studied for five years. Having secured a science scholarship at Carus College, Somervell entered Cambridge where he took his masters degree in science. Then Somervell was qualified as a doctor in the University College Hospital, London. He joined the Royal Medical Corps in 1915 in response to the call of his fatherland during World War 1. His service as a military doctor during the War gave him enormous opportunities for practical knowledge and experience in surgery.

Dr. Somervell choice of Travancore as the field of his medical work was inspired by Dr. Pughs services there. Dr. Somervell had already won world renown through his participation in the Mount Everest Expedition of 1922. Fresh from the Everest Expedition Dr. Somervell visited Neyyoor and found that the healthy man whom I had met in 1922 (Dr. Pugh) was pale and thin and obviously working himself to death.

51

He had to look after Neyyoor Hospital, which then had nearly a hundred beds, as well as fourteen branch hospitals and two leper homes. In addition, he had twenty Indian doctors and many other Indian hospital servants and nurses under his charge. He did almost all the operative work having developed this side of the Hospitals activities in a most remarkable manner, and had completely recognized the system on which the Medical Mission was run. All this was done in a tropical climate of continual damp heat, with a body which was far from physically fit. Therefore Dr. Somervell felt that: if I had not then gone to India at the call of suffering I should never have dared to look God in the Face, nor to say Prayers to Him again. Nobody who saw such need and neglected to relieve it could call himself either a Christian or sportsman. I take no credit for this decision and deserve none. I simply felt that my job lay in Neyyoor and that there was no getting out of it.1 The people of Travancore called the Neyyoor Hospital as Somervell Hospital. 2 Everything he did was characterised by remarkable brilliance and outstanding success. His years of service in the Mission in combination with Dr. Pugh gave him an opportunity to understand the people, their customs and their suffering. Dr. Somervell himself wrote of his experience under Dr. Pugh that, he (Pugh) was extremely through, and a very good companion for a distinctly slapdash person like myself. I learned from him to take pains and to be content with nothing less than ones considered judgment about every case. Dr. Somervells all previous experience in the Neyyoor Hospital were only as a junior doctor. But now he had to head the Medical Mission. To quote him, after less than three years at the Medical Mission, I suddenly found that all the responsibility was on my inadequate and entirely unworthy shoulders. It was a bitter blow. I always loathed responsibility, and I felt totally unprepared to mange so large a show as the south Travancore Medical Mission. Still it had to be done.3
52

Yet with high hopes and much enthusiasm Dr. Somervell took up the work of the medical Mission straight away. On the administrative side he was helped by the genial old writer Sandrothya who was a tower of strength to him. In the hospital work he was not left alone for much longer. For in the same year itself Dudly Marks, B. A. M.B.B.Ch, F.R.C.S. was sent by the board at home. Dr. Marks was an able surgeon extremely capable to deal with Indian patients. His efficiency can be gauged from one simple incident. In June 1927 four out of the five Mission students who returned from the Miraj Medical School failed in their final examinations. Dr. Marks gave them only six months tuition not averaging more than one hour every day. And got every one of them passed.4 Dr. Marks had great desire to stay in Travancore as one of the permanent members of the medical mission. But the rather unexpected death of his father him to retire him to retire from the mission in April 1928.5 In 1927 Dr. Somervell was relieved from the additional burden of office work with the arrival of Mr. Harlow as the business manager to the medical mission. Formerly he had been working in the L.M.S. Hospital in Hong Kong in the same capacity and therefore without much difficulty, he was able to run the business management of the medical mission. While shouldering the entire business responsibilities. Mr. Harlow took upon himself the responsibility of improving the financial situation of the medical mission also. The entire lot of drugs needed for the medical mission in those days was bought from the agents and not directly from the manufacturers. The agents charged high prices for them. Obviously, it was an avoidable waste of money. But now, under Mr. Harlow, the Neyyoor Hospital itself began to manufacture drugs, medicines, tablets, tooth-pastes, etc. These things thus manufactured were found sufficient for all

53

the hospitals under the south Travancore medical mission. The other hospitals in Travancore also began to send their orders to Neyyoor asking for these things. The manufacture of drugs and allied things in Neyyoor brought about a turning point in the financial condition of the medical mission and putting it on a firm foundation for the future. In addition to these works, Mr. Harlow took on his shoulders the responsibility of the x-ray department also for some time, which he had a special training at home. He worked at Neyyoor until 1947 and in that year he was transferred to Kundara along with the medical stores where he worked till 1953. During those days there existed a custom in the Neyyoor Hospital of taking the European into the bungalows of the doctors for treatment for want of convenience suitable to them in the general wards of hospital. Dr. James Davidsons desire to build a separate Nursing home for Europeans did not come into practice due to lack of money. But the task was now undertaken by Dr. Somervell. In 1927 he constructed a nursing home for Europeans at Neyyoor entirely at their own expense and to financed solely by them. Miss Lawrence from London hospital was arranged to be in charge of it. Her salary was paid by Messrs Harrisons and Crosfield Ltd. and Messrs Malayalam plantations Ltd.6 From 1928 onwards the European nursing home began to function.7 This brought a great relief to the doctors work, as it did away with the former practice of taking European patients into their bungalows. Also its establishment became a profitable one to the medical mission, for all the fees from the European patients went towards the medical mission, except for the first year or so when the fees obtained had to be used for the equipment of nursing home. Moreover, Miss Lawrence, apart from her work in the nursing home found a good deal of time for work in the main Hospital.

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A few months before the retirement of Dr. Marks, the medical mission rejoiced to receive Ian Orr, M. D, Ch. B., F. R. C. S. who came with his with his wife. The ill wind that blew them away from china became a favorable breeze for Travancore. Mrs. Orr was glad to enter into the house at Neyyoor where she was born when her father Dr. Bentall lived while working at Neyyoor. Dr. Orr was a first class surgeon and, since Dr. Somervell was also a surgeon, Neyyoor continued to be famous for surgery. The surgical cases of the branch were directed to the central hospital, for they dealt with only medical cases as there were little facilities for operations in them. Being a doctor with an enquiring type of brain, Dr. Orr was keen in research. While at Neyyoor he did two extremely thorough and useful pieces of research, fitting them in somehow with his very busy life and his hospital work. He investigated the problem of cancer of the mouth in Travancore. And he discovered it to be due to the tobacco which chewed with the betal nut, certain kinds of tobacco being much more apt to produce cancer than other varieties. Then he proceeded to investigate the problem of duodenal ulcer in conjunction with Dr. Somervell and they came to the conclusion that vitamin deficiency was the most essential factor in its production Travancore, Dr. Orr also perfected the transplantation of the uterus by operation.8

During the months of October and November 1928 south Travancore witnessed a cholera spreading over with all its all its severity. The countryside around Neyyoor for many miles was ravaged by it where many families were altogether wiped out within a few days. Though the Travancore government became aware of it and took every step to the people. They did not reach much interior from the roadsides. So we got busy. Wrote Dr. Somervell in the report for the

55

year, and spent many days in relieving the distress in villages off the roadside. One of our missionaries, with one of our Indian assistants and two orderlies, together with a supply of drugs and all the apparatus necessary for intravenous infusion, went about every day, going in a car and inquiring of houses along the roads as to where the new cases had started. Often we had to walk two or three miles to stricken villages, and on most days we did about fifty miles in a car and fifteen or twenty on foot.9 In the year 1930, the Medical Mission had the misfortune to lose Dr.R.Asirvatham, the Chief Medical Evangelist of the Neyyoor Hospital. Dr.Asirvatham was born in Kotticode in 1860. After completing his seminary education at Nagercoil, he joined the medical class conducted by Dr.T.S.Thomson in 1881. After his training was over, he was put in charge of the branch dispensary at Tittivilai for two years. In 1901 on the death of his cousin Dr.G.James, the Chief Medical Evangelist at Neyyoor, Dr.Asirvatham was called to fill his place. Dr.Asirvatham readily responded to this call and he worked in this capacity for twenty-nine long years, in company with the European doctors Fells, Bentall. Davidson Orrin, Pugh and Somervell. While at Neyyoor, both Christians and non-Christians were attracted by his medical skill, kidness and sympathy. He usually visited the poor in-patients in the Hospital to examine whether they were properly fed and the servants did their duty of keeping the rooms, wards and premises clean and tidy. He rendered useful service to the Home Church, Neyyoor as deacon for twenty-nine consecutive years. Apart from the fact that Dr.Asirvatham was an ideal Christian doctor, he was also an ardent student of the Bible His book The Gospel Peace was the result of his reading the Bible for over forty years according to the Y.M.C.A.Bible reading calendar. After serving the Medical Mission for forty-five years, he died on 19th October, 1930.10

56

Dr.Somervell, in the Medical Mission report of 1930, wrote about Dr.Asirvatham thus: Later in the year the senior member of our Neyyoor medical staff, Mr.Asirvatham, died after an illness of many weeks. He also had served as a Medical Evangelist for forty-five years, and for a long time had been in charge of the out-patient work in Neyyoor. Until his last illness, he had hardly missed a single days work for many years, and his kindly manner and long experience had won the confidence of thousands of people from the districts around our Central Hospital. Every Sunday his well-known and steady figure could be seen going down to Eraniel, a service attended chiefly by Hindus a piece of consistent and faithful work in difficult circumstances which was only equaled by his never-failing help and kindly manner at the hospital and the homes of the people. One of the most important achievements in the Neyyoor Hospital during the time of Dr.Somervell was the introduction of radium treatment for cancer in the year 1930. In that year he had a furlough to England during which time Dr.Orr managed the Medical Mission single handed. During the furlough, Dr.Somervell collected some money, largely as a result of his broad-casted account of his work in Travancore, with which nearly 1000 worth of radium had been obtained. The introduction of radium in a hospital like Neyyoor where cancer of the mouth was frequently seen brought immense benefits to hundreds and thousands of sufferers. By the end of the year 1930 two special wards were built in the Neyyoor Hospital for the radium treatment. These were the first radium wards to have been erected in the whole of India. The new wards were opened by Col. Pritchard, the newly arrived British Resident to Travancore.
11

The

tremendous enthusiasm with which the cancer wards were received by the thousands of cancer patients all over India has been explained by Dr.Somervell. The opening of our radium wardes has developed our facilities for relieving cases of cancer, and nearly five hundred operations have been performed for cancer, in 1931, many of these being the insertion of radium. Such is

57

the appalling frequency of cancer, especially of the mouth, in this country, that it is strikingly evident that our present supply of radium, able though it is to treat some two hundred cases every year, is hopelessly insufficient.12

The year 1933 was marked by the opening of the new laboratory, consulting room and Indian Nursing Home. Mr.Ananda Bhattar and Mr.S.K.Panickar had both contributed handsomely to this building and it was opened by His Highness the Maharajah of Travancore on 16th of January. In August 1936 a new mens medical ward was opened by Lt.Col Garstin, the Agent to the Governor General. This new ward was constructed to take the place of the old medical ward which had been pulled down to make room for the new chapel. It provided accommodation for 26 patients almost double the number which could be admitted into the old one. In the same year a chapel in Indian style of architecture was built by the Somervell family

in memory of Mr.W.H.Somervell, father of Dr.Somervell. In May 1935 the long felt need of a really adequate hospital in the northern area of the L.M.S in Travancore was at last realized. The Boys Brigade Companies connected with the Congregational Churches of England and Scotland undertook to take this job.13 They adopted the Kundara Hospital it being renamed as the Boys Brigade Hospital: from then on this Hospital grew rapidly. Dr.Somervell and Dr.Orr worked together for nine years and they did a colossal amount of surgical work. In January 1937, much to the regret of all in the Medical Mission, Dr. Orr left Neyyoor to take up the task of the surgical side of the American Presbyterian Mission Medical School at Miraj. He had done solid pieces of technical work, while in sole charge of the Neyyoor Hospital and brought credit to it. Though his resignation was a great loss to the Medical
58

Mission, his decision became a blessing in disguise, for many of the medical students at Miraj were from South India who could now obtain his skill and new techniques. Therefore Dr. Somervell comforted himself by writing, Our loss is their gain, and we can but give Dr. Orr up with a good grace, knowing that we is doing the right thing in accepting this post, with its great opportunities for service and influence.14 During the nine years when the two surgeons worked together they dealt with all types of cases. To quote Dr. Somervell: I was the eye department, the womens doctor and the physician, as well a surgeon, an ear specialist and an authority on skin disease! 15 This not only increased the work burden, but also the need for specialists. Of all, the need for a womens doctor was great. In countries like India, where the womenfolk was restricted within their homes, they often felt ashamed to be treated by male doctors. Until Dr. Pugh left Neyyoor Dr. Somervell never attended even a single women patient! Priority went to Dr. Pugh because he was a married man then. Even after Dr. Somervells marriage, it was strictly continued, for Dr. Pugh was much older than Dr. Somervell. With the opening of the womens ward in 1924, the womens side of work had much improved under a native medical Evangelist, Dr. Manuel. In 1930 Dr. Manuel retired from the Medical Mission after serving it for nearly forty five years. Therefore his place was taken over by Miss Solomon, L.M.P., who was trained at Vellore. 16Miss Solomon was the first lady doctor in the Medical Mission whose service brought much fruitful results among the women. Yet the need for a European lady doctor was greatly felt. Therefore in 1933, the Medical Committee of the Travancore Mission Council (L.M.S.) asked the Board at home to send a lady missionary doctor, explaining its need as follows: In Neyyoor there are 50 beds for women only, besides, a large midwifery practice throughout South Travancore. We consider it essential to have a European lady doctor in Neyyoor, only thus can we do justice to the calls of maternity
59

and ill-health; and only thus can womens side of our work in the branches be adequately dealt with. 17 It was during this hour of great need that Miss Joan Thompson, M.A., M.B.B Ch, M.R.C.D.G., the first European lady doctor of the Medical Mission came in 1936, and in the next year James Romances Davidson, M.D., whose father Dr.James Davidson had also worked at Neyyoor between 1905 and 1913. With their arrival things got clarity. Women and children were allotted to Miss Thompson and the medical cases went to Dr.Davidson, as well as the skin diseases. In addition to surgery Dr.Somervell continued to listen ears and eyes. This division of work eased the burden of the doctors and greatly improved the efficiency of their work. Rapid growth followed this specialization of work. There had been an increase in the number of patients dealt with, especially among the medical and maternity cases. Mr.Harlow improved the drug department and more than doubled its work by increasing the manufacture and accommodation facilities and by developing the distribution system. The laboratory work progressed and at several branches pathologists were appointed. The leper home was no longer an asylum but a place where patients could receive treatment which resulted in a number of cases being discharged as cured or arrested each year. New buildings were built on new site at Odayarvillai near Colachel, the mens wards being opened in 1933 and the womens in 1937. It provided accommodation for 200 patients. Dr.K.Abraham was put in charge of it, with a male nurse and a matron working under him. Besides these in-patients, weekly treatment was given in out-patients clinics both here and in the other branch hospitals to a large number of cases. This Leprosy Hospital (as we will later see)

60

began to register rapid growth when it came under the superintendence of Dr.D.Christdas in 1938. When in 1938 the South Travancore Medical Mission completed its one hundred years of service, the London Missionary Society in Travancore celebrated the occasion in a fitting manner. On the last day of the celebrations a Thanksgiving Meeting attended by thousands of people, was held at Neyyoor. Mr.K.K.Kuruvilla from North Travancore and Dr.Webb People from Dhonavur gave addresses.
18

Earlier it had been decided to collect a Centenary Fund that

could be used for the extention, of the Medical Mission. While a portion of it was used to improve the branches (in many cases the amount was used to construct new buildings), the major share went to the Neyyoor Hospital. A shortwave therapy and ultra-violet light therapy had been added to the method of treatment in the electrical department and a cutting diathermy to the surgical equipment. The front block of the Neyyoor Hospital was remodeled to its present form so as to have more space for patients and better facilities for nursing them. A new maternity block and an out-patient ward were also added. In response to the increasing demand for private wards, the old row of wards for private patients was partly replaced by more up-to-date buildings. One such building was built and presented to the Hospital by Mr.Ramanathan Chettiar of Kottaiyur19in 1941 and the rest built with money from the Centenary Fund. A cancer block for men patients was also erected partly with a gift of 1000 by an anonymous donor.
20

The Medical

Mission witnessed another netable event in the arrival in 1942 of Nicholas Ernest James, M.A., M.R.C.S, L.R.C.P., F.R.C.S. to join the band of European doctors at Neyyoor. During his time The Medical Mission, on its part always wanted to co-operate with the government medical service, and not to compete. 21 The Medical Mission did never intend to run

61

hospitals where there were already government hospitals or good private practitioners. For example, the Medical Mission refrained from founding its branches in places like Trivandrum and Quilon where there were well-established government hospitals. Again the co-operation which had already existed between the Medical Mission and the government in the execution of community health programme schemes have gained a new dimention during the time of Dr.Somervell. For example, the Medical Missions relief party and the government medical service got into close co-operation during the cholera that broke out in the year 1928. When, again, malaria erupted and ravaged the regions of Ravananchirai in 1935, a great deal of special programme of relief work was undertaken by the Medical Mission in co-operation with the government. While the Mission worked in a certain area, the government party worked in the adjacent area from the hospital at Neyyattinkara.22 The benign government became more and more aware of the service of the Medical Mission and in recognition of it, raised its monthly grant to the Neyyoor Hospital from Rs.100 to Rs.300 from 1 st Chingam 1122 (17th August 1946) onwards.23 Dr.Somervell brought the idea that Indians should be gradually put in responsible positions of the Medical Mission so that in the future they themselves could manage Missions affairs. Dr.Somervell had been often stressing this idea. For instance, a report published by him in the year 1942 runs as follows: . We are looking forward to a time when the Indian staff will shoulder the full responsibilities of the work in the whole Medical Mission, as is already being done at Kundara and the other branches to a large extent. The Indian church at some future date ought to take over the Medical Mission as part of its Christian witness, and responsibility should be gradually laid upon it to an increasing extent.24

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He took every step to meet the cost of the Medical Mission with the local resources, chiefly from fees, income from interest on vested funds, local donations etc. For example, of the total expenditure of Rs.268,493 for the year 1942-43, the L.M.S. grant was only 10, 24 (including special subscriptions).25 During his time the relation between the church and the Medical Mission became closer and closer. Dr.Somervell and his colleagues never hesitated to go to the relief of the people in the remote villages whenever a call for it came from the church. To mention only one of such instances, the people of the Central District of the L.M.S. in Travancore fell an easy prey to malaria in 1939. The disease became so wide-spread and so severe in its ravage that people were killed off by hundreds. Rev.J.E.Kesari, the Central District Chairman then, wrote about the Medical Missions relief on the occasion as follows: We appealed next to the Neyyoor Hospital. One village Poovathur where the disease was particularly bad was selected and Dr.&Mrs.Davidson arrived with the necessary drugs and an assistant and treated all the afflicted ones in the school and the congregation. We paid several visits to this place (between July and September 1939). Dr.&Mrs.Somervell with friends from Neyyoor also arrived with clothes, rice and materials for treatment. This prompt and very kind response from Neyyoor was of immense value. The epidemic was definitely checked in Poovathur.26 After a long and lustrous service in the Medical Mission this great Christian missionary doctor officially retired from it in 1945. Then the Travancore Mission Council of the L.M.S. passed the following resolution to honour him: In bidding farewell to Dr.Somervell, the council recalls with gratitude and sincere appreciation his long, brilliant and selfless labours as medical
63

missionary of the L.M.S. in South Travancore. His eminence as a surgeon and his self-sacrificing life have made it possible for thousands of people to get relief from suffering and cure from disease as well as a glimpse of the true Christian way of life, and it will be difficult to fill the vacancy created by his departure. In spite of the very busy time that he had in connection with his ministry of healing, he successfully kept in view his place as a missionary, in this his fascinating personality, his fine Christian character and his thorough understanding of and sympathy with almost all types of Indian life were very helpful. We also thank God for the life and service of Mrs. Somervell and for the sweet memory left behind by her in Travancore. We pray that God will abundantly bless Dr. and Mrs. Somervell and continue to use them for His glory.27 Dr.Somervell again came to Neyyoor in 1948 and took over the Medical Mission as its Medical Superintendent and as the Chairman of the Medical Board. But in 1949 he again left the Medical Mission when he felt that it would do better even without him and went to Velloor to use the knowledge and experience gained by twenty-five years of surgical service in India in order to pass it on to Indian medical students and produce qualified Christian doctors. 28 However, he came back and worked again at Neyyoor during 1950-51, going back to Vellore during 1951-53. Finally, he retired from missionary work in 1954 and returned to England to spend his old age. In 1973 the T.Howard Somervell Block of wards in the Neyyoor Hospital constructed to commemorate the great and noble services rendered by Dr. & Mrs.Somervell to the Medical Mission was finished and opened by Shri.K.K.Shaw, Governor of Tamil Nadu. This building costing more than Rs.400,000 is a humble monument today embodying the peoples never-dying gratitude to Dr.Somervell. A souvenir carrying a number of articles, letters and personal reminiscences on Dr.Somervell was also published. 29 He died on 23rd January 1975
64

aged 85. A memorial service was held at 6.30p.m. on 3 rd February 1975 at the Neyyoor Hospital Chapel. Rt.Rev.C.Selvamony, Bishop of the Kanyakumari Diocese (C.S.I) presided. Tributes were paid to the late medical missionary by several speakers including Dr.N.D.Jeyasekaran, Dr.J.R.Joel, Mrs.Pitchy Thompson, Mr.G.Kochumony, Professor D.G.Isaacs and Dr.Kingsley. A condolence resolution was proposed by Miss A.M.Fletcher and was adopted at this service.30 AFTER SOMERVELL The period after Somervell, is one full of events, events ushering momentous changes Independence, a change in the relationship between the Medical Mission and the Church, Church Union and the Transfer of the Mission Work to the Diocese. In 1947 India became independent. Already there had arisen doubts in the minds of the people concerning the future of missionary work in India. What will be the attitude of an independent Indian Government, wrote Rev.H.Leonard Hurst after a secretarial visit to India in 1946-47, to Christian Missions and to the Church is still a matter of much uncertainly and speculation.31 In view of such doubts, efforts were taken to Indianise the staff of the Medical Mission and every measure was resorted to make the Mission financially sound and self-supporting. As a first step in its efforts to Indianise the staff, the Medical Mission adopted the system of sponsoring its candidates for higher education and special training to institutions both in India and abroad. With a view to make the Medical Mission financially self-supporting, the L.M.S. grant was considerably reduced free treatment was therefore gradually brought down in the Mission Hospitals. They could no longer be called charitable institutions. They were rapidly becoming nursing homes maintained by the Church in Travancore. At one time many people expected to have completely free treatment simply because they were L.M.S.Christians. But the
65

Medical Mission could no longer fulfill their desires in that way. It was constrained to change its policies. But even in the changed situation, the living Lord who had guided it in the past continued to guide its destinies through His children according to the standard of the Christian status to which they had been enabled to grow from time to time. The next two events, the Church Union and the Transfer of the Mission Work (Medical Mission Work) to the Diocese were interconnected incidents that directly affected the Medical Mission. On September 27th 1947, the Church of South India was formed as an indigenous and autonomous church as a result of the union of three churches in South India. The churches that entered this union were the Church of India, Burma and Ceylon (Anglican), the (British) Methodist Church and the South India United Church in which the London Missionary Churches in Travancore formed a part. In the wake of the Church of South India the Travancore Mission Council of the L.M.S. under which the South Travancore Medical Mission was functioning and the Travancore Church Council were amalgamated to form the South Travancore Diocesan Council of the C.S.I. The Directors of the L.M.S. approved both the Church Union and the new Constitution of the South Travancore Diocesan Council. A Medical Board was created under the direction of the Diocesan Council. This Board had immediate supervision of the Medical Mission. References 1. T. Howard Somervell, After Everest,p.78 , 82 2. Rev. John A. Jacob , History of the London Missionary Society in South Travancore, p.108 3. T.Howard Somervell, Knife and Life in India,p.18
66

4. Report of the Medical Mission for the year 1927, p.9. 5. Report of the Medical Mission for the year 1928, p.6. 6. Report of the Medical Mission for the year 1927, p.10. 7. Report of the Medical Mission for the Ye3ar 1928, p.7. 8. T.Howard Somervell, Knife and Life in India, p.20. 9. Report of the Medical Mission for the year 1928, p.6 10. A.Vethasiromoni, Dr.R.Asirvatham, Home Church Neyyoor (C.S.I.) Pastorate Centenary Souvenir, p.9 11. Report of the Medical Mission for the year 1930, p.27. 12. Report of the Medical Mission for the year 1931, p.24. 13. Report of the Medical Mission for the year 1935, p.4. 14. Report of the Medical Mission for the year 1936, p.36. 15. T.Howard Somervell, Knife and Life in India, p.21 16. Report of the Medical Mission for the Year 1930, p.27 17. London Missionary Society: Travancore Mission Council, Minutes of Meetings Held in Nagercoil and Trivandrum, February and March 1933. p.22 18. Report of the Medical Mission for the year 1938, p.29. 19. London Missionary Society: Travancore Mission Council, Minutes of November 1940 and February 1941, p.36. 20. London Missionary Society: Travancore Mission Council, Minutes of August 1941, p.34 21. T.Howard Somervell, Knife and Life in India, p.30 22. Report of the Medical Mission for the year 1935, p.5

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23. London Missionary Society: Travancore Mission Council, Minutes of August and September 1946,p.43 24. London Missionary Society: Ten Years of Church and Mission in Travancore 1931 1940, p.64. 25. London Missionary Society: Travancore Mission Council, Accounts for 1942-43, p.23 26. A General Report of the L.M.S.Central District for the years 1939 and 1940, p.5 27. London Missionary Society: Travancore Mission Council, Minutes of January 1945, p.13 28. T.Howard Somerwell, Knife and Life in India,p.195. 29. T.H.Somervell Block Souvenir, Neyyoor Hospital, 1972 30. Kanyakumari Medical Mission C.S.I., Annual Report 1973-74, p.1 31. Report by Rev.H.Leonard Hurst, After a Secretarial Visit to India, July 1946-March 1947, P.1.

CHAPTER-IV GOVERNMENT INTERVENTION

Regarding the introduction of western medicine in the government sector, Koji Kwashima writes From the Hindu perspective as well as their modernizing stance, the
68

Maharajas and the Travancore government had an idea of a charitable state, and made great efforts to introduce western medicine. In this the missionaries were seen to be valuable allies rather than competing adversaries.1 He further argues that the missionaries and the state developed a mutually favourable one than in the field of education. Ibid. The administration

report of Travancore-Cochin shows that the European system of medical aid was first introduced, as indicated above, in the state of Travancore during the reign of Rani Lakshmi Bai in 1811. 2 The advantages of this method of treatment were at first confined to the members of the royal family and the officers of the government. With a view to protect her subjects from the outbreaks of small-pox which was frequent in those days, the queen sanctioned the establishment of a small vaccination section in 1813 (988 M.E.). As the people showed signs of alarm, the members of the royal house got themselves vaccinated first. Rani Parvathi Bayi established a charity dispensary at Thykad, where convicts in the jails were among the first to be treated. 3 In1817 a Durbar physician was appointed with clearly defined duties.4 The duties of the Durbar Physicians were, (1) To attend upon the king and his family, ( 2 ) to accompany the king on his tours when required to do so, (3) To attend upon the European civil officers in the state and their families in Trivandrum, (4) To attend, in case of need, upon other principal officers of the state and their families,

69

(5) to be the head of the Travancore Medical Department, to have control of all government hospitals and dispensaries within the state, and the Leper and Lunatic asylums except for the Nayar Brigade Hospital, (6) To be a visiting officer of the Central Prison at Trivandum and to advise the government on medical and sanitary matters connected therewith, (7) To direct and control the medical schools for midwives at Quilon and such other schools or relatives as the government may institute, (8) To have general charge of the medical stores, (9) To advise government on all matters connected with the Medical Department or when required, with vaccination and sanitation, (10) To be a member of the State Life Insurance Committees. Foreign Department5 The government took active part in the medical care of the subjects. In 1819 (994M.E.), two small dispensaries were opened, one in the Palace and the other within the premises of the Nayar Brigade barracks. A free dispensary was opened at Quilon under the supervision of the military medical officer there. In 1837 (1012 M.E.), King Swathi Thirunal established a charity lying-in hospital at Thykad. His successor king Uthram Thirunal took a special interest in the western medical sciences, studied the subject and found pleasure in treating cases in the dispensary attached to the palace. The king also trained some of his servants so as to be helpful to him in the treatment of diseases. The dispensary thus started by the king continued to work under the name of Elaya Rajas Dispensary until the Fort Dispensary was established. Seven

70

hospitals were opened in different parts of the state before the death of the king in 1860. 6 The medical department thus started made rapid advance during the early years of the illustrious reign of king Ayilyam Thirunal. On the first of Kanni 1040 M.E.(1864-65) the king laid the foundation stone of the Civil Hospital. The vaccination section was recognized as a separate division of the Medical Department. Hospitals were established at Alleppey and Kottayam in Kottayam in 1042 M.E. ( 1866- 67). In those days only very people afflicted with incurable diseases came in as in-patients. Naturally, the death-rate among the in-patients was high, and this aggravated the popular dislike for the western system of medical help. With a view to remove these defects and to restore public confidence, several changes were introduced in the year 1044 M.E. ( 1868-69 ). An experienced Ayurveda Physician was added to the staff of the Civil Hospital. A lunatic asylum was also started. A medical class was organized in 1045M.E. (186970) with a view to remove to train people for the staffing of the moffussil hospitals. In 1046 M.E. ( 1870-71) a new hospital was constructed in Quilon with accommodation for in-patients. Two Pulaya youths were trained to carry on vaccination among the Pulayas. From 1875 to 1877 the Deputy Surgeon General of Madras supervised the working of the hospitals in the state, but as the arrangement did not work satisfactorily, the supervision was transferred to the Durbar Physician. A proclamation of 1055 M.E. (1879-80) made vaccination compulsory on all government servants, pupils in schools, Vakils (advocates), persons seeking help from the hospitals, inmates of jails and persons depending on state charities.7 King Sri Visakhom Thirunal introduced many salutary changes in the Medical Department. At the end of his short reign in 1060 M.E. (184-1885) there were 31 hospitals and dispensaries in the state. During the reign of King Sri Mulam Thirunal a system of grant in aid to private medical institutions was begun. The medical class which was opened in 1045 M.E.
71

( 1869-70) was closed in 1064 M.E. ( 1888-89) and a compounding class was started instead. A small maternity Hospital was opened as an annex to the Zenana Mission Hospital,and as that institution soon became popular, maternity hospital was removed from the General Hospital and made a separate institution. In 1069 M.E. ( 1893-94) accommodation for in-patients was provided in most of the moffussil dispensaries. 8 Women were first entertained in the medical department in 1868 as obstetric and sick nurses. 9 A separate hospital for women and children was opened in the next year. In 1071 M.E. ( 189596) a separate department was organized to control vaccination, the collection of vital statistics and sanitation in towns. Several improvements were made in the General Hospital. A regular system of grant- in aid to private allopathic practitioners was begun about the same time. In 1072 M.E.( 1896-97) the Hospital for Women was reorganized and placed under a Lady Doctor. 10 In this year the building for the

Hospital for Incurables at Ulampara was completed and transferred to that building from Thykad. In 1902, ten scholarships of the value of Rs.20 each were sanctioned for those proceeding to study in the medical colleges at Madras and Tanjore. In 1899-1900, the Victoria Hospital at Quilon was separated from the local district hospital. In 1900, two young men were deputed for medical study in Edinburgh. A midwifery class was organized in the Hospital for women. In 1905, the Maternity Hospital was amalgamated with the Hospital for Women. In the same year a separate Ophthalmic Hospital was established. Sisters of the Holy Cross were first entertained as nurses in 1906.11 In 1910, a scholarship was awarded to a lady for medical study in Europe. Towards the close of 1911, the Durbar sanctioned a revision of the strength and staff of the department in the superior and inferior grades. A class consisting of six students, for a years courses and St.Johns Ambulance Association class for training in First Aid to the injured were started at Nagercoil,
72

Trivandrum, Quilon, Alleppey and Kottayam during the year 1911- 12. The Dental Sections were opened in the General Hospital. An Ambulance Class was started at Haripad in 1916 and in 1917 the Hospital for Women shifted to new building constructed at Thykad . In 1920, two officers were deputed to England to specialize in diseases of the eye and the ear. 12 A Bacteriologist was appointed during the year 1919-1920. A Special Officer was appointed in 1922 to investigate the diseases peculiar to Travancore and he studied and classified the mosquitoes in Trivandrum town as also the extent of infection due to filaria producing elephantiasis and allied diseases .He also conducted investigations on the hook-worm disease and in chronic bowel complaints and elephantiasis. During 1923-24 Anti-rabic treatment was undertaken. The X ray branch in the General Hospital was opened in 1912 and a new X' ray apparatus of the advanced model was installed in 1926. 13 Surgeries were also conducted. In 1939 10,913 operations were performed of which 2, 458 were major and 8.455 minor operations. In the same year Radium treatment was started.14 Thus modern medicine disseminated far and wide in Travancore. Anil Kumar argues, Whereas allopathy (mainly ) and homeopathy ( partly ) the two alien medical systems, struck deeper roots in the Indian soil, the indigenous medical system correspondingly lost ground steadily and irretrievably. 15 However the Ayurvedic system by embracing many of the scientific features of Western medicine revived as a result of Sankunni Variar's strenuous work which he started from Kotakkal.16 References 1. Koji Kwashima, Missionaries and a Hindu State-Travancore 1858-1936, Delhi, 1998,p.114
73

2. Report on the Administration of Travancore- Cochin, 1933-34, 78th Annual Report, p. 169. 3. Foreign Department Proceedings, 1909, No. 78 / 79, Political, No. 690 -91, dated 18 May 1909, F. 11. 4. Report on the Administration of Travancore- Cochin, 1933-34, 78th Annual Report, p. 169. 5. Proceedings, 1909, No. 78 / 79, Political, No. 690 -91, dated 18 May 1909, F. 11. 6. T.K. Velu Pillai, The Travancore State Manual, Vol. 4, Trivandrum, 1996, Reprint, p. 208. 7. Ibid., pp.208-209. 8. Ibid., pp.209-210. 9. Report on the Administration of Travancore- Cochin, 1933-34, p. 169. 10. T.K. Velu Pillai, The Travancore State Manual, Vol. 4, Trivandrum, 1996, Reprint, p. 208. 11. Report on the Administration of Travancore- Cochin, 1933-34, p. 169 - 70. 12. T.K. Velu Pillai, op.cit. 13. Report on the Administration of Travancore- Cochin, 1933-34, p. 169 - 70. 14. T.K. Velu Pillai., op.cit.

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15. Anil Kumar, Medicine and the Raj, British Medical Policy in India, 1835-1911, New Delhi, 1998, p.68. 16. Jaminibhushan Roy Kavirathna's Pesidential address at the All India Ayurvedic Conference Seventh Session, (Madras, 1915), Calcutta. Vol. 2, No. 2,p.6.Quoted by K.N. Panikkar in Culture, Ideology, Hegemony, Intellectuals and Social Consciousness in Colonial India, Thulika, New Delhi, 1995,p.154

CHAPTER-V WOMENS PARTICIPATION We can see three sectors working in the process of the dissemination of modern medicine - imperial, governmental and missionary. While the first sector concentrated mainly on the health care of the colonizers and their associates, the second in the initial stages focused on the fitness
75

of the royalty and later opened the doors to the general public. The third remained determined to alleviate the physical sufferings of the downtrodden social groups. Many foreign women played the pivotal role of launching the process of dissemination of modern medical care from Neyyur in the southern part of Travancore. In many cases the status of women who participated in the process of propagating modern medicine was as spouses or daughters of the male medical missionaries. Mrs Ramsay and her daughter Mrs Paul were the first women medical missionaries and they reached Neyyur in South Travancore on 6th April 1838 along with Dr Archibald Ramsay. 1 Jessie Thomson, the spouse of Mrs Thomson, another woman medical activist, came to Kerala in 1872.2 After her death Mr Thomson married Ann Martha Baylis in 1878 and she also contributed much to the cause of disseminating modern medicine.3 Mrs Fry, the wife of Dr Sargood Fry arrived in Nagercoil on 11th February 1886 and took charge of the Medical Mission. 4But we can also project many single women who had dedicated their lives to serving the sick. Miss M.E. MacDonnell arrived independently in Neyyur in 1892 to assist Dr Sargood Fry. 5 Later Mrs Greene Wilson came to Travancore to assist Miss M.E. MacDonnell for nearly four years from 1902 to 1906. 6 As mentioned above, the women missionaries started the process of disseminating the modern medicine from Neyyoor, in Nagercoil of South Travancore in 1838, and it can be said that their activities centered there for a long time. The start made was made by Mrs Ramsay and Miss Paul on 6 April 1838. 7 The first allopathic clinic was a thatched shed constructed by Mrs Mead in association with her spouse Rev. Mead. The thatched shed later developed into a hospital. When cholera was contracted by the people in 1872, Mrs Thomson supplied medicine

76

to the people of Neyyur and selected two native women named Thevai and Paripoornam to be trained in midwifery.8 Miss MacDonnell, a well trained nurse who came as per the request of Dr. Sargood Fry went a step further in starting a nursing section. 9 Nursing classes were started in 1893 with the help of Dr. Fells and Mrs. Jessie Fells. 10 Miss MacDonnell constructed a separate ward for treating maternity cases at the cost of Rs. 2700 collected from her friends in India and abroad.11 A new branch hospital was also started by her, spending nearly Rs. 2300.12 She imparted medical training to the natives irrespective of gender differentiation. 13 The nursing wing developed under the care of Miss Greene, Mrs Davidson and Miss Schaffter, a qualified nurse who had been a great help to Dr Somervell in conducting surgeries. The Neyyur hospital entered a new phase of development under Mrs Somervell. She re-opened the closed-down home for the care of the children of the lepers seeking help from the Property Committee of the Leper Mission on 20 January 1932.
14

Miss Edith Annie started a nursing class for boys for the first time and

established a training school for the nurses, dressers and midwives. Ten men and eleven women received training in administering medicines, midwifery and nursing. A noteworthy thing in this connection is that Miss. Edith Annie learned Tamil and could easily communicate with Tamil speaking people and thus she was able maintain close contact with the people including the patients.15 Miss Edith Florence joined the medical mission in 1926, conducting a campaign for 20 years about sanitation.16 Miss Eileen Alice organized a new section of native nurses for both men and women. The high quality of training imparted in the school prompted the government to grant official recognition to the course and many who passed out got placement in the government.17 From 1930, Eileen Alice and Miss Mills worked hand in hand to improve the level of medical education. Under their guidance five nurses passed the nursing examination conducted by the Christian Medical Association of India in 1930.
18

Thus the foreign medical

77

missionaries set out on the process of empowering the natives in the field of medical service. This was necessitated by the want of medical professionals for the medical activities in the branch hospitals at Colache, Kulasegaram, Kottarakkara, Nedumkulam, Agastheeswaram and Marthandam.19 With the arrival of Miss Lawrence the process of disseminating modern medicine received a fresh dimension, namely preventing the diseases instead of treating them. She too created awareness about sanitation and the need for a neat environment to lead a healthy life. She opened a reading room for the patients and narrated Bible stories to them. She also conducted excursions and games. 20 In 1932, Miss Riggs, lady who had much experience in serving in the London Hospital English joined the Medical Mission. She also gave importance to physical exercises to maintain a disease free body and organized games like badminton for both the nursing students and the patients.
21

Under Miss. Dorothy Joan Thomson, a highly qualified English woman who was a

the doctor who worked there from 1936 to 1950, the medical activities in Neyyoor entered yet another new phase.22 The importance of the LMS Hospital had increased so much that a missionary wrote, " All roads lead to the L. M. S. Hospital ".
23

Gradually, from Neyyoor modern

medicine disseminated to Kulatchel, Marthandam, Parassala, Kazhakkuttaom, and Kollam thanks to the sacrificial exertion of these Medical Women from England. Thus it was that the women missionaries from England triggered of a work in Neyyoor which later progressed and radiated to the whole of Kerala. It brought in revolutionary changes in medical management. The activities of the women created health awareness among the people, particularly the women and conducted to a successful campaign against epidemics.
78

Thereby they laid a solid foundation for clinical medicine and hospital management. They carried out this meritorious work with the help of the male medical missionaries and the encouragement given by the government. Koji Kwashima argues that the missionaries and the state developed a mutually favourable relationship more in the field of medicine than in the field of education.
24

But the Women Medical Missionaries had to face social resistance from the

orthodox sections. Some people feared that vaccination would lead to other contagious diseases like leprosy and venereal diseases like syphilis.25 Although the driving factor behind all their endeavours was evangelization, their work has undoubtedly benefited the people at large. Many socially alienated groups like the lepers and the orphans received care and concern leading to an era of charitable activities. Later many local residents were enabled to undergo medical education in reputed institutions and this culminated finally in the establishment of the Trivandrum Medical College in 1951. It has to be stressed that service rendered by these foreign women was in fact sacrificial as they had do all these strenuous activity in the midst of a hostile climate and a resisting orthodoxy. ------------000--------References 1. Annual Report of the LMS. London, 1839,p.65. Also Rev. Samuel Zachariah, The London Missionary Society in South Travancore, Nagercoil, 1897, p.180). 2. I.H. Hacker, Hundred Years in Travancore, p.72. 3. 4. Home Church Centenary Souvenir, Medical Mission, Neyyoor, 1866-1966, p. 32. Report of the TDC for 1890, Report of the Medical Mission Schools, p.5.

79

5.

Annual Report of the Ninth General Meeting of the LMS, London, Monday, May 8th 1893, p. 1 .

6. Annual Report of One Hundred and Twelfth Report of the LMS. London, 1907, p.13. 7. Samuel Zachariah, The London Missionary Society in South Travancore, Nagercoil, 1897, p.180. 8. I.H. Hacker, Memoirs of Thomas Smith Thomson, Piccadilly, 1887, p. 68. 9. Report of the TDC for 1892, p.10.

10. Report of the TDC for 1893, p. 19. 11. Report of the LMS, Medical Mission, South Travancore, 1901- 1910, p.39. 12. Report of the TDC for 1900, Reoprt of the Neyyoor Mission District, p.2. 13. Annual Report of the Travancore Mission Council Minutes, Agust 1937, p.6. 14. Travancore Mission Council Minutes, Leper Home, Neyyoor, February, 1932, p. 27. 15. Report of the Medical Mission for 1926, p.13. Miss. Edith Annie, the daughter of I.H. Hacker and Winifred at Neyyoor was born on 18 September 18, 1895. Home Board File, Diocesan Office, Nagercoil. 16. Somervell, Knife and Life in Travancore, p.110. 17. Travancore Mission Council Minutes, August 1939, p.29. 18. Travancore Mission Council Minutes, August 1940, p.12.

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19. Somervell, op. cit. 20. Report of the Medical Mission for 1933, p.32. 21. Reports of the Boards for the Year 1954-55, Church of South India, South Travancore Diocesan Council, p.36. 22. Home Church Centenary Souvenir, op.cit., p.30. 23. L.M.S. Report for 1928, p. 66. 24. Koji Kwashima, Missionaries and a Hindu State - Travancore 1858 - 1936, Delhi, 1998, p.114. 25. T.K. Menon, Keerivekkunnathu kondulla Chila Dhoshangal, Mangalodhayam, No.3, 1088 M.E. (A.D.1933). (Malayalam),

81

CHAPTER-V WOMENS PARTICIPATION We can see three sectors working in the process of the dissemination of modern medicine - imperial, governmental and missionary. While the first sector concentrated mainly on the health care of the colonizers and their associates, the second in the initial stages focused on the fitness of the royalty and later opened the doors to the general public. The third remained determined to alleviate the physical sufferings of the downtrodden social groups. Many foreign women played the pivotal role of launching the process of dissemination of modern medical care from Neyyur in the southern part of Travancore. In many cases the status of women who participated in the process of propagating modern medicine was as spouses or daughters of the male medical missionaries. Mrs Ramsay and her daughter Mrs Paul were the first women medical missionaries and they reached Neyyur in South Travancore on 6th April 1838 along with Dr Archibald Ramsay. 1 Jessie Thomson, the spouse of Mrs Thomson, another woman medical activist, came to Kerala in 1872.2 After her

82

death Mr Thomson married Ann Martha Baylis in 1878 and she also contributed much to the cause of disseminating modern medicine.3 Mrs Fry, the wife of Dr Sargood Fry arrived in Nagercoil on 11th February 1886 and took charge of the Medical Mission. 4But we can also project many single women who had dedicated their lives to serving the sick. Miss M.E. MacDonnell arrived independently in Neyyur in 1892 to assist Dr Sargood Fry. 5 Later Mrs Greene Wilson came to Travancore to assist Miss M.E. MacDonnell for nearly four years from 1902 to 1906. 6 As mentioned above, the women missionaries started the process of disseminating the modern medicine from Neyyoor, in Nagercoil of South Travancore in 1838, and it can be said that their activities centered there for a long time. The start made was made by Mrs Ramsay and Miss Paul on 6 April 1838. 7 The first allopathic clinic was a thatched shed constructed by Mrs Mead in association with her spouse Rev. Mead. The thatched shed later developed into a hospital. When cholera was contracted by the people in 1872, Mrs Thomson supplied medicine to the people of Neyyur and selected two native women named Thevai and Paripoornam to be trained in midwifery.8 Miss MacDonnell, a well trained nurse who came as per the request of Dr. Sargood Fry went a step further in starting a nursing section. 9 Nursing classes were started in 1893 with the help of Dr. Fells and Mrs. Jessie Fells. 10 Miss MacDonnell constructed a separate ward for treating maternity cases at the cost of Rs. 2700 collected from her friends in India and abroad.11 A new branch hospital was also started by her, spending nearly Rs. 2300.12 She imparted medical training to the natives irrespective of gender differentiation. 13 The nursing wing developed under the care of Miss Greene, Mrs Davidson and Miss Schaffter, a qualified nurse who had been a great help to Dr Somervell in conducting surgeries. The Neyyur hospital entered a new phase of development under Mrs Somervell. She re-opened the closed-down home for the
83

care of the children of the lepers seeking help from the Property Committee of the Leper Mission on 20 January 1932.
14

Miss Edith Annie started a nursing class for boys for the first time and

established a training school for the nurses, dressers and midwives. Ten men and eleven women received training in administering medicines, midwifery and nursing. A noteworthy thing in this connection is that Miss. Edith Annie learned Tamil and could easily communicate with Tamil speaking people and thus she was able maintain close contact with the people including the patients.15 Miss Edith Florence joined the medical mission in 1926, conducting a campaign for 20 years about sanitation.16 Miss Eileen Alice organized a new section of native nurses for both men and women. The high quality of training imparted in the school prompted the government to grant official recognition to the course and many who passed out got placement in the government.17 From 1930, Eileen Alice and Miss Mills worked hand in hand to improve the level of medical education. Under their guidance five nurses passed the nursing examination conducted by the Christian Medical Association of India in 1930.
18

Thus the foreign medical

missionaries set out on the process of empowering the natives in the field of medical service. This was necessitated by the want of medical professionals for the medical activities in the branch hospitals at Colache, Kulasegaram, Kottarakkara, Nedumkulam, Agastheeswaram and Marthandam.19 With the arrival of Miss Lawrence the process of disseminating modern medicine received a fresh dimension, namely preventing the diseases instead of treating them. She too created awareness about sanitation and the need for a neat environment to lead a healthy life. She opened a reading room for the patients and narrated Bible stories to them. She also conducted excursions and games. 20

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In 1932, Miss Riggs, lady who had much experience in serving in the London Hospital English joined the Medical Mission. She also gave importance to physical exercises to maintain a disease free body and organized games like badminton for both the nursing students and the patients.
21

Under Miss. Dorothy Joan Thomson, a highly qualified English woman who was a

the doctor who worked there from 1936 to 1950, the medical activities in Neyyoor entered yet another new phase.22 The importance of the LMS Hospital had increased so much that a missionary wrote, " All roads lead to the L. M. S. Hospital ".
23

Gradually, from Neyyoor modern

medicine disseminated to Kulatchel, Marthandam, Parassala, Kazhakkuttaom, and Kollam thanks to the sacrificial exertion of these Medical Women from England. Thus it was that the women missionaries from England triggered of a work in Neyyoor which later progressed and radiated to the whole of Kerala. It brought in revolutionary changes in medical management. The activities of the women created health awareness among the people, particularly the women and conducted to a successful campaign against epidemics. Thereby they laid a solid foundation for clinical medicine and hospital management. They carried out this meritorious work with the help of the male medical missionaries and the encouragement given by the government. Koji Kwashima argues that the missionaries and the state developed a mutually favourable relationship more in the field of medicine than in the field of education.
24

But the Women Medical Missionaries had to face social resistance from the

orthodox sections. Some people feared that vaccination would lead to other contagious diseases like leprosy and venereal diseases like syphilis.25 Although the driving factor behind all their endeavours was evangelization, their work has undoubtedly benefited the people at large. Many socially alienated groups like the lepers and the orphans received care and concern leading to an era of charitable activities. Later many local residents were enabled to undergo medical
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education in reputed institutions and this culminated finally in the establishment of the Trivandrum Medical College in 1951. It has to be stressed that service rendered by these foreign women was in fact sacrificial as they had do all these strenuous activity in the midst of a hostile climate and a resisting orthodoxy. ------------000--------References 1. Annual Report of the LMS. London, 1839,p.65. Also Rev. Samuel Zachariah, The London Missionary Society in South Travancore, Nagercoil, 1897, p.180). 2. I.H. Hacker, Hundred Years in Travancore, p.72. 3. 4. 5. Home Church Centenary Souvenir, Medical Mission, Neyyoor, 1866-1966, p. 32. Report of the TDC for 1890, Report of the Medical Mission Schools, p.5. Annual Report of the Ninth General Meeting of the LMS, London, Monday, May 8th 1893, p. 1 . 6. Annual Report of One Hundred and Twelfth Report of the LMS. London, 1907, p.13. 7. Samuel Zachariah, The London Missionary Society in South Travancore, Nagercoil, 1897, p.180. 8. I.H. Hacker, Memoirs of Thomas Smith Thomson, Piccadilly, 1887, p. 68. 9. Report of the TDC for 1892, p.10.

10. Report of the TDC for 1893, p. 19.

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11. Report of the LMS, Medical Mission, South Travancore, 1901- 1910, p.39. 12. Report of the TDC for 1900, Reoprt of the Neyyoor Mission District, p.2. 13. Annual Report of the Travancore Mission Council Minutes, Agust 1937, p.6. 14. Travancore Mission Council Minutes, Leper Home, Neyyoor, February, 1932, p. 27. 15. Report of the Medical Mission for 1926, p.13. Miss. Edith Annie, the daughter of I.H. Hacker and Winifred at Neyyoor was born on 18 September 18, 1895. Home Board File, Diocesan Office, Nagercoil. 16. Somervell, Knife and Life in Travancore, p.110. 17. Travancore Mission Council Minutes, August 1939, p.29. 18. Travancore Mission Council Minutes, August 1940, p.12. 19. Somervell, op. cit. 20. Report of the Medical Mission for 1933, p.32. 21. Reports of the Boards for the Year 1954-55, Church of South India, South Travancore Diocesan Council, p.36. 22. Home Church Centenary Souvenir, op.cit., p.30. 23. L.M.S. Report for 1928, p. 66. 24. Koji Kwashima, Missionaries and a Hindu State - Travancore 1858 - 1936, Delhi, 1998, p.114.

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25. T.K. Menon, Keerivekkunnathu kondulla Chila Dhoshangal, Mangalodhayam, No.3, 1088 M.E. (A.D.1933).

(Malayalam),

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