From Persons to Hospital Cases: The Rise of Hospital Medicine and the Calcutta Medical College in India

Abstract

From today’s medical perspective, there is little mention of case records in India. With the arrival of Western medicine in India in the 18th century, there emerged the practice of keeping case records in hospitals erected by European powers. It did not automatically lead to hospital medicine, which required physical examination, autopsy, statistics and museums for preserving the cases. The foundation of the Calcutta Medical College in 1835, built on the model of University College of London, ushered into it. Serial experiments in Calcutta like producing native dressers in Madras establishments, the founding of the Native Medical Institution (1822) for native doctors, introduction of medical classes at the Sanskrit College and Madrassa etc. preceded it. The 18th-19th century case records were of European soldiers by European doctors. Almost every surgeon had charge of 700 patients. They would keep a regular diary of cases. In 1826, Tytler had introduced keeping case records in Persian by the NMI students. The conceptual basis of clinical case is the ordering of its facts by the agency of time. Its material dimension is the transcription of this evidence in written form, thereafter embodied as a medical record of observed events. After 1826, the keeping of case records was internalized by Indian students. Till then they did not perform dissection beyond zootomy. Hence the cases were actually records of symptoms, instead of signs which were to be confirmed through pathological anatomy. The transition was made possible through CMC. In CMC, students were to examine patients at the bedside, perform dissection after his/her death and keep records which were to be produced during examination. At the same time, they had to keep records of both medical and surgical cases, and the reports of experimentation the Jennerian vaccine and various drugs – both European and indigenous – on patients. Along with CMC, through the Medical and Physical Society of Calcutta (1823) and its journal Transactions of the Medical and Physical Society of Calcutta (1825) circulation of medical, surgical, and pharmaco-botanical knowledge throughout India and to Europe became practicable. The introduction of anatomical dissection secularized both the notion of the body and medical education stripped off from caste prejudice and parochial hierarchy. The hospital case records became a materiality through internalization of hospital medicine in its full gamut by Indians like S G Chuckerbutty.