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I may mention that I became a beneficiary many years later, when the
Government of India changed the regulations.
Again, an occasion arose; when I made a certain suggestion, while the
meeting of the Governing Body was in progress. I was drawing the attention of
the Body to the good work which Dr Ramalingaswami, a student working in the
Nutrition Laboratories, had done in England and for which he was awarded a prize.
It was reported that he was the first Indian to receive it. Members of the Governing
Body suggested that I should convey to that scientist their appreciation of the
honour conferred on him. I replied: “Sir, why merely an appreciation? Why do we
not promote him to the next higher grade?” The Governing Body was in a mood
to agree. Then I said, “Sir, there is another young scientist, Dr Iyer, working in the
Cancer Research Centre in Bombay. He has done very good work indeed and he
is an employee of the Council. Should we also promote him to the next higher
grade?” The members agreed.
Later, the Secretary of the Ministry asked me why I had not put forward these
proposals to the Executive Committee in the first instance. “Sir”, I replied, “the
thought occurred to me at the meeting itself. I am sorry”. He smiled!
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CHAPTER III
PROMOTION OF RESEARCH IN MEDICAL
COLLEGES
The second recommendation of the Bhore Committee was related to the
complete absence of any research activity in the then medical colleges in
the country. I quote from their report:
“Broadly speaking, medical research receives little or no attention in the
medical colleges in India” ... “The authorities responsible for staffing and financing
the medical colleges are usually ignorant of the importance of research in relation
to the achievement of a high standard of teaching and the development of a
correct attitude of mind in the student” ... “Speaking generally, medical students
in this country complete their studies without coming into contact with planned
scientific investigation. This serious deficiency in their training is, in our view,
of even greater importance than failure to advance knowledge of the subjects
concerned”.
I had to consider, in due course, how to bring about a change in the situation
referred to by the Committee.
As stated earlier, at the time I had assumed office, funds for the current year’s
research programme had already been allotted to various research institutes for
their research projects. At the meeting of the Scientific Advisory Board of the IRFA
in New Delhi in 1946, I had suggested that the next meeting of the Board should be
held in the King Institute, Madras, and subsequent meetings thereafter, in other
institutes elsewhere by rotation. The suggestion was accepted. Since I had left
the King Institute, I thought of holding the meeting of the Board in the Madras
Medical College, just one step to arouse interest in research in the local staff. At
the time Dr (Mrs.) Ranadive was working as a research fellow of the IRFA in the
Cancer Research Institute in Bombay under Dr V.R. Khanolkar. She was doing
very well indeed. I decided to arrange lecture by her in the Medical College. Dr
Lakshmanaswamy Mudaliar, who was the Principal of the College, had initially
agreed to my suggestion but later decided that the meetings of the Board should
be held in the University building in Chepauk. As was to be expected, the place of
the meeting being far away, no member of the staff of the Medical College could
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attend the meetings of the Scientific Advisory Board of the Council, to get an idea
of the problems discussed, and above all to know how the requests for grants-in-
aid were discussed and disposed of. However, there was a packed house when Dr
(Mrs.) Ranadive gave her lecture. It was, as I was told afterwards, a unique occasion
when a young research fellow of the Council, and a lady at that, could give such a
good account of herself and her project.
I may, as well, relate now what happened when I attempted to hold such
meetings elsewhere during subsequent years and the impact they had in the
development of research in the medical colleges.
For the next meeting of the Scientific Advisory Board, I ‘chose’ Hyderabad. I
am using the word ‘chose’ deliberately for I did not expect anyone to send me an
invitation. General S. L. Bhatia, whom I had known very well both when he was the
Deputy Director-General in New Delhi and later as the Director of Public Health in
Madras, was then the Director of Public Health of the Hyderabad State. He readily
agreed to make all arrangements for holding the meetings. I visited the Medical
College and when all the arrangements had been made I was advised to hold the
meetings in the Osmania University. This experiment too was a complete failure
since no member of the medical college could attend any of the meetings owing
to distance!
Then came a big, albeit, a pleasant surprise! The pathologists in the country
had decided to form an Indian Association of Pathologists and Microbiologists and
they were holding their first meeting in Agra. My friend, Dr V. R. Khanolkar was to
be its first President. Dr Khanolkar suggested that I should hold the meetings of
the Scientific Advisory Board and of its advisory committees at the same time in
the Medical College at Agra. The proposal was mutually advantageous to both, for
some of the members of the Board and also of the advisory committees who were
also members of the Association, and their travelling allowance was to be met by
the Council. Dr P. N. Wahi, the Professor of Pathology in the Agra Medical College
was equally enthusiastic. He decided to organise the annual ‘Clinical Week’ of the
College at the same time and arranged lectures from visiting scientists on the
subjects of their specialities. The Clinical Week was a great success. There were
three lectures a day from 5pm to 8pm and not a seat in the hall was vacant!
At the meetings of the Board which were held in a hospital ward vacated for
the purpose, I had suggested that all senior medical students and postgraduates
could attend if they wished. They did.
I may as well describe here the procedure adopted for sanctioning funds for
projects received. After a preliminary scrutiny of the projects in my office, they
were referred to the concerned Advisory Committees. At the Committee meeting,
if the sponsorer of the project was present, he was asked to present it and answer
any questions raised by any member of the Committee. Those present at the
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meeting as visitors could also ask questions, if they thought fit. The members also
expressed their views on the suitability or otherwise of the project for a grant-in-
aid, and by a vote accepted or rejected the proposal. The whole exercise was an
education in itself to those who attended the meeting.
I adopted this technique, however, for a specific purpose, though the
procedure followed was quite different to that of other research councils whose
discussions were always in camera. Funds allotted to the Council were quite
meagre and requests for grants-in-aid were many. The participants realised that
the discussions were open and fair and there was no question of any nepotism—a
fear expressed by Dr Vishwanath to which reference had been made previously.
After a few years, the modus operandi was slightly altered. While the discussions
were open, the final decisions were taken in camera.
The next meeting was held in the Medical College at Jaipur. As usual, I had
to secure an invitation for it from my friend Col. M.K. Kelavkar, who was then
the Director of Health Services of Rajasthan. This time I had issued invitations to
the Directors of Public Health of various States, as well as the Health Ministers of
the States to attend the meetings to see for themselves the importance of the
problems discussed. Many of them did. Shri Pratap Singh Kairon of Haryana and
Dr Sushila Nayyar, the then Minister of Delhi State were frequent visitors. The
meetings provided an opportunity for the scientists to meet and discuss their
problems with each other quite informally especially in the evenings after dinner.
The meetings were thus a success and fulfilled the purpose for which they were
organised. At the end of the meetings in Jaipur, I received an ‘official invitation’ to
meet in Gwalior. My efforts had borne fruit!
Gwalior, however, brought about another change in the routine. When my
arrangements for the meet were almost finalised, I received a telephone call from
the Secretary to the Government of Madhya Bharat, as the State was then called,
wanting to know the details of the programme of the meetings of the Scientific
Advisory Board. I gave him the information.
“Is there no inauguration?” he queried. I explained that it was really not
possible to have inauguration of the Board’s meetings since the Board met last
after the meetings of the Advisory Committees were over.
“But this time can you not arrange it?” he asked.
“Why?”
“The President of India is paying us a visit and we were short of programmes
to keep him busy. Hence we thought if you had the inauguration, the President
could be requested to do it.”
“I will think it over and let you know” I replied. I consulted Rajkumariji and
she advised me to have the inauguration and to have a programme suitable for
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the occasion. I requested a few senior scientists to make a review of the advances
made in their fields and to present the findings at the meeting. However, the
President of India cancelled his programme. The meetings of the Board were
inaugurated by Rajkumari Amrit Kaur! The inauguration, thereafter, became a
regular feature. In the inaugural speech of the Minister which I had to prepare, I
took the opportunity to review the working of the Council during the year.
Subsequent meetings were held in the Medical Colleges at Baroda, Indore,
Pune, Mysore and Lucknow. They followed the usual pattern. I always enjoyed
these meetings, particularly the meetings of the Nutrition Advisory Committee.
They were always exciting for the participants who got excited in pleading for
recognition of their project for grant-in-aid! Again it was sometimes amusing to
see how an individual scientist mustered his colleagues at the session for support
of his enquiry. They used to leave as soon as the discussion on the particular
scheme was over.
These meetings were extremely profitable to me. I had the opportunity to
meet informally the scientists and heads of institutions, and to discuss with them
their own problems and also get their views on programmes and policies of the
Council. Their suggestions were most valuable in planning for the future. They were
equally happy to meet their counter-parts and to know what they were doing.
The evenings were equally enjoyable, what with the ‘shows’ organised by the
students of the College or the dinners given by the staff of the institutions. On
such occasions Dr Khanolkar provided lot of merriment. He was known for his
ready wit and humour! Let me relate an amusing incident at a dinner given by a
member of the staff of the medical college in Jaipur. The guests had assembled.
Before going to dinner, I visited the ‘bathroom’.
I found there, on a stool near the ‘seat’, the latest issue of the Indian Journal of
Pathology with a photograph of Dr Khanolkar prominently displayed. I came out
and asked another guest to go in. He came out smiling. Number of them made
the ‘pilgrimage’ to the bathroom, and all came out smiling. Then I announced;
“Gentlemen, as you must have seen, the pathologists are put in their proper place.”
There was general laughter. Dr Khanolkar was not to be put out by this. He said
he would like to tell a tale. “The Nizam of Hyderabad had the habit, as the story
goes, of keeping a picture of the Peshwa near his seat too. He could not function
properly without it”!
On a similar occasion at the meeting in Gwalior, the Maharani of Gwalior had
hosted a dinner in honour of the visiting scientists. As I and Dr Khanolkar walked
in, the Maharani exclaimed “Here come Laurel and Hardy”. Thereafter, we had to
discuss amongst ourselves, who, in our opinion, was Laurel and who was Hardy!
We were happy that at any rate we provided them with some amusement after
their interminable wrangling at the meetings for a grant-in-aid!
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I will now make a few comments on the meetings at Lucknow. These were
inaugurated by the then Minister of Health, Shri Karmarkar. He complimented
me on the arrangements made and on the manner in which the meetings were
conducted. In Lucknow I had made arrangements for, what might be called a
‘fire side chat’, at which the visitors could meet informally and discuss amongst
themselves any problem of their choice. When the participants had departed,
I was told that a group was formed to work against me for I was wielding, they
thought, too much influence and too much power! I did not take any notice of this
at the time.
Then an interesting thing happened. It was New Year’s Eve. I was in the Delhi
Gymkhana Club that evening when Shri Pillay, our Health Secretary met me. “I
have a new year’s present for you, Dr Pandit”, he said, “I have sent you a note giving
my views — on the working of the Council and have made a few suggestions. I am
sure you will like them”. I thanked him, of course, though wondering in my mind
what it was all about.
The next day when I saw the note, I was aghast! It was nothing but criticism
of the way I was handling the affairs of the Council, though it was couched in mild
language.
“What do I do with the note?” I asked him the next day.
“I would like it to be discussed at the meeting of the Executive Committee”.
“In that case I have to prepare a note giving my views on the points raised”.
He agreed.
In my note I gave my views on all the points raised and in the end I could not
resist the temptation of quoting Benjamin Franklin who had to answer criticism
against him. His view was neatly written, framed and hung in my office. I do not
have a copy of it as I write this. However, when at a later date the Secretary of
Health, USA, visited my office, he saw the noting and said that more or less the
same thing was said by Abraham Lincoln. He promised to send to me as soon as
he reached the USA. He did. It ran as follows:
“If I were to try to read, much less answer, all the attacks made on me, this shop
might as well be closed for any other business. I do the very best I know how — the
very best I can; and I mean to keep on doing so until the end. If the end brings me
out all right, what is said against me won’t amount to anything. If the end brings
me out wrong, ten angels swearing I was right would make no difference”.
(Report of Francis B. Carpenter—Six months at the White House with Abraham
Lincoln, New York, 1866, pp. 258-259. Quoted from a conversation).
This quotation did reflect my feelings at the time.
The Executive Committee met and to my surprise, Shri Karmarkarji announced
that the note of the Secretary and my reply to it need not be discussed.
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I thought it was the end of the matter, but apparently it was not. The Governing
Body of the Council met to consider the recommendations of the Scientific
Advisory Board. At the meeting Shri Pillay circulated a document criticising the
decisions of the Board in respect of about 40 research projects to which grants
were recommended. I was surprised. The note was neither shown to me nor was
it circulated to the members of the Governing Body before submitting it for their
consideration at the meeting. After some acrimonious debate, and at the
instance of Dr Sushila Nayyar, who was then a member of the Governing Body
nominated by the Parliament, it was decided to refer the controversial (?) projects
back to the Scientific Advisory Board for their reconsideration!
Here I must relate an interesting experience. The Governing Body had to meet
for two days to consider the note and other items on the agenda. We adjourned
at 6 pm the first day to meet again at 9.30 am the next day. When we assembled
the next day at the scheduled time, we found on our table a document of nearly 25
cyclostyled pages recording the proceedings of the previous day.
My staff had worked during the night and had cyclostyled the note jointly
prepared by Shri T. D. Joshi and Shri Prem Chand. I had not given any instructions
to that effect and told the Governing Body so. Needless to add that my staff
received genuine approbation from members of the Governing Body.
The Board met in due course for three days and scrutinised each project
in detail. Of course, I had to supply the background information based on the
discussions that had taken place at the meetings of the respective Advisory
Committees. It was our practice to maintain relevant notes on the points brought
out during discussion of each project which were enough to indicate reasons for
the acceptance or rejection of the proposals submitted. Ultimately the Board
decided to recommend to the Governing Body that the original decisions of the
Board should be accepted without any reservations.
The Governing Body met in due course, but the meeting was arranged at
Ooty instead of New Delhi on the plea that the Minister had an assignment in the
south. I had also drawn attention of the Minister to the fact that it would be highly
uneconomical to hold the sessions in Ootacamund. As it happened, most of the
members were unable to attend.
When the meeting began, I reported the findings of the Scientific Advisory
Board. Shri Karmarkarji, as was to be expected, did not like that ‘verdict’. He
moved a resolution that no new inquiry should be sanctioned that year and that
only the old inquiries may be allowed to continue. He further expressed the view
that research programmes of the Council should be reoriented particularly in the
field of communicable diseases, for which purpose a committee be set up to make
suitable recommendations! These suggestions were accepted and immediately a
small committee under the chairmanship of Lt. Gen. B. Chaudhari, the Director-
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General, Armed Forces Medical Services, was set up to draw a tentative plan for
the purpose. This Committee met soon after lunch. The Chairman asked me to
open the discussion. I said it would be appropriate if the members first expressed
their views. To my surprise, there was silence all round! To set the ball rolling, I
said:
“Sir, do you think there are problems in tuberculosis which need investigation?”
They agreed. I repeated the same question vis-a-vis cholera. They again
agreed. In the end the subcommittee presented a ‘list’ of communicable diseases
on which research effort could be directed!
What a futile exercise! They were certainly not serious. Perhaps the Minister
and the Secretary wanted to show their wrath at the decision of the Scientific
Advisory Board, and incidentally to ‘teach me a lesson’ as I heard one of them
saying so.
That evening we took the train at Mattapalayam to go to Madras, Gen.
Chaudhuri and I were sharing a compartment. I brought up the subject of the
afternoon’s meeting. “Sir”, I said, “you made a list of communicable diseases which
should receive attention. The Scientific Advisory Board had already recommended
a research programme on most of them. Could you have not considered that?”
“Sorry, we should have. Why not call a meeting of the Board again so that we
could again look at it?”
“But you had already taken the decision not to sanction any new enquiry” I
replied.
To that there was no reply. I had, of course, no intention of calling the meeting
of the Board again. Strangely enough, the Ministry did not bring up the subject
again. There was considerable resentment amongst the research workers. The
work of the Council did suffer a setback. The plot hatched at Lucknow had
succeeded temporarily. It was not difficult to trace who were responsible for the
initial list of forty projects under scrutiny.
It took me two years to get the Council back on its rails again!
To create interest in research through the meetings of the Advisory Committees
was one thing and to initiate actual programmes of research in medical colleges
another. I was often reminded of the statement of Raymond Fosdick when he
said:
“There seems to be a widespread public belief in what might be called the
magic wand theory of medical advance. According to this theory, our research
laboratories stand ready at any time to turn money into scientific discoveries; in
other words, the bottleneck to further advance is the lack of funds; with adequate
funds we can buy a cure for cancer, or any other disease which afflicts mankind.
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“The bottleneck, of course, is not the lack of funds; it is the lack of capable and
thoroughly trained investigators to use the funds. The medical schools, to which
we must look for these investigators, do not possess and cannot now obtain the
fundamental facilities through which alone this increasing demand can be met.
Indeed, many of our medical schools are in a position of a cook asked to
prepare a wedding breakfast for which the champagne has been furnished but
no water to boil the potatoes. We cannot build research without the foundations
of trained personnel. We cannot grow orchids in a greenhouse that lacks coal”.
Training of workers in the appropriate methods of research is an essential
feature of a research organization. The Health Survey and Development Committee
had recommended that the central organization for medical research, when
established, should assume responsibility for the selection and training of medical
research workers. The Council had already started such a programme since its
inception. It was soon evident, however, that the out-turn of work was not very
encouraging, and that the programme did not yield the results expected of it. The
Council, therefore, decided to reorientate its programme, and instead of restricting
the fellowships to research only, it was decided to award them for training both
in teaching and research. The trainees were to be the junior members of the
staff of medical colleges, who were expected to qualify themselves eventually for
higher posts in their respective institutions by the acquisition during training of
a higher degree or diploma in their respective specialities. For the success of the
programme, however, it was equally necessary to aid the development of certain
departments in medical colleges as Post-graduate Training Centres in some
selected specialities.
For the success of the programme, however, it was necessary to secure the
concurrence of the health ministries and administrative officers of the States
concerned. This was done. It was also agreed that the fellows after the completion
of their training, would be posted in the respective departments of the medical
colleges in the States and would not be assigned any other duties.
The programme attracted the attention of the Rockefeller Foundation. In view
of their interest in the development of medical education in India they suggested
that for every fellowship offered by the Council the Rockefeller Foundation would
provide funds for the award of two additional fellowships to ensure that training
of junior teachers in medical colleges was completed within as short a period as
possible. The offer was accepted and the programme came to be known thereafter
as ICMR/RF Training programme.
The programme was a success. Two hundred junior teachers from different
medical colleges in the country received their training at forty centres in different
medical colleges, both in basic sciences and clinical departments. It was indeed
gratifying to note that most of them became, in due course, heads of departments
in their respective specialities.
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In order to develop research in medical colleges on sound lines some additional
steps were contemplated. The Council was supporting research through grants-in-
aid to individual workers for specific lines of investigation. Most researchers were
individualistic and the spirit of teamwork between workers drawn from different
disciplines for the solution of a common problem was conspicuous by its absence.
In order to remedy the situation it was suggested that each medical college
should have a research committee of its own. During my visits to the USA I had seen
the functioning of such committees. The example of the Massachusetts General
Hospital Research Committee may be quoted. “The functions of this Committee
are not to plan or direct research. It stimulates, guides, coordinates work in various
units, assists staff members to obtain funds from appropriate sources, but does
not act as a censor or in any way interferes with the individual’s work.” The initiative
and freedom of the individual worker was thus assured. It was suggested that a
research committee along this line should be formed in each medical college.
As a matter of fact State research committees were in existence in some States,
e.g., Madras and Bihar. It was also suggested that for better coordination of work,
the Chairman of the State Committee should also be a member of the College
Committee. It was pointed out that if the proposals submitted above are carried
out, it should be possible to draw up a programme of research which would include
not only problems of particular interest to the workers in the institutions but also
problems which were peculiar to the area and which could be studied in that area.
It was also suggested that if such a Committee was created for each college, a
representative of that Committee could then be invited to attend the meetings of
the Scientific Advisory Board of the Council.
In the Memorandum on ‘Medical Research’ in the Second Five Year Plan,
we had expressed many views and discussed in detail the implications of the
suggestions made. After summarising the steps that were intended to be taken
for the furtherance of medical research in medical colleges, I concluded thus:
“The profound influence which the promotion of activities outlined above
will have on the general teaching programme of the institution can, therefore,
be hardly overemphasized. It will not only serve to produce valuable knowledge
but would also help to foster the spirit of teamwork in the College in which it is
undertaken.
Such studies will bring that institution into direct contact with the needs
of the community which it is intended to serve and will pave the way for the
establishment and proper functioning of the department of preventive and social
medicine in it. The growth of social outlook in the medical student who is the
prospective physician will be fostered. Medicine fulfils itself only if it is enabled to
perform increasingly social functions in the promotion of the health of the people.”
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CHAPTER IV
STAFFING PATTERN AND PROBLEMS OF
ACCOMMODATION
As these developments were taking place, the need for additional staff for
the administrative burden and adequate office accommodation was being
keenly felt. The office work was really getting heavy day by day. We had
to study the research projects submitted for grants-in-aid, keep notes on each of
them before submitting them to the concerned advisory committees, maintain
records of discussions at the Advisory Committees for further reference, if required,
and follow up action later. The need was thus both for scientific staff and office
personnel. To look after office work I had already appointed Dr C.V. Ramachandani
who had then retired as Assistant Director-General from the office of Director
of Health Services. Rajkumariji had also mentioned to me on various occasions
to recruit the scientific staff required as soon as possible. Indeed I was really
embarrassed to receive a letter from Dr M.C. Balfour of the Rockefeller Foundation
in which he had quoted an extract from a letter which he had received from her.
She had written:
“Like you, I have been greatly worried for some time past about the heavy
burden which Dr Pandit carries. The work of the ICMR has increased enormously
since he took over and since the help from your worthy Foundation has increased
too. He needs a good second-in-command, who would not only relieve him of
much of his routine duties, but also imbibe some of the spirit of his recent work
and love of his profession and of humanity that Dr Pandit is ...”
In selecting my ‘second-in-command’, I could have many choices. I could have
recruited someone direct by advertisement or I could have appointed someone
who was about to retire. However, I chose to make an experiment. Once in London
I was discussing with Dr Harrington, the Director of the Medical Research Council
Laboratory in Mill Hill, problems connected with recruitment of staff and other
cognate matters. He had expressed the view that it was essential to give a scientist
some mental rest if he had been engaged on a problem for a number of years and
give him some light but interesting work for a year or so. He quoted the examples
of Dr Andrews who had been on Influenza for a long time and who was, I think, the
first to isolate the virus. Accordingly, he had given him the assignment of receiving
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visitors and taking them round the various departments, and spend the rest of his
time in reading or in whatever pursuits he would like to follow. I had no occasion
to meet Dr Andrews and ascertain from him what he felt about this assignment,
but thinking over the suggestion, I did feel that it should be a very stimulating
experience to meet the visiting scientists, to listen and, of course, participate in
their discussion with heads of various departments, and thus get one’s horizon
broadly extended.
I was fascinated with the idea and decided to try to implement it but in a
different way. I thought that it should be equally stimulating to a young scientist
of promise, if he was brought to work in the headquarters of the ICMR for a
reasonably short period of three years and expose him to the various disciplines
of medical science when attending the meetings of the Advisory Committees and
take part in the evaluation of research projects submitted to the Council and thus
help him to increase his valencies.
At the time, Dr Dick Anderson of the Rockefeller Foundation and I were visiting
together the various medical colleges in the country. I discussed my ideas with
him to ascertain if he had any suitable person in mind whom I could bring over
to the Headquarters. Ultimately, we agreed that to take any one from institutions
which were not under the administrative control of the ICMR would create many
problems. It was, therefore, considered feasible to take someone from Council’s
own laboratory at the time, the Nutrition Laboratories, Conoor. The choice fell on
Dr V. Ramalingaswami.
I visited Conoor and had a discussion with Dr Patwardhan, the Director
of the Laboratories. He welcomed the idea and agreed to release him if he was
willing. I understood that Dr Ramalingaswami was rather hesitant and wanted
time to consider the offer. Finally he consulted Dr Khanolkar who, I understood
later, strongly advised him not to miss the opportunity of working in the ICMR. Dr
Ramalingaswami joined me in 1954 after the meetings of the Scientific Advisory
Board in Baroda.
I will forever remember my association with Dr Ramalingaswami. We had
spent many evenings after office hours discussing the problems of the ICMR.
His first task was to help me in drafting the report of the first National Medical
Education Conference held in New Delhi under the auspices of the Rockefeller
Foundation, and later on to assist me in preparing with his facile pen and sense
of humour, the addresses which I had to deliver on some occasion or the other in
the medical colleges. If they were well received credit must go to him. Eventually
I persuaded him to apply for the post of the Professor of Pathology at the All India
Institute of Medical Sciences, New Delhi. He was selected, and as I recollect, rather
hesitantly joined that Institute, as otherwise I had to remind him that eventually he
would have to go back to the Nutrition Laboratories. There was no point in making
an excellent scientist an administrator too early in his life!
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After Dr Ramalingaswami left, Dr Someshwar Rao from the same institute
joined me. So far as I was concerned, it turned out to be a fair choice. He had
been given an assignment, apart from the usual things, to produce material from
historical records, for writing, not only the early history of the IRFA, but also on
problems of the time and views expressed on the development of research in
India. He, however, left us soon to join an appointment with the WHO.
He was succeeded by Dr Sriramachari again from the Nutrition Research
Laboratories, though at the time he joined me he was working as a Neuropathologist
in the Government of India’s Institute for Mental Health at Bangalore. I had to
persuade him to join me to develop the concept of “The Registry of Pathology”.
He too proved himself a loyal colleague. It was mainly through his efforts that we
were able to produce a document of over a hundred and fifty typed pages which
I submitted to the Governing Body analysing the work of the Council since I took
over in 1948 till my retirement in 1965 pointing out our achievements and also our
failures! The document was not published. How much do I owe to these three of
my colleagues! Indeed they made me!
II
The problem of securing adequate accommodation for the office had posed
many problems. The three rooms in E Block were obviously in-sufficient for our
day to day requirements. After great difficulty the Ministry of Housing allotted
me five rooms in the P Block, quite close to the Parliament House. Even this
was insufficient. The bigger room amongst the five was occupied by me, Dr
Ramalingaswami who had joined me then and Shri T.D. I had a small table at one
end of the room to receive visitors.
I then decided that ICMR must have a building of its own. I created a building
fund, transferring to it a sum each year from the annual grant of the Council. The
Accountant-General, I remember, had raised some objection to the creation of the
fund but in the end, everything was sorted out. Then remained the problem of
securing a suitable site for the building. I wanted it in close proximity to a medical
college, and the campus of the All India Institute of Medical Sciences was the
obvious choice. I did feel that such an association with the Institute would be
to the mutual advantage of both, facilitating frequent consultations on scientific
matters. Rajkumariji, who was the President of the Governing Body of the Institute,
readily agreed to my request, and allotted the Council a plot of land within the
campus of the Institute but along the Ring Road.
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In the meanwhile, I was looking for better accommodation for the office. I
requested Dr B.B. Dikshit, the Director of the All India Institute to give me on rent a
block of flats in the campus of the Institute. The whole of the Institute’s faculty was
not yet in position and a few blocks were vacant. Dr Dikshit was gracious enough
to accede to my request. For the first time, I had a decent office accommodation,
and even space for a conference!
By the time these developments were taking place, my building fund had
accumulated to two and half lakhs. This sum was obviously inadequate for the
construction of the contemplated building I had in view.
I was discussing my problem with Dr Balfour one day. Then an idea
occurred to me. The Rockefeller Foundation was functioning in a rented building
belonging to the Tuberculosis Association of India. I made a proposition to Dr
Balfour. I suggested that if the Foundation were to capitalise the amount which
it was spending each month on rent and give it to me, I could provide rent free
accommodation in the pro-posed building of the ICMR for the stipulated period
depending on the amount given. I thought that the ICMR could easily spare the
space in the new building and that the Foundation too would not be losing much
financially. On calculation it appeared that this rent-free accommodation would
cover a period of not more than seven to eight years, and that the ICMR would not
be expanding that rapidly to feel a pinch about the accommodation placed at the
disposal of the Rockefeller Foundation. Dr Balfour, of course, was too shrewd to
understand why I had made this proposal. He agreed to my suggestion, certainly
not because of the soundness about the proposal financially, but because, I am
sure, of the sincere desire to help the ICMR! Ultimately, the Foundation agreed
to bear half the cost of the proposed building, since I had two and half lakhs with
me and the cost of the new building could be about five lakhs of rupees. The
Central PWD architect prepared the plans accordingly. Accommodation for the
Rockefeller Foundation was provided on the third floor with a set of rooms on
either side of the central corridor which could also be partitioned off if necessary.
Just when the construction of the building was about to start, there was an
unexpected development. Shri Morarjibhai, the former Minister of Finance at the
Centre, issued a ‘Farman’ that no new government building should be constructed
costing rupees five lakhs or more without prior permission of the Government!
I did not like the idea of asking for permission, get involved in protracted
correspondence or even risk a refusal for the construction of the building. I was
also committed to the Institute to vacate their residential block when needed. I,
therefore, asked the architect to reduce the length of the building suitably to be
within the permissible amount of expenditure stipulated by the Government.
This was done and one day the building was ready for occupation. However,
in the meanwhile, a major change had taken place in the policy of the Rockefeller
Foundation regarding their sphere of work in India. The emphasis had shifted from
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Health to Agriculture. The Foundation had rented a building to accommodate
their staff and Dr Balfour with his small staff had moved into it.
I met Dr Balfour in his new environment and asked him: “Sir, would you be
wanting accommodation in my office building?” He smiled. “I was expecting this
question, Dr Pandit. No, we do not want to move there now. You can have the
whole building to yourself. The money provided by us would be our contribution
to the ICMR for its extended activities!”
So that was that! The building had a ‘mural’ over the main entrance. Shri
Benjamin, the architect, had designed it in consultation with me. The ‘scene’ was a
conference table with some figures around it. It was amusing to note how different
people had interpreted it differently. When asked, I used to give my interpretation.
“In the centre, there is the table, yes. And around it, of course, many figures. No,
it is not a conference. The figures around are those of the Minister, Secretary,
Accountant-General and others. On the table is lying the Director of the ICMR.
They are trying to dissect him for the manner in which he had spent the funds of
the Council”.
We moved into the building, with a small religious ceremony to which I
had agreed at the insistence of some members of my staff. There was no formal
opening! I had only one regret, with the opening of the Headquarters building, we
started holding the meetings of the Scientific Advisory Board in New Delhi and my
intimate association with the medical colleges came to an end!
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CHAPTER V
MEDICAL RESEARCH: A BLUEPRINT FOR FUTURE*
I
General
As stated previously, the Advisory Committees of the Council were requested
not only to express opinion on the research schemes submitted, but also to
indicate areas in their respective fields on which research effort should be
directed. At its meeting in Baroda in 1954, the Board had organised a symposium
on medical research specifically in relation to the Second Five Year Plan. A number
of eminent scientists had participated in this symposium and many more had
indicated their views in writing. Thus, the procedure adopted brought medical
research in line with other nation building activities envisaged in the country’s
five-year plans.
The plan so evolved was printed as “Medical Research in the Second Five Year
Plan” and widely circulated. One feature of the document merits mention. It was
stated:
“A research programme, however, has many facets. It has to be ultimately
related to the public health policies of the governments concerned. Therefore,
policy making and administrative action are links in a chain and one cannot be
considered without the other. Therefore, while outlining a research programme in
the several fields mentioned above, reference has been made, wherever necessary
to the policies which governments should follow for the application of knowledge
gained through research and for the ultimate betterment of the health of the
people”.
The broad outline of the plan so developed was as follows:
• Strengthening of the facilities available for research in existing institutions
in the country in order that they may render greater service than in the
past in their special spheres of study.
• Creation of new institutes for research in specific fields.
• Training of research workers by a system of fellowships and other means.
• Providing opportunities for the maximum display of talent of research
*In writing this section of my narrative, I have quoted extensively from the document on ‘Medical Research in the Second Five
Year Plan’ prepared by us in 1955.
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workers by exposing them to appropriate challenging situations.
• Creating conditions, by the formation of a research cadre, by which
young and promising workers may be attracted to a career in research
and by which they may be induced to remain in research.
• Initiating research programmes for the solution of many of the urgent
problems in the fields of medicine and public health; and maintaining
close cooperation with national and international agencies in all matters
pertaining to research.
II
Research cadre
Steps suggested for the promotion of research in medical colleges and for
the training of research workers have already been listed. All the same, no plan,
however elaborate, can succeed unless the lot of research workers is bettered
and conditions created for them to work in a congenial atmosphere. The limited
experience of the Council at the time was rather disappointing. Most of the
young research workers were being employed on research projects, both in their
existing research institutes or in medical colleges which received grants on a year-
to-year basis. The usefulness of such temporary grants is, indeed, very limited.
In the words of Dr Alan Gregg “such temporary grants have favoured hasty work
sometimes on trivial questions. They dissuade the more honest and circumspect
young men from entering investigative careers”. To remedy the situation it was
decided to establish well equipped research units both in research institutes and
medical colleges on a more or less semi-permanent basis, which would be staffed
by research workers who would then be employed on a full time basis ensuring
their seniority of service and satisfactory emoluments. The formation of a research
cadre was thus mooted.
The purpose of establishing such a cadre was:
• To create a nucleus of trained research workers and to provide them with
reasonable security of service.
• To ensure that the cadre is sufficiently broad based to meet the growing
needs of modern research which would consist of representatives
of all fields of medical sciences including chemists, biophysicists,
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epidemiologists, statisticians, etc. It must be so continued as to be capable
of tackling any urgent problem that the country might be faced with.
• The cadre must be flexible enough to facilitate continual absorption of
men who have shown promise of original work.
• An intimate association must be secured between members of the
teaching and research cadres.
In considering how this association between teaching and research be
brought about, it was suggested that:
Firstly — members of the research cadre should be posted for work not only
in research institutions, as used to be the practice in the past, but
also the medical colleges and teaching hospitals. Research units
should be built around them;
Secondly — depending upon their qualifications and experience, the members
of the cadre should be eligible for recognition by the universities on
an All India basis as guides or supervisors for postgraduate students
working for high research degrees of the universities;
Thirdly — suitably qualified members of the cadre should have collateral
postgraduate teaching duties, however limited they might be; and
Lastly — there must be a free exchange of personnel between Teaching and
Research cadres.
During my tenure of office I was not able to implement the programme as
envisaged above. The views expressed were in the fond hope that there would be
no insufferable barriers in the migration of scientists from one State in the country
to another, even though health was a State subject. The research cadre did come
into existence, but I am told, it, in no way fulfils the ideologies and objectives
envisaged for it!
III
A research institute that never came into being
Whenever the development of research had been considered, the question of
establishing research institutes, at least in some specific fields had always come
to forefront. The National Institute of Sciences of India, now renamed as the Indian
National Science Academy, had suggested that it would be desirable in the first
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instance to establish research wings in well-equipped institutions where suitably
qualified workers were available to undertake the work. Indeed the Council had
followed in the past the same procedure. The units had been established in such
fields as Haematology, Nutrition, Industrial Health, Neuropathology, in certain
fields of communicable diseases, liver diseases, and also for clinical research. The
objectives for the establishment of such units were specifically stated. It was
emphasised that the principle underlying research units was to graft a team of
active research workers on to an institution for the study of the problem in close
association with the Universities.
While the idea of creating new research institutes was temporarily relegated
to the background, there were some exceptions to this rule. At a fire side chat at
one of the meetings of the Advisory Committees, when we were discussing future
programme of research, the need for research and training in biological sciences
became evident. It was generally admitted that biological sciences had not kept
pace with the advances of scientific research in other fields such as physics,
chemistry, mathematics, etc. One of the reasons for such a lag was the very nature
of biological sciences which require for their study a special environment which
is not essential for physical sciences. In India the subject of biology has been
taught almost entirely on dead specimens, and the young students rarely get
an opportunity of handling, observing and studying live objects. In the general
discussion it was agreed that a note on the subject should be prepared for the
consideration of the Scientific Advisory Board of the Council in due course. Dr
Khanolkar, who had participated in the discussion, was entrusted with the task.
Some extracts from his note are given below:
“It should, however, be made quite clear even at this stage, that the present
project does not envisage the establishment of a research institute of the type
contemplated by the National Institute of Sciences, with its avowed object of
promoting research into the many specialised fields of biology, viz., Protozoology,
Helminthology, Entomology, etc. It is only intended to create an educational
centre in biological sciences and incidentally to meet the essential requirements
of medical research by making available to teaching and research institutions a
supply of pure strain animals. The functions of such an institute will be to:
• Become a centre for Fundamental Cytology and Experimental Biology.
There would thus be created a small nucleus of permanent staff and a
floating population of visiting research workers. The field of studies which
could be opened up at the Centre would vary from time to time and
would naturally depend on the research workers who would be prepared
to utilize these laboratories for their special problems for limited periods.
• Become a nucleus for introducing the study of Biology in school children
and college students by starting vacation courses in theoretical and
practical knowledge of Zoology, Botany, Experimental Biology, etc.
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• Provide a field laboratory for studying the effects of radiation on animals
and plants and for taking up schemes for the culture of algae and other
aquatic plants as well as fungi of medicinal importance.
• Supply of appropriate animals in adequate numbers to various
laboratories in the country at a reasonable cost.
• Become a centre for the production of venoms and other biological
products for specialised laboratories in the country.
The question of breeding and supply of laboratory animals to other institutions
in the country was further elaborated in the note.
As regards the location of the institute some specific suggestions were
offered. In view of the functions envisaged for it, it was essential that the location
fulfilled certain criteria. They were listed as follows:
“An institute to meet the above requirements should be situated at a place
where the natural surroundings most suitable for laboratory animals exist
plentifully. The temperature variations between the maximum and minimum
should not be large. There should be institutions close by from which the
necessary personnel could be drawn for rearing and breeding work. The road, rail
and air transport facilities should be easily available”.
Taking all these factors into consideration, it was suggested that an area in
the vicinity of Bombay, i.e. about five to ten furlongs from the city, located in close
proximity to the Vihar and Tulsi lakes, though separated from them by high ridges,
would be most suitable, both from the climatic point of view and the availability
of abundant water and electric supplies. The area was really a reserve forest area.
It was in the then composite Bombay State. Maharashtra as a separate State had
not come into existence. The scientific personnel from the medical colleges in the
State, from Ahmedabad in the north to Dharwar in the south, and from different
science institutions in the State would be attracted to work in the institution when
established.
The scheme, as envisaged, was approved by the Scientific Advisory Board and
the Governing Body of the Council.
I decided to take steps to implement the scheme. Since the location of the
Institute had received the approval of the Council, my first task was to ascertain
what help could be rendered by the Bombay State in the matter of acquisition of
land in the area proposed for the Institute. I consulted Dr Jivraj Mehta who was
the Finance Minister of the State and also a member of the Governing Body of the
Council. He agreed to allot about 500 acres of land in the area proposed. Of course,
there were protracted discussions on the financial arrangements. However, at the
suggestion of Dr Jivraj, it was agreed to allot the five hundred acres of land to the
Council at a rent of one rupee per acre for, I recollect, ninety-nine years!
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Other bodies had evinced interest in the project. The Haffkine Institute was
toying with the idea of sharing the land with us for housing their horse stables.
The Natural History Society was, indeed, keen to have their building in the same
campus. This association would have been beneficial to both the Council and the
Natural History Society. The prospect was very encouraging.
Having completed the negotiations for land, I approached the Health Ministry
for permission to proceed further in the matter. I had suggested the constitution of
a special committee to work out the essential details. To my surprise, however, the
permission was refused. I was advised not to proceed further since the Council of
Scientific and Industrial Research was contemplating of having a ‘similar’ project
for the supply of animals to science institutions. Even though I pointed out that
supply of animals was only one aspect of the Institute’s work, the Ministry was
adamant. I could not proceed with the implementation of the scheme!
However, I kept the offer of the Bombay Government open till my retirement
on one pretext or another, particularly since the CSIR scheme had not materialised.
The offer was subsequently reduced, I understood, to hundred acres, and finally
withdrawn. The Institute for Biology did not come into being!
IV
Establishment of a Blood Group Reference Laboratory
The Council had already accepted the policy of building round men, if available,
in developing any speciality. So when the question of establishing a Blood Group
Reference Laboratory was mooted in view of the importance of the subject, it was
decided to establish this in Bombay in association with the Haffkine Institute,
the Cancer Research Centre, the G. S Medical College and the Wadia Maternity
Hospital where work had already been in progress on some facet or the other of
the problem. These institutions were also in close proximity to each other. It was
also decided to designate one of the officers of the above institutions as “Officer-
in-Charge” for administrative purposes. The following functions were envisaged
for the laboratory:
• Training centre for workers in this field.
• As a reference laboratory to examine material sent by other workers.
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• A centre for the preparation of various types of sera required for blood
grouping.
• To disseminate relevant information on the subject and give technical
advice, wherever necessary.
• To maintain a registry of donors for special needs in blood transfusion
and,
• As a centre for research in the speciality, independently or in association
with other centres doing similar work.
Within a few years of its existence the laboratory did outstanding work in the
spheres of its activity.
V
Research programmes in specific fields
As stated earlier the Advisory Committees of the Council had made many
specific recommendations for initiating research programmes in their respective
specialities, e.g. in Nutrition, Industrial Health, Maternal and Child Health,
Environmental sanitation, Drug Research, and above all, in communicable diseases.
As I recollect, the Nutrition Advisory Committee had always been active, both in
the days of the IRFA and subsequently of the ICMR. In their recommendations
they made specific reference for investigations into such problems as survey and
prevention of protein malnutrition, studies in human lactation, control of dietary
and nutritional diseases, e.g. goitre and endemic fluorosis in south India to which
I had already drawn attention, to collect reliable data on growth and development
of Indian children and many other problems in the nutritional field.
The Child Health Advisory Committees of the Council had stated, as early as
in 1945, as follows:
“The subject of Maternity and Child Welfare calls for a great increase in
research into the many factors that underlie the high mortality and morbidity
figures that are associated in India with a normal physiological function and
the course of an individual’s early years of life. Such research in the absence of
facilities for applying the results is barren!”
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The Committee had emphasised research into such problems as toxaemia
of pregnancy, standardisation of prenatal care, antenatal syphilis, Rh factor,
evaluation of institutional and domiciliary services, physiological standards in the
neonatal period and many other related problems.
In the programme for research in Industrial Health, the Advisory Committee
had given high priority to the investigations on problems of sanitary disposal of
industrial wastes. It had also recommended the establishment of an Occupational
Health Research Institute. This recommendation was based on the work already
done in the Industrial Health Research Unit of the Council in Calcutta. The research
institute was expected to initiate studies on problems of thermal environment in
relation to health and anthropometric studies in relation to human engineering.
Finally, I must refer to the problems in the field of communicable diseases. It
will be recollected that activities of the Indian Research Fund Association during the
past several years were mostly in the field of communicable diseases, particularly
in malaria, kala azar, cholera, rabies and other diseases. The field of communicable
diseases is not static. While diseases prevalent in the past have assumed new
significance, for example in cholera, where the introduction of the El tor vibrio
replacing the old `Classical’ strain of Vibrio cholerae created new problems in
the epidemiology of the disease and in the behaviour of cholera epidemics, other
diseases, particularly in the virus field, have come to light.
It was, therefore, decided to pay attention to such problems from the
investigative and control points of view. What was achieved would be evident from
what follows in other sections of this narrative.
It should be stated, however, that we did not wait for the finalisation of the plan.
Action was initiated as soon as possible, after taking note of the recommendations
of the Advisory Committee in any specific field. As I look back on the plan so
developed and referred to above, I have often wondered whether the views
expressed and the ideologies developed then, are not relevant even today!
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CHAPTER VI
NUTRITION RESEARCH LABORATORIES
SHIFT FROM CONOOR TO HYDERABAD
At the annual meetings of the Nutrition Advisory Committee of the IRFA, the
question of finding additional accommodation for the Nutrition Research
Laboratories in Conoor was always brought up. The Laboratories were first
established by Major General Sir Robert McCarrison when he received a grant
from the IRFA to study the Indian dietaries in all their aspects. McCarrison chose
Conoor, a hill station in southern India for his, work. Accommodation was initially
provided by the Association of Pasteur Institute of southern India, a non-official
organisation, in their own premises. As work expanded, more and more space
was made available to the laboratories for its activities. As work increased, more
accommodation for laboratories and animals was necessary and a time came
when further expansion was no longer possible in the campus of the Pasteur
Institute. The Pasteur Institute required extra accommodation too, for its own
needs, and was pressing for the return of some of the accommodation “loaned” to
the Nutrition Laboratories. In view of all these considerations and the urgent need
for enlarging the scope of nutrition research in several directions, it was essential
to find out suitable accommodation for the laboratories elsewhere. I discussed
this question with the President of ICMR, Rajkumari Amrit Kaur and obtained her
concurrence for shifting the laboratories to another suitable centre in the country.
Having worked in Madras for over two decades, it was but natural that I should
explore the possibilities of finding a suitable accommodation in Madras and I wrote
to the Government accordingly. Unfortunately, the response was not encouraging.
Even replies to my letters were not prompt.
In the meanwhile, when word got round about the proposed move of the
laboratories, I began to receive suggestions from interested persons. Shri Govind
Vallabha Pant, then the very influential Central Cabinet Minister, suggested that I
should consider Allahabad for the purpose and offered the buildings of the English
Club there for the location of the laboratories. I inspected the buildings and found
them entirely unsuitable. Dr Jivraj Mehta suggested Baroda. I did not think it was
the place for investigating any nutritional problems but, to be on the safe side,
asked Dr Patwardhan to visit the place and make a report. Dr Patwardhan agreed
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with my views. While I was debating in my mind on the next step, the solution to
my problem came unexpectedly!
I had decided then to spend my vacation in Hyderabad where my daughter
and son-in-law had recently been posted. This was soon after the police action. I
had visited Hyderabad only once previously in connection with the work of the
Bhore Committee. Dr G.B. Grant and I were asked to visit it and gather some data
on health problems. Hyderabad was very gay then and we had been well received
both by Government officials and members of the medical profession. Now the
situation was different. I knew a few doctors in the city. Talking to them on various
problems in medicine, medical education and health, I gathered the impression
that Hyderabad would be a suitable place for the location of the Nutrition
Research Laboratories. Hyderabad, a part B state then, represented the dietary
habits of Tamilians, the Andhraites, Maharashtrians, as well as those of the North.
Later in my discussion I called the region as the meeting ground of the different
“Nutritional Cultures” of India. Geographically, the city was centrally located and
could easily be reached by rail or by air.
I decided to consult Major General S.L. Bhatia who was then the Director of
Public Health. He generally agreed with my views and suggested that I should
meet Shri Phulchand Gandhi who was then the Minister of Health and seek his
advice and help, particularly in securing suitable accommodation to house the
laboratories, since many bungalows, almost palaces, were lying vacant in the city
as the owners had left for Pakistan.
Shri Phulchand Gandhi received me well and promised me all support. He
suggested, however, since he was busy then, that I should visit Hyderabad again,
on a mutually agreed day, when he would personally take me round the city and
inspect the various sites and bungalows which might be considered suitable for
housing the laboratories.
Accordingly, we met again and during the week saw many bungalows.
Unfortunately, none of them was really suitable for the purpose in view. The cost
of additions and alterations was almost such that it would be cheaper in the long
run, to construct a building suitable for our purpose. It was then that Gen. Bhatia
suggested that I should try to get a suitable site on the campus of the Osmania
University and construct the laboratories as per our own requirements. He informed
me that there were plans to move the Medical College also on the campus and
that the departments of Anatomy and Physiology were already working there. The
College of Agriculture was already working on the campus which would also be an
additional advantage for obvious reasons. The idea of locating our laboratories in
the University campus interested me immensely.
The next day we met by appointment, Sir Ali Yawar Jung, the Vice Chancellor
of the Osmania University. I had not met him before. He received us graciously
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Nutrition Research Laboratories, Hyderabad
Nutrition Research Laboratories, Conoor
Planning for the Future (1948-1965)
Major-General Sir Robert McCarrison, Founder of the
Nutrition Research Laboratories
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indeed. I explained the purpose of the visit and that why I thought the Conoor
laboratories should be shifted to Hyderabad and why their location in the campus
would be beneficial to all concerned.
“In what way could we help you, Dr Pandit?” he asked.
“Would it be possible for the University to donate us some land?’ “How much?”
asked the Vice Chancellor.
“About 30 acres”, I replied.
I mentioned this figure as it came to my mind, for I was not prepared for this
at our very first interview. Sir Ali Yawar Jung looked at me and said —
“All right, take the car, go round the campus and let me know which site you
would prefer”!
I went round the huge campus of the University. The grounds were rugged
and it was not easy to pick up 30 acres of level ground. Ultimately, I chose the
site I wanted and informed the Vice Chancellor accordingly. He looked at me for
a minute and said: “Did you see a small building there, quite close to the site?”
When I replied in the affirmative, he said: “That area, we thought we would reserve
for providing residential accommodation for the staff. I should have told you that
before you went round. However, since you have chosen that site, we would give it
to you. You can proceed on that basis”.
The interview ended. I could not believe what had happened. I had met many
administrators and Vice Chancellors since but never had I been impressed with
one so dynamic and so understanding.
I regret I did not have any occasion to meet Sir Ali Yawar Jung again. In
November 1969 when I had gone to Los Angeles as a Visiting Professor, I had to
give the Craig Memorial oration in Washington at the invitation of the American
Association of Tropical Medicine, Sir Ali Yawar Jung was our Ambassador then and
was invited to attend the meeting. Unfortunately, he could not do so as he was to
be away from Washington at that time. But he sent one of his representatives to
attend it and report. I was so disappointed to have missed seeing him then.
On return to New Delhi I informed Rajkumariji of the outcome of my visit.
She was genuinely pleased. I also informed Dr Patwardhan, the Director of the
Laboratories, of the developments.
This was not, however, the end of the story. I have a suspicion that when the
decision to move laboratories from Conoor to Hyderabad came to be known to the
staff, some of them who did not like to move away from Conoor must have sent a
representation to the Government of Madras. For soon after, a deputation led by
the Minister of Health in Rajaji’s cabinet arrived in New Delhi to protest against the
move. Rajkumariji met the members of the delegation when I was also present.
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We explained the problem fully but as it was to be expected, the delegation was
not convinced about the need for leaving Conoor. The leader was from Andhra.
I whispered to him that at least he should not object, for when the Andhra State
would be created eventually, he would have a premier nutrition institute in his
State. He smiled but said that was not the issue under discussion!
Finally, the deputationists met Pandit Nehru. He sent for me and wanted to
know all about the affair. Apparently he was satisfied, or at least I thought so, when
he finally said: “Well, Pandit, I see your point. However, consult Rajaji in the matter
and if he agrees, I have no objection”
I had no choice but to see Shri Rajagopalachari. I used to know him since I
had met him on several occasions while in Madras. After I had explained to him
the need for locating the laboratories elsewhere and the advantage to be gained
by moving to Hyderabad, I told him that our interest in the nutrition problems of
the Madras State would certainly not suffer because of our move to Hyderabad.
Indeed, I said, we were as near to Madras from Hyderabad as we were from Conoor,
if not nearer. It was only two hours by air from Hyderabad. His reply to this was
characteristic of him. He said:
“Well Pandit, do not spoil a good cause by bad argument! Tell Jawaharlal that
I have no objection to the proposal”.
I requested him to write to Panditji accordingly. He said that was not necessary.
It would be enough if I conveyed the message.
So that was that. However, in order that there should be no more obstacles in
implementing our proposal, I suggested that Rajkumariji should lay the foundation
stone of the new laboratories forthwith. In consultation with the architect of the
State, we held the ceremony of laying the foundation stone of the proposed
building.
Thereafter, Dr Patwardhan and his colleagues worked very hard, prepared
the plans for the laboratories in consultation with the State architect and after
the completion of the buildings, the shift was made with minimum disturbance
to work in progress. The Nutrition Research Laboratories have fulfilled the
expectations we had of it. The credit for this actually goes to Dr Patwardhan and to
his staff. What did the change from Conoor to Hyderabad mean? Indeed, I cannot
do better than to draw attention to the review in the Lancet in 1962, Vol. I, page 1031,
entitled: “Indian Nutrition Research”.
From “Lancet” Vol. 1 of 1962: page No. 1031 —
“Indian Nutrition Research”
“A further record of growth is presented in the annual report from the
Nutrition Research Laboratories of the Indian Council of Medical Research.* The
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Dr. V.N. Patwardhan, Contributed in the field of Nutrition
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Nutritional Community Studies: Investigation of
Nutritional Disorders on Field.
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laboratories have come a long way since their start at Conoor over forty years ago.
They are now housed at Hyderabad and staffed by 42 graduates. Dr C. Gopalan has
taken over as director from Dr Patwardhan, who has rejoined the World Health
Organisation at Geneva.
The laboratory staff is organised in five divisions —Chemistry, Clinical Studies,
Field studies, Physiology and Experimental Medicine and Pathology. During the
period covered by this report, it contributed 25 papers to the scientific Press. A
section of the field studies division is concerned with popular education. Work
in progress includes an investigation of nutrition in pregnancy and lactation with
special emphasis on the relation between the vitamin A intake of the mother
and the vitamin content of her milk; the use of groundnut protein in treatment
of kwashiorkor; anaemia in early infancy; iron metabolism in hookworm anaemia;
energy metabolism in undernourished subjects; the effect of protein deficiency on
the chemical composition of striated muscle; vitamin D and citrate metabolism;
vitamin K requirements of the monkey; and the effects of temperature and other
factors on the structure and functions of the rat testis.
“The laboratories have a large monkey colony, and extensive studies are being
made on the effect of various dietary fats on serum-cholesterol levels confirm and
extend observations on man. As yet they do not appeal ‘to throw any light on the
more difficult problem of the relation of the liquid changes in the blood to the
development of atherosclerosis.
“Probably no other laboratory in the world carries out a programme of nutrition
research on such a large scale. The Indian Council or Medical Research has provided
facilities for studies in the field, in hospital wards, and in laboratories combined
in one unit, these present great opportunities for investigation on nutritional
disorders. Any young British graduate in either medicine or biochemistry who
seeks experience in the practical problems of nutrition could not do better than
go to Hyderabad”.
There could not have been, I felt, a better tribute to our planning!
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CHAPTER VII
THE FIRST MEDICAL EDUCATION
CONFERENCE IN INDIA IN 1955
The Medical Education Conference was held in New Delhi on the 19th to 22nd
November 1955. I was a member of the Organising Committee and was
appointed later as the reporter of the Conference, along with Dr K.C.K.E. Raja.
I had to draft the final report as Dr Raja was preoccupied at the time with the affairs
of the All India Institute of Medical Sciences. I accepted this assignment readily
since I was interested in medical education and was involved then in promoting
research in the medical colleges in the country. Again the conference was held
against the background of certain developments which had already taken place.
The Bhore Committee in their report in 1945 had made detailed recommendations
on professional education. While suggesting the abolition of the Licentiate
course, many specific recommendations were made regarding the organisation
and teaching schedules of some specific departments, e.g. the departments of
anatomy, physiology and pharmacology and the department of preventive and
social medicine.
It must be remembered that medical education was receiving considerable
attention towards the termination of the Second World War and immediately
thereafter. This was, indeed, evident to me during my visit to UK and USA in 1944
in connection with the assignment for collecting data on ‘newer trends in medical
education and research’, which were considered essential for the establishment of
the All India Institute of Medical Sciences.
In India too, some positive steps were taken soon after independence. A
special reference has to be made to the Upgrading scheme ‘whereby selected
departments in individual medical colleges were being improved in order to provide
postgraduate training facilities of a high standard for students from all parts of
the country. In addition, steps were taken to give generous grants for improving
and modernising the equipment of medical colleges, for the establishment of
fulltime units with prohibition of private practice and for a scholarship scheme
whereby junior teachers were helped to take postgraduate qualifications in their
special subjects and to carry out at the same time, a prescribed piece of research.
This experiment has already been discussed in the ICMR-Rockefeller Foundation
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fellowship programme. Holding of the conference was thus opportune. We stated
in our ‘introduction’ to the final report as follows:
“Between the young graduate in medicine and his ultimate responsibility —
human life —nothing interposes. The issues of life and death are all in the day’s
work for him. From the very first the training of the doctor is, therefore, much more
complex and more directly momentous than that of a technician”. This statement
by Abraham Flexner conveys more directly than any other the challenges of
medical education. The teaching of traditional disciplines of medicine, such as
anatomy and physiology, medicine and surgery, is itself exposed to considerable
stress with the rapid advances in medicine and the ever -increasing specialities.
The increasing dependence of medicine upon the basic sciences of physics,
chemistry and biology requires a broadening of the content of medical education
to include these subjects. And yet medical education cannot be divorced from
the study of humanities, literature, history, philosophy and arts. To blend all these
requirements into a unified system of medical education is the need of the hour”.
“There is always a wide gap between the ideal and the practical. Medical
education is expensive and the nearer it approaches the ideal, the more expensive
it becomes. Medical education has, therefore, to be related to the resources that
are available and to the needs of country. All these adjustments require careful
thought and planning. The conference was intended to serve the purpose of
critically examining the existing systems of pre-medical and medical education, of
laying down the objectives to be achieved and of suggesting the steps necessary
to promote the attainment of those objectives”.
The noteworthy feature of the conference was the manner in which it was
organised. I have already stated that I was a member of the Organising Committee.
Other members were Lt. Col. C.K. Laxamanan, the Director General of Health
Services, and Dr K.C.K.E. Raja. Dr. M.C. Balfour, Representative of the Rockefeller
Foundation, was co-opted as a member of the Committee. The Committee met
in Bangalore for two days and decided that the Conference should deal with the
problems of undergraduate medical education only. It was also decided that
comprehensive memoranda on different aspects of medical education should be
prepared which would form the basis of discussion at the Conference.
It, therefore, established three Sub-committees, each being assigned a
particular area of the total field of undergraduate medical education. The Sub-
committee No. 1 had to deal with (a) premedical studies, (b) entrance requirements
and (c) selection of students. The Sub-committee No. 2 was assigned the task of
dealing with (a) curriculum hours—preclinical and clinical, (b) methods of integrated
teaching of preclinical and clinical subjects, (c) subjects needing special emphasis,
e.g. Preventive and Social Medicine, Psychiatry and Rural field experience, and (d)
internships and the Sub-committee No. 3 had to concern itself with other subjects,
e.g. medicine, surgery, paediatrics and also anatomy, physiology, pathology,
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pharmacology, etc. Finally the three Sub-committees and the Policy Committee
met together in New Delhi, discussed the reports prepared by them with a view
to evolving of agreement on the more important subjects covered by them. The
main ideas that emerged were brought together in a memorandum which was
then submitted to the Conference. The procedure adopted thus served to ensure
purposeful discussion at the Conference on various aspects of medical education.
The Conference was attended by over hundred representatives of the medical
colleges in the country and by twenty-five foreign delegates from countries in
South East Asia, including China, and representatives of the Rockefeller Foundation,
Technical Cooperation Mission and the World Health Organisation.
At the inaugural session, the Conference was addressed by Dr B.C. Roy, the
Prime Minister Shri Jawaharlal Nehru, the Health Minister Rajkumari Amrit Kaur
and Dr Alan Gregg of the Rockefeller Foundation.
As was to be expected, the Conference passed a number of resolutions on
several facets of the problems discussed. It is not my attention to list them here.
However, I quote from our final report: “They represented the trends of thought
on multiple facets of medical education and covered a wide ground ranging
from premedical requirements with its bearing on high school and university
education to the teaching of social, preventive and psychological medicine. The
feature that stood out prominently throughout the proceedings was the almost
unanimous realisation of the inadequacies of the present system and the equally
unanimous feeling that immediate steps must be taken to remedy some of the
existing deficiencies. No one in the Conference expected miracles to happen in
the immediate future. The problem of medical education is a complex one and any
change from the existing system will mean corresponding change in the general
educational system and is intimately linked with financial resources and technical
man power”.
One item that provoked considerable discussion at the Conference was the
proposal put forward by Dr Raja on the formation of an Association of Indian
Medical Colleges which would provide a forum to all educationists in the country
to discuss the problems of medical education and review from time to time the
progress made in different aspects of medical education. It was evident that there
was sharp difference of opinion on the subject. A view was expressed that it might
interfere with the legitimate functions of the Medical Council of India. Those who
were in favour of the proposal pointed out that during the deliberations of the
Conference, the need for experimental studies on several aspects of medical
education should be stressed, and as these studies progress, the organisation
proposed would provide the forum for discussing the results, if any, of such studies.
The view which ultimately emerged was that the initiative for the establishment
of such a body should come from the teachers themselves rather than from the
Conference. Accordingly, no formal resolution was adopted by the Conference.
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It will be of interest to record that an “Association for the Advancement of
Medical Education” came into being ultimately with Dr A. Lakshmanswamy
Mudaliar as its President. It started in due course a Journal of Medical Education
too. Again the Ministry of Health at the Centre had called periodically conferences
of Deans and Principals of Medical Colleges in the country which had also passed
several resolutions dealing with medical education. It would be of interest to
compare the resolutions passed at the first Conference and those adopted
subsequently and then to note what changes, if any, had taken place since the
first Conference was held, at least in our thinking, if not in the implementation of
any ideas propounded since the first Conference was held!
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CHAPTER VIII
RESEARCH IN AYURVEDA - BIRTH AND
DEATH OF A CONCEPT
Early in December 1949, Rajkumari Amrit Kaur sent for me and told me that
she was appointing me the Chairman of a Committee to work out a detailed
scheme for the establishment of a research institute in the indigenous
system of medicine according to the recommendations of the Chopra Committee.
I was really surprised at the invitation, since I thought that not being a student of
Ayurveda, I had no special qualification to be the Chairman of such a Committee
and told Rajkumariji so. While I was discussing the question, Dr K.C.K.E. Raja also
joined us. He pointed out that in the terms of reference to the Committee, it was
being stipulated that in carrying out research at this centre modern scientific
methods were the ones to be utilised, and since I was the Head of a research
organisation, fully acquainted (presumably?) with such methods, I should have no
hesitation to accept the proposal. Eventually I agreed.
As soon as the membership of the Committee was announced, there were
storms of protests from the Ayurvedic world! “Why should an ‘allopath’ be always
appointed as a chairman of such committees?” they asked. Eventually a small
delegation, headed by Dr V. Subrahmanyam— a representative of the Siddha
system, and a member of the Constituent Assembly of India--waited on the Health
Minister. I was asked to be present. After some discussion it was suggested that
the delegation should discuss with me all relevant matters in a general way, and
if later, the delegation wanted a change, the matter could be considered the next
day.
Accordingly, we met in my office in ‘E’ Block at 12 noon. After an exchange of
a few pleasantries we settled down to business. I acquainted them with my own
views in the matter and incidentally mentioned the work which Capt. Shrinivas
Murthy was doing in the indigenous school of medicine in Madras and to which
a reference was made in the report of the Chopra Committee. I then acquainted
the members with my own views regarding the manner in which the research
institute should function. I made it clear that so far as my views were concerned,
the institute will be in overall charge of the Ayurvedic team and the research
programme will be primarily drawn by them. However, I stressed the need for
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associating a ‘modern’ team, consisting of physicians, pathologists and chemists
with all aspects of institution’s work and the role it should play in the day-to-day
work of the institution. We discussed these and other problems over a lunch of
sandwiches and coffee and afternoon tea with biscuits, and finally bade goodbye
to each other, about seven in the evening! The members then agreed to acquaint
the Minister with the gist of our discussion the next day.
Rajkumariji sent for me the next day. She was all smiles! “Pandit what did you
tell the members yesterday? They said that not only were they happy having you
as the chairman, but they said they would have nobody else’.
Thus began my association with Ayurveda!
The composition of the Committee was announced by the Government of India
in their letter No.F.28-2/49-M1, dated 2nd December 1949. Dr V. Subhramanyam,
Kaviraj Ganesh Dutt Saraswat, Principal, Rishikul Ayurvedic College, Hardwar and
R.R. Pathak, Prinicpal, Ayurvedic College, Begusarai, Bihar represented Ayurveda.
Dr B.B. Yodh, Professor of Medicine, Grant Medical College, Bombay, Dr A.N. Goyle of
the Medical College, Amritsar and Dr D.N. Bannerji of the R.G. Kar Medical College,
Calcutta, were representatives of the modern system of medicine, and Mohd Ilyas
Khan was the sole member of the Unani system. Our terms of reference as follows:
• To work out and submit to Government a detailed scheme for the
development of a centre of research in Ayurvedic and Unani systems
of medicine on as broad a basis as possible on the lines indicated in
paragraph 251 of Volume 1 of the Report of the Committee on Indigeneous
Systems of Medicine. In carrying out research at this centre modern
scientific methods are the ones to be utilised in order that the fruits of
such research may be of proved value acceptable all over the world.
• To investigate and define in what manner special training in Ayurvedic
and Unani systems can be incorporated during the last year or so of
the under-graduate medical course in modern medical colleges, for
the benefit of those desiring to qualify themselves in these systems;
or alternatively, to suggest how Ayurvedic or Unani can be fitted in as
subjects for post-graduate medical study. In examining this matter the
Committee will give due consideration to the fact that India cannot
afford to permit her medical practitioners, whatever systems they may
individually adopt, to receive training which will fall short of the standards
of medical education considered necessary in all progressive countries.
• To make recommendations regarding the policy to be adopted as regards
the continuance, with such modifications as may be necessary, of certain
existing Ayurvedic and Unani medical schools and colleges in which
some training in subjects such as Anatomy, Physiology, etc. is carried out,
keeping in view the need for establishing a uniform system of medical
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education throughout the country and for ensuring the utilisation, to the
best advantage, of the available resources in the country in men and
material for the development of medical education.
My own interest was, of course, in the first term of reference. I had practically
no experience or knowledge regarding the type of instruction given in indigenous
schools of medicine. Fortunately, other members of the Committee, i.e. those
representing modern medicine, were more conversant with the subject. Dr Yodh
had, indeed, submitted a detailed report on many of the institutions in the country.
My role as a Chairman was to bring about any compromise, if possible, in the
divergent views expressed by members especially in regard to recommendations
to be made in respect of the last two terms of reference, i.e. those relating to the
teaching of Ayurveda in modern medical schools, and regarding teaching of
preclinical subjects in the schools of indigenous systems of medicine. It must be
stated that at the time we were considerably impressed with the recommendations
of the Bhore Committee in regard to the newer concepts regarding medical
education in colleges of modern medicine, particularly the concept of producing
a ‘Basic Doctor’. Should not similar considerations prevail in the production of a
doctor from schools of indigenous systems of medicine?
Indeed the Committee stated in their report that “some of these
recommendations which have been made after deliberate consideration, would
strike a familiar chord in the minds of those interested in the study of Ayurveda
especially with reference to measures designed to promote the concept of “man
as a whole”! We already see an integration, at any rate, of outlook! It is interesting
to note what the Committee had recommended regarding the development of
schools of indigenous systems of medicine. It agreed with the recommendation
of the Chopra Committee that “in the colleges of Indian medicine the basic
qualification of admission should be raised to the intermediate standard with the
three sciences, physics, chemistry and biology for the degree course”. In addition,
the students must also possess knowledge of Sanskrit of the matriculate standard
for the study of Ayurveda and Arabic for the study of Unani system of medicine!
We were bogged down in recommending an appropriate curriculum vis-a-
vis training in modern medical subjects, in these schools. The whole concept at
the time was to ensure ‘integrated teaching’ of both the systems. Eventually the
Committee agreed to a tentative plan worked out by a subcommittee. A pious
hope was expressed that the scheme would provide a useful basis to start with. It
was also hoped that when the results of the working of the research institute were
made available and suitable textbooks prepared, they would provide sufficient
basis to formulate a suitable curriculum. However, it was expressly stated that at
least one school of indigenous system of medicine should be upgraded to evolve,
after trial and error, a pattern which could be considered satisfactory from all
points of view.
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The Committee was apprehensive, like many others, that if the present state
continued for long, “it would not be long before the indigenous systems became
extinct”.
Over twenty years have elapsed since the above recommendations were
made and views expressed. What has happened since is common knowledge. I do
not know how many real schools of indigenous medicine exist today, and the type
of training being given in them. Apparently fewer and fewer students are wanting
to learn Ayurveda alone. There is more and more clamour for the incorporation of
subjects of modern medicine in most of them, and I wonder how many who come
out of these institutions, really want to practise Ayurveda alone. I am, therefore,
amazed at my own gullibility in believing then, that our recommendations would
not only be accepted, but would be implemented! Even the research centre, on
which we had put so much faith, and which did come into being, did not fare any
better! But let me not anticipate. Years later I had occasion to meet Pandit Shiva
Sharma, quite casually, at the Delhi airport. He was not only a noted Ayurvedic
physician, but weilded considerable power and influence in the deliberations of
the Ayurvedic Conferences being held from time to time. He was interested in
promoting the study of Ayurveda in neighbouring countries. He said, “Well Pandit,
Ayurveda will prosper in India only when it is imported from other countries!”
In dealing with the first term of reference relating to the establishment of
a research centre, the Committee did not have any serious difficulty. In our early
deliberations on the subject, the members representing the Ayurvedic system
expressed some apprehension regarding the directive given to the Committee,
viz. “In carrying out research at this centre modern scientific methods are the
ones to be utilised in order that the fruits of such research may be of proved value
and acceptable all over the world”. “How are you going to investigate”, they asked,
“Ayurvedic doctrines by ‘modern methods?” Apparently their objection was to the
word ‘modern’. After some lively discussion, they agreed to substitute ‘modern
scientific methods’ by ‘methodology of scientific investigation’. The expression
was considered to be sufficiently comprehensive which would take into account
all techniques and procedures which would further the objects for which the
centre was to be established.
After this initial ‘encounter’, the deliberations of the Committee were
marked by extreme cordiality.
It might be worthwhile now to record the Committee’s recommendations
regarding the scope and functions of the research Institute. The Chopra Committee
had listed several categories of research, viz. clinical research, literary research,
dietetic research, pharmacological research, and research into the fundamental
principles of Ayurveda. A perusal of the Committee’s report would give the
impression that it was contemplated that several teams should be engaged in
conducting researches in all these subjects simultaneously. The Committee
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felt that all efforts in that direction could be channelised through one channel,
i.e. through clinical research. Study of a disease or a disease syndrome would
certainly involve library research. Diagnosis of the ailment of a patient would have
to be done according to Ayurvedic concepts and thus involve researches into the
fundamental principles of Ayurveda. When proper records were maintained, it
would be possible to make a comparative study of several patients suffering from
the same disease complex in general and to evaluate the basic principles with a
view to evolving an accepted concept of the disease and its etiology. Again, the
knowledge thus gained could be retested by comparison, when other diseases
are taken up for investigation. In the opinion of the Committee, these could be
the first steps. Later, detailed studies into the above several categories of research
could be undertaken. Finally, such attempts would facilitate the preparation of text
books for both under-graduate and post-graduate students of both Indian as well
as modern systems of medicine.
As regards the organisation of the work of the research centre, the Committee
was emphatic in their recommendation when it stated that “the proposed
institution should be a separate one and not a part or wing of a hospital where
patients are admitted for all types of treatment, including treatment in terms of
modern medicine. The patients who seek admission ought to be aware of the
nature of treatment they would be receiving in it”.
Again, in order to ensure a comparative study of all problems entrusted to the
institution, it was considered essential that the staff of the institute, from the very
beginning, should consist of both the Ayurvedic physicians and physicians trained
in modern medicine. Such an approach was also suggested by Capt. Shrinivas
Murthi of Madras in a memorandum submitted to the Chopra Committee and
I was acquainted with the working of his institute there. The suggestion was, of
course, readily accepted. However, the Committee was careful in emphasising the
following points, viz:
• Since the Institute was intended primarily for the study of indigenous
systems of medicine, the responsibility for its day to day working, and the
selection of subjects for study should vest with the Ayurvedic team.
• It might be that during the course of the disease conditions may arise
which might necessitate surgical intervention. Since the modern team
would be associated with the day to day progress of the disease, they
would be in a better position to advice, whether or not in their opinion
surgical intervention was necessary or imperative. However, it was to be
clearly understood that decision to accept that advice should rest solely
with the Ayurvedic team since the patients would be under their care and
receiving treatment prescribed by them.
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I have attempted to give here only the most important recommendations
of the Committee in order to appreciate what happened subsequently when the
Institute actually started functioning.
The location of the Institute presented no difficulties. Most of the members of
the Committee were aware of the facilities, or rather the lack of them, available at
most of the Ayurvedic institutions in the country. Its location at the Tibbi College
in Delhi, which I had to visit, was ruled out as that institution was involved in some
kind of litigation over land and buildings. It was certainly in bad shape at the time
of my visit. Mr Dhulekar, M.P., who was later appointed on the Governing Body of
the Institute, suggested Jhansi in UP as the most suitable place for establishing
the new institute, an Ayurvedic school was functioning there. The Institute had
also three hundred acres of land allotted to it. Eventually I was told to establish an
Ayurvedic University in association with it, I decided to visit Jhansi.
I had hardly arrived at the Circuit House, when I received a telephone call from
one who refused to reveal his identity. He informed me not to have truck with
Shri Dhulekarji or his institution and told me several things hardly complimentary
either to Shri Dhulekar or the Institution!
On a visit to the Institution with Shri Dhulekar, my worst fears were confirmed.
The Institution was admitting about 150 students each year. The teaching facilities,
the equipment, and the faculty were not worth the name, not to mention the
facilities for clinical teaching! I met Dhulekarji at dinner in Delhi in the home of Shri
Pataskar and acquainted him with my views. Later I had to visit Jhansi again, along
with the Health Minister, Rajkumari Amrit Kaur, when at a ‘convocation’ ceremony
we were given the Doctorate of Laws (I believe) of the University! I believe Dr Shiv
Sharma and others were also similarly honoured!
While the Pandit Committee was in session, Dr B. B. Yodh made the suggestion
that in his opinion, Jamnagar in the then Saurashtra would be a suitable place for
the location of the Institute.
The Jamnagar Institution was under the patronage of Their Highnesses
the Maharaja and the Maharani of Jamnagar. When I visited the place, I was the
guest of Their Highnesses, and I was housed in the large Pratapsingh Palace with
its marvellous collection of paintings from many lands, and a special collection
of paintings by Raja Ravi Varma. I wonder what has happened now to that
collection. The Jam Sahib was a wonderful host and a brilliant conversationalist.
We were talking one day of his experiences at the UNO when he was one of India’s
representatives along with Mr B.N. Rao. When I asked him about the activities of
the delegation, he replied: “Well, Pandit, B.N. Rao looked after all serious matters,
and I looked after entertaining guests at lunches and dinners. I am good at that
sort of thing, you know, and not much good at anything else. But you do achieve a
lot at entertainments, don’t you?” I readily and politely agreed with the importance
of entertaining but not with the view that he was no good at anything else!
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One day he asked me what he should do with the Pratapsingh Palace. Can
the Centre make any use of it? “Why go to the Centre at all?” “Why not make it,
what the Russians have, as Palace of Pioneers?”, I replied. I had just returned from
a trip to Russia and had seen what use the Russians had made of the palaces of the
former noblemen. I explained what could be done. The Jam Sahib was apparently
not interested. He would have liked Delhi to take it over after, of course, payment!
The Institution in Jamnagar was primarily the creation of Her Highness
the Maharani, who had established a society which bore her name, “the Gulab
Kunwarba Ayurvedic Society”. The affairs of the Institution were being managed
by the Society. With princely support and interest of the State, the Institution had
developed remarkably.
The Institution was housed in a large newly constructed building at a cost of
over Rs. 20 lakhs where teaching in Ayurveda was being conducted according to
the curriculum recommended by the Bombay Board of Indigenous Systems of
Medicine. It had an auditorium which few Institutions in the country can boast
of! There was space and equipment for laboratories for pharmacological and
physiological studies. It had a library containing more than 6000 volumes, of
which over 2000 were pertaining to Ayurveda and, in addition, about 120 ancient
manuscripts. The Institution had a good herbarium with specimens of nearly 5000
common indigenous herbs and diagrams of over 3000 plants growing in India. In
addition to a small pharmacy a big pharmacy “the Sarangadhar Laboratories” had
been established. There was also a comprehensive hospital unit for treatment of
both the systems of medicine, indigenous and modern with provision of about 270
beds of which 50 beds were reserved for Ayurveda. In addition, a well-equipped
modern hospital was located nearby. It was indeed gratifying to note that
physicians belonging to both the systems of medicine were working in harmony!
I reported these findings to the Committee. However, before taking a final
decision, it was considered prudent to request the Ayurvedic members of the
Committee to visit Jamnagar and report their views on its suitability for the
establishment of the Institute. At this time the Committee had full information from
the States on their own centres and programmes for their further development as
well. Needless to state that the Committee finally voted in favour of Jamnagar as
the most suitable place for the location of the proposed Institute.
It is not necessary here to refer to the other recommendations of the Committee
vis-a-vis selection of the staff or the administrative control of the Institute. They had
followed the usual pattern. As a matter of fact, I was not interested in the procedures
for the selection of the staff. I know I could not distinguish between the relative
merits of the Ayurvedic physicians competing for any post in the Institute. It was
better, I thought, to leave the matter in the hands of the Selection Committee. As it
happened, I was amused to see that two members of the Committee got selected
to the two key posts in the Institute, when it was formally established.
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I must mention, however that in the Governing Body of the Institute, provision
was made to secure representatives of the States, in rotation, of course, to maintain
and preserve the all-India character of the Institute.
The report of the Committee, had a mixed reaction. So far as I could gather,
the “modern” physicians completely ignored it. This was not surprising, for it was
well known that either they were almost indifferent to the whole problem of
Ayurveda or they were almost hostile to the idea that Ayurveda could contribute
anything to the totality of medicine as a whole—be it either in ‘clinical’ medicine, or
in the therapeutic field. Indeed at a meeting of the Health Council in Hyderabad,
Dr Sen, the then President of the Indian Medical Association made almost a frontal
attack on me for hobnobbing with the Ayurvedists. In my reply I merely stated
that if the research institution at Jamnagar did achieve something, Dr Sen and his
colleagues would certainly thank me for having established it, and in the event it
failed after honest effort to elucidate the fundamentals of Ayurveda, they would
also thank me for having ceremoniously buried it forever! In any case, I said, I was
on a safe wicket!
The Ayurvedic profession was, however, critical. Individually when I talked
to them, they were appreciative of the proposed effort. Collectively, as in the
meeting of their Association, they were, indeed, highly critical! Indeed in the
lengthy “editorial” in the Journal of Ayurveda (October 1951, Vol. 3, No. 7, pp. 211-
216—signed as N.R.A.) it was stated that the Pandit Committee had “prejudged”
all issues. Pointing out that the Chopra Committee had envisaged six different
heads under which research should be conducted, the Committee “had ventured
to suggest that all efforts could be centralised through one channel, i.e. advances
made through clinical research” ... “thus indirectly hinting that all that was inherent
in Ayurveda was perhaps a few drugs and blocking the way of research on the
fundamental doctrines of Ayurveda”.
I was rather surprised at this comment, for in our discussion we had repeatedly
emphasised how important it was to investigate the fundamental principles of
Ayurveda and how it could be fruitfully done through detailed investigation of a
patient, apart from any individual approach towards such a study. Apparently, we
did not make our concept sufficiently clear. The fault was, however, entirely mine
for I had drafted the final report.
The same misconception was evident regarding the criticism on our
recommendations on the training of Ayurvedic physicians. There we had
recommended a higher qualification for admission with adequate knowledge
of physics and chemistry of the I.Sc. standard. Pointing out the difficulties in
implementing of our recommendation, we had drawn attention to the paucity of
teachers. Commenting on this editorial stated that “the Committee are perfectly
prepared to allow a batch or batches of students with the I.Sc. standard, and a
good knowledge of Sanskrit to go and get trained with unsuitable textbooks and
My World of Preventive Medicine 231
Planning for the Future (1948-1965)
by untrained teachers”! Here again, I must confess the fault, if any, was ours, for
we had not stipulated in any detail what was meant by ‘adequate knowledge of
premedical subjects’. Finally, after lamenting on the fact that some members of
the Committee particularly Ganesh Datt Saraswat, Ram Raksha Pathak and even
Dr Yodh had “changed their considered views with an ease bordering on avidity”,
the editorial concluded with the remark that “the Pandit Committee indeed seems
not to have allowed Ayurveda what may be described as a Rommel’s choice - to
commit an honourable suicide and get a Marshal’s burial, or to get executed in
shame and dishonour”!
As was to be expected, the report was considered at a special session of
the All India Ayurvedic Congress. It expressed its opinion thus :
“The Pandit Committee had drafted a scheme for research and there is
not much in it which the Vaidyas are finding objectionable. The main scheme has
been accepted, with the suggestion that the main responsibility of conducting
research in Ayurveda should be of Ayurvedic pandits and not of Allopathic doctors
and that the research in Ayurveda should be carried out in accordance with the
Ayurvedic system of medicine itself and by Ayurvedic scholars only. The Ayurvedic
scholars may, however, take the assistance of other methods of modern medicine
wherever found necessary.
The research institute in Jamnagar started functioning in 1953. There was no
formal opening. Since basic facilities were already available , the members of the
staff, as they were recruited, started working. Dr Pranjivan Mehta , M.D. who was an
Ayurvedic scholar with considerable experience was selected the Director of the
Institute by a Committee headed by Sir Ram Nath Chopra. Initially, the Ayurvedic
team decided to take up the study of ‘Pandu Roga’ —anaemia— since some
work on it had already been done in Jamnagar. However, for a scientific study it
was considered necessary to study ancient texts and prepare a comprehensive
performa to record all observations made on individual patients. It was indeed very
interesting to know the detailed symptomatology of the disease described in the
Ayurvedic texts. Seven shades were described regarding the colour of the urine
and similarly colour of the skin. When the proforma was finally prepared it ran into
seven or eight printed pages! I was told that these were widely in demand from
the other Ayurvedic institutions in the country.
Of particular interest was the statement in the Ayurvedic treatise ‘Vagbhat’. In
describing the treatment it was stated:
“When there is too much loss of blood, the patient should be given blood with
honey added to it, or raw liver containing bile from sheep or deer should be given
to eat.”
If our scientists had taken note of this, who knows, they would have discovered
the vitamin B12!
232 My World of Preventive Medicine
Planning for the Future (1948-1965)
However, everything was not smooth sailing. While it was stipulated, and
agreed, that the patient should be examined independently by the two teams
without any prior consultation, I was told that the Ayurvedic team preferred to
wait till the modern team had made its own observations. The modern team was
advised to take to the study of Ayurveda, in order to enable it to make its own
contribution in the understanding of the Ayurvedic doctrines. This did not happen,
and some members of the team sought jobs elsewhere.
In the meeting of the Governing Body too, there were conflicts. Some
members insisted that research should be undertaken according to Ayurvedic
doctrines. They, however, could not specifically mention what was meant and
in what way the working should be changed. When the question of preparing
“Bhasmas” was mentioned they objected to the use of “modern” implements to
record the temperature. One meeting of the Governing Body was particularly
“stormy.” The Biochemist on the staff had isolated an active principle from the
herb “Ashwagandha” (Withania somnifera) which had shown antibacterial activity,
particularly on S. aureus. After reporting this to the Governing Body, I suggested
that further work should be done at the Drug Research Institute, Lucknow and the
scientist should be deputed to go there for the purpose. This was very vehemently
opposed by one member of the Governing Body, Shri Dhulekarji, on the ground
that the Institute was being developed according to “allopathic” lines and not on
Ayurvedic principles and that I was primarily responsible for this development! I
do not know what happened subsequently but at dinner that night Shri Dhulekarji
was most apologetic and said that when the history of Ayurveda would be written,
my name would be written in gold!
On 2nd November 1955, Pandit Jawaharlal Nehru visited the Institute.
Rajkumari Amrit Kaur asked me to go to Jamnagar a day before to make the
arrangements for his visit. I found, however, that the Director had plans to receive
the distinguished in one room where he had assembled all the exhibits relating to
the working of the Institute. I suggested that it would be more appropriate if he
were taken round the various sections of the Institute where the staff concerned
would themselves explain to him what they were doing. He agreed and the exhibits
were taken back to their respective sections. I, however, suggested that I should
be allowed to the explain the working of the chemistry section where the work on
“Ashwagandha” referred to previously was being conducted.
Pandit Nehru went round the institute as scheduled, along with Shri
Morarjibhai, Shri Debendrabhai and His Highness the Maharaja of Jamnagar
and many others. He evinced keen interest in all the sections and asked staff
many questions. When I explained the work on Ashwagnadha, he immediately
exclaimed, “ Why not send him to Lucknow to complete the work where he will have
full facilities?” When I briefly told him the views of the Governing Body he turned
round and said “Morarjibhai, Ayurveda will not prosper this way!” Subsequently he
wrote in the visitor’s book as follows:
My World of Preventive Medicine 233
Planning for the Future (1948-1965)
“This is a fascinating inquiry going on in this research Institute and it may
well lead to very fruitful results. The so called conflict between Ayurvedic and
modern medicine has to be studied and resolved. The only right approach has
to be one of science, that is, of experiment, trial and error. In whatever type of
medicine we may deal with, we cannot profit by its study unless we apply the
methods of science. In this way there should not be many conflicting methods but
main aspects of one scientific approach. Nothing should be taken for granted.
Everything should be tested and proved and then it becomes a part of scientific
medicine—old and new.”
Jawaharlal Nehru
Nov. 2, 1955.
Soon after Panditji’s visit the Health Ministry suggested that a brochure
explaining in detail the philosophy underlying the working of the Institute should
be brought out for circulation to the members of the Parliament and the general
public. This was done. The brochure contained full information on the working of
the Institute and explained how research was being conducted fully according to
Ayurvedic principles. The role of the team of modern medicine was fully explained.
It was felt that such a detailed presentation would serve as a useful guide to those
who would like to undertake research in this field. The Brochure had the title:
“The Jamnagar Experiment.”
It might be of interest to state here that the Brochure began with a quotation
from Charak, which explains the broad, liberal outlook of the Ayurvedic physicians
of those days:
“There is no end of medical science. Skilfulness in practice should be acquired
from others without feeling any humiliation. Unto men of intelligence the whole
world acts as a teacher; unto men destitute of intelligence the entire world
appears as hostile”!
Charak : Vimanasthana
Chapter 8, SL, 14(1).
Finally under “Epilogue”, it was stated, with a spirit of optimism:
“The Institute in Jamnagar is the first of its kind….In this institute have been
laid the foundations of a vital experiment, the results of which may have far
reaching influence, not only on the future course of Ayurveda, but also of modern
medicine. A new and vigorous system of Ayurveda may emerge out of this study,
new and powerful remedies and newer concepts of health and disease may be
discovered, enriching and enlarging the broad front of medicine. But before the
ultimate objectives can be achieved, there is a long and arduous path to traverse.
The goal can only be reached through patience and perseverance and strict
234 My World of Preventive Medicine
Planning for the Future (1948-1965)
adherence to scientific methodology at all times… The Jamnagar institute does
not set out to prove or disprove anything. It explores and endeavours to discover
the truth. The whole world watches with interest the outcome of the Jamnagar
Experiment”.
Brave words! Yes. But this was what some of us genuinely believed at the
time.
The Institute continued to function for some time, after the publication of
the Brochure. However, it soon became apparent that conflicts were developing
amongst the Ayurvedic profession in Jamnagar over the future set up of Ayurveda.
Those who were in favour of “Shuddha” Ayurveda were the most vociferous. Ayurveda
in the fifties was, to some extent, a political force. I gathered the impression that the
Ministry of Health, Saurashtra, was not keen to continue the work of the Institute
on existing lines but was more keen to start an Ayurvedic School at Jamnagar. A
proposal to establish an Ayurvedic University was also mooted. Indeed the Gulab
Kunwarba Ayurvedic Society had constructed the magnificent buildings which
were considered eminently suitable for such development. It was very amusing
to see how the presence and control of the buildings had dominated the thinking
and influenced the final decisions!
It is not necessary to go further in this controversy. Shri Morarji-bhai succeeded
in persuading Dr Sushila Nayar, the then Minister of Health at the Centre, to hand
over the Research Institute to the Government of Saurashtra which initiated
far reaching changes in the staffing pattern and functions of the Institute. The
‘Jamnagar Experiment’ ended in a total failure!
My World of Preventive Medicine 235
Planning for the Future (1948-1965)
CHAPTER IX
ESTABLISHMENT OF CENTRES FOR
RESEARCH IN COMMUNICABLE DISEASES
I
Establishment of the Virus Research Centre in Poona and my
association with it in the early state of its working
It was sometime towards the end of 1949 that I was travelling from Bombay
to Delhi. When I got into the plane, I was surprised to find Dr Strode of
the Rockefeller Foundation seated next to me. During the course of the
conversation, he asked me who was doing the virus work in the King Institute now.
When I replied that since there was no trained virologist there, I had my doubts
whether virus work could go on there now. However, I said that I was thinking of
starting virus work somewhere in the country under the aegis of the IRFA. “Would
the Foundation help?” I asked. He said that the Foundation would help if that
was contemplated. “What are your plans?” he asked. “But I thought you were no
longer interested in virus research, since you had withdrawn Dr Theiler from the
Laboratories of the International Health Division where he was doing yellow fever
work and put him in research on problems of malaria!” “That was so”, he replied,
“but we are changing our policies, and he is back again in Virus Research. That is
why we could help you if you have any concrete plans to promote virus work in
India”.
There was a background to my thinking in this respect. When I reached Delhi
to take up my appointment, I was told that when the Governing Body of the IRFA
was discussing my appointment as Secretary, IRFA, Rajkumari Amrit Kaur had,
in fact, opposed my being brought to Delhi. She had visited the King Institute
along with Lady Mountbatten only two months before and, apparently, was well
impressed with the work carried on at the Institute. She did not like the idea that
I should be disturbed from doing scientific work. However, she agreed ultimately
with the views of the Governing Body.
Soon after the IRFA had a windfall of three lakhs of rupees. The amount had
been held in abeyance by the Accountant General and they had agreed finally to
release it. When I reported this to Rajkumariji, she suggested that I should utilise
the amount to provide for myself with facilities and funds for conducting my own
researches in an institution in Delhi. I knew, however, this was not going to be
possible, with the commitments I had in building up the IRFA as an active research
236 My World of Preventive Medicine
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