"It is better to sit than to walk, to lie down than to sit, to sleep than to wake, and death is the best of all," says the Brahman proverb.
Taking into consideration the points with which the preceding chapter is concerned, the question naturally arises as to how the Indian is affected by his own peculiar sanitary habits. That question may be answered in the words of an American scientist now studying in the country:
"From long consumption of diluted sewage they have actually acquired a degree of immunity. Yet all of them are walking menageries of intestinal parasites, which make a heavy drain upon their systems and which inevitably tell when some infection, such as pneumonia or influenza, comes along. Then the people die like flies. They have no resistance."
These conditions, added to infant marriage, sexual recklessness and venereal infections, further let down the bars to physical and mental miseries; and here again one is driven to speculate as to how peoples so living and so bred can have continued to exist.
A reply is thus couched by one of the most eminent of European International Public Health authorities:
"It is a question of adaptation, and of the evolution of a sub-grade of existence on which they now survive. The British are to blame for the world-threat that they constitute. If the British had not protected them, the virile races of the north would have wiped them out."
The superior virility of the northern races--including the Sikhs, and more especially the Pathans and other Muhammadan stocks--is favored by their superior diet. These hardy out-door folk are all large meat-eaters, and consume much milk and grain. The diet of the southern Hindu has little in it to build or repair tissue. He subsists mainly on sweets and carbo-hydrates, and, to the degree that he is able, he leads a sedentary life. Diabetes is often the incident that brings to its early close the career of the southern Indian public man.[1]
[1. For an extended exposition of this subject see The Protein Ele* ment in Nutrition, Major D. McCay, I.M.S., London, Edward Arnold 1912.]
Lieutenant-Colonel Christopher, I.M.S., Director of the Central Research Institute of the Government of India, in a paper called "What Disease Costs India," has said:[2]
[2. Indian Medical Gazette, April, 1924, pp. 196-200.]
The deaths in India annually number about 7,000,000, i.e., very nearly the population of greater London...Now all men must die, but it is to be hoped that each will have a run for his money...During the first year of life, the [Indian's] expectation of life is...about twenty-three years. At the age of five it is thirty-five years, the highest expectation at any age."
And Colonel Christopher further points out that so heavy a mortality inevitably indicates a background of widespread and continuous sickness, of reduced productivity, of enhanced costs of administration, and of penalized trade, whose combined tax upon the resources of the country, though difficult to calculate, cannot but be an enormous moral and economic burden to support, a heavy drag upon prosperity.
For this great field of need the lack of means is always conspicuous. For 1925-26, some of the provin-cial budgets showed the following items:[3]
[3] Indian Y ear-Book, 1926, pp. 89, 97, 107, 118.]
Education Public Health
Bombay Presidency $6,959,700 964,700
Madras Presidency 6,211,100 1,054,500
United Provinces 5,713,000 493,700
Bengal 4,322,000 880,000
The open road to better conditions is clear, and, alas, untrodden. One finger-post reads thus:[4]
[4. Statement Exhibiting the Moral and Material Progress...of India During the Years 1923-24, London, 1924, pp. 211-12.]
The necessary preliminary to any satisfactory advance...is the growth among the educated classes of a missionary and humanitarian spirit which will lead them to consecrate time, money and energy to the task of ameliorating the conditions in which their less fortunate brethren live...India can never be safeguarded from a disastrous death rate, punctuated by heavy epidemics, until her people can be weaned from their tenacious adherence to social observances which are as diametrically opposed to public health as they are to economic prosperity.
But that humanitarian spirit does not today exist.
Curiously lucid contributions on this line come from Mr. Gandhi; speaking as of Hindu medical men, he says:[5]
[5. Mr. Gandhi's statements quoted in this chapter will be found in his Indian Home Rule, Ganesh & Co., Madras, 1924, pp. 61-2.]
It is worth considering why we take up the profession of medicine. It is certainly not taken up for the purpose of serving humanity. We become doctors so that we may obtain honours and riches.
After which he affirms:
European doctors are the worst of all.
Amplifying his accusation, Mr. Gandhi continues:
These [European] doctors violate our religious instinct. Most of their medical preparations contain either animal fat or spirituous liquors; both of these are tabooed by Hindu and Mahomedans.
And again, more specifically:
I overeat, I have indigestion, I go to a doctor, he gives me medicine. I am cured, I overeat again, and I take his pills again. Had I not taken the pills in the first instance, I would have suffered the punishment deserved by me, and I would not have overeaten again...A continuance of a course of medicine must, therefore, result in loss of control over the mind.
"In these circumstances," he concludes, "we are unfit to serve the country." And therefore "to study European medicine is to deepen our slavery."
Whatever may be thought of Mr. Gandhi's judgment, his sincerity is not questioned. Holding such an opinion of the motives and value of western medical men in India, it is scarcely surprising that, in the period of his "non-cooperation" campaign against Government and all its works, not excepting its educational efforts, he should have exhorted medical and public health students to desert their classes and to boycott their schools.
Boy-fashion, they did it--for a time--and at what a cost to India!
The other side of this phase of Indian nationalism is its enthusiasm for the Aruvedic or ancient Hindu system of medicine under which a large part of the native population is today being treated, more particularly in Bengal and in central and southern India.
This system is held to have been handed down from the gods in earliest times, and to be of spiritual and inspired nature. Some hint of its quality may be gathered from an excerpt from the Sushruta Samhita, one of the two venerable works on which the system is based.[6]
[6. Translation of Kaviraj Kunja Lal Bishagratna, p. 270.]
The favourable or unfavourable termination of a disease may be predicted from the appearance, speech, dress and demeanour of the messenger sent to call a physician, or from the nature of the asterism and the lunar phase marking the time of the arrival, or from the direction of the wind blowing at the time, or from the nature of omens seen by him on the road, or from the posture or speech of the physician himself. A messenger belonging to the same caste as the patient himself should be regarded as an auspicious omen, whereas one from a different caste would indicate a fatal or an unfavourable termination of the disease.
Several works on modern Aruvedic practice have been published. These make the claim that the Sush-ruta anatomy and surgery of two thousand years ago were far superior to those of modern western science, and deduce that as Aruvedic methods have undergone no serious change since that time, they must be practically perfect. Says Sir Patrick Hehir:[7]
[7.The Medical Profession in India. Major-General Sir Patrick Hehir, I.M.S., Henry Frowde and Hodder and Stoughton, London, 1923, p. 104.]
One of the principles of the system is that diseases are the result of the operations of evil spirits who have to be pacified by various offerings and propitiated by incantations. Regarding the diseases of children it is stated[8] that these "are due to the action of certain spirits who were belated in obtaining lucrative posts in the retinue of the Destroyer and were compelled, to secure power, to tax sorrowing parents, who might have committed any of the hundred-odd ritual faults by afflicting their offspring." One searches in vain for anything approaching definite and rational therapeutics in this system. We have [here] in a modern Aruvedic work a complex combination of drugs extolled as being able to cure such diverse conditions as obesity and gonorrhea, and another extensive combination alleged to effect a cure in all diseases of women however caused.
[8. Quoted from Kaviraj Nagendra Nath Sen Gupta, The System of Medicine, 3 vols., Calcutta, 1909.]
My personal enquiry into Aruvedic surgical cases Was limited to two instances. The first was that of a little boy who walked into a Madras Presidency hospital one day in 1925, carrying his own forearm as a parcel, with a request to the British surgeon in charge, from a well-known Aruvedic doctor, to sew the forearm in place.
The history of this case was that the arm had sustained a compound fracture, the bone sticking through the flesh in an open wound. The Aruvedic doctor had first applied cow-dung to the open wound and then had clapped on splints, which he bound tight with strips of freshly-peeled tree-bark. The weather being hot and dry, the bark had contracted rapidly and produced extreme pressure. The circulation stopped, dry gangrene set in and the arm sloughed off at the elbow. Seeing which, the Aruvedic man thought it time to invoke the courtesies of the profession and to suggest the western needle.
The second case occurred in 1926, in the same prov-ince. An Aruvedic doctor attempted to operate according to his code upon a man having an enlarged gland in the groin. Holding his patient down, and without an anaesthetic, he opened the gland. As the knife went in, the patient jumped, an artery was cut and the peritoneal cavity slit open. The doctor, knowing no anatomy, then took his patient to a near-by government dispensary. But there the little dispensary man in charge, an Indian, out of sheer terror pushed the risk away.
"I am not meant for this sort of thing," he protested. "I am only meant for minor surgery. Take the man on to a hospital."
But before reaching the hospital the man died.
Action for manslaughter was brought by the police against the Aruvedic physician. But an association of Indian doctors holding western degrees, many of whom were in Government employ, defended his case and paid the expenses. "Our fine old Indian system must not be attacked," they said. Their lawyers first got the defendant off on a technicality; and then secured the prosecution of the little dispensary man for criminal delay.
The common arguments in favor of the old system are that it is cheaper for the people, that it particularly suits Indian constitutions and that it is of divine sanction and birth. Leaving the last tenet aside, as not in the field of discussion, we find that the cost of running an Aruvedic dispensary is much the same as that of running a dispensary on western lines;[9] and that no material difference has ever been discovered between white man and brown, in the matter of reaction of medicines upon the system.
[9. The Medical Profession in India, p. 116.]
The Montagu-Chelmsford Reforms, however, have occasioned a great recrudescence of native medicine. Provincial ministers dependent on popular vote are prone to favor spending public money to erect Aruvedic and Unani[10] colleges, hospitals and dispensaries. With the Indian National Congress claiming that Aruvedic medicine is "just as scientific as modern western medicine," with such men as Sir Rabindranath Tagore, the poet, fervently declaring that Aruvedic science surpasses anything the West can offer; and with Swarajists in general pushing it forward on patriotic grounds, you get the melancholy spectacle of the meager appropriations allotted to medicine and public health, in this most disease-stricken of lands, being heavily cut into to perpetuate a "science" on the same level as the "voodoo doctoring" of the West Indian negro.
[10. The ancient Arabic school of medicine.]
That the old native systems still exert a strong hold on the imaginations of the masses cannot be questioned. Also, like the voodoo doctors, they teach the use of a few good herbs. These two points enable their practitioners to induce enough "cures" to keep their prestige alive.
But once upon a time it chanced that Mr. Gandhi, having widely and publicly announced that "hospitals are institutions for propagating sin";[11] that "European doctors are the worst of all," and that "quacks whom we know are better than the doctors who put on an air of humaneness,"[12] himself fell suddenly ill of a pain in the side.
[11. Indian Home Rule, p. 61.]
[12. Ibid., p. 62.]
As he happened to be in prison at the time, a British surgeon of the Indian Medical Service came straightway to see him.
"Mr. Gandhi," said the surgeon, as the incident was reported, "I am sorry to have to tell you that you have appendicitis. If you were my patient, I should operate at once. But you will probably prefer to call in your Aruvedic physician."
Mr. Gandhi proved otherwise minded.
"I should prefer not to operate," pursued the surgeon, "because in case the outcome should be unfortunate, all your friends will lay it as a charge of malicious intent against us whose duty it is to care for you."
"If you will only consent to operate," pleaded Mr. Gandhi, "I will call in my friends, now, and explain to them that you do so at my request."
So, Mr. Gandhi willfully went to an "institution for propagating sin"; was operated upon by one of the "worst of all," an officer of the Indian Medical Service, and was attentively nursed through convalescence by an English Sister whom he is understood to have thought after all rather a useful sort of person.