Their Footprints Remain: Biomedical Beginnings Across the Indo-Tibetan Frontier (Iias Publications Series)

303 Pages·2008·1.69 MB·English

by  Alex McKay

publications series
Monographs 1
Their Footprints Remain
T
At the end of the 19th century, Western medicine was introduced into
h
Tibet, Sikkim and Bhutan by British imperial medical officers and e
i
Christian medical missionaries. Their Footprints Remain: Biomedi- r
F Biomedical Beginnings Across
cal Beginnings Across the Indo-Tibetan Frontier uses archival sources, o
o
personal letters, diaries, and oral sources to tell the fascinating story t
p the Indo-Tibetan Frontier
of how the new medical system became imbedded in the Himalayas. r
i
It identifies the individuals involved, including the local employees n
t
of the British, describes how the new system spread, and discusses s

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how it was received by the local people of this region, whose own e A lex McK ay
medical practices were based on an entirely different understanding m
of the world. It will appeal to everyone with an interest in medical a
i
history and anthropology, or the Himalayan world. n

›

Alex McKay has a PhD in South Asian History from the School of
A
Oriental and African Studies (London University). A former research l
e
fellow at SOAS and the Wellcome Trust Centre for the History of x

Medicine at University College London, he is an affiliated fellow at M
the International Institute for Asian Studies in Leiden. His research c
K
centres the history and culture of Tibet and the Indian Himalayas, a
y
particularly during the British colonial period.
‘Alex McKay provides a well-written and thoughtful account that
reflects his wide knowledge and broad approach. This book makes
an important contribution to how we consider the many issues in-
volved in the introduction and spread of ‘Western medicine’ in dif-
ferent parts of this fascinating region.’
— Dr. Susan Heydon, University of Otago
isbn 978 90 5356 518 6
amsterdam university press
www.aup.nl
9 789053 565186
amsterdam university press
McKay_def.indd 1 9-11-2007 18:28:39
Their Footprints Remain
Publications Series
SeriesEditors
MaxSparreboomandPaulvanderVelde
EditorialBoard
Prasenjit Duara (University of Chicago) / Carol Gluck (Columbia University) /
Christophe Jaffrelot (Centre d’E´tudes et de Recherches Internationales-Sciences-
po) / Victor T. King (University of Hull) / Yuri Sadoi (Meijo University) / A.B.
Shamsul (Institute of Occidental Studies / Universiti Kebangsaan Malaysia) /
HenkSchulteNordholt(RoyalNetherlands InstituteofSoutheastAsianandCar-
ibbeanStudies)/WimBoot(LeidenUniversity)
The IIAS Publications Series consists of Monographs and Edited Volumes. The
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parative researchon Europe andAsia andresults fromcooperationbetweenEur-
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basedinLeidenandAmsterdam,theNetherlands.Itsmainobjectiveistoencou-
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Forfurtherinformation,pleasevisitwww.iias.nl
Their Footprints Remain
Biomedical Beginnings Across
the Indo-Tibetan Frontier
Alex McKay
Publications Series
Monographs 1
Cover design:Maedium, Utrecht
Layout: The DocWorkers,Almere
ISBN 978 90 5356518 6
NUR 741 /763
© IIAS /Amsterdam University Press, 2007
All rights reserved. Without limiting the rights under copyright re-
served above, no part of this book may be reproduced, stored in or in-
troduced into a retrieval system, or transmitted, in any form or by any
means (electronic, mechanical, photocopying, recording or otherwise)
without the written permission of both the copyright owner and the
authorof the book.
Contents
Acknowledgements 9
List ofMaps and Tables 13
Glossary 15
Introduction 19
Regionalscope 22
Significance ofthe period 26
Motives 27
The historical context of medicinein the Tibetan world 30
Sources;primaryand secondary 34
Missionaries 40
The Indian Medical Service andthe Subordinate
MedicalService 42
Frontier medicine 47
Environment 49
1 Missionary Medicine and the Rise ofKalimpong 55
Early missionaryapproaches to Tibet throughthe western
Himalayas 61
Darjeeling andthe development of Kalimpong 67
The Church ofScotland Mission 71
Dr. Sheltonand theeasternTibetan frontier 76
Conclusions 78
2 Sikkim:Imperial Stepping-stone to Tibet 85
Sikkimese traditionalmedicine 90
Missionary medicinein Sikkim 91
State development ofbiomedicine 96
Health conditionsin Sikkim 103
The post-colonial generation 106
The modern Sikkimese medical world 110
Conclusions 111
6 CONTENTS
3 Biomedicine and Buddhist Medicine in Tibet 115
Missionary beginnings 115
Early Western medicinein Tibet 116
Medicalwork ontheYounghusband mission(1903-04) 118
The Gyantse dispensary 122
Issues of race and class 127
Smallpox vaccination in Tibet 134
4 Medical myths and Tibetan trends 143
The myth of venereal disease in Tibet 147
Accepting biomedicine in Tibet 153
Biomedicine at Lhasa 157
Biomedicine from other nations 163
Culturalperspectives and concessions 166
Post-colonial developments 168
5 Bhutan: ALater Development 172
Visitsby IMS officers 175
Maharajas andmissionaries 184
The colonialperiod:Some conclusions 187
Post-colonial developments 189
Structures and diseasesin Bhutanesepublic health 193
Medicalethics:A shared belief? 197
Bhutanese traditionalmedicine 199
6 The Choice ofSystems 205
An absence of hegemony 206
Availabilityand cost asfactors in medical resort 210
Nationalist factors in resort 213
Monasticcompetition and therise ofa new elite class 217
The importance ofeducation 219
World views, process,andbiomedicine 221
Patient choice 225
Conclusions 229
Process, policy,and resort 231
‘Enclavism’ and‘resistance’ 234
Intermediariesand patrons 236
Nationalism 239
Ethics andstandards 241
Appendix: Attendanceat Gyantseand Yatung IMS dispensaries 245
Civil Dispensary: Gyantse 245
Yatung 247
CONTENTS 7
Notes 249
Bibliography 285

Acknowledgements
The inspiration for this work came during earlier research into the his-
tory of the British imperial presence in Tibet. At the Tibetan exile cen-
tre of Dharamsala, Westerners could be seen attending theTibetan Tra-
ditional Medicine hospital while Tibetans could be seen attending bio-
medical Delek hospital. Despite this empirical observation, the existing
literature concerning ‘Tibetans’ and ‘medicine’ dealt almost exclusively
with Traditional Medicine. Given that this use of biomedicine was
clearly common throughout the Tibetan cultural world, a study of how
that pattern of resort arose was an obvious lacuna in thefield.
This study was undertaken in the UK, the Netherlands, US, India,
and Bhutan, with the financial and institutional support of a Wellcome
Trust Centre for the History of Medicine at University College London
research fellowship. I wish to thank Centre Director, Professor Hal
Cook, administrator Alan Shiel, secretary Emma Griffin and colleagues
Vivienne Lo, Rhodri Hayward, Michael Neve, and Professors Chris
Lawrence and Roger Cooter for their support, and for sage assistance
in matters Indic and Sanskritic over a number of years, Dominic Wu-
jastyk. I also gratefully acknowledge support from the British Academy
and theRoyal Society. Iespecially wish to thank the International Insti-
tute for Asian Studies (Leiden), in particular the now retired Director,
Professor Wim Stokhof for his long-standing support and encourage-
ment; and the IIAS staff, not least Josine Stremmelaar, Marloes Roz-
ing, andManuel Haneveld.
I have benefited from the assistance and expertise of a far larger
number of people than I am able to thank here. But I am particularly
indebted to all those formally interviewed for this work. Their names
are listed in the bibliography and recording their recollections and
achievements has been a source of great personal, as well as profes-
sional, pleasure. I also wish to thank a number of other colleagues and
friends who have assisted in aspects of this study. They include Profes-
sors Peter Robb, David Arnold, Michael Worboys, Paul Greenhaugh,
and Samten Karmay, as well as Alastair Lamb, T.Y. Pemba FRCS, Hu
Yuan, Roger Croston, Susan Heydon, Biswamoy Pati, Alexandre An-
dreyev, Isrun Engelhardt, Mark Harrison, H. Louis Fader, Francis Gar-