Advice to Officers in India/Chapter 1

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1. AN OUTLINE OF INDIA.—Though every one knows that India is the brightest gem in the British Crown, and the most important colony on the surface of the globe, yet few young officers arrive in the country with correct ideas of its geographical extent; the amount of its population; the quantity of its resources; the variety of its climate and seasons; or the strength of its army and navy. Its length from north to south, viz., from Peshawur to Cape Comorin, is about 1500 geographical miles, and its breadth from the Kybur Pass to Suddya in Assam about the same distance. Its population is computed at 150 millions (about double the population of Russia); its revenue at 30 millions; its army at 400,000 men; its navy of ships equipped for war, at 40;and its European officers nearly as follows:—

Officers of the Line . . . . 6000
Civilians . . . . . . . . 800
Chaplains . . . . . . . . 160
Surgeons . . . . . . . . 862
Indian Navy . . . . . . 260

Its inhabitants are of all shades of colour from the sombre to the fair; of all stamina from the most slender to the most athletic; and of all features from the hideous to the most handsome specimens of human nature. At the extreme east —at Singapore—we find the coarse, rugged,bony features of the Chinese. Proceeding westwards, we find the countenance rounding off through the Malays, the Burmese, and the Assamese, till it arrives at the utmost pitch of elegant form and feature, and effeminacy in the Bengali. Turning to the north-west, we find the mould expanding, the stature lengthening by degrees, and attaining the very beau ideal of manly form and feature in the Rohilla. Crossing the Sutlej, we find in the Seikh, men of still further strength and stature, but with less polish; and on entering Afghanistan, still further development of muscle, though with reduced stature and less refinement; fit companions for horses and camels; beasts of burden as well as stalwart men. Its climate and seasons embrace all varieties, from the tropics to the arctic regions; from the pestiferous Savannahs to the most healthy hills. The face of the country is diversified by the most extensive plains and the loftiest mountains in the world; intersected by the mightiest navigable rivers; with a fertility unknown in temperate countries; where vegetation is never suspended; but a series of crops innumerable double upon one another from one end of the year to another.

2. GOVERNMENT.—The Government of this mighty empire may be classed under two different heads: viz., the home authorities, and those resident in India. Under the former are placed the Board of Control and the Court of Directors; under the latter, the Governor-General of India, the Governors of Bengal, of Madras, of Bombay, of Agra, of the Punjaub, of Oude, and of the Straits of Malacca; each of these delegating his authority, viz., the collection of the revenue and the preservation of the peace, to innumerable commissioners,collectors, judges and magistrates, and downwards through the native grades to the peon or policeman of a village.

3. CIVIL AND MILITAEY ESTABLISHMENTS.— The armies of the three presidencies of Bengal, Madras and Bombay are as distinct as their governments, and differ nearly as widely as if they belonged to different kingdoms. Each presidency has its own commander-in-chief, its own grade of promotion, its own dress, its own code of laws and regulations; even its own language; and unless on the frontier, or on general field service, the armies do not come in contact, nor interchange duties. The European officers are picked men who enter the service as a profession for life,with honours and preferment held out as rewards for professional zeal and talent.

4. QUALIFICATIONS AND APPOINTMENTS.— All appointments to the Service were, till lately, made either by the Board of Control or the Directors. At certain seasons of the year, an estimate was made of the probable vacancies. These were portioned out amongst the Home Authorities, who selected their own candidates. Those destined for the Civil Service had to undergo an efficient preparatory education at Haileybury, those for the military at Addiscombe. Chaplains had to receive their license from Oxford or Cambridge, whilst Assistant-surgeons had to receive their diploma from the royal colleges of London, Edinburgh, or Dublin. Lately these rules have undergone great changes; Haileybury is now abolished as a preparatory college, and the wants of the Civil Service are supplied by public competition; candidates, educated wherever they please, presenting themselves at certain times before a Board of Examiners assembled on purpose, and if found duly qualified, they are passed into the Service. All medical appointments are now filled up in the same way by a medical board of examiners; but all other appointments remain subject to the old mode of nomination. The examination for medical appointments takes place at the India House in July and January; and all information respecting particulars can be got from the secretary in the military department at the India House.

Besides the professional qualifications required, young officers cannot be too careful to improve themselves in education, in the most comprehensive sense of the word. I am of opinion, that general education is too much neglected, and that cadets are too apt to be satisfied with having passed their curriculum without caring much for anything more. To write a good hand; a good essay; to be a good accountant, or a good mathematician; to play a piece of music,or paint a good picture, are no mean accomplishments. Besides, it will be very desirable to have a favourite pursuit to follow when they have nothing else to do. All officers in India may expect to be much left to themselves, to be cast entirely upon their own resources ;and happiest are they who have some pleasant hobby to mount independent of the world, and can take a quiet canter along the monotonous high-ways and bye-ways of tropical existence. But the possession of a hobby is not enough; they ought to be able to physic their own horses and dogs; to superintend the construction of their own houses and baggage carts; to know how to manage a farm-yard and a garden; how to cook their own dinner; brew their own ale; how to ride and how to drive how to shoot and how to sail; how to calculate their pay in vulgar and decimal fractions; and how to balance the debit and credit side of their accounts to the utmost farthing. The cadet, after having passed a creditable examination as a young soldier, may therefore find he has still a great deal to learn.

If an assistant-surgeon, he must be prepared to practice his profession in the most comprehensive sense of the word: no distinction is made between medicine and surgery. Every medical officer must act in either capacity, as circumstances demand, (which is more reasonable after all than drawing a line between two branches which cannot be separated),and perform the duty of aurist, oculist, accoucheur, chemist, and medical jurist, as occasion presents itself.

A cadet cannot enter the service before sixteen, years of age,nor after twenty-two.

An assistant-surgeon before twenty-two years, nor after twenty-eight.

A civilian before eighteen, nor after twenty-three.

A chaplain before being two years in orders, nor after forty.

5. PHOTOGRAPHY.—I would strongly recommend every assistant-surgeon to make himself master of photography in all its branches, on paper, on plate glass, and on metallic plates. I have practised it for many years, and know of no extra professional pursuit that will more repay him for all the expense and trouble (and both are very considerable) than this fascinating study —especially the new process by Collodion for the stereoscope. During the course of his service in India, he may make such a faithful collection of representations of man and animals, of architecture and landscape, that would be a welcome contribution to any museum. The camera should be made of good substantial mahogany, clamped with brass, made to stand extremes of heat. The flimsy, folding portable cameras, made light for Indian use, soon become useless. It is a great mistake to make things light and portable for Indian use, as if the owner himself had to carry them. Carriage for every piece of apparatus is cheap, safe, and abundant. French paper, Canson frères is the best, and does not get damaged by damp so soon as English paper.

6. MEDICAL LIST.— The present strength of the Bengal list is 414. Of these, the first 22 are called senior-surgeons;the next 120, surgeons; and the remainder, assistant-surgeons. Of the senior-surgeons, the first 3 compose the medical board, and are styled physician-general, surgeon-general, and inspector-general. The next 12 are denominated superintending-surgeons,one of whom is posted to a division of the army, and to whom is intrusted the superintendence of the medical duties; the remaining senior-surgeons and the surgeons are posted to regiments and staff appointments. By far the majority of the assistant-surgeons have independent charges of their own,being qualified to hold regimental and civil stations after having been two years in India, and having passed a colloquial examination in Hindostanee.


Medical Establishments Bengal. Madras. Bombay. Service or promotion.
Bengal. Madras. Bombay.
Members of Board 3 3 3
Superintending Surgeons 12 10 5 41 34 31
Surgeons 12 10 5 41 34 31
Assistant Surgeons 274 171 146 14 17 15
414 247 201 Total, 862.
Members of the Medical Board rank as Brigadier General.

Senior Surgeons as Majors.
Surgeons as Captains.
Assistant Surgeons as Lieutenants.

Promotion from assistant to surgeon is regulated by seniority alone. All surgeons of thirty years' standing are promoted to be senior surgeons, but the offices of superintending surgeon and member of the Board were, in 1842, declared staff appointments, to which seniority gave no claim; however, with a few exceptions, these have been filled up by seniority. It is somewhat remarkable, that promotion to the rank of senior surgeon is but an empty name, for by G. O. it "confers no claim whatever to superior allowances, and will make no change whatever in the nature of their employment." They get the rank of major at thirty years' service, but no corresponding increase of pay. In my opinion, this restriction is calculated to injure the public service most materially. An increase of pay, after having served 16 years as surgeon, was urgently called for. No surgeon can calculate upon any future increase of emolument now;and large numbers discouraged by this invidious distinction, retire from the service in the prime of life, when their skill and experience are of the greatest value to the state, and the higher duties of the profession are carried on by the aged and the infirm, or by men tied to the service by large debts or large families.

7. RANK.—Previous to embarkation, the assistant-surgeon must take the oath of allegiance to the East India Company at the India House; and then he will receive a certificate of his appointment to one or other Presidency,for which he will have to pay £5. Some months after his arrival in India, he will be presented with two commissions; one signed by the Governor-General and Council, confirming him in the Company's army; the other by the Commander-in-chief, conferring upon him the same privileges in the royal army in India. The fees upon these two commissions amount to about £4.

Formerly, the rank of all Company's officers was limited to India and to the eastward of the Cape of Good Hope; but in Europe, and westward of the Cape, it was null and void, and a major, a colonel, or a general returning home, became a simple layman. Of late, this invidious anomaly was abolished, and the Company's officers are allowed to rank on the same grounds with those of the royal army all over the world. They are thus qualified for entering the royal army.

8. MEDICAL BOARD.— The highest grade in the Medical Service is the Medical Board, composed of the three senior surgeons on the list, with a secretary, who is either a surgeon or an assistant. Members of the Board are obliged to vacate office after having held their appointments five years, but superintending surgeons are not so restricted. Their duties are to superintend the whole medical department; to receive health reports; to check supplies;and to make such suggestions for the health of the army as they may think proper; in fact, their duties are almost executive. They are allowed no exercise of patronage; they may recommend medical officers to the favourable consideration of Government; but all nominations are made either by the Governor-General,the Deputy Governor, or the Commander-in-chief. Their influence in their own department is,therefore, very circumscribed, and the Board has become a refuge for the three longest livers, rather than a college of health,omnipotent over their profession.

9. SUPEEINTENDING SUEGEON.—The grade of superintending surgeon (as has been before mentioned) was,in 1842, abolished, as a step between that of surgeon and the Board. The office is considered that of a staff appointment, to which any one of any standing is eligible to be nominated. However, the twelve seniors have hitherto held office, one being attached to each division of the army. The duty of superintending surgeon is to make an annual inspection of all the hospitals in his division; to collect weekly,monthly, or quarterly reports from the various medical offices; to receive and pass indents for articles wanted for the public service; to give such directions to his subordinates respecting the treatment of the sick, as he deems proper; in short, he is commanding officer on medical matters, and communicates the results to the Medical Board. But further than making temporary recommendations for the performance of duty, he is allowed no patronage.

10. SUEGEONS AND ASSISTANTS.— It is not possible to draw a distinction between the duties of surgeons and assistants, as both are for the most part independent of each other. In European regiments, every surgeon has two or three assistants under him, but by far the greater number of those enrolled as assistants hold independent charges quite as important as the surgeons. No regiment of Native Infantry has more than one surgeon or an assistant, and the duties of all civil stations are entrusted to assistants. Most civil appointments must be given up on promotion, or promotion must be given up to retain the appointment. Most staff appointments are now open to assistant-surgeons. Numerous appointments, exclusively filled by surgeons, are now filled by assistants. In fact, the greater number of the prizes of the seniors have been withdrawn, and the duties assigned to the juniors on greatly reduced allowances.

11. SLOWNESS OF PROMOTION.—Of late years, in consequence of the annexation of Scinde, of the Punjaub and Pegu, large additions were made to all branches of the army, and almost every officer received substantial steps of promotion.

'Tis true that corresponding additions were made to the medical list. On one occasion twenty or thirty were added to the bottom of the list of assistant surgeons which benefitted nobody,and on another occasion, twelve were added to the bottom of the list of surgeons which benefitted the surgeons of that day nothing. The juniors alone reaped the advantages and got their promotion in thirteen years, whereas the surgeons who had served sixteen and seventeen years as assistants, were overlooked and got no corresponding promotion. Indeed the spirit of the times seems to be to lower the emoluments of the seniors and reduce the inducements to continue in the service, as the eagerness with which the fund annuities are taken up, amply demonstrates.

The medical officers have again and again memorialized against their grievances but to no purpose; they feel that they have been looked upon as a discontented troublesome set of men,and that they have been treated accordingly with neglect.

These remarks are penned with no desire to decry the medical service of the Indian army, but with the best intentions of pointing out circumstances that are calculated to lower it in the estimation of the world and to operate against its efficiency. They are written unbiassed by self interest and unprejudiced by any feelings of resentment, and in the hope that the still small voice uttered in this chapter may not be in vain.

12. SUBORDINATE MEDICAL DEPARTMENT.— The "Subordinate Medical Department" is principally intended for European troops, and consists of Apothecaries and Stewards, the former for the compounding and distribution of medicines and minor surgical operations; the latter for the clothing and diet of the hospitals. Most of them are Europeans, some, the sons of European soldiers who have not had the benefit of an education in Europe. They enter the service as hospital apprentices on the pay of thirteen rupees a month, after two years service they may be promoted to assistant apothecaries or assistant stewards on seventy rupees a month, and after about nine years spent in that grade, they are promoted with pay of 120 or 140 a month. To every European regiment there is an apothecary and a steward attached with one or more assistants, and an important part of their duty is to write the very numerous returns required from all such hospitals.

13. NATIVE DOCTORS.—Every medical officer in charge of native troops and jails, is assisted by one or two native doctors whose duty is to compound medicines and see that they are taken; to attend the sick in the absence of the surgeon; and perform the minor operations of surgery. Previous to 1835, these young men were educated at the Calcutta Medical School, superintended by the late Dr. John Tytler, and all expressly for the public service. About this time the above school was abolished and the New Medical College instituted in its stead.

14. NEW MEDICAL COLLEGE.—This institution was founded in 1835 as an improvement upon the old Tytler school to supply the demands of the subordinate medical department and to diffuse European skill amongst the native community. At first, there were only three professors appointed to it, but these have from time to time been increased in number, till the College is placed on a scale of efficiency equal to our Home Schools of Medicine. The professors now amount to twelve, all members of the medical service; the students amount to about 240, and there is a magnificent new hospital attached, capable of containing two or three hundred patients. The prejudices of the natives against the taint of dead bodies has been overcome, and practical dissection is carried on at all seasons and with alacrity; degrees and diplomas are granted, and the course of study is acknowledged by our English schools to qualify for English degrees. The students of highest attainments, are styled sub-assistant surgeons, and are appointed to the numerous dispensaries established in most large cities, or to minor civil stations;during their course of study most of the students receive subsistence from Government, at the rate of five or more rupees a month. Their education costs them nothing, and their pay as sub-assistant surgeons runs from two to three hundred rupees a month.

All lectures are given in English, and the students exhibit a degree of zeal and application and even of proficiency highly creditable to them. Having officiated for a year as lecturer in clinical medicine in the College, I have had the best means of judging of native talent guided by European tuition. In the provincial dispensaries, I have seen them perform the capital operations of surgery with a degree of coolness,and self possession and dexterity worthy of all approbation. Several of the Calcutta students have highly distinguished themselves and taken high honours in our London schools, and one of their number lately passed a successful examination for a commission, and now is enrolled in the Bengal list of assistant surgeons— Dr. Chuckerbutty.

In all the principal cities of the Bengal Presidencythere are dispensaries supported by Government, and placed under the medical charge of a sub-assistant-surgeon. By a recent return, I find that the following is the result for one half-year only,inclusive of the Punjaub:—

Patients (out-door).... 127,778
Patients resident .... 4,719
Surgical operations .... 1,127

It is remarkable,that the natives generally have a great aversion to vaccination,and prefer the old mode of inoculation; for I believe this is still allowed, without any infringement of the law,as it would be if practised in England.

15. NATIVE SKILL.— The healing art has been practiced from time immemorial, amongst the natives, by self taught practitioners, and their precepts have been handed down from generation to generation as a valuable inheritance to their children. Every village has its doctor, and every village doctor has his thousand cures for all the ills that flesh is heir to. Many of their remedies are worthy of a place in our more enlightened codes, and have indeed been adopted, and their success in surgery in cases of cataract and calculus is wonderful,considering their ignorance of anatomy. Of course superstition, charms and philters form a large portion of their treatment.

16. MEDICAL LITERATURE.— This, like other branches of periodical literature in India, has hitherto not been of that healthy progressive character peculiar to temperate climates where its contributors have fixed abodes and are dependent in a great measure upon the position they can occupy in public journals; Calcutta once had a medical society with a numerous list of subscribers and a very creditable series of transactions, but, like most other societies it declined with the demise of its original members and long has ceased to exist. Since then, various journals conducted by individual enterprise have followed,but even these died prematurely.

Lately a valuable new journal, called the Indian Annals of Medicine, published half-yearly, has been established in Calcutta, and is at present the only representative of the profession in Bengal, its pages being occasionally enriched by official communications sent to and presented by the Medical Board.

About 20 years ago, the Supreme Government called upon the medical service for topographical reports of their respective charges holding out patronage and promotion to distinguished contributors. Contrary to what was expected, comparatively few came forward, and not more than half a dozen treatises met with approbation, the first of the series being the topography of Calcutta, by Dr. Martin. These were published at very considerable expense by Government, and distributed throughout the public offices of the presidency, and my topography of Assam was one of I that number, but I fear the rewards bestowed on such successful candidates, were not such as to encourage the Service generally to go and do likewise.

When men win prizes in the race of competition and receive nothing but the ordinary rations served out to those who never entered the lists, it is not encouraging towards the performance of extra professional services, and the Government is a loser by the neglect. The medical department as a body yield to none in a well grounded education, and a diversity of talent well fitted to advance the cause of science in all its departments, but where extra professional labours are required, and satisfactorily complied with, some adequate remuneration is necessary to insure a continuation of them.

17. MEDICAL ETIQUETTE.— A very good feeling generally prevails throughout the profession, re-markably contrasting with the fierce rivalry and wrangling so often seen at home. Medical etiquette forbids the surgeon of one corps attending the officers or families of another corps without the knowledge and consent of its surgeon. Officers who do not wish to give offence to their appointed medical attendant, will always express to him their wishes if they want the opinion of another surgeon, and a ready compliance will always be found, and a consultation the result. At the same time it must be borne in mind that it is the duty of any surgeon to visit any patient on any emergency when called on to do so, transferring the case afterwards to the surgeon of the corps that the sick officer belongs to.

18. DUELLING.—This has now become an obsolete practice. The world and the legislature have put it down, officers have seen the folly, the barbarity of the old mode of demanding satisfaction, and a duel is now a much rarer occurrence than a deliberate murder. It is now a branch of military law to fight a duel. In all cases, both principal and seconds must undergo the ordeal of a court martial, involving the risk of loss of commission, and in fatal cases the risk of being indicted for manslaughter or murder. Nor are insults and outrages more frequent from the suppression of the duello; on the contrary, I believe they are reduced in number; nor is the vindication of insulted honour the less, but satisfaction is obtained by other measures. When an insult is offered, the usual course to follow is to leave the spot immediately and without altercation, and either by letter or the medium of a friend, to demand explanation and apology. In most cases, this is complied with, but if it is not, then the alternative is to make a public complaint to the commanding officer and leave the affair in his hands. To take no measures to obtain reparation for insulted honour, subjects the officer insulted to the ordeal of a court martial.

19. PAY.— The pay of an Assistant Surgeon at a half batta station, is C.R. 225 12 per month, and at a full batta C.R. 256 10, and if in medical charge of a regiment, C. R. 165 is added as staff allowance, medical officers in charge of departments, are allowed C.R.12½ rupees for every 100 natives per month, and 25 percent, for Europeans. All stations within 200 miles of Calcutta, are considered as on half batta, and the difference of an assistant's pay between half and full batta, is C.R. 30 a month.

The following table will show the rates of pay of surgeons and assistants in the different branches of the Service.


Branch. Rank. Horse Allowance Tentage Staff Allowance Pay and Indian Allowance Extra Batts. Total.
Horse Artillery Surgeons 90 75 300 306 11 4 91 5 0 863 0 4
Assistants 60 50 .. 194 6 0 60 14 0 365 4 0
Foot Artillery Surgeons .. 75 300 267 5 0 91 5 0 733 10 0
Assistants .. 50 .. 154 14 0 60 14 0 265 12 0
Cavalry Surgeons 90 75 300 306 11 4 91 5 0 863 4 0
Assistants 60 50 .. 194 6 0 60 14 0 365 4 0
European and Native Infantry Surgeons .. 75 300 249 1 0 91 5 0 715 6 0
Assistants .. 50 165 145 12 0 60 14 0 421 10 0
Members of Medical Board C.R. 2409 13   per month
Superintending Surgeons, upper provinces, C.R. 1600     per month
SuperintendingDitto Surgeonsditto, Bengal, C.R. 1266 10 8 per month
Europeans, C.R. 25 per cent.
Natives, C.R. 12½ per cent.

From the preceding table it may appear a very simple matter to know what one's allowances are, but experience will show that it is indeed a very perplexing one and subject to many anomalies. All accounts of pay, must sooner or later have the sanction of the Military Auditor General. In general, these accounts do not come under his eye for a year or two after their disbursement and retrenchments are made upon pretexts most unlooked for, and upon interpretations of orders, assented to no where but in the audit office.

The audit office is a sort of Court of Chancery, as well known in India as Doctor's Commons is in England, where equal skill is brought into play to ward off the just claims of its constituents by prolonged litigation, until forced to disgorge by an appeal to the Governor General in Council.

The Auditor-General's hand is in every man's pocket, and the good intentions of a liberal Government are often thwarted by the vexatious despotism of this official. Few officers have passed through the service without at one time or another feeling aggrieved by these retrenchments.

20. PRIVATE PRACTICE.—Young men come to India with the idea that they will soon make their fortunes by private practice, but generally speaking, fees arc rare. Now and then a well paid staff-officer or a civilian gives something handsome, but even such are much rarer than they wont to be. Regimental surgeons have no right to demand a fee from any officer of the regiment or for his family, but Government have passed an order that civil surgeons have a right to remuneration for attendance on the families of civilians. As for native practice virtue alone is often its own reward. The natives are bad payers, and those who make anything of consequence by it, obtain it only by haggling and getting paid in advance, a system that few officers can submit to. Now and then their gratitude is expressed by a bunch of plantains or a fat kid, but that virtue is of a very evanescent character.

At one time, Government prohibited Europeans from receiving fees from natives,but that restriction has now been withdrawn. In most cases, the natives prefer their own countrymen as their medical attendants, and take the advice of European skill only in extreme cases or where they hope to profit by the influence of their medical attendants.

To one not initiated in the customs of the East, the mode of attendance on native ladies of rank must appear very absurd. The doctor is rarely, indeed, allowed to see his fair patient face to face. In most cases, the lady throws the door slightly open and extends her hand through the slit for him to feel her pulse, or in the event of his being admitted into the Harem, the patient lies in bed shrouded in curtains and exposes the tongue or the seat of disease through a hole in the curtain made expressly on purpose. Nor is this modesty confined to the young and the beautiful, but the old, and for what is known to the contrary, the ugly also are equally shy in exposing their person.

In Calcutta, private practice forms the principal source of income, and though the pay of a presidency surgeon is far below that of a regimental one, yet their appointments are eagerly sought for. The scale of remuneration varies with the income of the family attended, and runs from 200 to 800 rupees annually, or one week's pay of the head of the family.

Formerly, all surgeons at the presidency had the privilege of having the prescriptions for their patients, whether of or not of the service,made up free of expense at the Government Dispensary. Of late, this boon has been withdrawn, the doors of the dispensary have been closed against all dispensation and the wants of the sick are supplied by numerous druggists who drive a very flourishing trade in consequence. Very few practitioners not in the service, contrive to maintain a favourable position in practice in Calcutta unless through their capacity of druggists.