Reflections On The Evolution of Pharmacology in India During Twentieth Century
Reflections On The Evolution of Pharmacology in India During Twentieth Century
Reflections On The Evolution of Pharmacology in India During Twentieth Century
SPECIAL ARTICLE
PHARMACOLOGY IN TWENTIETH CENTURY
Revised: 19.12.98
Accepted: 23.12.98
SUMMARY
The paper traces the genesis of Pharmacology in India, to the early pioneers. It reflects on several
facets and trends in the growth of Pharmacology during the current century under several subheads:
Pharmacology and clinical care; Pharmacology as a career; Nonmedical personnel in Pharmacology;
Undergraduate teaching of Pharmacology; Pharmacology, Pharmacy and Pharmaceutical companies;
Postgraduate training in Pharmacology; Research; Clinical Pharmacology; Animal experiments. It
concludes reflecting on the glowing role of Pharmacology in this century and its promise for the coming
millenium.
KEY WORD
Pharmacology
clinical pharmacology
Pharmacology took shape as an independent subject at the beginning of 20th century. This paper is a
brief recapture of the early pangs of its birth; growth
in India and ramifications till it reached its present
stature. The names of men and institutions have been
mentioned as land marks in the development of this
vibrant and progressive science. There are many,
not mentioned here but whose contributions have
been equally significant and magnificent. This paper attempts to present different facets of Pharmacology and the background, which influenced its evolution during this century.
Dr. V Iswaraiah1, gave us a glimpse of Pharmacology at the beginning of the century. As a student in
Madras Medical College in mid thirties, the writer
(Iswaraiah) studied what was then called Materia
Medica (Drug Vendor or Drug Peddler). When I went
to specialize in the subject, conservative Edinburgh
still stuck to the name. At Madras, the teacher of the
subject then was a retired military assistant surgeon
(I.M.D.) whose academic qualification was about the
same as L.M.P. with which we are familiar today. The
subject was taught with Anatomy and Physiology in
the preclinical period or Second year. We had to
commit to memory 18 preparations of opium (Pilula
plumbi Co., Pilula Saponis Co) and over 25 laxatives
or purgatives ranging from castor oil to croton oil with
innumerable intermediates: Anthracene, Sulphur and
india
twentieth century
P.S.R.K. HARANATH
Chemical Pharmacology with a Professor to synthesize compounds for research. Lucknow has been
an active centre for development of Pharmacology
over the years with contributions from KG Medical
College, CDRI, and National Laboratory for Industrial Toxicology Research, Central Institute of Medicinal and Aromatic Plants, National Botanical Research
Institute etc.
in Osmania General Hospital, Hyderabad till his retirement in 1946. He was succeeded by Dr MY
Ansari, PhD (1943) who worked with AJ Clark and
JH Gaddum 6. Pharmacologists who had beds in
the hospital were irked slowly when they had no powers of admission and had to take responsibility for
emergencies. Some felt it better to relinquish this
half-baked arrangement.
V Iswariah MRCP (Applied Pharmacology & Medicine) and FRFPS (Medicine & Therapeutics) succeeded BB Dixit as Lecturer in Pharmacology,
Visakhapatnam A.P. in 1932. He fiercely fought for a
clinical attachment and got a permission to work
under Physician Unit II of the attached KG Hospital.
He used to attend the OPD of Veneriology and Dermatology for over 10 years. He formulated the syllabus for M.D. Degree as Pharmacology and Therapeutics with 2 examiners in Pharmacology and 2 in
Medicine for Therapeutics, with a paper in Medicine
and the Essay in Therapeutics & Pharmacology.
There was a clinical examination with long & short
cases, in addition to laboratory animal experiment.
The author of this paper took M.D. in Pharmacology
& Therapeutics with Dr. Iswariah in 1952 under the
above set up. At Andhra Medical College, Government issued orders allotting 5 beds in the K.G. Hospital Visakhapatnam to Professor of Pharmacology
in 1954. However, this was not implemented by the
then Principal, a Physician who remarked Today
Pharmacology wants beds, tomorrow Anatomy wants
beds! I could with difficulty persuade the clinicians
to use chlorpromazine to treat hiccups and published
a paper. The Dept. of Obstetrics however declined
my suggestion to use chlorpromazine in Eclampsia,
till it was tried 3 years later at Madras Medical College.
P.S.R.K. HARANATH
P.S.R.K. HARANATH
P.S.R.K. HARANATH
training received by a PG ranges from nil to excellent and varies between institutions.
At the end of the first year part I examination in general medicine with a common paper for all non-clinical subjects is held in some universities with professors of pharmacology and not medicine valuing the
papers. The final examination has 3/4 papers, usually set by external examiners. In some institutions
the internal examiner has a choice of selecting the
questions sent by externals either on the day of examination or earlier. In general, candidates do study
well and are better informed though no syllabus is
outlined. Only previous years question papers guide
them. The questions are so vast, vague and wide in
scope from the historical aspects to the latest and
vary from veteran to young examiners. Practical examination consists of a long experiment on a dog/
cat with parameters like respiration, blood pressure,
and intestinal movements/ spleen volume. This is
followed by a bioassay on an isolated tissue like
guineapig ileum with a test substance acetylcholine/
histamine (carried over into the night) with the varnished graph kept ready for next day. There may be
a chemical assay. The Viva is fairly long, satisfying
to the examiners and difficult to candidate.
PGs should be more familiar with experimental pharmacological techniques of different systems in the
body, latest technical developments in pharmacology, use of equipment like polygraphs (though hardly
few in the country in medical colleges), colorimetry,
chromatography, biochemical and enzyme techniques. There is a need for planned and well-defined syllabus of experiments to be practiced by PGs
as a routine, taking into consideration the availability
of animals equipment etc. While we are yet to formulate guidelines, Government is setting up committees to supervise animal experiments, and even
the little biological training to PGs will be in jeopardy.
PGs knowledge of chemistry, comprehension of
mathematical formulae, calculus, and understanding
a research publication in a contemporary journal of
pharmacology is limited. Biology, physics & chemistry (organic & inorganic) taught in pre registration
course for 6 months in 1940s, were shifted to the
first year MBBS course in 1950s and altogether deleted by 1970s when 12 year school education with
enlarged syllabus was introduced. Medical entrance
test papers of recent years reveal that their stand-
ards are far higher than those of 1950s at pre medical level are. The new entrants have good knowledge of chemistry, statistics and calculus, which definitely improved their understanding of biochemistry.
Pharmacology also requires a good back ground in
these subjects. But the staff of pharmacology, with
their own limited knowledge in organic chemistry,
statistics and calculus could not take advantage of
the enhanced background of their students. I recommended teaching of organic chemistry, biochemistry, statistics and calculus to PGs in pharmacology
during their first year of study with an examination at
the end by the professors of those subjects in a draft
MD syllabus of Annamalai University Chidamparam,
Tamilnadu. Statistics is particularly important for carrying out and publishing research work. Calculus
helps them to understand mathematical formulae and
equations commonly used in general pharmacology.
Most scientific publications in journals require this
back ground, without which they cannot be properly
understood.
Financial support to PG is insufficient. In 1950s, a
PG has to pay the institution Rs.250/- towards the
cost of chemicals to be used, pay for the animals,
staff assistance and buy any special chemicals himself. Situation improved. But research still is not an
integral duty of the department and, is treated as
optional or hobby of staff and the responsibility of
the PG.
Research:
One of the duties of professor of pharmacology at
the Calcutta School of Tropical Medicine was to undertake research investigations into merits and demerits of Indian indigenous drugs, which had been
used for centuries in ancient India and folklore medicine and to explore avenues for finding suitable Indian substitutes for imported drug 4. This goal before Chopra is true even today. Chopra published
several papers and reference books on Indigenous
Drugs of India, an Indian Pharmacopoeia and a
Handbook of Tropical Therapeutics (1935). Regional
Research Institutes at Jammu and Hyderabad followed the same research goals. Dr. Dwaraknath at
ICMR established a liaison for drug testing units by
different disciplines for exploring indigenous drugs.
Dr. GV Satyavathi, who retired as Director General
ICMR, kept the torch alive and vigorously active. She
revised and published Medicinal Plants of India vol.
10
P.S.R.K. HARANATH
11
Pharmacology have come up. Clinical Pharmacology is given a status of a super specialty by MCI. Its
history dates back to 1960s when UK Sheth gave it
a shape at Seth GS Medical College, Bombay and
also introduced a Diploma in Clinical Pharmacology
in 1969. ICMR was supporting 3 months training
courses each year at this centre for selected applicants from different medical colleges. The department had 30 beds with financial support from drug
industry, CSIR, and phase I & II drug trials were conducted. Today it has become an independent department of Clinical Pharmacology headed by a Professor (N Kshirasagar) with beds in KEM Hospital
and is starting a DM course. PGI Chandigarh, an
autonomous institute started DM Clinical Pharmacology in 1980s and Nizam Institute of Medical Sciences at Hyderabad followed in 1982. NBE awards
a Diplomate in Clinical Pharmacology. MCI (1993)
prescribed MD (Med) and MD (Pharmacol) as prerequisite PG degrees to be admitted to DM (Clinical
Pharmacology). Clinical pharmacology sections are
created in pharmacology departments at various
places: KG Medical College, Lucknow, Madras Medical College, JIPMER, Pondicherry,Christian Medical
College, Vellore and Calcutta Medical College.
Clinical pharmacology departments function in association with one or more clinical departments of
attached hospital. In some places they have beds in
attached hospital as in School of Tropical Medicine
where they admit patients of select disease/condition. In Seth GS Medical College, they have beds
and also run OP for specific group of patients. The
main functions of the clinical pharmacology are a)
Therapeutic drug monitoring like estimation of drug
levels in the patients b) observe patients under phase
I & II clinical trials c) compile adverse drug reactions
d) discuss and advise clinical colleagues on drug
usage e) submit reports of new findings. The above
functions vary from institution to institution on the
degree of acceptance and cooperation by clinical
colleagues, availability of beds in the hospital and
equipment necessary for drug estimations and qualified staff to carry out biochemical, microbiological
and chemical assays, clinico-pathological laboratories etc. Departments like biochemistry, pathology
and microbiology only submit a report on the material sent to them by clinicians. The functions of clinical pharmacologist are slowly evolving and there is
as yet no clear-cut mandate or plan for organizing
the departments. The DM course prescribes the PG
12
P.S.R.K. HARANATH
13
4.
Chopra RN. Problems and Prospects of a Pharmacological career in India. In Annual Reviews of Pharmacology,
Ed: Cutting WC, Dreisbach RH, Elliot HW vol 5, Annual
Reviews Inc. Palo Alto, California 1963 p 1-8
5.
6.
7.
8.
Haranath PSRK. Indigenous drugs. A plea for assimilation of Indian Systems of Medicine into main stream of
scientific medicine. Ann Natl Acad Med Sci (India)
1992;28(3&4): 101-116.
9.
10.
Dandiya PC, Bapna JS. Pharmacological Research in India. In Annual Reviews of Pharmacology Ed Elliot HW,
Okun R, George R vol 14 Annual Revews Inc., Palo Alto,
California, 1974 p 115-126
11.
Das PK, Dhawan BN. Editors. Current Research in Pharmacology in India (1975-1982). Indian National Science
Academy, New Delhi, 1984.
ACKNOWLEDGEMENT
12.
I thank Dr UK Sheth for going through the manuscript fully and for his suggestions. Several friends,
colleagues and organizations helped me in collecting information to which I am thankful.
13.
REFERENCES
14.
15.
1.
Iswaraiah V Retrospect & Prospect in Pharmacology. Souvenir of Neuropharmacology Workshop and IIIrd Regional Conference of Indian Pharmacol Society, Kurnool 1974. p 1-4.
2.