The Ambiguities of Adulteration

In the public sphere, ‘adulteration’ had several connotations, which sometimes overlapped. The category of adulteration, while quite clear to the consuming public as representing commodities that were not of the quality that they expected, in fact, hid several meanings and was used indiscriminately. Therefore, cases of poisoning, if not deliberate, were often defined as adulteration. Adulterants in food and drink were abundant. As scholars have pointed out, the use of adulterants identified low-caste vendors/suppliers and related to a complex framework of purity that encompassed the caste Hindu body and its functions. British medical men were similarly persuaded by the rhetoric of adulterants in foodstuffs; outbreaks of epidemic dropsy (often confused with what was later identified as beriberi) were, from the first outbreak in Calcutta in 1878, blamed on adulterants in mustard oil.⁶ Other products commonly identified as adulterated were cosmetics and therapeutic goods where the packaging of a product was made to resemble the original, branded products and sold as such, and commonly found in the newly established brands for soap and toothpaste. Established brands in India often advertised and sent out flyers in English and regional languages to warn consumers and medical practitioners about ‘imitation’ medicine or toiletry.⁷ Yet another category of adulteration was the sale of therapies in all forms that did not conform to the B.P. This was an ambivalent category and difficult to identify or prosecute. The B.P. was not the official pharmacopeia but it did serve as the unofficial mark of quality. The potency or the lack of adequate potency in any drug, therefore, was seen as adulteration in official, medical, and often public discourses. Since the potency of any therapy was often not labelled on the therapeutic products, there was distrust of any therapies available on the market. As far as Indigenous drugs were concerned, as we have seen, their potency and their active principles (or lack of these) were identified with the inefficacy of the drugs themselves. But where potency was an ambivalent category, every drug – Western or Indigenous – could be identified as adulterated.

This ambivalence was sustained by the legislative vacuum that encompassed both the content of therapeutic products for sale and the qualifications/training of the dispensers/medical practitioners themselves. Legislation to control both aspects evolved piecemeal and regionally. There was no food and drugs law in colonial India overall; laws regulating the sale of poisons and narcotics like cocaine evolved haphazardly. In Bengal, all pharmacists selling British pharmaceuticals containing any form of poison had to be registered, but this regulation hardly precluded hundreds of sellers from trading in the informal market. In Bombay, a similar act sought to restrict the sale of poisons but was largely ineffectual.⁸ For medico-juridical purposes, provincial governments in Madras, Calcutta, and Bombay had appointed chemical examiners from the mid-nineteenth century whose duty, among many, was to examine food and other substances sold in the market and seized by the authorities, usually in cases of grave illness or the death of a consumer.⁹ An all-India Poisons Act by the Government of India was only enacted in 1904 after a decade of deliberation; even here, its implementation was fragmentary at best.

Among the elite medical officials of the ims, there were discussions on some regulation of the drug market. These began in the nineteenth century and continued until the inter-war years when British importers and Indian pharmaceutical companies successfully lobbied for a drug standardization committee, which presented its report in 1931. Its recommendations were not enforced until the Drug Act of 1944. Effectively, there was little or no control over the drug market in late colonial India. Adulteration, therefore, remained a catch-all term that encapsulated both the crude and processed drugs market until 1940.

In official discourse, the pre-existence of a large, informal market in variable drugs was supposed to have prevented any legislation to control it. At the first Indian Medical Congress at Calcutta in 1895, two ims officials, including Chunilal Bose who served as chemical examiner to the Government of Bengal, read a paper together on the sale and ‘ease of distribution’ of poisons in India.¹⁰ They pointed out that the chemical examiner in Calcutta and Madras had found hundreds of deaths by poisoning and urged for some kind of legal control. The Office of the Chemical Examiner was not new; the presidency of Bengal has established it in 1840 and other provinces followed by the middle of the nineteenth century. The duties of the chemical examiner extended to the examination and identification of cases of poisoning, both human and cattle; contamination in suspect foodstuffs and alcoholic spirits; and drugs, medicines, and cosmetics sold in the bazaars, and in other consumable products in the market.¹¹ At the turn of the century, British officials claimed that it was ‘Utopian’ for India to have a poison schedule similar to Britain’s Drugs Act.¹² Even after the Indian Poisons Act was enacted in 1904, as the Bombay Gazette highlighted, only druggists selling B.P. products were covered under the terms of the law, whereas Indian medicines were exempt, and, moreover, ‘Bunneahs and small dealers sell any number of drugs’.¹³

The Poisons Act (1904) referred only to poisons and specific narcotics and was mostly aimed at poisoning through arsenic, which was used in multiple ways in the everyday lives of ordinary Indians. The Poisons Act was, therefore, limited in scope and did not address the quality of drugs or other products that did not include specific, identifiable toxins. Any other drug, whether in an impure/adulterated state or imitations of original branded products, did not come under the legislation. These drugs varied in quality, their diversity a rich source of contention between competing British-Indian manufacturing firms as well as among Indian dealers. But the bulk of the blame for the preponderance of substandard products fell on the ‘bazaar’ traders, from the large wholesale importer to the modest pavement drug seller.

The market for adulterated (through fraud or accident) consumer products was vast and complex; complaints about adulteration in food, drink, cosmetics, and drugs abounded from the early nineteenth century. By the end of the century, with the established markets in urban India and the British manufacturing industry’s aggressive advertising and sales in colonial markets, adulteration became the common trope for marketing British-manufactured therapies. In 1889, Charles W. White, the British agent for B.W. & Co., A.F. Pears & Co. and Burgoyne, Burbidges & Co. of England, claimed during a visit to England that German, French, and American competition, with full complicity of the Indian wholesalers, was marginalizing the British manufacturers with brazen adulterated oils and powders: ‘calomel containing 50 per cent of chalk, santonin half boracic acid, sent here from France and Germany carriage paid and sold in the currency of the country, I fail to see how honest British competition can stand’¹⁴ White successfully challenged the sale of an imitation of the popular Pears glycerine soap by dealers in Bombay as well as secured a fine of one thousand rupees to be paid by Messrs W.H. Nebel & Co. who was selling imitation Calvert’s soap; both products allegedly supplied from Germany.¹⁵ Next year, Bertie Smith, a British wholesale importer of drugs based in Bombay, identified ‘German competition’ as his problem and accused Continental firms of monopolising trade in certain drugs by exporting cheap, adulterated material to ‘native’ drug importers.¹⁶ Similarly, the anonymous Indian correspondent of the Chemist and Druggist claimed that an ‘American-made bazaar counterfeit’ of an English-brand of patent drug made from sarsaparilla flourished in the Indian market.¹⁷

As we have seen in chapter 2, even British-owned importers dealt in diverse products, some of their own manufacture, and, due to their pre-established mercantile connections, supplied all major government departments. Naturally, these agencies acquired a reputation for purity and quality, not only among British residents but also among elite Indians who could afford to use their products. But even here, their products could arouse contention with the Indian drug importers carrying most of the blame for the inferior quality of patent medicines exported from Continental Europe.

Figure 5.1

Advertisement for Mellin’s food (Indian Medical Gazette, April 1895).

Figure 5.2

Advertisement for imported brandies, Calcutta Medical Journal 1, no. 3 (Sept. 1906).

Indian medical practitioners also participated in the discourse of adulteration. In 1905, the independent Parsi physician Dosabhai Rastamji Bardi, who taught at the Grant Medical College in Bombay, pointed out that adulteration prevailed on a large scale in several categories of food, cosmetics, and drugs in British India. His intervention identified exporters to India as the perpetrators of adulteration rather than retailers, whether British-Indian or ‘bazaar’ sellers. Citing records of the Chemical Examiners of Bombay from 1872 to 1902, Bardi claimed that there was consistent adulteration of commodities from Britain, the Continent, and America to the Indian market:

It is necessary to remember that the retail druggist hardly adulterates them, but as people want cheap drugs, he buys adulterated articles … no wonder that medical men are disappointed in their treatment. Bombay, and for the matter … the whole of India, depends on European and American markets for their supply of drugs, at any rate of all important pharmaceutical and chemical preparations.¹⁸

Figure 5.3

Miscellaneous medical advertisements in Indian Medical Gazette, March 1920.

The sheer diversity and quantity of the therapeutic products on sale in India appeared to defy any serious attempt at regulation. As we have seen in previous chapters, a ‘colonial addendum’ to the B.P. of 1898 legitimised the substitution of several drugs for those that were easily available and commonly used in India by Western practitioners.²⁰ In chapter 3, we saw that this addendum was the consequence of a long campaign in India by several eminent medical personnel, both British and Indian.²¹ British pharmacists alleged that the addendum was only of academic value:

In India there is no Pharmacy Act; a Pharmacopeia is looked upon more as a guide … and the authoritative recognition of certain drugs, which, though used for centuries by the people of India, had never become commercial articles, was about as helpful as the omission of a number of drugs in daily use in every pharmacy in the East.²²

Therefore, there was a wide spectrum between ‘pure’ and ‘impure’ drugs that embraced several degrees of authenticity. At this time, the public health movements that prevailed in India were focussed on sanitation and municipal improvement to minimise epidemics; the control of drugs (apart from poisons) was not a civil or government priority. The only drug that the government attempted to distribute widely in India was quinine and its alkaloids, at first for free, and then sold at a nominal price. Through inexpensive packets sold at post offices and, later, through a wide-ranging network of distributors including vaccinators and revenue collectors, various provincial governments sought to limit the devastation caused by malaria, especially during epidemics. As Patricia Barton has demonstrated, the high levels of adulteration (up to 80 per cent) of the quinine tablets sold by government agents and other distributors subverted the policy.²³

Meanwhile, it was the Indian druggists who stocked the cheaper drugs and faced most of the blame for adulteration and substandard products in the market. These included imported patent medicines as well as drugs commonly used in both Indigenous and Western systems of medicine, such as belladonna, aconite, senna, and asafoetida. In 1910, the British and Colonial Druggist suggested that while, ‘It would be unfair perhaps to say that quality does not count, but the native vendor is keen after a bargain … when it is said that he can purchase Easton’s syrup in four oz. bottles, each packed in a carton at 36s. gross, it appears that the limit of cheapness has been reached’.²⁴

Stung by the criticism in the Anglo-Indian and the regional press, the British-Indian importers and distributors pointed out that manufacturers in Britain and the Continent specifically produced low-quality commodities for the Indian market. Bathgate & Company, the oldest chemist and druggist retailer in Calcutta, clarified to the medical press that:

We say that the majority of the British and Continental firms ship to Indian dealers very large quantities of drugs, the sale of which in England, Germany, France or the United States … would expose the vendors to prosecution, and which only remotely resemble the drug whose name they bear on, the labels as far as their physiological efficacy is concerned …

India … is a cheap market … Every device to reduce the cost and secure business is practised – short weight, misdescription, imitation of labels and packing, and adulteration to a most astonishing extent. ‘Anything is good enough for India’ seems to be the motto of such shippers, and Caveat emptor their safeguard.²⁵

Both from the ‘legitimate’ trade and from the official medical standpoint, the problem of adulteration was two-fold: the wilful dilution and imitation of standard drugs and proprietaries including the supply of cheaper varieties and the essentially large, uncontrollable, and uncertain quality of the fresh drugs on the market that problematized the Indigenous drugs market. A variant to this category was the deterioration of drugs in transit and due to climatic conditions, but these instances were subsumed in the broader category of wilful adulteration or dilution of drugs. Public discourse in India displayed a sporadic recognition that legislation was needed, and in the Upper Provinces, one Indian councillor even referred a request for legislation to the Select Committee in 1911.²⁷

The discourse of adulteration was entangled with racial overtones and imperial dominance of the consumer market. Swadeshi manufacturers and the English and regional presses pointed out, in turn, that British, American, and Continental manufacturers produced substandard therapies specifically for the Indian market. As mentioned in chapter 3, The Statesman (Calcutta) began a campaign against spurious drugs in 1911 and alleged that diluted or impure drugs from Britain, the usa, Germany, and Japan were being imported on a large scale by distributors in India.²⁸ An intense debate ensued. Norman Hirst, a British pharmacist, alleged that ‘they send out to India cheap varieties of quinine sulphates; compound extracts of sarsaparilla in some instances consisting chiefly of glucose and many other medicinal preparations … are almost entirely deficient in active principle and are practically inert’.²⁹ He identified the complicity of both the consumers and exporters in this trade and especially indicated that the British-Indian companies that needed drugs on a large scale for their labouring populations, such as ‘tea gardens, railway companies, collieries, … send round “tender forms” or quotations for their medicines, and they usually accept the lowest tender’.³⁰ The problem of adulteration was, therefore, integral to the industry and the trade itself. The Indian Medical Gazette, which represented the medical fraternity of the ims, agreed that there was widespread adulteration of drugs in India. Quinine, all vegetable oils including sandalwood and mustard, santonin, iodine, and alcohol-based tinctures were most affected. The Indian Medical Gazette pointed out that while the adulterated supplies were imported from England, North America, and Europe, ‘These impure drugs are largely sold in India by small firms in the bazar and elsewhere’.³¹

With the increase in prices and scarcity during the First World War, adulterants in food and medicine became a visible problem in the cities. As with the poisons, legislation to curb adulteration was enacted piecemeal. In 1916, R. Braunfel, a commissioner of the Calcutta Corporation, introduced a bill for the prevention of food and drugs to be applicable to all municipal and districts in Bengal.³² The bill was finally enacted in 1919 but referred only to adulterants in food and beverages. Similar political mobilisation within local governments and politics resulted in legislation on adulterants in food in Madras (1918), Bombay (1925), Punjab (1929), up (1916), and in the Central Provinces (1919).³³ Srirupa Prasad has pointed out how the affective trope of adulteration engendered anxieties about the physical deterioration among the Bengali middle classes in late colonial India. She argues that in the lively Bengali public sphere ‘alimentary anxieties’ transcended the physical body and pervaded insecurity about the health and purity of several the Bengali nation, community, and selfhood.³⁴ As Saurabh Mishra has pointed out, anxieties about adulterants involved low-caste communities who sold the ritually pure commodities of milk and ghee, which were also used to make sweetmeats at the bazaars.³⁵ Brahminical ritual purity and the proliferation of prepared food in the bazaars coalesced and crashed in the cities of colonial India, eliciting complex discussions on adulteration, purity, and the self, both physical and metaphorical (of the ‘community’/nation), health and prosperity, virility and masculinity.³⁶ These were undoubtedly informed by nineteenth-century colonial discourses of Bengalis as an emaciated, effeminate race.³⁷

Significant as it was within nationalist imaginaries of the Bengali self, adulteration in consumable goods was not only a Bengali concern, even in Calcutta. Adulteration of food was a familiar issue within the influential Anglo-Indian (English) press and in the Hindi and Tamil presses as well; it was an all-India concern.³⁸ These concerns were linked to the new science of nutrition and the identification of a consumer market for vitamins and hormonal products such as insulin. Especially after the First World War, when micro-nutrients in food were discovered, synthesised, and marketed in the forms of tonics and pills, the distinction between commercial food/medicines/beverages grew ever blurrier. As local governments in urban India responded to the elite/upper caste’s vocal protests about the poor quality of milk and ghee in the markets, a clutch of legislation at the provincial level was enacted. But these did not criminalise fraudulent marketing if it did not prove to be actively, physically harmful to the consumer. Even in that case, ‘intent’ had to be proved to ensure conviction. And the legislation still did not refer to drugs or therapeutic products, except poisons.³⁹

The public sphere resonated with demands for control over poor-quality drugs and the deliberate introduction of adulterants in therapeutic products. Indian (as well as British) medical professionals were deeply involved in the discussions and medical journals as much as the lay press abounded in discussions on ways and means of ensuring the quality of therapeutic goods in the market. In the age of nationalist mobilisation, Western-trained Indian medical professionals often tended to view it at two levels: the failure of self-regulation by the merchants and industrialists, and the lack of professionalization by pharmacists. Both were instances of self-regulation and borrowed from similar solutions in Britain. The imr argued for co-operative associations and suggested the organisation of ‘co-operatives’ as well as the establishment of an apprentice system to train prospective pharmacists.⁴⁰ It was not clear who were to organise the idyllic co-operatives – the traders, the Indian manufacturers, or the small minority of qualified pharmacists.

Adulteration and Disparate Dispensing

This lack of clarity was, in one respect, representative of the heterogeneity of medical practitioners and dispensers who prescribed and distributed medicines to their patients. There were no legal restrictions on who could practice medicine, after all. The Medical Registration Acts enacted in Bengal, Bombay, and Madras in 1912–14 were only intended to prevent unqualified doctors claiming Western medical training from being employed in government service or acting as medical witnesses in courts. Independent medical practitioners spanned across epistemic boundaries with the same ease with which they appropriated drugs and therapies from disparate sources. Most doctors dispensed medicines themselves as part of their practice, which included generic pills or tonics made in their workshops or dispensaries, or patented therapies advertised in every medical and lay periodical.

In 1864, Goodeve Chuckerbutty, one of the first Indians to train in Western medicine in Great Britain and secure in his self-worth as a legitimate medical graduate, had pointed out at the Bengal branch annual meeting of the bmj that:

Even the metropolis of India [Calcutta] is infested by a host of impudent harpies who prey upon the credulity of the unsuspecting. Every druggist and chemist, every apothecary and quack, every … fool, enjoys as yet full liberty to style himself a Doctor and prescribe for the sick … That any disappointed Sircar or worthless European may set himself up as a Medical practitioner by buying a few doses of quinine, castor oil, opium, and tartar emetic, and giving these out to the sick under false and bombastic names, is a grievous wrong to western medicine.⁴¹

The process of vernacularization, useful though it is to understand Indigenous appropriations, implies a one-way relationship between Western drugs and Indian medical practitioners and consumers. It does not explain the significance that India held in the international search for Indigenous drugs to incorporate within Western pharmacopeia until the twentieth century. Similar appropriations of Western therapies and techniques/instruments of diagnosis were incorporated at other sites of non-European medical praxis, such as the traditional Chinese medicine (tcm) or local Sino-Vietnamese medicine.⁴⁴ Nor does vernacularization adequately explain how the international drugs trade infiltrated and hybridised medical therapies and practice on a global scale in this period.

As indicated elsewhere in this book, it is essential to complicate the divides between the Indigenous and the Western therapeutics on which the arguments for vernacularization reside. This, in turn, helps us to understand why the problem of adulteration existed across the therapeutic spectrum of the Indian market. To start with, until the 1920s, there was not a great deal to distinguish Western therapies from Indigenous ones. As seen in chapter 3, drugs from the Indian bazaar were continuously adapted to Western pharmacopeia and substitutions or replacements were carefully presented. As the Indian Medical Gazette editorialized in 1879 there was a:

Practical and useful threefold classification of the medicinal products of India, namely (1) pharmacopceial drugs indigenous to or procurable in India; (2) non-pharmacopoeial drugs used in Native medicine, and (3) medicinal substances whose properties have not been as yet investigated nor their applications in disease defined.⁴⁵

In colonial India, the public sphere was crowded with medical practitioners’ interventions in public debates, offering varying degrees of medical authority and knowledge. Debates on masculinity or effeminacy; the necessity or otherwise for bodily purity and continence among (male) nationalists; the suitable age for marriage, sexual intercourse, and reproduction for girls or women were all up for debate, involving medical experts of all persuasions as well as political workers, educationists, and social reformers. Western medical practitioners and many prominent vaids and hakims participated in these debates and found relevance in the public sphere on account of their ability to process Indian cultural norms of the body to Western medical practises and, in turn, translate Western therapeutic praxis into forms that were meaningful in the social and cultural worlds of (largely upper-caste) Indians. Historians have focussed on the medico-cultural debates and conflictual moralities that colonial modernity generated among literate Indians. The acceptance of Western medicine, however, occurred not just at the site of the public iterations of the ideal national Indian bodies of men and women. The extent of consumption of these commodities depended on the range, quality, and quantities of the commodities in the market. The most visible element in this market was the therapies on sale.

Therefore, the indigenization or vernacularization and ‘nationalization’ of medicines in colonial India were the reflection of the unregulated market where such experiments in ‘braiding’ and mixing medical technologies and drugs were possible.⁴⁶ This heterogeneity characterised medicines as well as much of the medical professions, including doctors, hakims, and homeopaths as well as apothecaries, dispensers, and itinerant pill pedlars in India. Professionalization, as understood in the Western experience, did not occur until after the government legislated drug control laws after 1940, and only in a fragmented way thereafter. There was a thin line between heterogeneity and adulteration of drugs in the market. The sale of adulterated, cheap medicines flourished in the absence of drug control legislation and because the private drugs market catered to those with fewer means as well as the more affluent.

Legislating Adulteration

The problem of adulteration reinvented itself with the new urgency for drug control in the twentieth century. The popular movement for a drug control policy continued in the Indian press, both national and regional. In 1925, an article in the daily The Bengalee, an English language moderate nationalist daily, alleged that all reputed pharmaceutical companies in Calcutta, both British-owned and Indian, made a regular practice of misleading customers by labelling their products as being of B.P. strength, including bcpw, Stanistreet, Smith & Co., D. Waldie & Co., and B.K. Paul. It claimed that the Chemical Examiner of Calcutta had reported that ‘local firms in competition with one another and with the importing firms try to reduce the manufacturing cost by using less medicament and alcohol, and that the importing firms in their turn have begun a similar practice’.⁴⁷ The piece caused mayhem. It was reprinted in the Statesman, which, as we have seen, had initiated a campaign against drug adulteration in 1911. After a strong protest from Stanistreet, Smith & Co., the Indian Medical Record retracted the piece. But the all-pervasive collusion of manufacturers, producers, and distributors in various stages of adulterating drugs was apparent and raised continual pleas for a food and drugs act for India in the medical and the general press.

During the First World War, several Indian manufacturers particularly the large producer-retailers, made a fortune in supplying government contracts. The Indian army itself was deployed at several places in Mesopotamia, imports from Europe proved difficult, and those from Germany ceased altogether. The gms’s produce proved inadequate; it relied on manufacturers based in India to provide several standard drugs and surgical products. British-Indian importers/manufacturers including Smith Stanistreet & Co. (Calcutta), D. Kemp & Co. (Bombay), as well as newer companies such as Bengal Immunity (Calcutta) benefitted from the virtual cessation of imports.⁴⁸ Immediately after the First World War, the Smith Stanistreet & Co. moved to new, larger premises that accommodated both their factory and large retail outlet. Yet, even here, the problems of variations in the potency of medicine and the quality of surgical products persisted. In 1916, the ramc blacklisted the Bombay-based British-Indian manufacturer Phillips & Co. for providing the British Army in Mesopotamia with surgical dressings that had little or no antiseptic content and, therefore, violated its terms of contract.⁴⁹ As we have seen in chapters 3 and 4, the promise of ‘import substitution’ and a deeper exploration of indigenous drug plants (shorn of their ‘impurities’) by medical men and entrepreneurs alike enabled the complexity of the market to intensify rather than become simplified and streamlined, as Western medical professionals had hoped. The huge range of Indigenous drugs and the local manufacture of drugs came to official and medical notice more vividly, and the public discourse and medical disquiet on the lack of regulation in the market grew in the inter-war period. At this time, the UK and Europe-based companies were accused of dumping their outdated surplus articles on the Indian market.

The Government of India set up a biochemical standardisation laboratory in 1937 in Calcutta. In 1939, the laboratory found that of 130 samples of liquid ergot, used in emergency haemorrhage cases, 112 were substantially below strength, and fifty-eight had no active principles evident in them. Both locally manufactured and imported drugs were implicated. Of the samples examined, 103 were local, and twenty-seven were of foreign manufacture. The img pointed out that ‘that an inferior quality of both crude and finished preparations of ergot, unsaleable in their countries of origin due to stringent drug laws, is being purchased in India at a cheap price’.⁵⁰

Feeding the confusion over adulteration was the heterogeneity of the market itself. This heterogeneity was manifest in the therapeutic commodities as much as in the knowledge, experience, and qualifications of medical practitioners and dispensers themselves. The spectrum of medical products in the Indian market reflected the range of medical practitioners and their changing crafts as well as the literate, self-medicating consumers. The principal manufacturing firms in Calcutta, Bombay, and other metropolises offered a range of products that used formularies from both ‘Western’ and ‘Indigenous’ traditions. The vibrant print cultures and the emergence of the literate and self-aware middle-class Indian, therefore, joined and informed the content of medical writings in the medical and general presses.

The incremental number of Indian and imported self-help prescription manuals and more formal academic works on materia medica that also flooded the market in this period was underscored by the intense trade in pharmaceutical products. These publications were inundated with advertisements for a bewildering array of therapeutic commodities and instruments – from pills and powders to syrups and tonics, instruments for extracting ‘meat juices’, dried milk and eggs, vitamins, and hormonal products. The possibilities for ‘adulterants’ in the foodstuffs as well as medicines were seemingly infinite.

There were distinct trajectories of adulteration in the drug market. Indian manufacturers presented their therapeutic products as both physically and culturally more suitable vis-à-vis imports. Indian manufacturers were reinforced by claims from vaids, hakims, and even a few Indian doctors that imported drugs were materially and culturally unsuitable for use in India. The claims were based on two fronts; first, that several products from the UK or North America deteriorated in quality and declined in potency during the maritime passage to India, whereas local products were fresher and provided the potency that their labels indicated. This was an established criticism. Indeed, the degradation in the quality of the medicines brought from the UK had initially occasioned the use of local and bazaar medicines by the surgeons of the first Navy hospitals in British India. Although the shipments arrived faster now, the long-held views about the heat and moisture of the tropics and their adverse effect on medicines persisted in medical discourse. Indigenous suppliers could claim that their goods were more reliable and superior. Related to this was the older, Orientalist discourse of the characteristic, distinct tropical body. This discourse had a rich and tenacious life; from the eighteenth-century European medical thought reflected on the tropical climate and correspondingly to the legitimacy of local medicines for tropical (native) constitutions.⁵¹ The arguments shifted emphasis and acquired overlapping implications. Racial distinctions remained significant, but arguments for ‘seasoning’ or adaptability of white bodies in the tropics declined. Local or Indigenous medicines were loaded with not just cultural heft and historical meaning, its enthusiasts pointed out the advantages of fresh and, therefore, more ‘active’ effects. As late as 1938, an Indian pharmacologist trained in London pointed out that in certain circumstances, local Ayurvedic drugs were more convenient and efficacious as Western preparations of the same drug.⁵² Therefore, decayed/deteriorated medicines and adulteration led to a campaign for Indian medicines.⁵³ Even the Secretary of State’s office in London, heavily biased in favour of British exports in the late nineteenth century, advised the Government of India against the purchase of elastic syringes for children as they ‘deteriorate in the hot climate’.⁵⁴

The second claim of adulteration was directed towards proprietary drugs and their contents. This referred to proprietary medicines that were imported, mostly from the UK and North America, and available at the reputed, established end of the medical market. Proprietary medicines were also locally manufactured across the spectrum of Western and Indigenous medical therapies. The so-called patent and proprietary medicines formed a substantial part of the drug market in colonial India. There was no patent law in India until 1911; even then, the so-called patent medicines were not formally patented as such.⁵⁵ They referred to all preparations with secret content, i.e., they were packaged materials whose constituents were not public. Patent and proprietary remedies were widely used. In a medical market where self-help manuals for diagnosis and treatment were common, advertisements in print media plentiful, and multiple layers of medical practitioners and dispensers were rife, packaged proprietary medicine for specific ailments could create a huge demand.⁵⁶ This demand originated both from the practitioners and dispensers as well as from the consumers.

Proprietary remedies and their overstated, often ludicrous, claims were common in Great Britain and indeed, in the usa in the nineteenth century. As the medical occupations formalised their distinct skills and services, pharmacists formed their own self-regulatory bodies, and doctors and pharmacists campaigned extensively for drug control legislation and surveillance over the claims of medical advertisements and proprietary medicines. In the early twentieth century, the British Medical Association and the Royal College of Physicians debated the ethical boundaries of the claims made by manufacturers of proprietary medicines and went to the extent of publishing the (widely used) ingredients of the most popular proprietary remedies sold on the market and gave evidence to the Select Committee on the Sale of Patent and Proprietary Medicines in 1912.⁵⁷ Historians have pointed out that qualified physicians’ monopolization of the practice of medicine and their delegitimizing of medicines manufactured by chemists as quackery were due to the rivalry and conflict over consumer-patients.⁵⁸ Of course, the line between the hypothetical ethical physician and the commercially minded drug seller was not entirely clear cut, especially in the poorer regions, for instance, physicians dispensed medicines and doubled as shopkeepers in Scotland in the early twentieth century.⁵⁹ The narratives of professionalization of medical experts in Britain would not be replicated in British India. As we have seen in the previous chapters, medical cultures and the relationship between consumers and the medical market in India represented a strand of colonial modernity, and its contours would not fit into the palimpsest of the praxis of medicine and the market in the metropolis. Nonetheless, the need for a set of rules to regulate the quality of the medical commodities that swamped the market in colonial India became urgent and clear during and after the First World War. When the Government of India experienced international pressure to restrain the trade in narcotic drugs (at the time sold in pharmacies), it instituted the Drugs Enquiry Committee (dec) in 1930.

The Long Half-life of the DEC Report

In the inter-war period when the Health Committee of the League of Nations initiated international cooperation on both the control of narcotic drugs and the standardization of sera and vaccines, the Government of India gave in to the general clamour at home as well as to the new international initiatives. It formulated and passed the Dangerous Drugs Act (1930) that enforced control over trade in drugs derived from Indian hemp, coca leaves, and opium.⁶⁰ More significantly, it also instituted the dec. The committee was chaired by R.N. Chopra, who had extensively researched the properties of Indigenous drugs at the Calcutta School of Tropical Medicine. The committee was to devise a system of legislating all drugs, Indigenous and Western, as well as recommend ways to institutionalise the drug-dispensing professions in all of British India. The dec submitted its report in 1931. The report was comprehensive and its recommendations were clear and simple. It arrived at these through consultation with the nascent industry, retailers, government medical officials, pharmacists, and independent medical practitioners. The report made recommendations to regulate the import, sale, and manufacture of pharmaceutical products in the country and to streamline the training of pharmacists in technical institutes.

In this final section, we will see how the committee’s report attempted to consolidate and make uniform the impossibly plural drug industry. It provided, for the first time, an informed overview of drug production and dispensing in government and private hands throughout India. The dec report had a long shelf life; the central government acted on the bulk of these recommendations only when it passed the Drug Act in 1944. At first glance, the delay in implementing the recommendations of the dec for more than a decade seems normal; after all, most reports of the Government of India were commissioned to elicit information and they rarely inspired clear-cut action by the government. The Indian Industrial (Holland) Commission report (1918) was case in point. It was convened during the First World War to examine the conditions for industrialisation in British India. The recommendations of the Committee, including legislation for industrial safety and labour laws and the establishment of an India-wide chemical service, were mostly ignored once the war was over.⁶¹ The newly constituted provincial governments did set up a separate department of industries and made a few gestures to promote technical education but these instances were rare and limited to specific industries and skills, such a railway ‘workshop’ technical school in Lucknow.⁶²

The dec was established partly in response to Western nations’ aims to curtail trade in narcotic goods (cocaine and opium) between the wars through the agency of the League of Nations. The prospect of the standardisation of drugs within British India was a relatively minor digression from controlling the free flow of opium or cocaine products for recreational use and manufactured by pharmaceutical firms in Europe.⁶³ By the 1930s, the Geneva Convention on narcotics had settled on policing the trade/export and supply of narcotic drugs. One reason for the halting progress on the recommendations of the dec was that the colonial government was politically invested in the narcotics trade. Once the diplomatic arrangements for policing international trade in narcotics were established, it was reluctant to place any further checks on the drugs trade, especially given the large proportion of British exports of drugs and chemicals to India.

Controlling the drug market was a complicated affair. As we have seen, the unregulated elements included multiple drugs from differing epistemic frameworks, a large and variegated set of producers and manufacturers, as well as several categories of medical practitioners and drug dispensers. Moreover, by no means were these categories mutually exclusive. Above all, drug control was expensive; apart from establishing central and provincial drug testing/standardisation laboratories, some government medical colleges would need to offer diplomas in pharmacy to train dispensers. Legislative action would be required at the central and provincial levels to regulate the medical professions. Any determined effort to regulate the trade would require a clear judgement of how to assess Indigenous drugs and those that did not belong to the bp. The government would also finally have to legislate Indigenous therapies, their training methods, and their diplomas rather than rely on their corporate bodies to regulate these. Most of these would require financial resources and political will. With the government’s declining finances after the crash of 1929, and the strong nationalist alliances of the Ayurvedic and Unani organisations at this time, this promised to prove difficult and contentious.

Once the report was published, the Government of India consulted with the provinces on the specific points of standardisation of laboratories, inspection of factories, establishment of medical colleges to train pharmacists, and the advisability of controlling Indigenous drug production. Most provincial governments cavilled at the cost, some flatly declaring that these could not be funded provincially. Smaller provinces, like Coorg, declared that it could ‘ill-afford’ a pharmacy council and did not have a single medical college.⁶⁴ The Assam government pointed out that the formation of an Indian pharmacopeia or a pharmacy council, or assessing the clinical value of Indigenous drugs, were best done by the federal government.⁶⁵ Several provinces voiced dismay at the prospect of losing excise revenue income if, following the recommendations of the dec, they stopped imposing excise duties on alcohol-based medicines.

Even more significantly, the Royal Society of Medicine in London objected to implementing most of the recommendations of the Report, including an Indian pharmacopeia; ‘The proposal to create an ip is one which cannot be too strongly deprecated. The world needs fewer, rather than more pharmacopeia, and to add another national pharmacopeia to the existing number, would be a retrograde step’.⁶⁶ It also objected to the inspection system for drug manufacturers in India, arguing that India did not yet have enough trained chemists to usefully benefit from these. The Society was not keen for British drug manufacturers to lose their Indian markets as credible drugs legislation would guarantee the quality of the relatively cheaper and easily available Indian therapeutic products and challenge the near-iconic status of British medical commodities.

The central government did formalize a drug standardisation centre in Calcutta, headed by R.N. Chopra. The Benares Hindu University offered degrees in pharmacy from 1937, admitting twenty students annually.⁶⁷ The rough and ready ‘compounders’ – unqualified dispensers – who acted as pharmacists in most dispensing stores numbered around 27,000 at this time. They carried the burden of the ill fame of the dispensing profession, as did the Indigenous dais (midwives) who were caught between halfhearted attempts to regulate their profession by the government and qualified medical practitioners.⁶⁸

Attempts on the part of the government to begin regulating the drug trade included the introduction of a Drugs Import Bill in 1937. It was intended to control the import of foreign drugs, especially those ‘misbranded’ and, as the federal government explained, was not intended to ‘interfere in the legitimate drugs trade’.⁶⁹ The Indian Merchants’ Chamber, the most influential association of Indian entrepreneurs with strong nationalist ties, cautiously welcomed the proposed legislation but pointed out that to be effective, the legislation needed to be extended to princely states and encouraged the provincial governments to enact similar legislation for Indian manufactures:

As however, the bill extended only to British India … necessary that imports of drugs and medicines to Indian States should be similarly controlled, and that to this end, efforts to secure passing of similar legislation by Indian States in their jurisdiction should be made. They also suggested the necessity for having provincial legislation for controlling similarly manufacture and sale of drugs and medicines within the country.⁷⁰