The indigenisation of western medicine in Sikkim

The British imperial Government of India established its direct authority over Sikkim after the conflicts of 1888-89, appointing John Claude White to fill the newly created post of Political Officer Sikkim. As the imperial representative in Gangtok, White enjoyed considerable power - it was difficult for a local state to resist the 'advice' of a Political Officer who so prominently represented the economic and military power of the British Empire - and until his retirement in 1908, White effectively ruled Sikkim through a Durbar that he appointed and controlled; as he put it, 'everything was in my hands'.     But when White took up his position, Sikkim was of little but strategic value to Britain's Indian Empire. It was impoverished and lacking in most of the structures of modern government - there were no police, no law courts, no public works, no secular education system, and no public health system. White was expected to develop his domain, but imperial government funding for this was limited to a subsidy of 12,000 rupees per annum. This was originally paid directly to the Sikkimese ruler, but with White determined to stamp his authority over the state, the Chogyal was effectively exiled from Gangtok until late 1895, and after his banishment the subsidy went 'towards the expense of management of the State by a British officer', suggesting that the Political Officer used this money for his own expenses. In order to obtain the finance necessary to create and develop the state structures seen by the British as essential to modern government, White initiated a series of revenue-raising measures in Sikkim. A land revenue settlement was made, forestry excise measures were introduced, and, acting through the council that he dominated, White was able to introduce the unpopular measure of increasing immigration from Nepal in order to enlarge the tax base and raise agricultural production. Within a decade the revenue of the Sikkim state (which in 1891 was home to just 30,458 people), had increased from just over £500 to £150,000 per annum.  This income enabled White to begin financing modernisation initiatives such as the education of Sikkimese youths in British India and the introduction of allopathic, or what is popularly known as 'Western', medicine. This paper, drawing on the records of the imperial government and interviews with Sikkimese medical practitioners, will examine the subsequent development of this new medical system in the wider context of modernisation, and discuss how it came to develop the indigenised character it has in Sikkim state today. In presenting a narrative of medical progress, it is not the author's intention to suggest that this was uncontested, or that the process did not involve complex negotiations with practitioners of the indigenous medical systems. Nor is it to ignore contemporary problems and issues. The author's concern, however, is primarily with the influence and actions of individuals and institutions on the indigenisation process.