Dargah Hazratbal

image

Brief History of Moi Muqadass written on a stone outside Dargah at Hazratbal, Srinagar in Kashmir

Advertisements

Tallest Kashmiri or The Two Kashmir Giants

Whenever the name of tallest Kashmiri in history is talked, we spontaneously understand that the name of Sheikh Abdullah is being said but here the phrase of ‘tallest Kashmiri’ is really about tallest Kashmiri in true sense. An American, Professor James Ricalton was friends with two Giants (twin brothers) of Kashmir with whom he clicked photos in Srinagar as well as in Delhi in 1903 during the Delhi Durbar. The two giants are known by Cashmere Giants or Kashmir Giants and were elite riflemen of Maharaja of Kashmir. One of them was 7ft 9in & other was 7ft 4in. The taller one was considered the the tallest of men in India at that time. At Delhi Darbar the photos were taken by George Rose in 1903. According to the notes available, we get to know that the Giants belonged to Balmokand, Kashmir. After searching, i can’t find where Balmokand is. It seems Balmokand’s name has been changed to something else now.

At Delhi Durbar

At Delhi Durbar

The Brisbane Courier Wednesday 4 February 1903. (Durbar took place in January 1903)

The Brisbane Courier Wednesday 4 February 1903. (Durbar took place in January 1903

At Delhi Durbar

At Delhi Durbar

GiantsGiantGiantGiantGiant

At Delhi Durbar

At Delhi Durbar

At Srinagar

At Srinagar

Kashmir and Sheikh Abdullah in Australian Press (1947-53)

Following are some newspaper clippings related to Kashmir and Sheikh Abdullah from 1947-53.

Click on the Pictures to enlarge and for your convenience please open the pictures divided into parts as a,b,c… in different windows so that there is less difficulty in reading & understanding.

old man

The Mail (Adelaide, SA ) Saturday 17 June 1950

Kashmir Is A Sportsman's Mecca  (By Harold K. Milks)  SRINAGAR (Associated Press). — Kashmir may be one big headache lo the United Nations. But it is paradise to the sportsman, especially if — like the writer — he prefers his hunting and fishing served up on a platter.  Mention the word trout within hearing of a Kashmiri and there arc dozens of fishermen clamour ing to lake you to their favourite streams. Mention black or brown bear. Inquire about any or a half a dozen species of mountain goat from the seldom-shot markhor downward. Whisper a desire to shoot scrre deer, a giant panther, a snow leopard, some wild sheep. Suggest that your favourite sport is downing giant geese or ducks from a blind. The answer is all the same from personable Colonel Ghulam Qadir (Director General of Kashmir Tour ism), who has hunted in both North and South America. Africa and Europe — who still - says there is no sporting place like Kashmir. 'Wo have them all, just wait ing to be hunted,' he said. 'In most cases the hunting is not too difficult. This correspondent mentioned in an off moment that he had never shot a bear. 'Well fix that,' said Colonel Qadir. Forty-five minutes after leaving Nedous Hotel, the famous Kash mir resort founded in Srinagar by Qadir's grandfather, we were in bear country.  Twenty onnutes later, after a walk of only 10 minutes from our jeep trail, 1 had the sights of a heavy double rifle on a husky voun'g bear, and within seconds the 3001b. animal was on his way to being a fur rug in this cor respondent's home. The personable colonel pro posed a return hunt and promised that it would include a good stag, plenty of geese and ducks, and — if the snow was not too heavy on the Himalayan Ranges — a monster brown bear as big and as dangerous as the North American grizzlies. 'This is the poor man's para dise,' insisted the colonel. 'Once you have a licence (and it is 130 rupees for the whole season) there are few other costs. Bring your own guns and ammunition, spend a few rupees for a shikarie (hunting guide) and shoot until the cows come home.' Black and brown bear are plentiful within 15 miles of Erinagar, Kashmir's capital, the black bear ranging upward to 5001b., the brownies weighing in at a top mark of around 8001b. Giant red stags are found in the highlands, especially during the autumn and winter. Higher up on the slopes of the Himalayan Ranges are no less than half a dozen varieties of wild goats, including the mark hors, which Colonel Qadir said is the world record markhor. Besides markhors, there are plenty of ibex, thar, gorel and serow, all types of mountain goats, plus Tibetan gazelles (goa) and Tibetan antelope (chiru). Wild sheep, cousins to the high-climbing goats, include ovis ammon (Hodgson), Sharpu (ovis vignei), and gharal or blue sheep (preseudois nayaur). HUGE ANTLERS Deer family members in the Kashmir shooting grounds are the hangul or Barasungha (Kashmir stag), whose antlers range up to a record mark of 51$ inches, and musk deer with four-inch tusks. Autumn brings some of the finest small game shooting in the world, and Colonel Qadir's guest book lists the names of some of the world's best known sports men who have shot from his blinds. Geese, duck, snipe, pheasants, and other game birds are found in plenty. Geese and ducks swarm into Keshmir in October, stay on until March, feeding over the lakes, rivers, and canals of the Kashmir Valley. Game and game birds are so plentiful— and hunters so few— that except for stag the Kashmir State Government has not found it necessary to fix bag limits. Even market hunters— boatmen who have mounted punt guns, muzzle-loading weapons with nails of old scrap iron on their boats— make no visible impres sion in the number of geese or ducks available in Kashmir. Pishing is much the same story. Several decades ago British sportsmen— with a financial boost from the then Maharaja of Kash muv-decided to stock some glacier-fed mountains with trout. To-day brown and rainbow trout are so plentiful that a season angler is guaranteed for his annual permit costing 400 rupees the right to fish in a dif ferent stream by himself every day between April 1 and Septem ber 30. Completely acclimatised, the trout reproduce on such a scale that fish and game wardens have found it un necessary to restock the streams from either of Kash mir's large trout hatcheries. For the man who wants a few days' fishing, Kashmir offers a choice of trout streams for a daily fee of only seven rupees. Top catch in the 1951 season was a trout of HZ-lb., taken oh a flv.  The disturbed political situation between India and Pakistan over Kashmir is in part responsible for the glut of fish and game in this Himalayan State. Colonel Qadir said the situation had kept away many sportsmen who feared hunting and fishing areas would be closed, or pro hibitions imposed on bringing firearms and ammunition into a 'disturbed area.' Actually, Colonel Qadir said, there are no restrictions on any of the hunting and fishing re gions in Kashmir.

2a Nambour Chronicle and North Coast Advertiser Friday 18 January 1952

2b Nambour Chronicle and North Coast Advertiser Friday 18 January 1952

2c Nambour Chronicle and North Coast Advertiser Friday 18 January 1952

2d Nambour Chronicle and North Coast Advertiser Friday 18 January 1952

3a The Courier-Mail (Brisbane, Qld) Friday 31 October 1947

3b The Courier-Mail (Brisbane) Friday 31 October 1947

3c The Courier-Mail (Brisbane) Friday 31 October 1947

Capture 2

4 The Daily News (Perth, WA) Tuesday 4 November 1947

5a The Mercury (Hobart, Tas.) Tuesday 24 May 1949

5b The Mercury (Hobart, Tas.) Tuesday 24 May 1949

6 The Advertiser (Adelaide, SA) Thursday 22 May 1952

7b The Argus (Melbourne, Vic) Monday 23 March 1953

7a The Argus (Melbourne, Vic) Monday 23 March 1953

8a The Advertiser (Adelaide, SA ) Wednesday 8 April 1953

8b The Advertiser (Adelaide, SA ) Wednesday 8 April 1953

9 The Mercury (Hobart, Tas) Thursday 30 July 1953

8c The Advertiser (Adelaide, SA ) Wednesday 8 April 1953

10a The Sunday Herald (Sydney, NSW )Sunday 16 August 1953

10b The Sunday Herald (Sydney, NSW ) Sunday 16 August 1953

11a The Sun-Herald (Sydney, NSW) Sunday 29 November 1953

11b The Sun-Herald (Sydney, NSW) Sunday 29 November 1953

12a The Advertiser (Adelaide, SA) Saturday 5 December 1953

12b The Advertiser (Adelaide, SA) Saturday 5 December 1953

Memoirs of Doctors who worked in the Kashmir Medical Missionary

As i was searching on the topic of Kashmir Medical Missionary, i came across two books written by the two Missionary Doctors of that time which give us interesting information about life & times of common Kashmiris. The first book which i got hold of is ‘SEEDTIME IN KASHMIR’ which is a memoir of Dr William Elmslie & the second book is ‘BEYOND THE PIR PANJAL – LIFE AND MISSIONARY ENTERPRISE IN KASHMIR’ written by Dr Ernest Neve. Both the books lay emphasis on the missionary activities for which they were actually sent by the Church to Kashmir. William Elmslie’s book, ‘Seedtime in Kashmir’ is titled so as to denote the start of the Christian Missionary activity in Kashmir. William Elmslie was a Scottish Doctor who started first dispensary in Kashmir in 1865. This book has a collection of his notes, his letters to his mother and what he told to his friend & his wife. In the book, Dr Elmslie describes valley of Kashmir as Valley of Sin because according to him, the valley is reeling under darkness of other religions & not his religion. He at various times mocks the religions being followed in the valley. The major emphasis of this book as well his purpose of him being in Kashmir was  the missionary activity. The doctor talks of numerous instances where due to his missionary work, he was confronted by the Muslim Preachers & the Maharaja of that time. He talks of an event in which he was warded off by the preacher when he went to Hazratbal. He also talks of an unofficial offer being given by the Maharaja that if he stopped his missionary work & concentrated only on the medical work, he would be given thousand rupees per year. With all this written in the book, he also has some firsts in the medical field in Kashmir. Following are some of the excerpts of his book :

“But what is this oppression that I have spoken of? It is this — that at one swoop half of every man’s produce goes into the Government treasury. Half of everything, not merely of his grain, but even of the produce of his cattle, or whatever he has ; so that from each cow he must give every second year a calf to Government, and from every half-dozen of his chickens three go to the all-devouring sirkar. More than this even, his very fruit trees are watched by Government and half taken for the Maharajah. A poor Kashmiri can call nothing his own. But, in reality, it is not only half a man loses, for at least another quarter is taken by the rapacious government officials who have to collect the nominal half. Shakdars, Kardars, Ziladars, soldiers, and others, all come in for their share. The wonder is, how the people exist at all. Of course I am a credulous missionary, and believed every story I heard, but I should like to find the man in Kashmir who could deny these facts. But it is not only the poor peasants who suffer ; perhaps the condition of the shawl weavers is worse still They are all the servants of the Government, which supplies them with material, and doles out to them a scanty pittance of two annas a day, and then sells them the rice (which it has taken from the peasants) at any price which it chooses to set upon it. These shawl weavers are a lean wan race, recognizable at once from their sallow complexion, thin cheeks and despondent look………….

         “But there are other things in Kashmir which most terribly detract from its pleasure as a place of residence. The dirt is beyond description. Who can tell what Kashmir smells are ? Not the odours of roses, such as one has expected to fill the air ; but, oh ! such, that the dirtiest of London courts is sweeter than the cleanest of Kashmir villages. The clothes, too, of the people are filthy; not that the filth shows much, for all their garments are of grey wool, which is a most perfect concealer of dirt ; but not a few of their diseases are the result of their uncleanliness, and how often I have almost shrunk away from them, as, in my dispensary, when I have been examining a patient, I have seen the lice crawling on his clothes and his fleas skipping over to me…………..

Dr Elmslie had the habit of recording the events of his daily routine. Some of them which have a significance are noted below :

9th May,1865To-day is memorable in the history of the Kashmir Medical Mission, from the fact that I opened my dispensary this morning. I had given notice that I intended receiving patients from this date. The verandah on the southern aspect of the house was prepared for the sick people to meet in. Punctually at seven o’clock a.m., I, Qadir, the catechist, and my two native assistants went into the verandah, after supplicating together the blessing of God on the work which we were about to initiate in Srinagar. Qadir read the opening verses of the fifth chapter of the Gospel of Matthew, and made a running and suitable commentary on the passage. The service was closed with a brief prayer for the divine blessing. I now retired to the small verandah on the east side of the house, which I had fitted up — very rudely, I must confess — as a dispensary. Here the patients were seen one by one. The number present to-day was ten.

” 18th May,1865 — The number of patients this morning was forty. Excised a cystic tumour from a young man. Having explained the object and effects of chloroform, I asked him if he wished me to give it to him.. After some slight hesitation he consented. In all probability this is the first time a native Kashmiri has been anaesthetised in the valley with chloroform

 “31st May,1865Opened my small hospital to-day. It accommodates from four to five patients. The verandah, in which the patients used to assemble to hear the address, has been fitted up for this purpose, while the long verandah downstairs is in future to be our meeting-room, being much larger than the one above. Vaccinated the two children of the Brahmin at the head of financial matters in Kashmir.

” 15th June,1865 — With the aid of chloroform, removed a large staphyloma. The people are becoming acquainted with the fact there is a medicine that takes away pain by making them sleep, and readily take it when it is required. Heard to-day that orders had been issued by the heads of the native Government that no sepoy is to come to me for advice and medicine.

” 17th June,1865 — A poor coolie, who had been accidentally shot in the thigh, died this morning in hospital. His relatives would not grant a postmortem examination. It is impossible for medicine to make much progress in India as long as it continues to be so difficult to obtain specimens of morbid anatomy.

 ” 19th June,1865 — Assisted by the Eev. Mr. Yeates, performed resection of the wrist-joint. The patient was a young woman. Her parents were present during the operation.

” 21th July,1865 — (Srinagar). In the afternoon, performed Chopart’s operation for caries of the bones of tarsus. The patient was a girl, whose father and mother were present during the operation. Chloroform was administered to the patient, who went off very quickly. In operating, my difficulties are legion, for I have everything to do myself.

_____________________________________________________________________________________

Some portions from Dr Ernest Neve’s book, Beyond The Pir Panjal : To begin with, a Kashmiri saying in the book

                     ” Haki’mas ta hakimas nishh tachhtam Khodayo.”

                     ” O God, save me from physicians and rulers “

‘In spite of his great physical strength and powers of endurance, the Kashmiri is highly strung and neurotic, and he will  often weep on slight provocation. In the presence of very little danger he will sob like a child. These people can bear pain much better than Europeans, but owing to want of self-control they make more fuss. Naturally impulsive and huffy, they respond readily to tactful handing  On the whole they are grateful for benefits. Their moral sense is  fairly well-developed. They readily distinguish between right and wrong. In money affairs they are close, and the more wealthy are mean. They spend little,  and except at weddings care nothing for show. Even the rich wear dirty clothes  lest they should be thought too well off. …………………….

A widespread cholera epidemic in 1867, while diminishing  the  number of  ordinary  patients, gave  the  Medical Mission the opportunity of helping the cholera-stricken. When Dr Elmslie laid down his work in 1869, he had achieved much. The opposition of the State authorities overcome  the confidence had been, to a considerable extent, of the Kashmiris had been won, and an immense amount of relief had been afforded to sufferers. Four Kashmiris had become Christians. One of these for many years continued to render faithful service in Kashmir as a Christian teacher. As an indirect result of the work of the Medical Mission, the first Kashmir State Dispensary had been started. And this was the forerunner of the present extensive State Medical Service…………

                  Dr Theodore Maxwell, who was Elmslie’s successor, was fortunate in meeting with a very friendly reception from the Maharajah Ranbir Singh, who, hearing that Maxwell was a nephew of General John Nicholson of Delhi fame, promised to grant good house accommodation. The work was reopened in 1874 under favourable conditions. Official opposition was  withdrawn. The State medical officer was friendly. The Maharajah granted a site for a hospital,  and at State expense a small building was erected on the north side of the Rustum Gaddi Hill………

                  From 1877-1879 Kashmir was limited by an appalling famine. In some parts of the valley, including Srinagar, it  is  said that the population was reduced by more than a half. Heavy rain fell  in the autumn, before the crops were gathered in. The rice and maize which arc the staple foods rotted. During the winter, rain continued. The cattle died from want of food. The spring harvest failed owing to bad weather. The authorities made a fatal mistake and ordered a house-to-house search for seed-grain, which the cultivators had stored for spring use. Believing, probably with good reason, that this grain would be confiscated by tyrannous and absolutely unprincipled officials, the people consumed the seed-grain themselves, or by hiding it in damp places they so damaged it  that it was no longer available for sowing. As a result, the  famine continued until  October 1879. Oil-cake, rice, chaff, the bark of the elm and yew, and even grasses and roots were eagerly devoured by the  starving people, who became absolutely demoralized and like  ravenous beasts, each struggling for his own life.The corpses of those who had perished were left lying or hastily dragged to the nearest well or hole, until these became choked with dead bodies. Dogs wandered about in troops preying upon the unburied carcasses  Pestilence dogged the steps of want and cholera broke out. Everything combined to intensify the disaster. Many officials in high places proved apathetic, or worse still, for selfish purposes, aided and abetted in keeping up prices, and even  intercepting the grain which was being sent in over rough mountain tracks for the relief of the dying.

                Quoting Dr A Neve, ‘Of recent years the completion of the  Jhelum Valley Road and the greatly increased traffic  to and from India have unfortunately made outbreaks of  cholera more frequent. In  twenty  years  there  have  been  five  serious epidemics with at least  forty thousand deaths. The fatal years were 1888, 1892, 1900, 1907 and 1910. Before the year 1900, however, a supply of pure water had been laid on to most parts of the city,  and thousands of lives were saved thereby. In 1888 and 1892 Srinagar was a City of Dreadful Death.” We are looking from the bows of our matroofed boat for the first sight of Srinagar, the so-called Venice of the East…’

               Until the introduction of general vaccination, practically the whole population  of  Kashmir contracted smallpox in childhood. The mortality was appalling. From this and other causes fifty per cent, of the children of Kashmir are said to die in infancy. I often wish the opponents of vaccination could be present in our consulting room to see the melancholy procession, day by day, of those who have lost their sight from smallpox.  For this disease is the most frequent cause of total incurable blindness. Like many other towns with large rivers, Srinagar, in a marvelous way, escaped having plague in a severe form. There was, however, a sharp epidemic in 1903. A man died immediately after his  arrival in the mail-cart from India. His body was buried  in  quicklime. His  friends  secretly exhumed the corpse in order to re-inter it near a sacred shrine. They were attacked and the  disease  spread rapidly. It assumed the pneumonic form. And curiously enough there was no  associated  rat  mortality. The authorities  took vigorous measures, at first burning down all plague-infected houses.They were, however, compelled to abandon this, owing to popular opposition. The disease gradually died out, after lingering with singular persistence in some isolated villages near the Wular Lake.The mortality, all  through, was terrible—over 95 per cent. Kashmiris, who were under European influence, were willing to submit to prophylactic inoculation. No European was attacked by plague.’

Early Days of Kashmir Mission Hospital and the case of Kangri

I was searching that how the allopathic medicine started in Kashmir & stumbled across a few references and papers on it which i would like to share with you people. I got references from the Indian Medical Gazette & Journal. Also i got a reference from a paper published online by the Royal College of Physicians in 2008.

Following is the Paper : 

mir-page-001

Paper J R Coll Physicians Edinb 2008;38:85–8© 2008 Royal College of Physicians of Edinburgh

Inspirational people and care for the deprived: medical missionaries in Kashmir

 NA Mir, V  Connell  Mir

Consultant Paediatrician, North Cheshire Hospitals NHS Trust,Warrington; Clinical Lecturer (Hon.), University of Liverpool; Clinical Nurse Specialist, Royal Liverpool Children’s Hospital, Alder Hey, Liverpool, UK

Published online March 2008

 In the European cemetery in Srinagar is the grave of Lieutenant Robert Thorpe, a British soldier who gave up his life for the people of Kashmir in the late nineteenth century. Like many other British officers, Thorpe came to Kashmir, in 1860, to escape from the heat of the plains and to shoot big game in the mountains. However, he was overwhelmed by the sorrows and the suffering of the people under the maharaja’s rule. He tried to bring the harsh conditions of the people to the attention of the maharaja as well as the British administration in New Delhi, and wrote to various newspapers in England. Thorpe was then ordered to leave the country and, when he refused, was bound to his bed and carried towards the border by other soldiers. He managed to escape and returned to Srinagar; however, the next morning he died of poisoning after taking his breakfast. There was no further investigation from the British authorities in New Delhi, and Thorpe was quietly buried in Srinagar. Other British officers who had been aware of Thorpe’s efforts raised 14,000 rupees for the CMS in London and requested them to send a medical missionary team to Kashmir.

   The picturesque valley of Kashmir is situated at an altitude of 1,730–7,077 metres above sea level and has a present-day population of more than 6·3 million people; it has two state-run medical schools, multiple tertiary healthcare centres including a supra-regional medical centre, and a large network of district and sub-district hospitals and dispensaries, offering free medical facilities to the people. At the beginning of nineteenth century, however, there was no hospital or dispensary in the state. Then, the country was very poor, and people died of malnutrition and in epidemics of cholera, plague and other illnesses.

EARLY MEDICAL MISSIONARIES

In 1864, the Reverend Robert Clark, the senior CMS missionary in the Punjab, went over the mountain passes into the Kashmir Valley. He was accompanied by his wife, who, without asking anybody’s leave, quietly opened a dispensary for women – now the site of the Government College For Women, Nowakadal – in Srinagar. Clark’s wife was not a qualified doctor, but knew more than the native hakims (herbalists) and very soon hundreds of women, who would have otherwise died of simple illnesses, came to her to receive treatment.

A young Scottish doctor of distinction, William Jackson Elmslie (born in Aberdeen in 1832), a graduate of the University of Edinburgh, responded to the Punjab Appeal initiated by the British officers after Thorpe’s campaign,and the following summer arrived and opened his dispensary on 9 May 1865. Elmslie (Figure 1) worked under extremely hard conditions; there was no hospital and he held his clinic in the open under a tree. During that first summer he saw more than 2,000 patients. There was opposition from the maharaja and his officials, who put firm conditions on the team: they were not allowed to stay in winter or purchase any land or buildings. Hence, Elmslie had to use a tent, adapting its inner part for inpatients. In the summer of 1866, more than 3,500 patients were seen by just two doctors. The work went on for seven summers,and overseas visitors helped Elmslie to carry out his work.The maharaja surrounded the dispensary with a cordon of soldiers to mark who attended, and opened a rival hospital himself, which was all to the good as there had not been anything of the kind before.

 Elmslie was a keen surgeon and performed many procedures under abysmal conditions but with successful results.This included the first lithotomy, for bladder stone, performed on 23 May 1866. He reported 30 cases of skin epithelioma and suggested its relationship with the use of Kangri, a clay fire-pot used close to the skin to keep warm in winter. Elmslie died while crossing the mountains in 1872.

Dr Theodore Maxwell, who succeeded Elmslie, was the nephew of General John Nicholson and exerted his New Delhi influence.Thus, the maharaja’s government became more favourable and gave land at the foothills of Solomon’s Temple in Srinagar for the construction of a hospital.

There was no end to the hardships of the people, with terrible famine following an exceptionally early winter in 1877. Another eminent physician, Dr Edmund Downes, and his team undertook much relief work, distributing food and helping to dig a canal.The plight of the mentally sick was distressing and, as these patients had no home or carers, they wandered through the streets and living as beggars.An asylum was built by the state in 1881–82 and handed over to the Mission Hospital team. Downes opened the asylum for the mentally sick; during its first year more than 250 patients were treated as inpatients. This was followed by the opening of a Leper Hospital, built in 1891–92, in Srinagar. On 15 August 1888, a dispensary that later became a hospital exclusively for women was opened by the Church of England Zenana (Ladies) Missionary Society. Among the notable female medical missionaries who worked hard to run this hospital were Dr Fanny J Butler and Dr Kate Knowles, with trained nurses Miss Irene Petrie and Miss Elizabeth Newman. During 1877–1880 Downes and the Reverend Mr Wade opened an orphanage where more than 150 children were cared for.

THE MISSION HOSPITAL

Two significant events changed conditions for the better in the Valley of Kashmir. The first was the arrival of Dr Arthur Neve in 1882 and the second was the Maharaja Rhanbir Singh’s death in 1885, leading to his son, Maharaja Pratap Singh,taking over the reigns of the state. Upon his arrival, Dr Neve  found the hospital to be a line of mud huts on the side of the hill. His vision was to develop a modern hospital. He and his brother, Ernest Neve, who joined him four years later, gradually gathered enough funds from donations to build and run the 80-bed Mission Hospital, which opened in 1888. In 1893, the then 135-bed Mission Hospital catered for 20,606 patient visits, including 853 inpatients and 2,589 operations. Other British staff who joined included Dr Cecil Vosper, Dr MR Roche and three English nurses, Nora Neve (Neve’s niece), Lucy McCormick and H Smith.A large number of visiting British physicians, surgeons and nurses helped them during the peak periods.

The new maharaja, Pratap Singh, was a reformist who took steps to eradicate poverty by abolishing harsh taxation laws and forced labour. He was very impressed with the Mission Hospital work and gave annual donations and free power supplies, and visited the hospital on several occasions. He also ceased the decree that demanded expulsion of foreigners each winter. However, the maharaja was unable to implement any real social and welfare plans for the improvement of people because of his weak and corrupt administration. Consequently, in 1889 the British government in New Delhi decided to hand over most of the maharaja’s administrative powers to the British Resident, Mr C Plowden, and his council in Srinagar. Kashmir Valley had an epidemic of cholera in 1896 and an outbreak of the plague in 1903–1904, which cost thousands of lives.The Mission Hospital team was at the forefront of relief work and helped the local administration in setting up medical facilities in various towns; including the opening of a new well-equipped hospital in Srinagar. In 1899, the now 150-bed Mission Hospital treated 16,158 outpatients with a total attendance of 38,954 patients, which included 4,143 operations.

 DR ARTHUR NEVE, FRCSE (1859–1919)

Dr Neve undertook his medical training at the University of Edinburgh in 1876. After working as a house physician in the Royal Infirmary of Edinburgh, he was appointed resident medical officer to the Livingstone Memorial Dispensary and Training Institution in Edinburgh, under the Medical Missionary Society. In 1881 he worked as a resident physician at 39 Cowgate, a dispensary and hostel for senior students in one of the poorest districts of Edinburgh. He later joined the CMS and went to Kashmir in 1882. Besides publishing several medical papers in The Lancet, he was the author of numerous books, including Kashmir, Ladakh and Tibet (1899), Picturesque Kashmir (1900), ThirtyYears in Kashmir (1913), and TheTourist’s Guide to Kashmir, Ladakh and Skardo (1923). He was a keen mountaineer and paid three visits to the 23,409-ft Nun Kun mountain peaks in 1902, 1904 and 1910. Romesh Thong Peak is also called Sunset Peak, a name given to it by Neve. He was awarded the Kaiser-i-Hind Gold Medal by the British government in India in 1901, served as the vice-president of the Indian Medical Congress in 1909 and was the president of the Medical Missionary Association of India from 1908–1910.

In 1915, Neve joined the British war effort, returning to Kashmir in the spring of 1919. At the end of August 1919, he was suddenly struck down by a fever and died in Kashmir, at the age of 59, on 5 September. He had spent 34 years of his life in the region, with the sole objective of helping the poor and the sick.The state had never before witnessed such a large gathering of local people to mourn the death of a hero.

DR ERNEST NEVE, FRCSE (1861–1946)

Ernest Neve was Arthur Neve’s younger brother by two years. He joined Arthur in medical training at the University of Edinburgh in 1878 and then followed him to Kashmir in 1886. Ernest was also the author of several books, including Beyond the Pir Panjal. Life Among the Mountains and Valleys of Kashmir (1912); A Crusader in Kashmir (1928), the story of his brother’s life and work;and Things Seen in Kashmir (1931). He pioneered work on Kangri cancers, which, as Elmslie had suggested the previous century, are epitheliomas induced on the abdominal wall or inner surface of the thigh of Kashmiri people, who warm themselves by braziers containing live coals held under their clothing and thus sustain recurrent burns. In 1923, Ernest Neve reported the results of his success with the surgical treatment of Kangri-burn cancer in a series of 2,491 cases in the British Medical Journal.

CONCLUSION

Within the wider history of the British empire, the work of medical missionaries in India offers an interesting and important insight into the humanitarian role played by these physicians and nurses. It also reflects the level of their dedication in providing modern medical treatment to the sick and the needy. Scottish medical missionaries were the first to establish modern medical care in the valley of Kashmir in 1864. With their own distinct Scottish missionary zeal and healthcare traditions, they were able to initiate, guide and influence the development of medical treatment facilities in the state of Kashmir.They continue to inspire and remind us of the core values of caring for the sick in deprived areas.At the site of the old Mission Hospital in Srinagar now stands the largest Chest Disease Hospital in the valley, a monument to the great medical missionary pioneers who laid down their lives in the service of the Kashmiri people.

____________________________________________________________________________________

____________________________________________________________________________________

From The Indian Medical Gazette published in January 1907, i also got some clinical conditions which were treated in Srinagar by the doctors of The Kashmir Medical Mission.

CASE OP PYONEPHROSIS WITH CALCULUS. KASHMIR MISSION HOSPITAL. Undbbthb care op A. Neve, F.R.C.8.B.

A WOMAN aged 30 was admitted on April 4th 1903, with a history of pain for some months. A large hard swelling was felt in the right hypochondriac region, extending downwards to near the crest of the ilium, and forwards to within three inches of the umbilicus. The dullness could be marked off above from the liver. The fever and anaemia of the patient indicated suppuration. Being sure that adequate adhesion must have formed, an incision was made over the most prominent part, and at no great depth pus was tapped. On exploring, a stone was felt, and withdrawn with narrow bladed forceps. It was not firmly embedded. It was a black irregular calculus, about the size of a water chestnut. The wound was drained with a rubber tube 3 inches long, and for the first fortnight the suppuration was free, and the temperature several times went over 102, but later on she made good progress. After a month the temperature remained normal, and there was very little discharge, although a sinus remained. She was dismissed on tlie 18ch of June.

CASE OF LARGE GOITRE; EXCISION THYROIDISM: RECOVERY. By B. F. NEVE, p.b.c.8. (Kdin.), Kashmir Mission Hospital.

Fatah, cbL 23, male, was admitted on September 8th, 1903, suffering from a large bronchocele. The tumour, which w?is the size of a small cocoanut, was on the right side. The isthmus was flattened out and pressing on the trachea. The left lobe was also somewhat enlarged. As a general rule, Kashmiris are well satisfied with the result of the action of the biniodide of mercury ointment, which has a great reputation, and for which they frequently ask. Consequently, unless the goitre is giving considerable discomfort, they decline operative interference. The following day, I removed the tumour with the kind assistance of Dr. H. T. Holland of Quetta. The operation presented no special difficulty, but was tedious and involved the h’gature of an enormous number of vessels, although we were working well beyond the limits of the capsule. And the isthmus was broad and very adherent. There was a good deal of unavoidable handling of the tumour mass. After excision I noticed that the cut surface of the isthmus was oozing freely and continued to do so, but the blood was thin and watery. The amount of blood lost was small. This was fortunate, for an hour afterwards, I was urgently summoned to the wards on account of haemorrhage. On removing the dressings, there was an appalling gush. I opened up the wound and, passing my thumb round immediately above the clavicle, commanded all the vessels and secured a branch of the internal jugular, which had been cut near the main trunk and had retracted. The ligature had apparently slipped off from the stra n of vomiting. The patient had lost 15 to 20 ounces of blood in the interval. He was fairly well till the following day, but began then to get restless, and a troublesome cough set in, and his condition soon became critical. He kept on trying to clear his throat and complained of severe headache. The pulse rate was found to be very high — 148, while the> temperature was 100 2**. The patient’s face was”” rather suffused. The dressings were soaked with a thin discharge. The combination of symptoms was unmistakable  and pointed to thyroid intoxication. The following treatment was adopted. The wound was opened and irrigated, and then carefully stuffed with iodoform gauze. As often as this got moist every few hours, it was removed, the wound again irrigated and fresh gauze inserted. Immediate improvement set in. The patient himself remarked upon the relief experienced every time the wound was dressed. On September 13th, the temperature was normal, the pulse had dropped to 90, and from that time recovery was uninterrupted. The points of interest about the case are that the symptoms did not at once follow the haemorrhage and slowly pass off, but that they gradually set in during the 24 hours following the operation, reaching their maximum intensity after 24 hours. The peculiar cough, restlessness, rapid pulse and suffused face, and the copious watery discharge were all, I think, characteristic of thyroidism. The actual poison was, no doubt, in the discharge and probably was derived from the isthmus. Possibly cases with a broad isthmus are more likely to suffer from this complication. In doing the operation the tumour should be very gently handled and not squeezed, and, if possible, the isthmus should be ligatured en bloc. If this is impossible, and oozing is occurring from the surface, it would be wise to sear it with the thermo- or electric cautery. It is important to recognise thyroid intoxication when it occurs and to treat it promptly, as otherwise it is likely to prove fatal.

THE KASHMIR MEDICAL MISSION. Our pages for many years past have been enriched with the records of the good surgical and medical work done in the hospitals (of the Sept. 1904) NOTES ON CURRENT TOPICS. Kashmir Medical Mission, and to our readers the names of Mr. Arthur Neve, F.R.C.S., (Ed.) and Dr. E. F. Neve are very well known. We have received the annual report of the medical work of the mission for 1903. The introduction describes the floods of June 1903, which did so much damage in the neighbourhood of Srinagar. So with flood, scarcity and even plague, the ” Happy Valley ” was not so pleasant as is usual. The summary notes no less than 3,390 operations. The writer comments upon the rarity of tuberculous disease of glands and joints as compared with their frequency in British hospitals. ” Appendicitis is extremely rare. If we except the peculiar kangH-huvn cancer, of which we had 65 cases, malignant disease is not common in Kashmir. Our returns for the past year show only two cases of carcinoma of the breast, and 19 instances of sarcoma. Two more successful ovariotomies were performed. Both ovarian and fibroid tumours are relatively quite rare. On the other hand, as is usual in the East, eye diseases are common. For entropion alone,480 operations were required, and for pterygium 237. Altogether there were more than 1,000 operations for eye diseases,’* (including 80 for cataract).

The carcinoma statistics quoted in this paper hear out the general principle that cancer tends to occur at the sites of chronic irritation where there is constant need for cell repair. Fifty-eight cases of epithelioma and 36 of rodent ulcer occurred in the skin, which in India is almost constantly the seat of injury, owing to the scanty clothing worn by the Natives. Many of these are the scalp. It seems possible that they are set up by irritation caused by cuts with a blunt razor, for most Mahomedans shave the head as a whole, while many Hindus shave a portion. In patients from Kashmir an epithelioma of the skin of the exterior abdominal wall is common from bums produced by small charcoal fires in earthenware vessels, which they hold against the bare skin under the long, flowing skirt in winter to keep themselves warm. The freedom of Mahomedans from cancer of the penis, and their practice of circumcision, bears upon this point.

_____________________________________________________________________________________

_____________________________________________________________________________________

From the Indian National Medical Journal Vol.23, No.1, 2010, the following pages i have extracted which are in relevance to Kashmir :

Classics in Indian Medicine

Capture

William Elmslie initially studied at the University of Aberdeen and graduated in 1864 from the University of Edinburgh. He went to Kashmir in 1865 when he heard of the plight of the people there because of the practically non-existent health services. Elmslie was the first person to practise western medicine in Kashmir. He was a dedicated surgeon who, because of resistance from the Maharaja and the local officials, was forced to hold his clinic under a tree and later in a tent! In fact, after some years, the Maharaja opened a rival hospital. Elmslie was perhaps the first person to describe what we now term as ‘kangri cancer’ and also correctly suggest its aetiology. He also did lithotomies for bladder stones and contributed greatly during the cholera outbreaks. He had planned to bring out a dictionary of the Kashmiri language, but died young of a liver disease in Gujarat on 18 November 1872.

Arthur Neve did his medical training at the University of Edinburgh in 1876. After working in Edinburgh for some years, he joined the Church Missionary Society and went to Kashmir in 1882. He was head of the Kashmir Mission Hospital for 37 years until his death in 1919. Besides being a skilful surgeon, he was a Himalayan mountaineer of repute and was the author of such books as Kashmir, Ladakh and Tibet, Picturesque Kashmir, and Thirty Years in Kashmir. During World WarI, he served as a Major in England, and later, in France. In 1919, he returned to Kashmir where he was given additional charge of the State Leper Asylum. He died of a fever suddenly on 5 September 1919 and was awarded a state funeral by the Maharaja of Kashmir. He was the subject of two biographies, Arthur Neve of Kashmir written by A. P.Shepherd and published by the Church Missionary Society, London in 1926 as well as A Crusader in Kashmir written by Ernest Neve.

Ernest F. Neve followed in his brother’s footsteps and trained at Edinburgh and joined him in Kashmir in 1886. He served as honorary/consulting surgeon at the same hospital until his death. His range of surgery and his contributions to the people of Kashmir are evident when one realizes that he published papers on cataract surgery, tubercular lymphadenitis, caesarean section in osteomalacia, besides kangri cancer. He was also one of the founders of the Kashmir State Leper Hospital in 1892 and was an honorary superintendent. Like his elder brother, he was a mountaineer and writer and wrote Beyond the Pir Panjal, Things Seen in Kashmir and A Crusader in Kashmir, a biography of Arthur’s life and work. He too served (as Captain) in the army during World War I. For over a decade after retirement, he continued to stay in Kashmir, where he eventually died in 1946.

ETIOLOGY OF EPITHELIOMA AMONG THE KASHMIRIS

BY  W. J. ELMSLIE.

In the beginning of the month of May, 1865, a Medical Mission Dispensary was opened in Sirinagar, the capital of Kashmir, under the auspices of the Punjab Medical Mission Society, and was kept open till the middle of October, when the season, as it is called, comes to an end, and all Europeans, whatever may be the nation to which they belong, are compelled to quit the valley, unless they be in the pay of His Highness the Maharaja of Kashmir and Jummoo. About the same time this year the dispensary was re-opened, and has been daily frequented by the sick, both men and women of the city and the adjoining country. The total number of patients belonging to the valley who have, up to the present date (18th September), applied at the dispensary for medicine and treatment is 5,080 and of this number no fewer than 30 have been cases of unmistakeable epithelioma, as was clearly and indubitably shown by the history, symptoms, and microscopical characters of the disease. These figures yield the most remarkable and unusually high proportion of one case of epithelioma in every 254 patients. The following table exhibits briefly, at a glance the names, sexes, ages, country, sites of disease, and treatment of these 20 cases of epithelioma.

 Epithelioma, as it occurs at home, is a disease which seldom makes its appearance before the age of 40; more frequently affects men than women ; as to situation, is partial to the lower lip, the penis, the scrotum, the vulva, the os uteri, the bladder, the larynx and the tongue, and is generally supposed to be produced by some sort of irritation. Now it will readily be observed, on inspecting the prefixed table, that there are certain remarkable differences existing between the disease as it is met with in England, and

Table of twenty cases of Epithelioma treated at the Medical Mission dispensary, Sirinagar, Kashmir.

Number Names Sex Age Country Site Treatment
1 Mukhti… Female 20 yrs Kashmiri Abdomen Excision
2 Rajbah… Male 38
3 Razakh… 30 Left thigh
4 Gafara… 24 Right thigh
5 Razakh… 50 Would not
submit to
treatment
6 Naki… 21 Abdomen Excision
7 Gulab… 60
8 Jamil… 70 Right thigh
9 Doni… Female 40 Abdomen
10 Adna… Male 50 Left thigh
11 Alam… 50 Abdomen
12 Hatim… 50 Left thigh
13 Fazli… Female 42 Abdomen
14 Sadik… Male 19
15 Gafara… 3
16 Jamah… 60
17 Mouli… Female 60 Caustics
18 Sadik… Male 50
19 Akldar… 60 Right thigh
20 Masihena… 50 Abdomen

the affection as it presents itself in Kashmir. While the disease is rarely met with before 40 in England, no fewer than 7 out of the 20 cases treated at the Medical Mission Dispensary, Sirinagar, occurred before that age, and one little patient was only three years old.

It must not be supposed that the table gives the true state of matters with respect to the comparative frequency of the disease as occurring amongst males and females ; for very many of the women, in common with the great majority of Asiatic women, entertain a strong and all but insuperable antipathy towards European skill and medicine, more especially when their ailments are situated in parts of the body where a spurious delicacy dictates to the pitiable and ignorant sufferers that it is preferable to allow them to remain uncared for and untreated, than expose them to the gaze of a foreigner and a white face. It seems probable that the apparent dislike of the European physician entertained by native women is mainly due, in very many instances at least, to the evil and bigoted influence of their male relatives and friends. But be this as it may, this antipathy of native women towards the Doctor of another continent is nevertheless true, and should be constantly remembered when statistics are brought forward to show the comparative frequency of particular diseases among native men and women, for if it is forgotten, the statistics are sure to lead to an erroneous conclusion. Although, therefore, it would appear from the mere inspection of the table that the frequency with which epithelioma affects men and women in Kashmir, is pretty similar to what it is at home, nevertheless, knowing and remembering this fact respecting the strong objections which native women have to European physicians, we have good reason for believing that a much larger proportion of women suffer from epithelioma than the prefixed table would lead us to conclude.

One of the most curious and interesting points connected with epithelioma as it obtains amongst the degraded Kashmiris, is its remarkable preference for the abdomen and inner aspects of the thighs. It would be hasty and unwarrantable, with our present very limited observation and experience, to say that epithelioma occurs in no other situations among the pitiable inhabitants of the Fair Valley, but certainly, so far as the disease has been seen at the Medical Mission Dispensary, Sirinagar, these are the two sites it has invariably occupied. What can be the cause of this most note-worthy preference as to situation? That there must be something special and peculiar in the habits and customs of the Kashmiris to account for this exclusive choice of the abdomen and thighs on the part of epithelioma, seems pretty certain, and we believe that something to be what we shall now proceed to relate.

The clothing of the Kashmiris, both men and women, consists essentially of one long loose woollen garment, which extends from the neck to the ankles, and is not very unlike a woollen night-gown. So far as this article of clothing is concerned, men and women are dressed exactly alike. The men, however, frequently wear a kamarband round their waists when they have a journey to make, or some piece of work to perform which requires more or less of activity. The sleeves of the garment being wide and capacious, the wearer can with the greatest facility take his or her arms out of them, and place them alongside the body, in immediate contact with the bare skin. So much for the dress of the Kashmiris, in so far as it concerns our present subject; and now for a word or two respecting the climate of the valley.

Kashmir, a valley about forty miles long from north-west to south-east, and on an average fifteen miles broad, is situated in 34° 05′ 28″.69′” north latitude, 74° 58′ 00″ east longitude, and 5,350 feet above the level of the sea. The climate which this proverbially beautiful valley enjoys is in some respects similar to that which prevails in the most favoured spots in the south of England. The winter, however, is said some years to be extremely severe, as many as two feet of snow sometimes falling. We know for certain that many of the mornings and evenings of the months of April and May, and September and October are very cold indeed, although no snow falls in the plains during these months.

The houses of the Kashmiris are not at all calculated to afford efficient shelter to their occupants against the inclemency of the weather, being for the most part built of wood, and being besides generally in the most rickety and tumble-down condition imaginable. So far as the writer is aware, they are entirely destitute of fire-places, and when a fire is kindled inside one of them, the smoke must find a way of escape, either by the door or the window, which is never of glass, but as a rule, of trellis work, which is often very pretty, and for which Kashmir is justly famous.

Coal being unknown in the valley, wood is the material generally employed as fuel. The very poorest of the people, however, collect in the summer and autumn the ordure of cattle, which they mix with straw and then form into round cakes which they dry in the sun’s rays and carefully preserve against the coming winter. Having premised so much respecting the clothing and houses of the Kashmiris, and the climate and fuel of the valley, it only now remains briefly to describe a remarkable custom which the Kashmiris have, and which has an important bearing on the etiology of epithelioma, if we are not very much mistaken.

The Kashmiris being extremely poor and inactive, and the climate at different seasons of the year being unpleasantly and bitterly cold, the inhabitants of the Fair Valley are in the habit of carrying about with them, wherever they go, earthen-ware pots, which they have denominated kangris. These kangris or portable braziers are made of clay of varying fineness, and are usually covered with wicker-work, more or less ornamented according to the price of the article. Men and women, young and old, rich and poor, Hindu and Mussulman, all have their kangri, and all consider it indispensable in the cold season. The annexed rough pen-and-ink sketch will perhaps enable the fancy to form a dim conception of the shape and general appearance of the utensil as used by the Kashmiris.*

When the weather is extremely cold, it is customary for both men and women, while walking about out of doors, to carry the kangri under their loose woollen gowns, and in close proximity with the bare skin of the abdomen. When in doors, or in a sitting posture, the Kashmiris place the kangri between their thighs. The fuel consumed in the kangri is charcoal, and the heat evolved is often considerable. These then are the facts concerning epithelioma, and the use of the kangri or portable brazier used by the inhabitants of the valley of Kashmir ; and to say the very least, it seems highly probable that the disease is caused by the injurious effects of the heat of the kangri on the skin of the abdomen and thighs, the very part with which the utensil comes in contact when used. Do these facts respecting epithelioma among the Kashmiris throw any light on the disease as it occurs in the lower lip of smokers at home? It seems probable that they do, for the disease is said most frequently to affect those who use short-stalked pipes, as is generally done in Scotland. If the heat of the kangri acts injuriously on the skin, giving rise to epithelioma, it is just what we should have expected that those who use the shortest-stalked pipes would be the most liable to the disease at home, because then the heat of the stalk, coeteris paribus, will be greater.

With respect to the use of portable braziers for the purpose of warming, the custom is not altogether unknown in England, for in the straw plait districts the children employed in that work are said to carry earthen-ware or tin pots with them to warm themselves with in winter while engaged at their work. The writer saw with his own eyes, during a tour in the north of Italy, the inhabitants of Florence making use of a vessel not very much different from the Kashmirian kangri, and for exactly the same purpose. The use of portable braziers is not calculated to act injuriously in a similar manner in the case of the English and Italians, as the arrangement of the dress is considerably different to what obtains among the poverty-stricken inhabitants of the Fair Valley.

SQUAMOUS CELLED EPITHELIOMA DUE TO KANGRI BURN

BY  ERNEST F. NEVE, M.D., C.M., F.R.C.S.E., Senior Surgeon, Kashmir Mission Hospital.

AT the present time the causation of cancer is being so vigorously investigated that at any time a flood of light may be thrown upon the whole subject. Meanwhile, although the origin of many forms of malignant disease is involved in profound obscurity, there are certain types of cancer, which have a sharply defined causation. The kangri cancer is a case in point.

The affection is considerably commoner in men. This is perhaps due to women not using the kangri so continuously as men, owing to domestic occupations, cooking, etc. The essential cause of the disease is constant irritation by intense heat from the kangri (Fig. 1) being held against the body and producing first dermatitis, then proliferation of epithelium, followed by escape of the overgrown cell elements from trophic control. Heat is the prime factor. Wood charcoal is consumed in the kangri. Products of combustion, wood ash, and volatile substances may play a secondary part. There is a series of epitheliomata. At one end of the scale we have tar, paraffin and soot cancers. Intermediate are clay-pipe lip cancer and tongue and lip cancer probably caused by smoking cigarettes. At the other end of the scale are the cancers due to heat irritation. I have not met with cases due to the sun’s heat or to light rays, but further down the spectrum the minute x-ray waves and radium are dangerous. Then there is a group due to chemical irritants, caustics, the betel chewers’ cancer, and the mysterious action of arsenic which ought to be a help in elucidating the problem underlying cancerous cell proliferation.

The epithelioma of workers in comb factories, due to contact of hot water pipes with the skin, is important because it appears to be an instance of simple heat action apart from chemical agencies euxetics, etc.

The kangri burn cancer is I think also due to simple heat. The temperature to which the skin is exposed is, I have found by experiment, between 150° and 200° F. Thus, year by year we have going on under observation the experimental production of cancer by the action of one particular cause. The average age of the patients affected is 55. I have seen a few cases in patients under 40 but they are rare. About 6 or 7 per cent. are over 70 years of age. There may be some pre-disposing factor. Many elderly Kashmiris exhibit small localized papules or macules. These are dry, slightly scaly and usually pigmented. Curiously enough they are found not only on areas exposed to heat irritation but also on extensor surfaces and on the back, although they are more abundant on sites liable to intermittent kangri burn. Does heat irritation in one area stimulate epithelial growth elsewhere?

Where there is actual exposure to heat rays, every stage of chronic dermatitis may be seen, from redness with or without desquamation to thickened patches, warty induration, or even horny outgrowth projecting from the surface. The skin of the thighs and abdomen, owing to the constant application of heat, often appears dry and horny. Pigmentation is increased over the distribution of the superficial veins, the course of which is marked by brown discolouration. Such patients are especially prone to epithelioma. The frequency of actual scars from previous burns is noteworthy. And it is these which usually form the starting point of the malignant growth.

Thus we have under observation, in different patients, every stage, from the earliest signs of epithelial proliferation to the most advanced cancerous growths with secondary deposits.

The evidence of the kangri burn cancer is indeed strongly against the parasitic theory of cancer. It is a local disease from a local cause, arising on a site which is in a protected position. The hands, face and feet, which are exposed without clothing are never attacked. Parasitic diseases are more apt to attack young people than the elderly. The local infectivity of cancer is no proof of parasitic origin. Skin grafts by Thiersch’s method not only adhere but grow, and the more sterile they are the better they grow. The peculiar vital stimulating influence of such a graft has probably some bearing on the problem. The essential factor in epithelioma is the outlawing of a mass of tissue, over which the nerve influence controlling growth has

ceased to act. What is the mechanism of regulation of epithelial growth? What part does trophic nerve influence play? What share have endocrines? The skin changes in Addison’s disease are suggestive. So are the influence of the ovarian internal secretion on mammary cancer and the action of arsenic in the occasional production of epithelioma. All these considerations are adverse to the parasitic theory of origin of epithelial cancer. The incidence in elderly people emphasises the probable relation to impaired functions of growth and repair and unstable equilibrium of endocrines.

The kangri burn epithelioma is usually met with as a single or multiple growth resting on a scarred skin surface. It is confined to the flexor aspects of the body. In the earliest stages warty or keratinous thickening may be present without erosion. But more commonly there is an ulcer. There may be excavation with little increase of tissue. But there is also a type with fungation. The eroded type is more characteristic of the aged. It consists of ulceration with irregular steep edges, undermined in places, and a ragged floor with necrotic areas and deep recesses, the whole bathed in thin, intensely foul discharge which has overflowed at some dependent angle and dried on the skin around. In many cases, however, overgrowth is more evident and there is a projection of two or three inches diameter approximately circular or oval with a crater like ulcer (Fig. 2). Sometimes the overgrowth is the most striking feature and there is a fungating excrescence projecting one or two inches from the surface and measuring three or four inches across. In advanced cases muscles, peritoneum, costal cartilages or even bone may be encroached upon by the infiltrating base of such tumours. More than fifty per cent. of the cases, when first seen show secondary infection of lymph glands. If the growth is above the umbilicus, the anterior axillary glands may be attacked. As, however, the tumour is usually on the thigh or lower abdomen it is the glands of Scarpa’s triangle and along Poupart’s ligament which require examination and especially those close to the pubic spine. In advanced cases the deep femoral and even the external iliac glands are involved. Infected glands soften early. They may attain the size of a pigeon’s egg. When they break down, rapid diffuse infiltration occurs, the overlying skin becomes red and brawny, and suppuration follows. Such a secondary growth in the groin or axilla then presents a similar appearance to the primary cancerous ulcer except that it is deeper and undefined in extent (Fig. 2). From its ragged cavities and deep recesses there is copious foul discharge until, after months of suffering the patient dies of exhaustion, septic intoxication, or haemorrhage. The external iliac, femoral or axillary arteries may be opened up by ulceration with rapidly fatal result.

The appearance of the kangri burn cancer on section are characteristic. Stiles’ method is useful in demonstrating the epithelial neoplastic infiltration. The substance of the tumour consists of a framework of fibrous tissue with numerous blood vessels and masses of friable tissue, mottled red and grey.

Sometimes woolly looking patches are found, composed of cholesterin crystals. The surface of the tumour shows thickened and heaped up edges. The floor is thinner and grey or cream coloured with translucent opaque patches. Microscopically, the growths present all the characters of typical squamous–celled epithelioma with abundant cell nests (Figs. 3 and 4). The lymph glands are often mere bags of soft septic epithelial debris. In the early stages they show on section grey spots or patches and later on granular pultaceous areas. These are found to consist of large

epithelial cells of the same type as the primary tumour. Microscopically, nucleated cells are found in the sinuses, arranged concentrically, the inner layers being flattened and keratinous (Fig. 5).

During the past thirty-five years, on an average, we have performed 45 operations annually for kangri burn cancer as compared with 10 per annum for other forms of cancer.

The first procedure is to remove the lymph glands through a separate incision. The “Scylla” of imperfect removal or damage with wound implantation and the “Charybdis” of excessive dissection in subcutaneous tissue, imperilling the vitality of the thin skin of the groin or axilla, must be equally avoided. The glands, if softened, may have septic contents. Rough handling must be avoided or they may rupture. Small glands of the external pubic group are apt to elude observation. In epigastric tumours both axillae should be carefully examined.

There is a knack in excising the primary growth in such a manner as to avoid infection of the fresh wound. It may previously be cauterized with pure carbolic acid or chloride of zinc. Too much care cannot be taken in striving to render the surrounding foul and sodden skin aseptic. With the aid of two or three volsellae fixed in the skin well beyond the tumour above and below and perhaps at the sides and held by an assistant, the growth is raised as far as possible and then excised with a rapid clean incision. Frequently underlying muscle requires removal and small areas of peritoneum may require excision. Even where the edges cannot be brought together and omentum is

exposed, I have obtained healing under a dressing of ambrine wax. In advanced cases very extensive operation may be required. An incision more than a foot in length may be required to clear tumour, intervening area and axilla or groin. Ill defined induration and redness in a lymphatic area almost invariably preclude operation. Such cases if dealt with are largely responsible for mortality from rapid recurrence, or early haemorrhage due to ulceration into a large vessel. Occasionally it may be worth while to excise the primary growth, even if the glands are inoperable.

A large number of cases when first seen are, however, too advanced for surgical treatment. Many patients after discharge continue to use the kangri and sometimes get a recurrent local growth. Recurrence in lymph glands is doubtless due to an incomplete operation. Most patients in whom a return of the disease occurs probably come back to us. Such cases form certainly less than 20 per cent. of the total.

Summary.—The cause of the kangri burn epitheliomais definite irritation, viz., the continued application of intense heat. In this respect it is similar to the cancers arising from electrical, chemical, thermal and mechanical stimulation. The nature of this causation is against a parasitic theory of origin and favours the view that direct irritation is sufficient to start epithelial proliferation, uncontrolled by trophic nerve influence. In early stages the malignancy is mild and glandular infection supervenes slowly. Distant metastases do not occur. The disease is very amenable to operative treatment. It is a typical squamous celled epithelioma.

 

Curious Case of Queen Victoria’s Boat in Kashmir

Few months back, the Queen Victoria’s gift which was a steam boat presented to Maharaja Ranbir Singh was in news. First i would like to share the news items related to it written in two newspapers below:

From Indian Express :

Victorian era boat rusting in Kashmir museum

Srinagar, Wed Apr 04 2012

A Victorian era boat, evidence of Kashmir’s historic connections with the British empire, is decaying and rusting in an open parking lot of SPS Museum here.

The boat was a gift from Queen Victoria of United Kingdom, who was coronated in 1838 and remained the Empress of India from 1876 until her death in 1901, to Maharaja Ranbir Singh, a monarch who ruled Jammu and Kashmir from 1857 to 1885.

In today’s Kashmir, this royal gift is withering in sun, snow and rain as it remains lying in the open parking lot of the Sri Partap Singh Museum, named after the Maharaja’s son.

What remains of the nearly 30-feet-long boat, which is up to eight feet in width, is the rusted decaying structure.

The entire body of the boat is covered with rust, at places several layers deep, and a large hole has damaged the lower frontal part of it.

Several smaller holes, of the size of a football, have also punctured the boat at its bow and stern.

The museum has no details about the year when the boat was gifted and when it reached Kashmir.

From the timeline of the two rulers, the boat was gifted to the Dogra king of Kashmir anytime between 1857 and 1885, when he was the Maharaja.

A marker on the boat, which has words engraved on it, is the only testimony that it was exchanged between the two Royals.

“Presented by H.M. Queen Victoria to H.H. Shree Maharaja Ranbir Singh Ji Bahadar,” the text — on the marker, which is a sort of an epitaph — in bold capital letters reads.

The initials mentioned in the text – H.M. – meant ‘Her Majesty’ as the Queen of United Kingdom was called and H.H. meant ‘His Highness’, then attributed to the dynastic heads of the major princely states.

The only detail available in the museum records show the boat was transferred to the museum from Tosh Khana, treasury of the Kashmir’s erstwhile monarchs, in 1987.

Since then the boat remained decaying, year after year, in a damp pit, adjoining the main museum building, until the construction for a new building began when the pit was filled, leading to boat’s relocation to a new spot — the open parking lot.

“We have a proposal with the government to have a glass fibre cover for the boat,” the curator of the museum, Mushtaq Ahmad Beigh,said.

He said the glass fibre cover will be in place once a permanent spot is decided for the boat.

“We have to wait for the designer to decide the spot,” Beigh said.

The designers, a Mumbai-based interior designing consultancy, has been tasked to design the new building, which is under construction for the last five years.

From Daily Mail :

Queen Victoria’s gift rusts in peace: Royal present reflecting Kashmir’s connection with the British Empire ends up in parking lot

PUBLISHED: 00:12 GMT, 19 August 2012

To the naked eye, it’s just a piece of rusty junk.

But look closer and you’ll find this rusty boat is of royal lineage.

Engraved on a plaque are the words: ‘Presented by H.M. Queen Victoria to H.H. Shree Maharaja Ranbir Singh Ji.’

The boat presented by Queen Victoria to Maharaja Ranbir Singh has corroded after it was shifted to a parking lot in SPS MuseumThe boat presented by Queen Victoria to Maharaja Ranbir Singh has corroded after it was shifted to a parking lot in SPS Museum
 Blue blood couldn’t be thicker. But this Victorian-era boat, which reflects Kashmir’s connection with the British Empire, has been kept in a parking lot at Sri Pratap Singh (SPS) Museum in Srinagar.

The already rusty piece is thus open to the ravages of the elements. Ranbir Singh, a Dogra Maharaja, ruled Kashmir from 1857 to 1885.

Queen Victoria, who was crowned in 1838, remained Empress of India from 1876 to 1901.

Mushtaq Ahmad Baig, the curator of the museum, said the boat will be shifted to a new museum whenever it is open.

The plaque showing the boat's royal heritageThe plaque showing the boat’s royal heritage

The new museum was built by Ghulam Nabi Azad when he was the chief minister of the state in 2007.

Azad used to personally monitor the progress of the museum.

The building came up in a record six months time and finally Azad laid its foundation stone on March 20, 2008.

He had set an 18-month deadline to complete the interiors of the building.

Azad wanted to throw the museum open during his tenure but couldn’t, thanks to his premature exit from the government in the wake of the protests against transfer of land to the Shri Amarnath Shrine Board and subsequent withdrawal of support by coalition partner People’s Democratic Party(PDP).

The museum hasn’t been opened to public since then.

The present SPS Museum has been declared as an unsafe building.

Maharaja Pratap Singh had established it in 1898 in his guest house at Lal Mandi.

The SPS Museum houses a precious collection of archaeological excavations, ancient coins, seals, terracotta, inscriptions, paintings, shawls, stuffed birds and animals and silver and bronze utensils of different civilizations.

But the delay in the completion of the new building has hampered its shifting.

‘It is sad that the royal boat is in the open. It should not have been there at the first place.

‘But because of lack of space in our old museum, we have no alternative,’ Baig said.

The curator also said that a number of artifacts  mostly stones, have been kept in the open as they would not face any damage.

‘We have kept less important things of archival value in open air.

‘But once the new museum is handed over to us, we will select a proper space for the boat and cover it with fibreglass.’ Baig added.

———————————————————————————————————————————————————

Recently i came across a book which talked about the above mentioned Steam Boat in detail & out of curiosity also began to search more about the steam boat. First on searching upon the subject, i came across another book Titled, ‘Central Asia: An Outline History’ written by Professor Ram Rahul. The writer on Page 83 writes :

Muhammad Yaqub ( who actually was a Fort Commander of Kashgarh) sent Yakub Khan Tora as an envoy to Maharaja Ranbir Singh of Jammu and Kashmir in 1871, with the request that the British Government in India could be persuaded  to enter into a political alliance with him. Maharaja Ranbir Singh supported his request. From Srinagar, Yaqub Khan went to Constantinople (now Istanbul), There he agreed to the recitation of the Khutba in the name of Sultan Abdel Aziz of Turkey in the mosques of Kashgarh, i.e Sultan Abdul Aziz as the Khalifa of the Muslims of Kashgarhia. Sultan Abdul Aziz gave Muhammad Yaqub the tile of Amir ul Moomineen, ‘Commander of the Faithful’, i.e the Muslims.

          Lord Thomas George Baring Northbookof Stratton, the Viceroy and Governor-General of India (Calcutta) from 1872 to 1876, appointed Thomas Douglas Forsyth to conduct a mission to Yarkand, Kashgarhia. The staff, native assistants of the Forsyth Mission included Nain Singh & Kishan Singh – the surveyor pandits of Survey of India. Yakub Beig who was on his way back from Constantinople, accompanied the Forsyth Mission. British India and Kashgarhia concluded their treaty of commerce at Kashgarh on 2nd February 1874. Queen Victoria sent a small steam boat to Maharaja Ranbir Singh for his services to the Forsyth Mission. 

So from the excerpt of the book, it is clear that Queen Victoria had given the gift of Steam Boat after February 1874 to Maharaja Ranbir Singh.

It should be noted that Cecil Earle Tyndale Biscoe   mentions about the Steam Boat also in his book here : ‘Moored to the bank (on Jehlum, near Shergarhi) opposite the palace is an elegant steam launch presented to his Highness by Queen Victoria, also a modern fast motor launch from Thornycroft’s.’ 

The most detailed account ( actually the book i was reading initially) talking about the Steam Launch is the William Wakefield’s book, The Happy Valley: Sketches of Kashmir & the Kashmiris. In the Preface of the book, the author, who actually served as a medical officer to the Forces writes that he had visited the valley in the Summer of 1875. The author writes in his memoirs that he was fortunate that during his visit to Srinagar, he received an invitation from Maharaja at the Shalimar Bagh on the occasion of launching of a small steam vessel on the Dal Lake. Following is the excerpt from the book telling us about the launch of steam vessel in the summer of 1875 :

In a minor degree we were so fortunate as to see it in its greatest perfection, even if shorn of some of its former elegance, as we were bidden to a fete within its walls, given by the Maharajah in honour of the launching of a small steam-vessel upon the lake. 

               This event, and the subsequent festivities at the Shalimar, were very diverting to us, and, by way of concluding the description of the Dal lake, a short sketch of that memorable day in the history of Kashmir may very well here find a place. A memorable day indeed it was to the inhabitants of the Valley, and long talked of both before and after ; for steam power was a mystery to them, and never before had the mountains surrounding their homes echoed back the sound of the whistle, the shrill scream of that invention which proves wherever it is introduced the most civilizing agent, and the most potent uprooter of old ideas and prejudices known to man. At an early hour of the day which was to mark the first step of the onward march of progress in Kashmir, the city was full of people, and the river crowded with boats of every size and description. The entire population of the Valley were gathered together, all thrilling with excitement, and all actuated by the same motive, that of getting as good a place as possible near the scene of action, so as to obtain a sight of that mystery of mysteries, a boat moving over the water without the usual, and to them well known, agency of hands. Their first introduction to this new and unknown motive-power being made in connection with a boat one of the institutions of the country, and with the working of which all were familiar undoubtedly explained the great interest taken in the proceedings by both young and old ; for I question if the first essay had been a piece of machinery applied to any other purpose half the curiosity manifested would have been aroused. But to move a boat was intelligible enough, although the means employed were incomprehensible ; and already hopes were aroused and visions were opened of the day when the weary work of towing and paddling should be a thing of the past, and their floating homes should walk the waters, like things of life, without any exertion on their part. If applied to the vessel they were about to see, why should it not be applied to all and sundry ? 
Full of these hopes and aspirations, and bursting with curiosity, the people all .wended their way, hours before the time fixed for the ceremony, to that portion of the lake devoted to its performance, and soon the capital presented a deserted and forlorn appearance. 

    The hour fixed for the important ceremony was four o’clock ; and arriving on the scene about that hour, we found ourselves in a mass of boats, all wedged closely together and ranged in a double line, so as to keep a space of clear water in the centre for the steamer to proceed on her triumphal way. On the bank of the lake at one extremity of this space a grand stand had been erected, which was occupied by the Maharajah, his court, and the 
majority of the strangers then visiting the Valley. Soldiers stood all around, and the royal musicians were discoursing the music of their native land, which, lacking sweetness or even harmony, was yet loud enough to satisfy the Oriental taste, and add to the noise and uproar incidental to any show in the East. Directly in front of the stand’ and resting lightly on the water was the innocent cause of all this excitement ; for it was not so much a launch as a trial-trip we were to witness, the vessel having been put together and committed to its 
proper element some time before. The boat itself was one of the steam-launches usually carried by the ships of the Royal Navy, and was a present to the Maharajah from our gracious Queen, having been sent to his country in pieces, which were finally put together, under the direction of a European engineer who accompanied the gift, and who remained in charge to instruct the recipient and his attendants as to the management of the machinery. 
Very soon after our arrival the occupants of the boats that surrounded us, for we did not attempt to land or make our way to the place of honour, became if possible more excited than ever, and shrieked, gesticulated, and swayed about on their frail crafts, each laden with human beings to the utmost extent of its carrying power, and we knew the crisis was at hand. The Maharajah took his seat on the deck in a solemn and dignified manner, but having withal an anxious appearance, as if not quite certain what was going to happen. Probably he had been told that steam, like fire, is a good servant but a bad master, and that boilers sometimes burst, and accidents will happen, despite every reasonable precaution. This may have had some effect, as he was that day brought into personal 
contact with the power of steam for the first time, for he looked grave ; but with the courage worthy of his regal descent he took his seat, and gave the word to start. The whistle sounded, the musicians blew their loudest, the drummers smote their drums until their arms ached, and the people shouted so that the mountains echoed back the sound. Yet with all this the old adage of ‘ man proposes ‘ was exemplified, for the vessel would not move. We 
observed much running to and fro on the part of the engineer and his assistants, and our ears were assailed with loud and discordant shrieks from the steam whistle and escape-pipe ; but it was all of no avail, the vessel stirred not. We waited some time, but not finding our patience in. any way rewarded, pushed our way without the heaving mass, and 
rowed straight across the lake to the Shalimar Gardens, where the second part of the entertainment, the feasting, was to take place. We were almost the first to start, but the remainder of the guests were not long in following our example ; 
while the bulk of the Kashmiris, hovered about the scene for some considerable time in hopes of witnessing something remarkable. Their hopes were not, however, then fulfilled ; for it was not until the following day that the defect in the machinery which caused the failure in the proceedings was rectified. That having been done, the boat was brought through the canal from the lake on to the river Jhelam, when its acquisition proved a source of great amusement to the Maharajah, who every evening steamed up and down the 
watery highway of the city, looking as pleased as a child with a new toy, much to the delight of his faithful subjects, who clustered like bees on every commanding point that afforded a view of the royal progress. 

Thus it is clear that the steam engine presented by Queen Victoria to the Maharaja Ranbir Singh of Jammu Kashmir was in the summer of 1875 for his services to the Forsyth mission.

Early Days of Kashmir Telegraphy

It was in the year 1877 that on behalf of Maharaja Ranbir Singh of the princely state of Jammu & Kashmir, the Indian Telegraph Department supplied the first telegraph line between Srinagar and Gilgit. Telegraph line between Jammu and Srinagar was completed in May 1878. At 4pm, 1878, Maharaja Ranbir Singh personally had visited the Jammu Telegraph office. Telegraph line from Srinagar to Gilgit was completed & opened in 1894.

                                     THE TELEGRAPH TREATIES

{ Source of Treaties : Kashmirstamps.ca }

I.  The Treaty of 1878.

Agreement entered into between the British Government and the Cashmere State in regard to the Construction of Telegraph Lines from Jummoo to Srinuggur and from Srinuggur to Gilgit—1878. Whereas His Highness the Maharaja of Cashmere is desirous of obtaining the assistance of the British Government towards the construction of lines of telegraph from Jummoo to Srinuggur and from Srinuggur to Gilgit, the following terms are agreed upon by Major Philip Durham Henderson, C.S.I., Officer on special duty in Cashmere, on the part of the British Government, duly empowered by the Viceroy and Governor-General in Council on that behalf, and by Baboo Nilumber Mookerjee, M.A., B.L., Judge of the Sadr Adalut of Cashmere, duly empowered by His Highness the Maharaja on that behalf:

1.  The British Government agrees to construct for the Cashmere State two lines of telegraph, each consisting of one wire, to be carried on such suitable supports as are procurable in the vicinity, the one to be erected between Jummoo and Srinuggur at a cost of Rs. 21,600 more or less, and the other between Srinuggur and Gilgit at a cost of Rs. 31,900 more or less, provided in each case the following conditions are observed:—

   (a)  That the transport of all telegraph materials from Sealkote to the Cashmere frontier and within the limits of the Cashmere State shall be directly arranged and paid for by some duly authorised officer of the Cashmere State.

   (b)  That all labourers, whom the officer in charge of the construction of the line shall require to employ, shall be engaged and paid by a duly authorised officer of the Cashmere State.

   (c)  That on due notice being given by the officer in charge of the construction of the line, the Cashmere Government shall, to the utmost of its power, comply with requisitions for transport or labour.

   (d)  That sound seasoned deodar posts, where these are procurable, suitable for telegraph supports, shall be provided by the Cashmere State and distributed along the route to be taken by the telegraph lines, in such manner as the officer in charge of the work may direct.

   (e)  That no bracket or insulators be used in the construction of the lines, as their cost has not been provided in the estimated amounts stated above.

2.  The British Government guarantees that all telegraph materials, including the wire supplied by it, shall be of the best quality used for its own lines, and that the lines shall be handed over the Cashmere Government in full working order.

3.  His Highness the Maharaja agrees to pay to the British Government, as the money may be required, the actual cost incurred by it in the construction and establishment of the lines, such cost being inclusive of:—

(a)  The salaries and allowances of all members of the Indian Telegraph establishment for the whole period they may be detained on duty in Cashmere; and

   (b)  The cost of insulating the line, or of any other charges in the original scheme that may be made hereafter with the concurrence, or at the request of the Cashmere State.

4.  The salaries and allowances of all members of the Indian Telegraph establishment will be paid to them by the Government of India through the Officer on special duty, and the amounts of such payments will be recovered subsequently from the Cashmere State.

5.  On the application in writing of the Cashmere State, the Telegraph Department will supply at cost price all telegraph instruments and material required from time to time for the maintenance and working of the telegraph lines and offices about to be established.

6.  On the application in writing of the Cashmere State, the Telegraph Department will afford such advice and instruction as may be required and desired by the Cashmere State for the maintenance and working of such telegraph lines and offices.

7.  On the application in writing of the Cashmere State, the Telegraph Department will lend the services of any Native signallers, who may volunteer for the duty, and whose services can be spared, for such specified periods as may be sufficient to enable the Cashmere State to train its own signallers.

8. The foregoing provisions are accepted by the British Government as a mark of friendship and good-will towards His Highness the Maharaja; but it is to be understood that after the lines are delivered over [to] the Cashmere Government, no responsibility whatever attached to the British Government in respect of their subsequent maintenance and working. (Sd.) P.D. Henderson, Major. Officer on special duty in Cashmere. (Sd.) Nilumber Mookerjee. Judge of the Sadr Adalut of Cashmere. The 9th March, 1878.

II. The Treaty of 1890.

In 1890 a further agreement was entered into by the two Governments for the maintenance and working of a third line of telegraph along the State Railway from Suchet Carh to Jammu. It was signed at Gulmarg on 3rd July, 1890, by R. Parry Nisbet—British Resident in Kashmir, and by Raja Amar Singh—Prime Minister and President of the Jammu-Kashmir State Council, being further approved and confirmed at Simla some three weeks later. 

Following is an 1897 newspaper page of New York NY Tribune pertaining to the Srinagar-Gilgit Telegraph line titled ‘PERILS OF ASIATIC TELEGRAPHING’ :New York NY Tribune 1897 Perils of Asiatic Telegraphing - New York NY Tribune ReportPerils of Asiatic Telegraphing - New York NY Tribune Report