M"EDICAL ESTABLISHMENT IN SRI LANKA DURING THE DUTCH PERTOD Q640.

1t96)

K. D.

PenarsevrrlNe

fl. earlier expeditions of the Dutch to the East took back .. 'if."":;i,ril",, with them_1ot only rhe smell of fresh spice, bur Craze". The Dutch merchants in Amsterdam "fr, were anxious to deal in Indian goods for which there was much demand in Europe. wa_s an unprecedented rush among the Dutch peoplo 'to Jlrerg jLrin Eest Indian expeditions during the firsi few decades of the lTth century. They were mostiy d.riven by lure of wealth.
The United Dutch Erst India Company (VOC) which was in Amsterdam in 1602, considlered that ii was its duty to look after the hearth of its employees.r wirh thar objective
established

the chamberAmsterdam added to rts caare three posts ofmedicar professionals, namely, an apothecary, a doctor and a surgeon. fn 1602, there was an apothe"ury io A-ri".dam who supplied medicinal ships leaving for rhe Easr.2 During the period 1602_t632 :.hrrj:.t_" the Middelburg Chamber employed I 14 surgeons and 3 doctors.
century a university degree was not essential to become a surgeon. Therefore, urry oftJn it was considered that a surgeon belonged to a little lower grade than a doctor. Experience was more important than a deg.e" to become u ,urg."n. Another task of these two was to carry iut research together on various diseases. It was also their duty to see that correct instru_ nents were supplied to the ships, surgeons who were leaviog ior

In the 17th

the East.

dir"o;;d;i the circulation of brood by william Harvey and that of red

"Itr the lTth and lgth centuries the germ theory of disease and cellular structure of the body *.r. ,till unknown. t;r;i; the importance' of such scientific landmarks as the

104

I{EDICAL ESTABT,ISHMTNT

IN SRI LANKA

.:OLIRNAL

R. A. S. OF SRr LANKA l/ol. xxxilI(N..S.)

l988i89

105

still largely influenced by the traditional Greco-Roman humoral pathology, which considered all diseases as an imbalance or an irnpurity of the four bodily "huinours'n or fluids. Treatment aimed at readjusting the balance predominantly by the use of enemas, purging, bleeding, and dieting but also by the employment of stimulants, tonics and drugs'"3

corpuscules and spermatozoa by the Dutsh microscopist Anthony van Leeuwenhoek, medical diagnosis and treatment were

blood

The policy for administration of hospitals in the island was laid down by the Dutch Political Council in Colombo, the seat af their government. A few years after the Dutch captured Colombo from the Portuguese, in or around 1661, a city council rvas appointed to look after the interests of their compatric,ts in rvith two assistants.s council too.
Colombo. It was recorded for the ilrst time in 1666 that tire senior surgeon Michiel Dibbe was appointed as the surgeon in Colombo

He

was a member

of the Colombo city

The Duteh East India Company had to meet the increasing One demand for hospitals in tireir newly acpuired territories' from Europe had reason for this demand was that ships arriving a considerable number of sick persons on board' Sailors who left Holland in search of wealth had to undergo many hardships on their way to the East' They sufferecl by being confined on board' eating stale food and undergoing surlden changes of the tropical climatic conditions during their months long voyage'

The fi.rst document that I came across in this connection among the Dutch records in the National Archives was a set of instructions issued to regularise the functions of the stewards of the (Schaffbass) Dutch Hospital in Colornbo. dated 01.02.1669, in which it is stated that :'It has been considered that it is a duty of the Company to restore the health of its officers who are on board ships as well as in the outposts,'.
the Political Council, the chief surgeon hospital, Jacobus de La Haije stated ,, that (Company's) invalid officers could be brought back to their former state of health with the blessings of the God only by way of good care and attention. Therefore it is necessary to issue clear instructions to senior surgeons who are in the service of the Company in this country to perform their duties deligently'".2

The Cape of Good Hope which was once called the 'oTavrn of the Inclian Ocean" (hdisihe Zeeherberg ) lvas the best resting place for seamen on their way from Europe' The crews ol lhe butch lndiameu gencrally suffered lrom scurvy and other shipboard d.iseases. In 1782, for example, ten Indiamen from the

af the Colombo

ln a memorandum to

fatherland carrying 2653 men suffered heavy casualties and--1095 or 43/, of thim clied before reaching the Cape of Good Hope' wnile b15 survivors were admitted to hospital' Such was the situation mid-way

to

Colombo-

Colombo were in need of pure air, green vegetables and fresh rneat' Thcse contributed more to their recovery than a doctor with his

The next major and comfortable port of call for the seafaring Dutch population was Coiombo. The sailors who landed in

Decisions on medical establishment were very often based submissions made by the chief surgeon in Colombo hospital, '-rn rvho was considered to be the best qualified and experienced person ior such submissions.

medicines. Probably the increasing mortality and morbidity on board during the second half of the l8th century-were due to the chronic ill - health of so many of the men who embarked ships. The Dutch authorities in Colombo were cornpelled provide a sufficiently large hospital in Colombo and the outpos in Sri Lanka, according to the strength of the garrison and tl European communitY.

In August,

1788

nrent

The chief surgeon who had the longest service in the Colombo hospital, Barend Alleman (1756 - l79l) submittecl his observations to the Political council orr the entire set-up of the medical establish-

discussed extensively the medical establishment in the counrry. According to these minutes it is ciear that the medical service was well establishedin the countrybythe second half ofthe lgth century.

the Dutch political Council in Colombo

in the conntry.s

106

IVIEDICAL ESTABLISHMENT

IN SRI LANKA

-:,OURNAL R. A.

$. oF' sRI LANKA

Vol.

XXXilI (N..t.)

1988189

t07

According to his report there were 8 hospitals administered by the Dutch authorities in Ceylon namely; Colombo, Jaffna, Galle, Trincomalee, Matara, Kalpitiya, Batticaloa, Mannar and the South Indian town Tuticorin. According to. circurnstances generally a good beef soup and

Some of the local drugs which supplemented western medicines gall-nut (aralu, S.), Gentiana chirata (bin-kohomba, S.), Citrus Aurantium (ernbul-dodan, S.), pepper, clove, aloe (komarika, S. ), cinnamon, Cassia auriculata (ranau,ara,S. ), nutmeg, tamarind nnd Piper longunr (tippili, S.).

rvere

a dessert were given to the patients in all hospitals. The patients who were not suffering from serlere diseases were given vegetable and fish. Seriously ill patients were served with gruel, milk,
chicken, soup, sago and sometimes fruits or bread on prescription.

Cinnanlon, which was a spice exblusive to Sri Lanka, pepper well known as an aromatic condiment and corriander which is

a diaphoretic in Ayurvedic
pharmacopoeia.

medicine figured often in the D:-rtch

the Colombo hospital about 300 men could have been accommodated, whereas the capacity in Jaffna and Galle was about 100 - 150, and in Trincomalee 60 - 80.

In

Except for trusses nothing was given free to the patients. Almost all the patients treated in hopitals were service personnel and the Company deducted half their salary as hospital dues for the period they stayed in hospital. According to the requirements of the patient, linen, a pillow and a mattress were supplied for this amount. It was recommended in 1788 that patients be given one rupee per month to enable them to purchase sugar, tea, coffee, tobacco etc. This money was also deducted from their salary.

Wine was generally considered a panacea for a number of minor diseases. Different varieties of wine were supplied for ruse in the hospital bacause of their balmic qualities. It was considered a tonic for patients languishing frorn loose motions' Those who had weakened entrails could easily bear up with the Capered winebecause of the acidity found in it. Liquor, including arrack, was given to patients under certain circumstances.
Opium too was used as a common drug and rvas imported from Suraf one of the Dutch possessions in India.

in the Company"s warehouses. No cine was allowed to open

the
chests without the knowledge of the doctor

The medicines imported from Europe were stored in chests

who kept the

keys

with him.

Even if the apothecary needed some medicine he had to go to the warehouse with the doctor to open the chests and fetch his requirements. The stock in hand and the amount consumed were carefully entered in the books provided for the
purpose.

The Dutch studied the medicinal value of local herbs right from the commencement of their administration in Sri Lanka. Dr. Faul Hermann, the surgeon who was described as "The Father of Botany" in Sri Lanka and who later was appointed to the chair of medicine (16S0) at Lieden University, served in the Colombo Hospital from 1672 to 1679 and took more interest in botany than in surgery.ll He collected local plants and sent them to Leiden. The herbarium iollected by Hermann during his stay in Sri Lanka rvas brought to light about 70 years after his death when its classification was published under the title 'oFlora Zeylanica" by Carolus Linnaeus (t707 - 1778.|z

All medicines were dispensed according to a pharmacopoeia approved by the Political Council and listed in its entirety in the Political Council minutes of 1757.e This pharmacopoeia was in use throughout thesecondhalfofthe l8th century. It should be rnentioned here that this pharmacopoeia was in conformity with similar contemporary works adopted in London, Berlir
and Edinburgh.

and heal himself, as there are no doctors or surgeons here, so each one prescribes rough remedies, for hirnseif generally having tn the house veiy good ointments and wholesome oils which heal aknost anything. Also they make some emetic and purging

A contemporary writer Francois Valentijn (1666 - 1727\ while referring to native medicine said that, "among them chicken pox and fever prevail strongly, from which each must protect

108

il{5I)ICAL ES'TABLISI{MENT IN SRI LANKA

louRNAL R. A. S. OF SRI LANKA Vol. XXXUI(N..S.)

t98g/S9

109

drinks for which tirey are able to choose certain leaves and barks of trees which are very useful, and also a certain thorny tree and some obking berries. There are few diseases for which they know no remedy even to the extent of completely curing sorneone who is
poisoned or is bitten by a poisonous creature, though this happens seld.orn without their being taken over by this or that magician.

"They have berries in this land from which they know how to make an ointment with which they can cure a broken leg and set it well again in a ferv hours."l3 The Dutch, in fact, appreciated the superior knoweldge of herbal nredicines possessed by ayurved.a physicians. They made use of this knowledge. A far reaching resolution was adopted in the Political Council in 1793 by which provision was made to appoint "native" physicians to each of the Dutch hospitals in the island. The Dutch acts of appointments of the Colombo Secre-

The pay-rnent of a gratuity to the surgeon who successfully treated pa.tients rvith so called "dirty diseases" was approved by a Folitical Council resolution in 1788. The resolution states that the doctors and surgeons in Sri Lanka were not benefited by the resolution on gratuity passed by the High Government in Batavia. Therefore the Council approved that the superintendents of Colombo, Galle ancl Trincomalee be paid a gratuity. It was fixed at Rds. 200 for Colombo and R.ds. 100 each to Galle and
Trincomalee.le

tariat recorded three such appointments even shortly before 1793. Zareek Lebbe in l79l,ta Mira Lebbe Meestriar seka Marikkar in l7glts and Jenedien Thambie Kandoe in 1792t6 were appointed "physicians". These three were named as physicians while the rest were referred to as doctors or surgeons. The word 'physician' may have been used because they werJ natives. Their duiy was to assist the chief surgeon during his daily visits to the sick in such a way that their knowledge could be used by him in the best manner.
Europeans stationed in Sri Lanka were badly affected by several tropical diseases which prevailed in the country. They suffered frorn them more than the local inhabitants due to lack

In conclusion, it is appropriate to quote Johan Wolfgang I{eydt, a German write.r, who was in the Company's service in Ceylon, about the reputation of the medical establishment in the island: "I have already mentioned in nry earlier pages concerrling Batavia the bad arrangements of the hospital there but here the conditions are very different. I think the Company has no better hospital in all the Indies than in Colombo. Since here various and costly medcines are prepared, and there is a doctor to be found provided with a good laboratory together with two, three assistants who are experienced in medicines".20 Although this statement refers only to the Colombo hospital it is relevant to other hospitals in the lsland since it was a model for them ton.
NOTES

"

1.

sufficient immunity. The garrisons outside Colombo were reported to have dysentery and diarrhoea in epidcmic proportions. I'hey were brought to the closest hospital for more careful treatment. Malaria too was au acute problem outside Colombo. The Dutch had taken timely action against leprosy an<1 established a
separate hospital

of

Pieter Van Dam, Ileschrijving Van cle Oostinclische Compagnie, Eerste Boek, Deel IV Dr. F. W. Stapel, 's-Gravenhage. 192?.
607

ppr.

- 619.

2. F. M. Wieringa, De
University

of

YOC in Amsterdam verslg van een *erkgroep,

Amsterdam, 1982,

p.

105.

3. ;{. 5.

in

Hendala

in

1708.17

p.

C. R. Boxer, The Dutch seaborne Enryire 16A0 - 1800, London, 1965

178

The Dutch paid special attention to the problem of curing patients with veneral diseases (onreine zieklen). Christopher Schweitzer saw many soldiers in Colombo hospital "who in pursuit of their lustful desires destroy themselves by venereal
distempers".ls

Op. cit. p. 243

Sri Lanka National Archives. Dntch Pr;liticcrl Council Minutes. 1(,6605-09, SLNA 1i12.

6. SLNA, t/1453 7 SLNA, 1118, p. 49-52.

ll0
8. 9. 10. 11. 12. 13. . 14. 15. 16. 17. 18.
r9.
20.

MEDICAI- E5TABLISH&IENT

IN SRI

LANKA

SLNA, 1/202, SLNA, 1/180, SLNA, 1/180,

1788-08-02.

1780-06-20. 1780-06-20.

Rt. Rev. Dr. Edmund Peiris, Paul Hermantt the Father Botany, JRAS (CB), (N^S) I/e,/. II, 1952, pp. l-20.

of

Ceylon

Rt. Rev. Dr. Eclmund Peiris, OMI Srudies in Medical Herbaria during tlte Portuguese and the Dutch times in Sri Lanka, Transactions of the Ceylon College of Physicians, Vol. 6, No. I, 1973, pp. 97-L08.
Francois Valentijn Desuiption

of

Ceylon, Translated and Edited by

1978,

Dr. S. Arasaratnam, The Hakhryt Society, London, SLNA, SLNA, SLNA,

112548,

p.

168.

p.

266.

1i2s48, p.266. 112549,

p.4:.

C. de. F. W. .Goonaratn a, Sonrc l{istorical. Aspects of Leptrosy in Ce,vlon buring the Dutch Period, 1658 * 1796, Medical History, 1971, Vol. 15, pp. 68 - 78 and Medical History, 1973 Vol. 17, pp. 308 - 315.

R. Raven - Hart, Germans in Dutch Ceylon Tbe National of Ceylon - Translations Series. Vol. I. (No date) p.49.
SLN.A,, r1202, l788-08-07"

Museums

Johann Wolfgang Heydt, Heydt's Ceylon Translated by R. Raven Hart, Colombo. Ceylon Government Inloraation Department, Colombo, 1952. p.3.