The Scent Of A Flower: The Forgotten Genius Of Colonel Chopra – Part II

The Age Of New Beginnings

Srinagar. Late afternoon. Flaming red and yellow Chinar leaves cushion the autumn walkways and catch the sun, giving the appearance of molten lava streaming down valley hills.

Rushing home, Raghunath Chopra is beside himself. A message has arrived from his wife in Gujranwala, Punjab. He has become the father of a baby boy.

The news has lifted his spirits in ways it is hard to imagine for others, including the members of his own family. These past few years have brought only misery and stress for Raghunath, tasked as he had been with tackling the economic crisis and human suffering that has plagued Kashmir.

The great Kashmir famine of 1877, which lasted a little over two years, has shattered the valley. More than half the population has perished, and with three-quarters of livestock gone, the land parched; so, too, the rivers and the lakes; with limited sources of income and no manufacturing industry to speak of, the woeful management of the crisis has left even the normally indifferent British seething at the current ruler, Maharaja Ranbir Singh, son of Gulab Singh.

Raghunath decides to take a detour to Gujranwala for his son’s naming ceremony.

The year is 1882, a year of great churning worldwide, of ideologies – both scientific and political – that would define and shape the next century. Charles Darwin has just died, and his theory of evolution is at long last beginning to find acceptance despite vigorous and, at times, violent challenges by the Church. Gandhi is all of 13 and experimenting with truth. Marx has left behind confused ideas that haven’t yet been picked up by confused people but would soon be, leading to the murder of 100 million (10 crore) humans over the next 100 years. Imperialism is at its peak; whole continents are being subjugated, pummelled, annihilated.

Amid this great churning, Alexander Cunningham’s massive excavation project – from Gaya in the east to Indus in the north-west, and from Kalsi in the north to the Dhamnar caves in the south – is churning out thousands of years of India’s forgotten history.

The university city of Takshashila is still a buried secret though, miles below Rawalpindi where Raghunath is trotting about. The British have meanwhile decided to set up a centre of learning in the region, some 200 miles from Takshashila. The University of Panjab will be housed in the neo-gothic Government College building in Lahore.

Raghunath names his little boy “Ram”. Two decades hence, Ram would hone his talent at this very university in Lahore, much like Jivaka did at Takshashila a thousand years ago.

The motives of the British to establish such places of learning may be brought into question or, with the benefit of hindsight, criticised, for doubtless they were ulterior and selfish. But that they laid the foundations of modern India is beyond reproach, for brilliance, wisdom, genius is seldom established in a vacuum. They need a guiding hand, a critical mass of the like-minded.

A few years later, things begin to look up for Kashmir as well as Raghunath. He lives with his wife and son in Jammu, the summer capital of Kashmir. The valley has got a lease of sarkari bandobast under the new king, Maharaja Pratap Singh, who cannot resist the long-pending plan of the British to force a British Regent on the state unlike his deceased father, Ranbir Singh.

With limited power, financial and otherwise that his throne is now left with under the British, Pratap Singh initiates numerous development and construction projects. Other important projects on his list include a clutch of primary schools across the valley, a brand new forest department, and Kashmir’s first major road, the Jhelum Valley Cart Road.

To provide economic security and fair taxation for farmers, Pratap Singh also sanctions much-needed land reforms. He requests the British to induct a land settlement officer. Walter Lawrence, an astute civil services officer, is dispatched to Kashmir by the British government to design and execute new land settlement rules.

Schools, land reforms, a more effective administration, and, last but not the least, benevolent rain gods are helping Kashmir return slowly to its trademark charm and cheer.

Ram grows up a happy child, receiving his schooling both in Jammu and Srinagar. His exceptional abilities can no longer be kept hidden from the outside world. The teachers advise Raghunath to send Ram to Lahore for higher studies. The advice is accepted.

At Lahore, Ram breaks university records, and this time it is the British who notice him. The dean, a friend of Raghunath from his Kashmir days, calls up for a friendly chat.

“The bright young lad must go to England, Raghunath,” he insists.

"But at my salary?" says the proud yet uneasy father.

"It is a matter of time," smiles the dean, "before Ram starts to support you on his salary. Take a loan, sell your house, I do not care, but Ram belongs in Cambridge, not in Lahore. He needs to be among those who are as good or better than him. Half of wisdom is humility. I thought you knew that."

Nothing more needs to be said. The father agrees. Ram's fate is sealed. So, too, is India's.

In 1902, as Ram, the bright, young 20-year-old scientist, prepares to leave Lahore for Cambridge, John Marshall, a bright, young 26-year-old archaeologist, is preparing to leave Cambridge for Lahore. One, to vanquish; the other, to be vanquished.

Their paths would cross decades later, but by then those paths would be run over by blood and politics, not science and scholarship. Little mercy there is half a century left yet for discovery to triumph disaster.

John Marshall is handed charge of the Archaeological Survey of India. Besides pursuing the immediate task of protecting monuments at the ancient Buddhist and Hindu sites, he intends to use the opportunity to satiate his personal ambition – to reopen excavation projects in Rawalpindi, Gandhar, and Bihar, suspended since Cunningham's time.

Meanwhile, at Cambridge, Ram outshines his peers. After completing his BA Tripos in the natural sciences with an exemplary grade, it is time for him to choose an area of specialisation. The year is 1905, or Einstein's annus mirabilis, as it would be called soon. Robert Koch has just won the Nobel Prize in Medicine for his work on tuberculosis, the world's greatest scourge. Understandably, Ram’s heart is set on medicine. He is fascinated and inspired by the teaching methods of one Walter E Dixon, who has joined the university as a “reader”, the first-ever faculty position in pharmacology at Cambridge.

It is a relatively new field, tied at one end to clinical medicine and at the other to chemistry. While plants and metals have been prescribed extensively to cure diseases in both the Western and Asian systems of medicine, their working mechanisms and the precise sites of action in the human body still remain an enigma. But it is the ultimate beneficial effects of natural products that drive their empirical use, with no knowledge or understanding of the science behind the associated benefit.

It was only around 1875 that a group of German scientists at Strasbourg managed to isolate and identify compounds from the therapeutic extracts of natural products in order to understand their interaction with living systems.

Not to be left behind, America soon followed suit by establishing the John Hopkins Medical School in 1893, with one of the Strasbourg alumni, Dr John J Able, joining as a professor of pharmacology and biological chemistry.

Scottish universities also set up chairs of Materia Medica, of which the one at Edinburgh has turned out to be the most active of all. Edinburgh students would soon travel to London to deliver Materia Medica lectures at St Bartholomew’s hospital.Pharmacology is in the air. It has taken 30 years for England to break out of the old Victorian and Edwardian disregard for laboratory-based medical sciences and its philosophical conflict against vivisection.

The year Ram enters medical college, the University College of London gets a full chair in pharmacology, King’s College initiates a part-time chair, and Cambridge opens a readership position in pharmacology, taken up by Professor Dixon. Never before have funds been released or institutional support provided for studies on pharmacology.

The tide is turning. Soon, these unprecedented events would shape in large measure not only Ram’s identity but also his passion for the scientific revival of Ayurveda.

Meanwhile, thousands of miles away, another storm is brewing. The nationalists have just launched the Swadeshi movement. The natural product on this side of the world is blood.

That year, Dr Dixon’s pharmacology course turned out to be the most sought-after. His lectures were interspersed with lab demonstrations, humorous anecdotes, and several opportunities for students to assist him in designing and running his research experiments.

One such demonstration, of an isolated mammalian heart being kept alive and ticking for hours with salt infusions in varying concentrations, makes Ram particularly drawn towards the subject. With wide-eyed wonderment and awe, Ram volunteers most of his afternoons tucked away in Dixon’s lab. They develop intellectual camaraderie.

Often their fiery and wide-ranging discussions would remind Ram of a certain herb or potion prescribed in Ayurveda. He would narrate to Dixon a few stories he learnt as a schoolboy – from Kalhana's Rajatarangini.

Written in Sanskrit, this eleventh-century poetic treatise chronicles the socio-political structure and medical knowledge of ancient Kashmir under Hindu rulers across 10 centuries.

Intrigued and fascinated, Dixon encourages Ram to design experimental approaches to investigate the widely used cures from Ayurveda for their active ingredients and mechanism of action.

As his first year draws to an end, Ram makes up his mind. He wants to build his medical career around pharmacology and emulate Dixon in every which way – his scientific temper, affable nature, and career profile. Ram willingly takes up an independent research project in Dixon's lab.

In addition to his regular coursework and exam schedule, Ram runs nightly experiments to study the effects of various drugs and expectorants on the ciliary movement in the respiratory tract. Dixon is blown away with Ram’s experimental methods and record-keeping, rating them worthy of a full-fledged scientific paper, and detailed enough to be presented as a thesis to earn an MD (Doctor of Medicine).

Ram's thesis, combined with his splendid examination scores, qualifies him to be conferred with an MB-MCh (the United Kingdom equivalent of an MBBS) along with an MD and an MRCP. In just three years, Ram collects four degrees, the shortest possible time for any student to have done so at Cambridge. The world is there for his taking. But Ram decides to return to India. Brimming with excitement and daring research ideas, he can’t wait to start his career in pharmacology. And this is where things begin to go wrong.

The Age Of Revelation

A thousand miles away, India is to Ram what a mirage is to a thirsty man. He feels that his every effort to gain and gather knowledge, his every struggle, every discovery was towards a bigger goal – returning to India and establishing her as a power in the field of modern medicine, returning her to the glory days of the past when she was a global leader in this field.

But having landed in India, Ram gets a taste of the bitter reality.

While India has established Western medicine training schools in Calcutta, Madras, Bombay, and Lahore for more than half a century, the discipline of modern pharmacology doesn’t yet exist. Health and medicine garner meagre funds, and then, too, these are mostly diverted for epidemic prevention, expanding whatever little is possible for the pitiful public health infrastructure; and lastly, training hakims and vaidyas in Western medicine licentiates.

Research and innovation are on the backburner. None of the big four medical training institutes in the country has a suitable position for Ram. Disappointed, he is left with no option but to pursue clinical medicine. He clears the Indian Medical Services (IMS) examination with ease and in March of 1909 is inducted as a lieutenant. Biding his time – what else can he do – he serves as an IMS officer at various military outposts in north India.

Years pass by. He climbs up the ranks, dreaming of the day when he would realise his vision, clinging on to the faintest of hopes that somewhere, someplace in this vast subcontinent a teaching position of his liking may open up in the near future. For, he knows, and knows only too well, that a nudge is all that is needed in science, and the next thing one knows, the race to the top is well and truly underway.

After all, it took but a decade for Britain to catch up with France, Germany, and America; and that indefatigable workhorse named Dixon was still at it, trying to make Britain a world leader.

Ram waits and waits. Then, one day, his hopes are dashed. A government missive arrives announcing his next posting. It reveals British East Africa (BEA) as the location.

The BEA (now Kenya) has been facing increased military aggression from the neighbouring German East African colony (now Tanzania) in the wake of the Great War. Several battalions of the Sikh Regiment in the British Indian Army have been assigned to fight in the war.

On 19 August 1913, Ram’s colleagues climb aboard S S Nairung at the Karachi port to sail to the BEA. Joining them are the men of the 29th Punjabis battalion and a section of the 120th Field Ambulance. And now it is Ram's turn. Going to war with limbs agile but a mind that is defeated, clutching the family heirloom in the form of Guru Granth Sahib ji to give him solace, he joins their ranks, hiding the disappointment life has served him deep within his heart.

Around the same time, another Europe-trained doctor is on the call of duty, roaming the length and breadth of India on an exploratory mission.

Dr Paira Mall, also a multilinguist and somewhat of an authority on Asian culture, is on a mission eerily similar to that dreamt by Ram. Equipped with a waterproof bag, camera, a travelling kit, and folding camp furniture, he has been in India since 1911, collecting medical artefacts for Henry Wellcome, a wealthy British pharmaceutical entrepreneur.

With the world wrecked by war and destruction, and, consequently, preservation of the arts and sciences not on the minds of the politicians, leave alone scientists who have been drafted for war duties, that Henry Wellcome is trying to build a corpus to capture the art and science of healing through the ages is a miracle in itself.

Phosgene, not plants, is apparently what the world needs, or so the scientists of the warring nations have been told. But Wellcome disagrees. It helps that he has the money to be bold enough to disagree. He establishes the Historical Medical Museum at Wigmore Street in London. But he knows only too well that a museum is only as good as what inhabits it, and this is where Mall comes in.

Inducted to search for ancient manuscripts, herbs, therapeutic recipes, instruments, sculptures, paintings, and familial traditions, Mall has been scouting for healers, art dealers, herdsmen, priests in several towns, remote settlements, and hermitages. He dispatches regular reports and crates of material back to England with detailed notes on their origins, whether, for example, they are from Ayurveda, Tibb-Unani, or the Siddha medical practices.

It is 1918. The First World War has finally drawn to a close. As victorious Britain picks up the pieces and life without war resumes, Paira Mall is ordered to proceed from India to Ceylon, Burma, Sumatra, and the Straits settlements in Southeast Asia. Wellcome has been overawed lately by Mall's abilities, and besides, the museum shelves are groaning with the weight of the astounding medical artefacts of the colonies.

Meanwhile in India, John Marshall, now five years into his Gandhara excavation project, has finally secured permission to build a museum to house the invaluable relics and artefacts of Takshashila.

Lord Chelmsford is invited to lay the foundation stone of the magnificent Taxila Museum on the outskirts of Islamabad, just off the Grand Trunk Road and midway to Rawalpindi. The sciences and arts are slowly being allowed to creep back into the world's conscience.

As if on cue, Ram, now Major Ram Nath Chopra, sails back to Karachi, having survived the Great War that has claimed 74,000 Indian lives and left 65,000 grievously wounded. Though consigned to East Africa for the duration of the war, he has been keeping himself abreast of developments in the field of medical science. He yearns for the flow after the ebb.

To his delight, medical seats have seen a remarkable upsurge in colleges. Indian doctors and teachers are being offered specialised subject chairs. That tiny flicker of his subdued ambition is still alive, bolstered recently by the news of his hero, Upendranath Brahmachari of Campbell Medical College Calcutta fame, winning a grant from the Indian Research Fund Association to find a cure for Kala-azar.

There is also, rather unexpectedly, a growing sentiment in support of the Indian systems of medicine in the British physician community. The strongest endorsement comes from Sir Pardy Lukis, the director general of the IMS, who in his 36 years of service in India has finally grasped that it isn’t quackery and that the learned practitioners of Ayurveda hold great wisdom and promise in treating tropical diseases the West has no knowledge or cure for.

Besides, the reach of Western medicine remains confined to metropolitan elites or “colonial enclaves” such as the army, civil services, or prisons even as the rest of India relies on indigenous systems. Driven by the vision of establishing native knowledge systems to be at par with, if not superior to, the foreign ones, this cause is soon taken up by the Indian National Congress (INC).

At the Nagpur convention in 1920, the INC calls for the establishment of colleges and hospitals of indigenous systems of medicine as a part of its members’ commitment to Swaraj. Asserting claims to the usefulness of Ayurveda medicine, the Congress demands that it becomes an integral part of the national healthcare system.

The logic is undeniable. Nine-tenths of the Indian population resides in rural villages with no access to facilities and doctors of Western medicine, dependent entirely on local hakims and vaids. The Madras presidency with a population of 42 million (4.2 crore), for example, has only 3,000 practitioners of Western medicine.

Both the Madras and Bengal legislative councils agree to consider the matter. While the Madras legislative council installs a committee to review and recommend the next steps, the Bengal government decides to take immediate action, bringing Ram’s long and patient wait to an end.

The Age Of Discovery

In 1921, the Bengal government invites Major Ram Nath Chopra to accept the first-ever chair of pharmacology at Calcutta’s newly established School of Tropical Medicine. As a professor, he is expected to design and deliver a full course in pharmacology to graduate and postgraduate medical students, and as a researcher in tropical medicine, he is to undertake investigations into indigenous "folklore" drugs that have been used since ancient times. The idea is to discover suitable Indian substitutes for imported drugs.

Two academic roles – no mean task and tough to manage in the best of times. Raised in the hills, Ram would also find it hard to adjust to hot and sultry Calcutta. But an overjoyed Ram is unfazed by the thought. He is raring to live out his dream, to follow in the footsteps of Professor Dixon, to lay the foundation of pharmacology in India.

He accepts the offer and, at once, sets out to organise funds and seek professional help from senior colleagues in other disciplines. But very soon, despondency sets in. India is not Europe and Calcutta is not London. There is a severe crunch of money and resources. Ram’s priority – to build a well-equipped pharmacology lab – is a critical aspect of his vision, to assemble a team of young medical students.

Money can wait if the temptress is the mind. He focuses, for the time being, on teaching, emulating Dixon’s style and approachability to inspire and enthuse students. Soon, they are eating out of his hand and yearning to confront the unexplored vistas of this new discipline.

Following close on Ram’s appointment, another UK-trained pharmacologist, Dr B N Ghosh, is offered professorship in pharmacology at another medical college within Calcutta. Soon, he joins forces with Chopra to standardise pharmacological techniques that are to be employed for animal experiments.

Word spreads fast. Another colleague, Colonel H W Acton, a professor in the pathology department at the Calcutta School of Tropical Medicine, also initiates a collaboration with Ram. An IMS officer, Acton had had a brush with pharmacology early in his career at the National Institute of Medical Research in London. Now he helps Ram navigate the administrative processes required for organising funds and approvals to import essential equipment from England for unimpeded teaching and research in pharmacology. Critical mass is building up.

The year is 1928. The pharmacology laboratory at the Calcutta School of Tropical Medicine now stands as well equipped as any pharmacological laboratory in the UK. Lieutenant Colonel Chopra’s research group comprises a bunch of energetic young researchers and trainees running numerous projects. Chopra trains them in cutting-edge pharmacological techniques, but, more importantly, inculcates in them the spirit of observation and enquiry needed to make discoveries.

An open mind is as important as an open petri dish, especially as September brings the news of the discovery by Sir Alexander Fleming of Penicillin from a stray mould in an open petri dish kept exposed to the elements on a window ledge. It is just the tonic that Chopra and his team need. Luck favours the prepared mind, Flemming had quipped, and to Chopra, who has been readying himself for a momentous discovery that he believes is just around the corner, given the incredible wealth of India's plant biodiversity, a stroke of luck is all that he needs.

His team is investigating a large repertoire of Western and Indian drugs for effective dosing regimens and side effects as understood in Indian conditions – quinine alkaloids for malaria, emetine for dysentery, and antimony and bismuth for Kala-azar. Nothing is left to chance. Cobra venom and venom from other snakes are being evaluated as pain relievers and blood clotting agents. The breathtaking scale of his project is matched only by another being conducted elsewhere in India at the same time – John Marshall’s excavation at Takshashila. The sciences and the arts, relegated for long because of the intervening war, are about to stun the world with their discoveries.

The university site at Takshashila has consistently been tossing up a unique assortment of surprises in the form of stupas, symmetric buildings, apsidal temples, shrines, ornaments, and records in the Kharosthi script. To call it a gold mine would be an understatement.

Far from the hustle and bustle of archaeologists and their finds, Chopra and his dedicated group of students have made the lab their home, just as it would have been two millennia ago in Takshashila. Given the close association of Chopra’s lab with hospitals within Calcutta, all research projects are designed in direct relevance to the clinical outcomes of Indian diseases. Chopra refuses to be an old-school, orthodox scientist. He doesn’t shy away from commissioning projects far away from a central pharmacological theme if they can break dogmatic beliefs through rational experimentation. The projects that he has undertaken, and the resulting publications, have earned his lab a formidable reputation in clinical medicine. The importance of experimental pharmacology is no longer under debate. It has been adopted as an essential subject under medical curricula in colleges across India.

Meanwhile, India has grabbed the attention of the entire world. The news of the discovery of the Indus valley civilisation in Harappa and Mohenjodaro in September of 1924 has shaken the Western world’s perception of an 8,000 year-old civilisation. And the imagination now held is soon captured with India winning the 1928 Men’s Hockey Olympic Gold in Amsterdam.

Away from sports and culture, there is a perceptive change also in the attitude of the international scientific and medical community towards Indian civilisation and knowledge.

The Wellcome Museum, with its collection of artefacts and ancient documents amassed from India, has thrown open the history of medicine to the world, introducing the incredible depth of India’s knowledge in human anatomy, physiology, diseases, medicine, and surgery. Never before has the Indian system of medicine received such attention and acknowledgement.

In his 1928 Birdwood Memorial lecture, Captain Johnston Saint, Secretary of the Wellcome Historical Museum, exults: “Extraordinary advance was made both in surgery and medicine in India when Europe was groping for light in her cradle in Greece. The Materia Medica of the ancient Hindus is a marvel from which both the Greeks and Romans freely borrowed."

On cue, the British government decides to update the Indian Pharmacopeia (printed last in 1858 as Pharmacographia Indica) with a view to incorporate the important ones into the British Pharmacopeia.

Ram Nath Chopra is the man of the moment – at the right place, at the right time. He strikes a collaboration with Dr S Ghosh of the chemistry department of the Botanical Survey of India (BSI) to initiate a systematic pharmacologic study of indigenous plants.

Even as Mahatma Gandhi hoists the Indian flag in Lahore as a declaration of Purna Swaraj, Chopra puts his vision into action, triggering the equivalent of a Swadeshi movement for drugs. At the onset of an economic crisis that will soon drive the world to penury, he takes it upon himself the responsibility of Indians not losing access to essential drugs as a result of the anticipated shortage of imports. He wants India to develop, test, and manufacture drugs on her own and minimise dependence on imports from England.

For India to attain self-sufficiency, Ram Nath intends to explore the wealth of proprietary knowledge of natural products being used in Ayurveda and other indigenous systems for ages. Some herbs of known and accepted therapeutic value in the British pharmacopeia, and found in abundance in India, could, he feels, open the potential of India’s manufactured products to be exported to Britain to help India’s frail economy. This is years, if not decades, ahead in thinking and nothing short of revolutionary.

Predictably, it puts him on the wrong side of the British. To export drugs to Britain is blasphemy in itself, but to base modern drugs on ancient Indian wisdom is nothing short of treason. It flies in the face of Kipling's preamble that had acted as a bulwark of imperialism – the so-called white man's burden. Chopra will pay dearly for this intransigence and he knows it. La guillotine awaits. But now is not the time to be worrying about it.

Chopra’s vision takes shape in 1929 during his Sukhraj Ray Readership lecture tour to Patna University to take a course in natural sciences. He designs the course around the theme of exploring the medical and economic aspects of Indian medicinal plants. He rolls out a massive project to investigate and classify all indigenous medicines used in India, whether of plant, animal, or mineral origin, according to their chemical composition, pharmacologic action, and therapeutic uses. His students, Bishnupada Mukerji and J C Gupta, and colleague Dr S Ghosh eagerly pick up their parts in this mission. To set the ball rolling, a research grant is approved by the Indian Research Fund Association.

On the same tour, he realises how British and American medical textbooks are not altogether relevant for imparting medical education to Indians. The therapeutic methods taught from these books are not universally applicable, especially in the tropics, where the climactic and morbid conditions are dissimilar. He decides to review and record therapeutics in the context of Indian conditions across specialties.

Many of his physician-colleagues willingly sign up to contribute to this time-consuming initiative. Less than six months in, on both these projects Dr Chopra is called in to preside over a Drug Enquiry Committee. The government is eager to intervene to control the menace of spurious drugs of impure quality being imported or locally manufactured and sold in the provinces – a cause that Dr Chopra believes in, and his pharmacist friend Jyotish Chandra Ghosh from the School of Chemical Technology, Calcutta, has been relentlessly pushing for since 1918.

The Drug Enquiry Committee is mandated with legally enforceable controls and standards for the manufacture and sale of foods and drugs enlisted in the British Pharmacopeia. As the Chairman of this committee, most of Chopra’s time and attention shifts to this task. Mukerji and Ghosh proceed on the indigenous drugs project with Chopra missing for more than a year.

The year is 1931 and Chopra is back at his lab bench now that the Enquiry Committee is through with its review. He shifts his focus entirely on gleaning through old Materia Medica texts in Sanskrit and Persian literature and the more recent ones compiled by the Dutch and the Portuguese to help the indigenous drugs project pick up the pace.

He stumbles upon a copy of Kalpastanum, one of the ancient treatises on Vrikshayurveda (medicines for plants) carrying elaborate classification of medicinal plants by type, smell, sites, and the climates they flourish in, seasons to collect them to extract medicine, storage methods, application, and duration of therapeutic effects.

Startled at how Hindu physicians of yore knew so intricately of the Himalayan herbs such as belladonna, artemisia, and ephedra, he can’t bear to think how such knowledge was left to diminish into oblivion for 15 centuries.

Detailed conversations with his good friends in Calcutta, Kartick Bose (of Calcutta Medical College) and Kaviraj Gananath Sen, further strengthens his interest in the field.

Gananath Sen, a practising ayurvedic vaid, holds a rational outlook on Ayurveda’s glory. He tells Ram, “Much of the old valuable literature has been lost and what exists is not often studied in scientific spirit. I see a crying need for reform in Ayurveda. Our chemistry, Botany and Materia Medica might have been once ahead of the West, but now we must recast and remodel them according to the present high scientific standards. We must re-establish the principles of Ayurveda on the sound-footing of actual observations and experiments according to methods of modern science. Ram, such an investigation into the action and uses of indigenous drugs has begun by foreigners. I fear Ayurveda will not profit much by the results of these investigations. The western Pharmacopeia will profit by them and pamper on them whilst the chances are that the Ayurvedic Pharmacopoeia will grow poorer”.

Kaviraj Gananath Sen brings to their attention the twining shrub of sarpagandha (Rauwolfia serpentina). Kartick Bose confirms to Ram that a powder of the dried roots of sarpagandha is easily available in the village markets for cheap. Commonly known as chandra or do paise ki pagalon ki dawa (inexpensive medicine for the mad) in the Bengal-Bihar region, sarpagandha has been used for centuries to manage insanity and insomnia and as an antidote for stings and bites of poisonous insects and reptiles.

Both Kaviraj and Kartick have independently used it in their practice. They apprise Ram of the benefits conferred by a twice-daily dose of sarpagandha powder in patients suffering from insanity. Both have seen a reduction in violent maniacal symptoms in their patients and, in addition, they have observed a new phenomenon that finds no mention in any of the Ayurvedic nighantus – the lowering of blood pressure by sarpagandha.

They put it on record: “As this drug is one of the rare merits, further investigation and researches on the chemical composition, physiological action, and therapeutic uses are needed. We invite the research workers’ attention to this active medicament.”

Around the same time, Chopra comes across valuable research results from Professor Salimuzzaman Siddiqui’s lab at Delhi’s Tibbia College. Ever since Siddiqui’s return from Germany in 1927, he has been conducting systematic research on the active constituents of sarpagandha root and root bark, much before the report by Bose and Sen.

Having been closely associated with art and music at the Shanti Niketan, Siddiqui has known of sarpagandha’s use by the local vaids and hakims of Bengal for a long time. Siddiqui’s group has already isolated five alkaloids from the sarpagandha extract that have been classified into two groups, the serpentine group and the ajmaline group (named after Tibbia College’s founder, Hakim Ajmal Khan).

Intrigued by these two recent reports on sarpagandha, Professor Chopra decides to take the sarpagandha alkaloid characterisation project a step further. He personally takes part in investigative experimentation with his student Bishnupada Mukerji. Most of his days start as early as four in the morning and extend to late in the evening.

In moments of extreme exhaustion, he pushes himself by recalling a comment made by Professor Greenish of the London School of Pharmacy: “India owing to the remarkable variations she possesses of climate, altitude, and soil, is in position to produce successfully every variety of medicinal herb required for Europe”. His zeal and drive are infectious and it rubs off on his students and colleagues too. Soon, the entire lab is on it.

In parallel, he also carves out time to join forces with Jyotish Chandra Ghosh for another common cause, close to their heart – development of the profession of pharmacy in India, currently nowhere close to England’s standard.

Indian doctors make-do with untrained compounders to mix and dispense medicines according to their prescription, whereas modern pharmacists in England are knowledgeable about the chemical and physical properties of drugs. They work hand-in-hand with physicians during all the phases of drug development and its use in preventive and curative medicine.

Pharmacy is a regulated discipline, controlled by the Pharmaceutical Society of Great Britain. In India, except Jyotish Chandra’s alma mater, Madras Medical College, no other institution trains chemists and druggists for proficiency in pharmacy. There is no reason to add more seats to the course or have more medical colleges open a course in pharmacy as those taking it will not find jobs. After all, no one is thinking the way Dr Chopra and Ghosh are, that without good quality professionals in pharmacy, there is little hope for improvement or conformity in the standards of purity of drugs and chemicals sold in India, whether manufactured or imported.

He had insisted that his recommendations be recorded in the Drugs Enquiry Committee Report. But the report had been lying in abeyance for months, gathering dust. Undeterred, Chopra decides to do whatever little he can at a personal level. During his lab breaks, he steps out to mingle with the compounders of the All Bengal Compounders Association to generate awareness about the importance of their role and the urgent need for skilling.

While this is no less than launching a movement to bring respect and notice to the profession of pharmacy, it doesn’t sit well with the hierarchical mindset of his physician colleagues. Indeed, his affability with the compounders and efforts to bring them to a level complementary to the physician’s role is leading to much turmoil in the high-nosed physicians circle of Calcutta. But change is coming.

With Chopra’s motivation and advice, the All Bengal Compounders Association transforms into the Bengal Pharmaceutical Association. Professor Mahadev Lal Schroff at Banaras Hindu University is the first one to subscribe to and act on Chopra’s submission. He initiates pharmacy as a course at his university.

Benaras, once the land of new discoveries in Ayurveda, becomes the torchbearer of degree-level pharmacy education.

The year is 1933. Two years have passed since Chopra began work on the sarpagandha project. The world economy has crumbled under the weight of the Great Depression. Nations that took part in the Great War, or were forced to pitch in, are yet to recover from its debilitating economic and financial cost. Governments are vexed. Britain’s ruling coalition of conservatives, liberals, and Labour party members led by Prime Minister Ramsay MacDonald is in total disarray, having failed to agree on a common action plan for the Commonwealth's economic recovery.

The old rogue Winston Churchill is not part of the current British cabinet. Vaulting from one government job to another after the Great War, he is watching intently the carryings-on from a distance. Meanwhile, Franklin Roosevelt’s recent election as the thirty-second President of the United States of America has rekindled faint hopes of a recovery, what with his promise to usher in a “New Deal”.

Roosevelt and Churchill, both seasoned politicians, and possessing an uncanny knack of foretelling lurking dangers resulting from the economic catastrophe, spot the rise of a little-known Austrian water-colour painter. But they are as yet powerless to stop it.

Adolf Hitler has just issued the “Proclamation to the German People”. It is devastating in its clarity of threat and victimhood, harping as it does on the economic devastation caused by the Great War. “The insane notion of victor and vanquished has destroyed the trust between nations and thereby also the world economy. But the misery of our Volk is dreadful! The misery of millions of unemployed, starving proletarians in industry is being followed by the impoverishment of the entire middle class and artisan vocations. If this disintegration also engulfs the German peasants, we will be confronted by a catastrophe of incalculable dimensions. For not only will this mean the end of a Reich, but also of a two-thousand-year-old inheritance of the highest and loftiest values of human culture and civilization.”

The message hits home. Hitler becomes the world's first democratically elected dictator. Dark clouds arrive to hang low.

While Roosevelt and Churchill could foresee the threat outside, they are oblivious to the danger lurking inside, the health condition that they suffer from – perilously high blood pressure. But they don’t fear it, as high blood pressure is not yet considered a clinical malady in Western medicine. The prevailing view is that it is the body’s essential compensatory mechanism for the heart to keep pumping properly.

At a medical congregation, the legendary Dr Hay of Liverpool University warns: “There is some truth in the saying that the greatest danger to a man with a high blood pressure lies in its discovery, because then some fool is certain to try and reduce it." To escape this humiliation, that is precisely what President Roosevelt’s physician continues to do – give his patient a clean chit on health despite the signs of hardening of arteries and regular blood pressure readings of 162/98.

This is in stark contrast to what Indians have known since ancient times. Ayurveda practitioners have always talked, and in meticulous detail, of a strong correlation between the rhythm of the pulse (nadi-pariksha) and one’s vascular health, and that if left untreated, a hardened pulse eventually leads to vein rupture and haemorrhagic stroke. Reducing blood volume by venesection, or bleeding by leeches, has been prescribed to alleviate severe headaches caused by a hardened pulse.

Modern physicians in India, unlike their Western counterparts, acknowledge that high blood pressure is a grave health problem with persistently high mortality. They have been managing the condition with a trial-and-error approach, testing several compounds that claim lower blood pressure such as nitrites, iodides, calcium, diuretin, and bromides. The results have been unpredictable and inconsistent. Sedatives are the only drugs that they confidently prescribe as a cure, so as to make the patient overcome discomfort to sleep, at least for a few hours.

In October of 1933, Chopra, bringing to culmination years of back-breaking research, successfully proves the dramatic blood pressure-lowering effect of one of the alkaloids isolated from sarpagandha. He adds that this alkaloid also possesses potent hypnotic and sedative properties. This is a monumental find for medical science, a good 30 years ahead of its time and decades before modern medical science eventually acknowledges the devastating consequences of high blood pressure on general health.

While this landmark paper – from a ramshackle lab, from the land of snake-charmers – goes unnoticed in Britain and the rest of the "civilised" world, Indian physicians offer their willingness to prescribe sarpagandha as a treatment for hypertension. Dr Kartick Chandra Bose and Vaidyaraj Gananath Sen join hands in spreading the message within the physician community.

Despite a severe resource crunch, the Calcutta group moves to the next stage of drug development. They conduct extensive toxicity tests to determine the safe dosage of sarpagandha extracts for humans.

Next, its efficacy is tested in a controlled clinical setting at the Carmichael Hospital. Once established, Dr Chopra motivates local manufacturers to make the drug available either in tablet form or as vials of liquid extract.

The Himalaya Drug House of Dehradun takes up the challenge of making tablets of the sarpagandha extract while Bengal Chemicals and Smith Stanistreet of Calcutta choose the liquid extract.

Not to overlook Sarpgandha’s hypnotic properties, Dr Chopra dispatches alcoholic extracts of the drug to Dr Dhunjibhoy and Dr Pacheco at the Indian Mental Hospital in Ranchi for conducting clinical trials.

Around the same time, the final proof of the compendium of Indian drugs that Chopra has been compiling laboriously goes into publication. Six hundred seventy pages thick and a storehouse of precious knowledge, the ground-breaking book is titled Indigenous Drugs of India – Their Medical and Economic Aspects. It carries an extensive list of more than 2,000 plants used in indigenous medicine along with their active principles and purpose, many of which are scientifically classified to allow medical practitioners to judge their merits and demerits.

Many from the animal and mineral origins are also included. The book also carries their bazaar or vernacular names for easier correlation. That year, he also lays the foundation for developing an exhaustive herbarium of medicinal and poisonous plants of India.

The book becomes a sensation. Professor Chopra’s contributions are recognised by conferring on him his next promotion. He is now a Colonel. Promptly invited by the Health Ministry to establish and head India’s first Biochemical Standardisation Lab in Calcutta, he accepts the additional responsibility.

The year is 1934. In parallel, he works on the early drafts of his second book, a record of medical teaching and practising experiences of his own and of his colleagues in India. He wants to encourage the rational use of drugs, keeping in mind the differences in the progression of the disease and pharmacological action of Western and indigenous drugs in tropical conditions, which may not match the course of action described in medical course textbooks.

By 1936, the laboratory is established and his second book, A Handbook of Tropical Therapeutics, is launched. Both his books find wide circulation within the physician community. Several academics and researchers are inspired by Chopra’s idealism, unflinching devotion to clinical lab work, and remarkable foresight. His former students and colleagues are teaming up to start research projects on indigenous drugs to fulfill Chopra’s mission of putting modern pharmacology on the scientific map of India.

Multiple projects are initiated in the universities and colleges of Bombay, Dhaka, Patna, Allahabad, Lucknow, Lahore, Madras, and Trivandrum. Dr B B Bhatia, Head of the Pharmacology Department of King Edward Memorial Medical (KEM) College in Lucknow, gets particularly interested in sarpagandha’s blood pressure-lowering properties.

Unconnected, he has been working on two other flowering plants used as indigenous drugs, Tirruli (Pristimera indica) and Chitrak (Plumbago zeylanica). Without waiting further for the chemistry of sarpagandha to be cracked so as to identify the exact mechanism of action and the alkaloid composition, he decides to put the drug through further clinical investigation.

He begins his trial in 1939, just when another group of scientists at Oxford decides to take another high-potential drug candidate into trials in living beings for the first time. Howard Florey together with Ernst Chain, Norman Heatly, and Jim Kent purify penicillin to put it to test for its antibiotic action in mice. But science would have to wait. Storm clouds are gathering. Soon, the world is engulfed by the likes of a war machine never before witnessed in human history. A little-known Austrian corporal, having bewitched Germany with his supremacist and fascist views, has blazed through much of Europe and conquered it.

The Age Of Misgivings

It is May 1940. With the rest of Europe in chains, Britain stands alone against the might of Hitler. Churchill takes over the reins of this beleaguered island as the Prime Minister. His immediate task is to evacuate the thousands of troops trapped on the harbours and beaches of Dunkirk. He delivers a near-miracle. Operation Dynamo is a success. About 338,000 English and French soldiers are brought back from Dunkirk.

While Britain celebrates, France and other European countries plunge into darkness.

Through July and August, Britain secures another miraculous victory against Germany in what will be remembered as the Battle of Britain. Regardless of these wins, the danger of Britain falling prey to Nazi occupation looms large. Britain must arrange more men, and vital war material, from its colonies to spruce up her military might.

An Indian contingent has been vital at Dunkirk and during the air raids. The valour of Indian Sikhs during the First World War has not been forgotten. India’s viceroy, Lord Linlithgow, pledges more support from India, much to the ire of Indian leaders. They aren’t asked or consulted before putting so many Indian lives at stake.

To allay the concerns of agitated Indian leaders, Churchill makes them an “August Offer” in return for full cooperation in the war. The offer entails immediate inclusion of Indians into the Viceroy’s Executive Council, a proposal to frame a constitution for India after the war, and an assurance of protection for minorities against a majoritarian government.

Not trusting Britain’s intentions, it is rejected by the INC and Muslim League alike. Gandhi insists on nothing but total freedom. Nonetheless, several regiments receive orders to get their men ready for the call of duty to assist the British Expeditionary Force.

To mark the disapproval of the August Offer, Mahatma Gandhi asks Vinobha Bhave and Jawaharlal Nehru to undertake massive satyagraha campaigns.

Meanwhile, Dr Bhatia at Lucknow’s KEM College initiates the grand sarpagandha clinical trial, unprecedented in Indian medical history. He runs the trial in two groups of high blood pressure patients, one suffering with concomitant kidney damage and the other without.

As if on cue, after having kept the Chopra Committee Report in limbo for more than a decade, the government finally adopts its recommendations, incorporating them into the 1940 Drugs Act, to regulate the import, manufacture, distribution, and sale of drugs.

Dr Chopra is now a member of the Royal College of Physicians, the American Society for Pharmacology and Experimental Therapeutics, the Asiatic Society of Bengal, and the Belgian Society of Tropical Medicine. He is also on the list of those to be conferred knighthood in the following year. The tide is turning. In war as in science.

November sees Roosevelt elected as the President of the United States the third time over. Under him, an advisory committee has been working overtime since his last term, on the Manhattan Project. Being forewarned by the Einstein-Szilard letter, what Roosevelt doesn’t want is for America to trail Germany in developing an atomic bomb.

Meanwhile, even as Britain withstands furious bombing raids, Hitler launches Operation Barbarossa, the largest assembly of military force ever to have invaded Russia since Napoleon. Japan and Italy join hands with Hitler to form the so-called Axis Alliance. Japan leads the front in the East and advances into Burma. Britain at once dispatches 86,000 troops to fight Japan in what would be called the Battle of Malaya. Two-thirds of this massive number constitutes Indians and more than half of them are Sikhs.

America, much to Britain's frustration, continues to watch from a distance. But the war is taking a heavy toll. Roosevelt’s blood pressure is mercurial, hovering way above normal, frequently touching 220/120. His physician continues to record it as "unremarkable", with no administration of drugs or prescriptive advice to bring it down close to the homeostatic reading of 80/120.

Meanwhile, closing in on two years since Dr Bhatia initiated his trial, the publication of his findings is nearly ready. He records: “I have no hesitation in saying that in Rauwolfia serpentina, we have a drug which is far superior in its effect on high blood pressure to those which we have so far used. The drug is particularly useful in relieving the symptoms of high blood pressure such as headache, tinnitus vertigo, giddiness, and insomnia. The drug is not curative but is undoubtedly the best for the relief of symptoms caused by high blood pressure."

What better could Dr Chopra hope for as a parting gift upon his retirement from Calcutta School of Tropical Medicine. It is an emotional time for all at the school to bid farewell to the father of Indian pharmacology. But for his untiring efforts, the medical curricula and drug research would have remained in the domain of non-experimental teaching, the field of indigenous medicine would have been stuck in oblivion, and India would have been without a thoroughly researched and well-argued India-centric Drugs Act. It is an equally moving occasion for Professor Chopra. But he is joyful. His retirement doesn’t mark a discontinuity in his passion for pharmacology.

To top it all, he moves back home, to the house he has built to his taste in Srinagar. He has an offer from Maharaja Hari Singh to take up duties as the director of medical services and research at the newly set-up Drug Research Laboratory in Jammu.

On a personal level, after 20 years of surviving Calcutta’s tropical weather, Chopra is pleased to be back to the climate of his liking, and land that bears sweet memories of his childhood. The prickly climate had been his only grouse with Calcutta, the city that otherwise presented to him the unmatched joy of living out his dream, to create an invaluable body of work in pharmacology recorded in four books, 322 research publications, a herbarium, and a long list of students he trained and inspired, including his eldest son, Ish.

Warm wishes and personal letters of thanks keep pouring in from all over the world, acknowledging Ram Nath Chopra’s unmatched accomplishments in his 20-year teaching career and for the lives he has touched, through his mentorship and collaboration with dozens of grateful colleagues or through patients. Sarpagandha has gained unprecedented popularity in India since his group established its blood-pressure-lowering effects in 1933. One manufacturer alone claims to have sold 50 million tablets. It has firmly established itself as the go-to remedy for managing elevated blood pressure. Almost every physician and cardiologist is prescribing it. The scene outside of India, however, is different.

The news of the remarkable success of the sarpagandha trial in Lucknow has not yet travelled across the Atlantic. Something else has. Via the Pacific.

On 7 December 1941, the bulk of the US naval force wakes up to Japan’s devastating aerial attack on Pearl Harbour. Reeling yet defiant, America declares war on Japan and the Axis and joins forces with Britain and Russia. History would record the Pearl Harbour attack as the single act that destroyed Hitler's dream of world domination. But it is not quite apparent as yet.

Two months following Pearl Harbour, the British surrender the so-called impregnable fortress of Singapore to the Imperial Japanese Army. An exasperated Churchill proclaims the Battle of Singapore as the “worst disaster and the largest capitulation in British history.”

Asia, the part of the world he considers nothing but an expanse meant for colonial exploitation, has become a stinging thorn in his side. Last year, it was the spunky escape of Subhas Bose right under his watchful nose. This year, it is Gandhi’s do-or-die call, daring the British to Quit India.

Churchill is beside himself. With Britain standing alone against the might of Hitler in Europe, and with Japan sneaking up to India, his blood pressure is constantly high; and yet, he has not been advised of any medical intervention to bring it down. He does, however, try his hand at self-remedy through a heady combination of 13 cigarettes and Johnny Walker Red that has been legitimately approved by a doctor, not to mention an after-dinner dose of three brandies to help keep up his spirit.

Meanwhile, India is witnessing something exhilarating. Swift arrests of thousands of freedom fighters soon after Gandhi’s call to the British to quit India has flared the nationalist spirit like never before. It is percolating deeper and quicker into all sections of society. The youth in particular have a new hero in Subhash Chandra Bose.

The Maharaja and the political leaders of the princely state of Jammu and Kashmir are not left untouched by the goings-on. Local leaders are deeply affected and motivated by the Swadeshi and non-cooperation movements. In fact, they are framing their crusade against the autocracy in Kashmir along the same lines to deal with the issues of their princely state.

Elsewhere, someone is equally determined to fight a battle of his own.

Being focused and navigating resources and permissions amidst a politically surcharged atmosphere to build a formidable institution of higher learning isn’t new for Professor Chopra. The mission that he fathered in Calcutta, of investigating indigenous drugs for tropical diseases, needs to be taken forward with renewed and relentless zeal lest all gains are squandered. And what better place than Kashmir to achieve this – an ancient land with the priceless legacy of hosting discourses on Ayurveda among sages from Takshashila and Pataliputra, and home to Dridhabala, one of the editors and contributors to Charak Samhita.

This time, though, Professor Chopra is not alone. Joining him in this mission is a sharp surgeon-turned-pharmacologist, a spitting image of his youth, his son Ish Chopra, now a scientist like his father.

Professor Chopra fondly invokes his childhood memory, of the story of Kashmir in Rajtarangani, and is delighted to have received the opportunity to take forward what India’s ancient sages and philosophers have passed on over generations – exploring the treasure trove of medicinal plants of the bountiful Himalayas to add to the herbarium that he established in Calcutta.

In a decade, the herbarium boasts of a collection of 6,000 specimens from 1,600 plant species, representing two-thirds of the total species of known medicinal and poisonous plants of India. It exists in triplicates. One at the CSTM, the second one as a personal collection that he has brought along with him to Kashmir, and the third that he has gifted to the Forest Research Institute in Dehradun.

In his current role, he also decides to work towards solving issues that would enable the mass cultivation of medicinal plants in Kashmir for the national drug industry.

On the side, the father-son duo works towards understanding the quantum of the high blood pressure menace in India. Whether or not the world accepts it, several Indian patients suffer from it. They initiate an observational study to classify a range of normal blood pressure of most Indians. Shockingly, what is taken as “normal” thus far is based on records from European population studies. Meticulously recording the blood pressure of 10,000 persons from different parts of India, they publish their findings in the Indian Medical Gazette with some ground-breaking observations. The “Indian normal” turns out to be 5-10 points lower than the European systolic and diastolic blood pressure ranges.

Meanwhile, on the subject of sarpagandha, the main question remains unresolved – what exactly in its root extract determines the hypotensive action. Chopra and Chopra decide to dig deeper. They run an advanced pharmacological evaluation of all factions – each of the individual alkaloids in comparison with the full mixture; the leftover alcoholic faction, namely oleoresin; and the serpentine faction. Among these, they discover the oleoresin faction to exhibit the most potent effect in bringing down blood pressure. But the active principle behind this effect is yet not known.

The quest to pinpoint the exact compound in the oleoresin faction causing the blood pressure to fall is giving them sleepless nights. Further investigation requires extensive experimentation with more advanced technology, a luxury they do not presently have.

Thus begins the journey that would take the father-son duo through moments of self-doubt and certitude, where battling mindsets and bureaucracy would take up most of their time, and victory would remain as elusive as the recognition of their genius – in The Age of Isolation.

Authors' note: This is part two of a three-part article. As in part one, to bring alive the history, we have dramatised the events, dialogues, incidents, and interactions while keeping true to the dramatis personae and the locations that are all real and referenced herein.

Read Part 1: The Scent Of A Flower: The Forgotten Genius Of Colonel Chopra