A photo of the TB Institute, taken in the 1940s by Dr Mathuram Santosham, courtesy the Santosham family archives.

Strange though it may seem, and despite the fact that TB was a known killer from ancient times in India, most colonials assumed that the disease was hardly prevalent here. It was WEE Conwell, of the Madras Medical Establishment, who in his Observations on Pulmonary Diseases in India, in 1830, first noted that this was a wrong assumption. TB he said was very much present. This gave rise to some research and soon it was established that the disease was prevalent in some cantonment towns and particularly “among the natives of Madras.”

Thereafter, for a 100 years or so, nothing much happened. It was commonly assumed that Phthisis as TB was then known, was caused by such sources as contaminated milk or buttermilk and precautions were taken for against these. It was only in the first All India Sanitary Conference held in Bombay in 1911 that the prevalence of TB in the crowded metropolises was taken note of. The second conference was held in Madras, this more or less coinciding with the opening of the sanatorium at Madanapalle. The agenda for the conference was dominated by TB and the necessity for providing fresh air and open spaces for people to recover from the disease.

The King Edward VII Memorial Tuberculosis Institute was opened on July 15, 1916 in Madras, the money coming from collections for a suitable tribute to the late King Emperor. It was located on Pantheon Road, though where exactly remains a mystery. A year later, the foundation stone for a new building was laid by Lord Pentland, the then Governor, at a site abutting the Spur Tank at Chetpet. The beautiful peach-coloured building, with its iconic dome was completed by 1921, when it was inaugurated by Lord Willingdon. Even in its first year of operation, it attended to over 3000 patients, an indication of how prevalent the disease was. In 1929, with the King Emperor George V recovering from a serious illness, a thanksgiving fund was created, which was given to the Red Cross to administer TB institutes across the country. In 1937, the TB Institute in Chetpet was upgraded with money received from the King George V Memorial Fund as well. This is now the State TB Hospital with the Institute of Thoracic Medicine and Chest Diseases of the Madras Medical College attached to it.

Even as the TB Institute was growing, the Government appears to have opened a TB Hospital in Royapettah in 1929. Heading this was Dr K Vasudeva Rao, who had rounded off a brilliant academic career at the MMC with an MD in Tropical Diseases. He lated qualified for the MRCP at Edinburgh, with TB as his specialisation. Returning to Madras in 1935 he became Director of the TB Institute and the Superintendent of the Royapettah TB Hospital. When Dr Chowry Muthu’s sanatorium was taken over he became Superintendent of that as well.

A young Dr Mathuram Santosham, pic courtesy Santosham family archives

In the years leading to Independence, doctors considered being sent to the TB Institute a punishment posting – prolonged exposure to TB patients meant you ran the risk of contracting the disease. Besides, money and fame it was felt lay in becoming a general physician or a surgeon. Thus when the young Mathuram Santosham, in his final year (1936) at the MMC became a member of the Madras Student Organisation, which was affiliated to the Congress, he was promptly shunted off to the TB Institute for his tenure as a house surgeon. He referred to it colourfully as a dustbin posting. But strangely enough, that would shape his career – he set up the Lung Clinic on Egmore High Road at a strategic spot where the road curved sharply. This has today grown into the Santosham Chest Hospital.

Back then, in 1938, investing in an AP (artificial pneumothorax) pump, which was then the chief apparatus for treating TB patients, Dr Santosham set himself up in the profession. The only other doctor (Dr Vasudeva Rao?) in the city with this equipment charged Rs 65 for a house visit while he charged Rs 5. Soon he became well known as a TB specialist. During the Second World War he was designated as a Casualty Officer in the Air Raid Precaution corps and after the conflict ended was absorbed into Government service. This was a short stint but it was during this time that he was posted to Chengalpet, which he decided was the ideal spot for setting up a sanatorium. This became the Abraham Santosham Memorial Tuberculosis Sanatorium, named after his father. The foundation stone was laid in 1945 and inaugurated a year later by Rukmini Lakshmipathy, Minister in the T Prakasam Government, Madras. This was one of the city’s major TB sanatoria and we will return to this in a subsequent episode.

The Thiruvateeswarar TB Hospital on the day of its inauguration, courtesy, the Madras handbook

In 1948, the Corporation was gifted a hospital for treating TB patients. The Sri Thiruvatteeswarar Tuberculosis Hospital on Konnur High Road was owing to the munificence of Rao Sahib TP Ramaswami Pillai, a businessman who made his fortune in “excisable commodities” (a euphemism of the time for liquor). A pious person who in his will stated that all the wealth he had accumulated was due to the grace of Thiruvateeswarar (he also funded a shrine for Sri Thiruvottreeswarar in the centre of the Thiruvottiyur temple), Ramaswami Pillai set up numerous charities; indeed the bulk of his fortunes went to them. He gave land for the hospital and funded up to 50 per cent of the cost of Rs 3.00 lakhs spent in the construction. Declared open by the then premier Omandur Ramaswami Reddiar, the hospital had the latest equipment of its time, along with 48 beds. This is now the Government Thiruvateeswarar Hospital for Thoracic Medicine.

Thus between the sanatorium at Tambaram, the facilities of Dr Santosham, the TB Institute and its Royapettah Hospital, and the Thiruvatteeswarar Hospital,Madras was well equipped to handle tuberculosis cases and soon became a centre for the fight against the disease. And yet, it was the lead killer, as Dr K Vasudeva Rao noted in 1947, one out of seven deaths in Madras was due to the disease. Nationally, 5 lakhs died each year!

You can read part 1 of the series here

Next – the arrival of medication and vaccination

You may also want to read – How Madras eradicated smallpox

This article owes much to the following:

  1. The web site of the Madras Medical College.
  2. https://tbfacts.org/tb-India-history/
  3. Neelakantan, Vivek; Tuberculosis control in postcolonial South India and Southeast Asia: Fractured sovereignties in international health, 1948-1960
  4. The Santosham family
  5. Sriram V; Goodness and Mercy, the Life and Times of Dr Mathuram Santosham, The Santosham Hospital Public Trust, Chennai, 2013
  6. Life details of Dr K Vasudeva Rao