The historiography of western medicine in colonial India has predominantly been analysed from the perspectives of the elite services – the Indian Medical Service (IMS) and their recruits. Unfortunately, perceiving colonial medical practices through the lens of the IMS has remained inadequate to provide a nuanced understanding of the role played by Indians in the semi-urban and rural areas of colonial India. This article examines the contributions of local administration and the role played by the recruits of the Subordinate Medical Service. This article uses the Madras Presidency as its case study and focusses on the medical subordinates who were pivotal in establishing a western medical tradition in the region. This will shift the urban-centric focus and examine mostly the rural parts of the presidency, in particular, the district hospitals and dispensaries located in the districts, taluks and villages. The article analyses the transformation in the Madras medical administration from the late nineteenth century until 1935 to argue how subordinates were the ones controlling the local medical services, and thus pulling the strings of health administration in the presidency. This will also demonstrate the uniqueness of Madras and how it disseminated western medical care with an active participation and involvement of the local residents.
