This essay aims to situate the emergence of Siddha medicine as a separate medical system in the erstwhile Madras Presidency of colonial India within a broader socio-economic context. Scholars who have worked on Siddha medicine have stressed more on political dimensions like nationalism and sub-nationalism with inadequate attention to the interplay of various (other) factors including contemporary global developments, changes in the attitude of the colonial State and especially to the new promises held by the greater deference shown to indigenous medical systems from the 1920s. If the construction of ‘national medicine’ based on the Sanskrit texts and the accompanying marginalisation of regional texts and practices were the only reasons for the emergence of Siddha medicine as presented by scholars, it leaves open the question as to why this emergence happened only during the third decade of the twentieth century, though the marginalisation processes started during the first decade itself. This paper seeks to find an answer by analysing the formation of Siddha medical identity beyond the frameworks of nationalism and sub-nationalism. Further, it explicates how material factors served as immediate cause along with the other, and more ideational factors related to the rise of the Dravidian political and cultural movement.

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.