VR Khanolkar’s research and academic activities in K.E.M. Hospital and Seth G.S. Medical College

Abstract

Vasant Ramji Khanolkar was the first Professor and Head of Pathology at Seth Gordhandas Sunderdas Medical College and King Edward Memorial VII Hospital [GSMC] in Bombay (now Mumbai). Although he later gained international recognition as a pathologist during his career at Tata Memorial Hospital, Bombay, after 1941, little is known about his scientific contributions during his years at GSMC. This article outlines his research and other academic activities at GSMC, with specific dates; his memberships in societies and the congresses he attended in India and Paris, France; and the examination patterns of the 1920s. Additionally, it highlights the personal interests that enriched his life.

Dr. V.R. Khanolkar was a pioneer in the field of pathology in India.[1,2] He served as Professor of Pathology at Grant Medical College and Sir Jamsetjee Jejeebhoy Hospital (GMC) from 1924 to 1926 and at Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital (GSMC) from 1926 to 1940. Subsequently, he became Chief of Laboratories at Tata Memorial Hospital from 1941 to 1953 and later served as Director of Indian Cancer Research Centre from 1952 to 1963—all institutions located in erstwhile Bombay (now Mumbai). From 1960 to 1963, he held the position of Vice-Chancellor at the University of Bombay and was honored as the first National Research Professor in medicine.[1,2]

A recent article investigated the research undertaken by Dr. V. R. Khanolkar during the period 1924 to 1941, when he was at GMC and GSMC.[3] Following the publication of that article, certain facts have come to light. This article aims to shed light on other scientific and noteworthy activities of Dr. Khanolkar and fill gaps in the data presented in earlier papers about him.

Research and Presentations

The use of the Internet archive website led to some unexpected discoveries.

The journal La Presse Medicale records that Vasant Khanolkar presented a case of “Atypical lymphoma” at a conference of the Société Anatomique in Paris, France, on January 9, 1930.[4] The journal Annales d’Anatomie Pathologique provides a detailed account of this case and also includes a separate report documenting a case of a carotid body tumor.[5,6]

Through the courtesy of the Bibliothèque Nationale de France in Paris, I was able to retrieve the relevant pages of Annales d’Anatomie Pathologique.

In both reports, the authors is identified as “Vasant Khanolkar (de Bombay).” Although no specific author affiliation is mentioned, the second statement in the first report states that the patient was a 28- year-old man who had been admitted to “Edward VII hospital in Bombay,” confirming the author’s affiliation [Figure 1]. A biopsy of the terminal ileum was interpreted as chronic inflammation, which was explicitly stated to be neither syphilitic, tubercular, nor actinomycotic.

Figure 1.

Title, author, and opening section of the paper in Annales d’Anatomie Pathologique

The patient died 2 weeks later. At autopsy, multiple polypoid nodules were observed on the mucosal surface of the terminal ileum and ileocaecal region. There was no lymphadenopathy elsewhere, and the spleen was not involved. Based on these findings, Khanolkar concluded that this was an unusual form of lymphoma that was “unlike those described by Hodgkin or Paltauff.” This essay was followed by a brief discussion by M. Cailliau.

As expected, the quality of the image from that time is poor by today’s standards, making it impossible to definitively identify the neoplasm. Based on the macroscopic description, it is plausible to speculate that this could have been a case of what is now referred to as mantle cell lymphoma.

The second case was that of a carotid body tumor measuring 5 cm in diameter, located at the angle of the jaw on the right side of the neck, in a 38-year-old man with a history of 7 years. On auscultation, a systolic murmur was detected. The mass, which was connected to the artery, was surgically excised with an initial clinical diagnosis of an aneurysm of the common carotid artery. However, histology revealed the “typical characteristics of a carotid body tumour.” The patient recovered quickly.

Historically minded readers may find it noteworthy that a PubMed search for “carotid body tumor” yields only five citations between 1906 (the earliest record) and 1930. Although Khanolkar’s report is not listed on PubMed, it is possibly among the earliest documented cases of this fascinating neoplasm. However, it must be noted that a review article by H.W. Farr in 1980 states that the first carotid body tumor excision was performed by Riegner in 1881, and F. Marchand provided the first histologic description of the tumour in 1891.[7]

Research in Anemia

The earlier paper[3] referenced Khanolkar’s interest and research in anemia.[8]

Additional evidence is now available in the book Memorandum On anaemia in pregnancy in India by L. Everard Napier and M. I. Neal Edwards, published for the Indian Research Fund Association in 1942.[9] In the essay titled “A short chronological history of anaemia investigations under the Indian Research Fund Association from 1925 to 1939,” it is noted: “At the 7^th Research Workers’ Conference (December 1929)…. a grant was recommended for the investigation of haemoglobin standards in health and disease in Bombay by Dr. V. R. Khanolkar, M.R.C.S. (Eng.), L.R.C.P. (Lond.).”

The essay further states: “The scope of this inquiry showed signs of widening…. Dr. Khanolkar reported his findings with different methods of haemoglobin estimation.”

At the 9^th Research Workers’ Conference (December 1931), the continuation of Dr. Khanolkar’s inquiry was recommended. However, no results were provided or published during that year.

At the 10^th Research Workers’ Conference (December 1932), a report was presented on Dr. Khanolkar’s inquiry.

The subsequent essay, “Report of the Anaemia Sub-Committee appointed by the Scientific Advisory Board of the Indian Research Fund Association (December 1939), included the following members: Dr. M. I. Neal Edwards, Dr. V. R. Khanolkar, Lieut.-Colonel S. S. Sokhey (IMS), and Dr. L. E. Napier (Convenor). The article states: “The terms of reference for the Committee were: (1) to examine the results of the inquiries on anaemia, especially those on anaemia in pregnancy financed by the Indian Research Fund Association and (2) to make recommendations for future work on this subject.”

The recommendations included carrying out hematological surveys in both urban and rural areas. These surveys could be conducted by hospital and college staff, while the surveys in rural areas would be managed through short-term inquiries by university scholars, with preliminary work conducted at a central laboratory. Experimental work would be undertaken only if deemed absolutely essential.

Evidence of Khanolkar’s research interest is also found in a 1931 issue of the Indian Medical Gazette, which states:[10]

“…. enquiries, the continuance of which it was decided were advisable, were …. a new proposal by Dr. V. R. Khanolkar of Bombay for a study of methods of culture of human parasitic protozoa,….”

Unfortunately, I have been unable to locate any results or publication on this topic by Khanolkar.

Khanolkar as a Mentor

Besides his own research, Khanolkar clearly assisted and encouraged others to conduct research and has been acknowledged by many, including M.J. Parmanand, S.B. Anklesaria, and K.D. Manohar.[11,12,13]

Congresses Attended

During his tenure at Grant Medical College, Khanolkar was a member on the General Executive Committee of the Seventh Congress of the Far Eastern Association of Tropical Medicine, held in Calcutta from December 5 to 24, 1924.[14]

He also appears to have participated in the 21^st meeting of the Indian Science Congress, held in Bombay in January 1934. His article about the recently established KEM Hospital and GSMC features in the souvenir of the congress. The entire volume provides valuable information about the history, geography, flora, fauna, educational institutions, museums, picnic spots., and more in the cities of Bombay and Poona [now Pune]. As a guidebook, it is a veritable treasure trove.[15]

Khanolkar also delivered lectures at local meetings. One such lecture is recorded in the Journal of the Indian Medical Association in 1933, where the Bombay Branch Report of the medical lecture series notes: “The first lecture was given by Dr. V. R. Khanolkar, M.D. (Lond.), on “Clinical interpretation of some laboratory tests ….”[16]

Contributions to Organizations

Based on McCarrison’s recommendation that Indians create an institution devoted to medical research, similar to the Rockefeller Institute of Medical Research (established in 1901), the “Indian Institute for Medical Research” was established in Calcutta in 1935, This was the “first nonofficial modern institute for medical research” in India.[17,18,19]

Khanolkar was one of the members of the first governing council of this Institute. This institute has now been renamed the CSIR-Indian Institute of Chemical Biology.[18]

Khanolkar was on the editorial board of the Journal of the University of Bombay.[20] However, it appears that his membership in the Royal Society of Medicine did not extend beyond 1924/25.[21]

The year 2024 marks the platinum jubilee of the Indian Association of Pathologists and Microbiologists, which was established in 1949 with Khanolkar as its first president. However, we now know that there was a predecessor organization, which that few people, if at all anyone, are aware of. The Proceedings of the 25^th Indian Science Congress, held in Calcutta (now Kolkatta) in 1938 states:

“The Indian Society of Pathology and Microbiology was formally inaugurated with a provisional Executive Committee of which Sir U. N. Brahmachari was elected President…”[22]

I have been unable to locate any further information on this society.

Other Interests – and His Resignation from KEM

Additional information is available about Khanolkar’s varied interests, including his non-medical ones. He was elected a member of the Bombay Natural History Society, as noted in its meeting documented from 30 March, 1931. He was also a member of the Rationalist Association of India[23,24]. The magazine Reason, published by the society, states: “Dr. V. R. Khanolkar, the well-known pathologist, who is a life member of the R. A. I. and was its Secretary in 1935, has left for America for Cancer Research and on his return will take up charge of the Research Department of the Tata Cancer Institute in Bombay.”[24]

This statement aligns with a paragraph found in the Administration report of the King Edward VII Memorial Hospital and the Seth Gordhandas Sunderdas Medical College, Bombay, for the year: 1940-41.[25] The paragraph reads:

“The institution had to suffer yet another loss during the year under report in the retirement of Dr. V. R. Khanolkar, B.Sc., M.D. (Lond.), M. R.C.S. (Eng.), Professor of Pathology and Bacteriology, who went on long leave from 6^th May 1940 to 5^th September 1942 prior to retirement. He was mainly responsible for the creation of the Pathology Department of the College which has won a place for itself amongst the Medical Colleges throughout India. He was also an able teacher. In order to commemorate the association of Dr. Khanolkar with this College and Hospital. “Dr. Khanolkar Farewell Fund” has been started, the object of which is to institute a scholarship or a prize in the subject of his speciality….”

Unlike the earlier belief that Khanolkar worked at GSMC until he joined TMH, we now know that he resigned from GSMC and trained abroad before joining TMH.

Further, the Hong Kong newspaper Hong Kong Daily Press of 16^th December, 1940, in the Prominent Personalities section, states the same under the heading “SS President Jackson in HK: maiden voyage around the world,” “Dr. Vasant Ramji Khanolkar, Director of Research Laboratories at the Memorial Hospital in Bombay. Dr. Khanolkar has recently completed. research work at the Hospital’s New York branch and is working towards enlightenment on cancer.”[26]

Question Papers of the 1920s

Khanolkar became professor of pathology (at the age of 31!) and was the first M.D. in Pathology in India. The GSMC Calendar of 1929–30 indicates that he was appointed as an examiner for undergraduate [MBBS] and postgraduate [MD, pathology] examinations.

Further, the book contains some question papers that indicate that pathology was part of the final MBBS exam.[27] Moreover, the MD question papers were practically oriented, unlike the theoretical questions observed in many exam papers today. An emphasis on the history of medicine is also evident in these papers [Figure 2].[28]

Figure 2.

Question paper for the M.D.(Pathology) examination in 1927

Summary

In summary, while Khanolkar achieved international reputation after joining Tata Memorial Hospital, he set the base for it through preliminary research, presentations at local, national, and international meetings, and collaborating with peers in the formation of institutions and scientific societies during his 15-year-long association with GSMC.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.