“The Birth of a Clinic”? The IMS Dispensary in Gyantse (Tibet), 1904–1910

The establishment in 1904 of a British hospital at Gyantse, in southwestern Tibet, marked the formal introduction of biomedicine into that Himalayan state. In the ensuing decades, officers of the Indian Medical Service (IMS) offered treatment to Tibetans from their Gyantse base as a part of the British imperial relationship with the Tibetan state. Given that Gyantse was a small town of little political or economic importance, the medical impact of the IMS dispensary on Tibet as a whole was insignificant. But it provided a base from which in 1936–37 the British expanded their medical services to establish a hospital in Lhasa, the Tibetan capital. In the 1940s the Republican, and later the Communist Chinese governments also established biomedical hospitals in Lhasa, and while the indigenous medical system(s) of Tibet survived, the urban centres of central Tibet have had access to biomedicine since that time. Thus the history of the first permanent biomedical position in Tibet is a part of the medical history of both the British imperial government in South Asia and of Tibet itself. We are fortunate in that this pioneering imperial medical endeavour was of such political importance at the time that it produced a considerable amount of official correspondence, which was preserved in the imperial archives. These sources not only provide evidence for the scope of, and the processes surrounding, the British imperial medical project in early twentieth-century South Asia but also give indications of the indigenous reactions to this initiative. In this paper I discuss the establishment of the Gyantse hospital and locate in a wider context the issues that arose there during the first five years of its existence down to 1910. Within that brief period, the principal features of the biomedical encounter with Tibet