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Sexually transmitted diseases ( STDs) such as syphilis and gonorrhoea were unknown in India before the 16th century.

One of the earliest references to syphilis are found in "Bhavaprakasha", a mid 16th century text.
Reputed to be the work of Bhavamisra, an Ayruvedic physician at Varanasi, this books talks about treatment of syphilis.

In that age and for a long time after that, syphilis was known as Firangi / Firanga ( Franks/ Europeans ) roga ( disease )
It was said to be introduced by the Portuguese in the early 16th century. However, by the early 19th century, the disease had already spread over a large part of India although no data to measure its extent is available.
In 1808, a British doctor in Mysore ranked syphilis next to smallpox as one of the "most destructive and most perilous diseases in India" and claimed that few middle aged men were entirely free of it.
In the first half of 19th century STDs were known to be widely present among European soldiers of East India company. However, until the 1850s, the highly enervating but rarely fatal STDs were overshadowed by high mortality from diseases such as Cholera, Malaria and Dysentery.
However, after the Crimean war and reforms in Army nursing and medical provision started by Florence Nightingale, the great mutiny of 1857 in India highlighted the poor state of health of European soldiers in India.
The Royal Commission on the Sanitary State of the Army in India, (1863) stressed need for urgent improvements in these soldiers.Venereal disease was an important element in this.
Also, as the mortality of British troops declined sharply, from 32 per 1000 in 1860-64 to 15 in 1890-94 and to 4 in 1910-14,

the focus shifted to leading causes of morbidity.
For much of 2nd half of 19th century, STDs were 2nd only to Malaria among causes for hospitalisation.
In Bengal, where the majority of European soldiers were stationed, 177 men out of every thousand were hospitalised in 1855 for the treatment of STDs. As more British troops were called during the mutiny of 1857, this no. went to 359 in 1859 but again fell back to 167 in1867.
However, the introduction of short service system in British army led to an increase in the proportion of young, unmarried soldiers sent to India. By 1880, 41% of British soldiers in India were under 25 years of age while 75% were under 29 years of age.
This caused a rise in STDs once again. No. of hospitalisations due to STDs ( Equally split between Syphilis and Gonorrhoea ) went up to 205 / 1000 in 1875 and peaked at 552 in 1895. This means more than half of British soldiers were being treated for STDs !
This was much higher than the prevalence of STDs among soldiers in Europe :

Italy- 104, France- 44, Germany- 27 and British soldiers in England- 212
Although sexual relations with infected Indian prostitutes by soldiers was seen as the primary cause for the high incidence of STDs in the army, given the high no. for British soldiers even within Europe, one may argue these prostitutes were first infected by British soldiers.
However, after 1895 the rate of hospitalisation due to STDs started declining. It was 276/ 1000 in 1901 and went down to 53 1913 which was almost 10% of the peak in 1895.
The prevalence among Indian soldiers was much lower with rate of hospitalisation at 27 per 1000 in 1877, 41 in 1890 and 31 in 1895. However, these figures may not show the full picture as Indian soldiers received far less medical scrutiny than British soldiers before world war 1
Before the first world war, STDs in India were viewed almost exclusively in the context of Army and there was little concern about incidence of STDs among the civilian population except for the prostitutes associated with the army.
Increased awareness of STDs was in part, a result of debates over the regulation of prostitution in Indian cities and cantonments. The development of a women's medical movement in India from 1880s onwards was also important in revealing the extent of STDs.
A report on the Jafar Suleman Dispensary for women and children in Bombay by the pioneer woman doctor Edith Pechey recorded that out of 2,817 patients examined in 2nd half of 1884, 74 women and 23 children were suffering from syphilis while 55 had Gonorrhoea.
However, despite an increasing awareness of STDs ,data about its prevalence was scarce. Some measure of the extent of STDs came from data prepared by Bombay prostitution committee of 1921-22. As Bombay's population was about a million, this showed an incidence of 67 per 1000.
A survey by John Megaw, Director Gen. of the Indian Medical Service, in 1933 reported 37 cases of syphilis and gonorrhoea for every 1,000 patients attending hospitals. it was also estimated that there were 5.5 million cases of syphilis and 7.5 million of gonorrhoea in India.
This was a staggeringly high number. More so, given the fact that this country didn't even know of diseases until 4 centuries back and was mostly limited to Army less than a century back. Without any doubt, this was a direct outcome of the British rule in India.
It was a story of relocation of men due to economic reasons such as military service leading to a moral loosening reflected in behaviours such as visits to prostitutes which in turn lead to loss of health through diseases such as syphilis and Gonorrhoea.
The white man's civilising mission didn't come with this objective: They were as troubled by it as Indians were. However, it's a fact that the British rule ended up causing immense moral and physical damage to India.
This fact ought to be highlighted more often and forcefully in the discussions regarding the legacy of the raj. However, this alone will only correct the historical narrative. From a future point of view the lesson is that morality and physical health are strongly correlated.
The thread ends. Would like to thank @rvrbreeze ji for triggering this by pointing out to the high rates of STDs among British soldiers in India.
The thread is based on David Arnold's article "Sexually transmitted diseases in nineteenth and twentieth century India" (1993)
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