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NEW HORIZON  
Year : 2020  |  Volume : 63  |  Issue : 4  |  Page : 518-520
Dr. R. K. Gadgil - An eminent Indian pathologist, pioneer in starting rural medical camps and a researcher who discovered an endemic focus of schistosomiasis in Maharashtra, India


1 Department of Pathology, Gujarat Adani Institute of Medical Sciences, Bhuj, Kachchh, Gujarat; Formerly Prof. and Head Pathology, Grant Government Medical College, Mumbai, Maharashtra, India
2 Formerly Prof. and Head Pathology, Grant Government Medical College, Mumbai; Consultant Pathologist, Central Pathology Consultancy, Pune, Maharashtra, India
3 Clinical Professor of Pathology, Medical College of Virginia, Virginia Commonwealth University School of Medicine, Richmond VA; Consultant Pediatric Pathologist, Hartford Hospital, Hartford, CT, USA

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Date of Submission09-Jun-2020
Date of Acceptance01-Jul-2020
Date of Web Publication28-Oct-2020
 

   Abstract 


Dr. Ramchandra Krishnaji Gadgil (RKG) was a pioneer and an eminent researcher. Along with clinician colleagues, he started rural medical camps in 1952, in Maharashtra, India. Through his meticulous research, he discovered in the same year an endemic focus of schistosomiasis in the village, Gimvi, and in 1956, went on to establish a life cycle of the Schistosoma hematobium, involving a completely new intermediate Mollusk host “Ferrisia tenuis”, a rather epoch making discovery in the realm of Mollusk intermediate host in relation to human schistosomiasis. His instructions and guidance to the Government Public Health department led eventually to eradication of the schistosomiasis focus in that village in 1969, thereby setting an example for pathologists to head out into the field, do clinical work and pursue with disciplined curiosity a new pathological finding in the laboratory. The fascinating story of his life, education and research is described in this paper.

Keywords: Ferrisia tenuis, Gadgil R. K., Gimvi, India, Schistosoma hematobium

How to cite this article:
Lanjewar DN, Wagholikar UL, Joshi VV. Dr. R. K. Gadgil - An eminent Indian pathologist, pioneer in starting rural medical camps and a researcher who discovered an endemic focus of schistosomiasis in Maharashtra, India. Indian J Pathol Microbiol 2020;63:518-20

How to cite this URL:
Lanjewar DN, Wagholikar UL, Joshi VV. Dr. R. K. Gadgil - An eminent Indian pathologist, pioneer in starting rural medical camps and a researcher who discovered an endemic focus of schistosomiasis in Maharashtra, India. Indian J Pathol Microbiol [serial online] 2020 [cited 2020 Nov 28];63:518-20. Available from: https://www.ijpmonline.org/text.asp?2020/63/4/518/299321





   Birth Lace, Family and Education Top


Dr. Ramchandra Krishnaji Gadgil [Figure 1], was born in the middle class farmer's family on January 13, 1922 at Guhagar in Maharashtra.[1] Life in Konkan was difficult, there was poverty, illiteracy, prevalent customs and superstitions all around. His father, Mr. Krishnaji was a social worker and mother Mrs. Rakhmabai was a housewife, they had an ambition, that all their children must get good education. RKG completed MBBS in 1946 and MD (Pathology and Bacteriology) in 1949 from the Grant Medical College (GMC), Mumbai. RKG was married to Mrs. Urmila on May 20, 1950, and she delivered a baby boy on September 12, 1952 and expired on November 15, 1953, due to mitral stenosis. RKG did not remarry and devoted his entire life for research and social work. RKG was conscious of his social obligations and had deep desire to serve the villagers. In October 1951, during Diwali, when he went to Guhagar, he expressed an idea of holding a medical camp to village leaders, which was agreed to. After returning to Mumbai, RKG convinced his colleagues in Sir J. J. Hospital (JJH) about medical camps and they joined him for this noble cause. In the morning of May 3, 1952, a medical camp was started in the Zilla Parishad primary school Gimvi [Figure 2]a. This was the first rural medical camp in India, hence RKG can be called as a “Father of Rural Medical camp”. During interrogation, it was noticed that school students had one common complaint of passing red color urine. Microscopic examination of their urine showed presence of eggs with a terminal spine; suggestive of eggs of S. hematobium. This unexpected finding was the beginning of research of RKG. On May 11, 1952, when medical camps in other three villages finished, the team of doctors returned to Mumbai.
Figure 1: Dr. R. K. Gadgil, MD, PhD, FRC Path (London)

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Figure 2: (a) Zilla Parishad School Gimvi, large number of students of this school had common complaint of passing red color urine, (b)Rivulet in Gimvi village wherein intermediate host Ferrisia tenuis was discovered, (c) Pathology School Grant Medical College, Mumbai, wherein life cycle of S. hematobium was established, (d) Master laboratory aquarium used for breeding and maintenance of Ferrisia tenuis

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On May 19, 1952, RKG along with Dr. S. N. Shah, returned to Gimvi to do epidemiological survey and further investigations. The villagers informed RKG that since the past 60 years, they had a history of passing red color urine.[1] A rivulet originates in the hillock and runs down the slope through the Gimvi [Figure 2]b. About 40 families (603 inhabitants) were residing close to the rivulet and used the stream water for bathing and washing clothes, while children used to swim and discharge urine in the rivulet. The examination of urine in 278 students (153 boys and 125 girls) showed eggs of S. hematobium.[2],[3] Thus, on the basis of the clinical findings and presence of eggs of S. hematobium in urine, the endemic focus of schistosomiasis was discovered in the Gimvi.


   the Study of the Snails Top


Snails of Bulinus genera are the intermediate host of S. hematobium, these snails do not exist in India. Therefore authorities of the Zoological Survey of India had declared that there was no possibility of endemic focus of S. hematobium being established in India.[4] Hence the finding of S. hematobium eggs in 46% of population in Gimvi was alarming and required further investigations. Therefore “A Schistosomiasis Inquiry of Indian Council of Medical Research (ICMR) was established in the Pathology School GMC, Mumbai [Figure 2]c, RKG was in charge of this Inquiry. RKG collected few snails from the rivulet and visited Dr. B. S. Chauhan; Director of Zoological Survey of India, Kolkata, and requested him to send zoologist in Gimvi. A team of Zoologist reached Gimvi and identified two varieties of snails in the rivulet, the larger one as Paludomus obesa and the smaller one as Ferrisia tenuis.[5] The dissection of F. tenuis showed presence of Brivifircate and Fercocercaria, hence attention was focused on study of F. tenuis. RKG also visited other centers in India to observe techniques of infection of snails by miracidium, emission of cercaria by infected snails and infection of experimental animal by cercaria.


   Experimental Work in Pathology School, GMC Top


The first part of the experiment was to breed F. tenuis, for which aquaria of different sizes were prepared and after many attempts, it was possible to breed and maintain the F. tenuis in the master aquarium [Figure 2]d. For supply of eggs of S. hematobium students from Gimvi, were brought to pathology school. Their fresh urine samples were collected, centrifuged and sediments were kept in a refrigerator for a few minutes for the liberation of miracidium. The second part of the experiment was to infect Ferrisia tenuis by miracidium. Aquarium water is then taken in a beaker, add approximately 100, F. tenuis in it and then to it add suspension of 500 miracidium. The infected snails which survived 4 weeks were collected, 100 in each test tube and these test tubes are kept in water bath at 27° Celsius to emit cercaria.[6] The emitted cercaria are collected in separate test tubes and are used for infection of laboratory bred white mice. The mice was immobilized by wrapping a thin gauze bandage around all limbs, then it was tied to a thin wooden board having hole in it, through which the tail of mice is pulled out and dipped for 2 hours in a test tube containing cercaria suspension and then mice was kept in its cage. In this experiment, three out of four mice died during the first month; their dissection did not show parasites. The fourth mice was sacrificed after 62 days, and dissected, mesenteric vein did not show parasite. The liver was cut into thin slices and each slice, after teasing a little, was pressed between two glass slides, it showed one pair of parasite.[7] This confirmed that F. tenuis is an intermediate host of S. hematobium in Gimvi. To procure large number of parasites, further experiments were continued. In these experiments, the cercaria suspension was poured in an enamel tray and two mice/hamsters were kept in the tray and a glass lid was kept over enamel tray. After 4 hours, mice/hamsters were taken out from tray and kept in their respective cages. In this way, 30 mice and 6 hamsters were infected. The animals were sacrificed and dissected, the dissection of mesenteric veins and portal veins of 18 mice and 4 hamsters showed adult worms. A total of 150 adult worms of S. hematobium were recovered.[8]. Histology of liver showed segments of adult worms in the branches of portal veins; in addition liver parenchyma, ileum, caecum, appendix and lung showed eggs of S. hematobium.


   Fellowships and Awards Top


In June 1958, RKG and Mr. Mujumdar (Public health Department) were invited on WHO fellowship to Egypt to observe the eradication program of Schistosomiasis. Mr. Mujumdar observed the eradication program while RKG focused his attention on studying pathology of schistosomiasis. The organs infected by schistosomiasis made a great impact on mind of RKG and he was worried about long term consequences of S. hematobium on the health of Gimvi villagers. In 1962, RKG was invited in Boston Parasitology laboratory, USA, to establish a life cycle of S. hematobium with F. tenuis as intermediate host. For supply of eggs of S. hematobium, school students from Gimvi were brought to the pathology school in Mumbai. Their fresh urine samples were collected, centrifuged and sediments were preserved in thermos box and then were air lifted from Mumbai to Washington and then to Boston parasitology laboratory, USA. In 1959, RKG registered himself for Ph.D. course in Savitribai Phule, Pune University (earlier Pune University). His PhD thesis was evaluated by Prof. of Parasitology, London School of Tropical Medicine, London (UK) and he was awarded Ph. D. in 1962. In addition, RKG was awarded the “Dr. Bhalerao Gold Medal” for his research on Schistosomiasis during the Indian Science Congress held in Mumbai.[1]


   Eradication of Schistosomiasis Top


In 1958, RKG with the help of public health department undertook eradication program of intermediate Mollusk host, F. tenuis in the rivulet of Gimvi. Copper sulphate was used as a Molluskcide, Gimvi became totally free from schistosomiasis in 1969.


   Rkg as Researcher and Professor Top


Aside from his original contribution of discovering Schistosomiasis, Professor Gadgil's scientific articles on lipid profile in healthy Indians,[9] elastic tissue in chondrosarcomas,[10] LDH in hepatobiliary diseases,[11] carcinoma of liver,[12],[13] and tropical eosinophilia[14] are notable primarily for their originality. His career as a professor spanned from 1955 to 1973, and then as a Dean from 1973 to 1974. As a head, he was a strict disciplinarian and task master. “Saheb” was a fond unanimous designation for him. He took keen personal interest in his residents and they became successful academician or practicing pathologists in India and abroad. He was an active member of “Teaching Pathologists Association” Mumbai, ICMR, New Delhi, Indian Association of Pathologists and Microbiologists, of which he was president in 1981. He also was a President of Maharashtra Medical Council from 1979 to 1984.

Dr. Gadgil had a happy joint family with a son Charudatta, a daughter in law, granddaughters and a great granddaughter. His son (an engineer) was working for Air India (International). RKG lived a happy, contented life and rose to his heavenly abode at the age of 97 years without discomfort, distress or pain. Dr. R. K. Gadgil was truly an inimitable pathologist, a rarity in this age of sub specialization.

Acknowledgement

We would like to acknowledge Dr. K. P. Deodhar (Mumbai), Dr. Abhay Chowdhary (Mumbai), and Mr. Charudatta Gadgil (Mumbai) for their support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Gadgil RK. Hematobium G. An Autobiography of a Doctor Researcher. 1st ed. Mumbai, India: Hema Publications; 2009.  Back to cited text no. 1
    
2.
Gadgil RK, Shah SN. Human schistosomiasis in India. Discovery of an endemic focus in the Bombay state. Ind J Med Sci 1952;6:760-3.  Back to cited text no. 2
    
3.
Shah SN, Gadgil RK. Human Schistosomiasis in India. Part III. Note on the clinical survey of the endemic focus. Ind J Med Res 1955;43:703-6.  Back to cited text no. 3
    
4.
Bhalerao GD. Blood fluke problem in India, Presidential address. Proceeding of 35th Indian Science Congress in Mumbai, India. 1948. p. 57-71.  Back to cited text no. 4
    
5.
Shah SN, Gadgil RK. Human schistosomiasis in India. Part I. The study of snails. Ind J Med Res 1955;43:689-94.  Back to cited text no. 5
    
6.
Gadgil RK, Shah SN. Human schistosomiasis in India. Part II. Infection of snails with Schistosoma hematobium. Ind J Med Res 1955;43:695-701.  Back to cited text no. 6
    
7.
Gadgil RK, Shah SN. Human schistosomiasis in India. Part IV. Establishing the life cycle in the laboratory. Ind J Med Res 1956;44:577-80.  Back to cited text no. 7
    
8.
Gadgil RK. Human schistosomiasis in India. Ind J Med Res 1963;51:244-51.  Back to cited text no. 8
    
9.
Dave JK, Mani PS, Panvalkar RS, Gadgil RK. Serum lipid pattern in health. Ind J Med Sci 1960;14:867-72.  Back to cited text no. 9
    
10.
Subbuswamy SG, Tulpule SS, Gadgil RK. Elastic tissue in chondrosarcomas. J Pathol 1974;113:141-5.  Back to cited text no. 10
    
11.
Dave JK, Gadgil RK, Joshi VB. Serum lactic dehydrogenase in hepatobiliary diseases. Ind J Pathol Bacteriol 1963;124:223-9.  Back to cited text no. 11
    
12.
Kshirsagar VH, Mansukhani SH, Gadgil RK. Primary carcinoma of the liver. Ind J Pathol Bacteriol 1968;11:112-20.  Back to cited text no. 12
    
13.
Patwardhan JR, Kshirsagar VH, Gadgil RK. Utility of liver biopsy in the diagnosis of carcinoma of the liver. Ind J Cancer 1971;8:258-62.  Back to cited text no. 13
    
14.
Joshi VV, Udwadia FE, Gadgil RK. Etiology of tropical eosinophilia. A study of lung biopsies and review of published reports. Am J Trop Med Hyg 1969;18:231-40.  Back to cited text no. 14
    

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Correspondence Address:
Dhaneshwar N Lanjewar
Prof. and Head Department of Pathology, Gujarat Adani Institute of Medical Sciences, Bhuj, Kachchh . 370 001, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_686_20

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