Vasant Ramji Khanolkar: Architect of Indian Pathology

Dear Editor, On the return leg of his historic march from Kabul to Kandahar in mid-1880, General Frederick Roberts, the 1st Earl Roberts, and his regiment stopped in a quaint little city surrounded by four hills.[1,2] In this band of soldiers was a subassistant surgeon who hailed from a small Konkan village who captivated by the town’s imposing grandeur moved his family from the Konkan coast to settle in Quetta (now in Balochistan, Pakistan).[1] There, on April 13th, 1895, Vasant Ramji Khanolkar was born to Dr. Ramji Dhondji Kanolkar and Janki Jai Khanolkar. He was the second of eight brothers and two sisters.[3] He grew up in a progressive, well-educated family - a foundation that would shape his illustrious medical career.[1] In 1912, at the age of 17, he left behind colorful Quetta for the bustling metropolis of Bombay. His education continued in England, earning a B.Sc. from the University of London in 1916, an MBBS in 1918 [Figure 1], and an MD in Pathology in 1923, likely the first Indian to do so.[4]Figure 1: A young Dr. Khanolkar (Source: https://actrec.gov.in/photo-gallery/dr-vr-khanolkar-founder?page = 5)In 1924, he returned to India and joined Grant Medical College and Sir JJ Hospital as a professor of Pathology and Bacteriology.[5] When the King Edward Memorial Hospital (KEM) was set up by the Bombay Municipal Corporation, he moved to the newly minted institution, helping transform its pathology department into a premier center for education, research, and diagnostics.[3,5] He also established the central clinical laboratory and pathology museum and served as Dean from 1931 to 1933.[3] When the Sir Dorabji Tata Trust funded Tata Memorial Hospital (TMH) – India’s first specialist cancer hospital – Khanolkar was offered the post of Chief Pathologist. Initially hesitant, he accepted when told the post would otherwise go to a foreigner. As before, he threw himself into establishing the pathology department as one of the finest in the country.[3] Ten years later, the Indian Cancer Research Centre (ICRC) was established under Health Minister Rajkumari Amrit Kaur and DGHS K.C.K.E. Raja. Khanolkar was unanimously appointed Director.[1] In 1950, Prof Khanolkar became the founding president of the Indian Association for Pathology and Microbiology.[2] A decade later, he was appointed vice-chancellor of the University of Bombay, the first medical graduate to hold that position. His contributions earned him multiple international honors, including Fellowship of the Royal College of Physicians, an honorary Doctor of Law, and two terms as President of the International Cancer Research Commission (1950–1954 and 1958–1962). He held key WHO committee roles and served as an advisor to the Indonesian government on medical education (1952). He received the Padma Shri (1954) and Padma Bhushan (1955) for his work in medicine.[1-3,6] Prof Khanolkar’s research spanned leprosy, cancer, blood groups, genetics, contraception, radiation, biophysics, and biochemistry. He was the first researcher to identify the so-called “dhoti” cancer – a squamous cell carcinoma of the trunk and waist caused due to the constant repetitive irritative stimulus caused by the overly tight-fitting dhotis or sarees. Along with Sanghvi and Rao, he established the link between oropharyngeal cancer and tobacco use, including beedis and khaini as causes of carcinoma palate.[1] His work in leprosy, alongside Robert Cochrane, helped define the concept of dimorphous leprosy. He also confirmed the neural inception of leprosy and led the team that isolated the ICRC strain of Mycobacterium leprae in 1958. His book, “Perspectives in the Pathology of Leprosy”, became required reading for Leprosy.[2,3] In the 1940s, he pioneered the use of needle aspiration cytology for tumor diagnosis in India, a practice that would later become a cornerstone of cancer pathology.[2] In 1944, he played a key role in recognizing silicosis among miners which then led to legislative changes to the Indian Mines Act.[1] It was on his initiative that the ICMR instituted the advisory committee on family planning (at a time when the very topic was taboo), of which he was the chairman for seven years. His vision took shape through the first family planning units in Parel, Bombay, and culminated in the founding of the Institute for Research in Reproduction.[3] In addition, he also studied the distribution of Rh blood groups and erythroblastosis fetalis in Mumbai.[2] Khanolkar played a foundational role in establishing many of India’s leading medical institutions, including GS Medical College and KEM Hospital, the Institute for Research in Reproduction, the Cancer Research Institute, and the TMH laboratories [Figure 2]. His work was also instrumental in the planning of AIIMS, New Delhi, and PGIMER, Chandigarh. His student, Dr. Kamal J. Ranadive, recalled that discussions on Bhabha Atomic Research Centre’s (BARC) nodular laboratories took place in Khanolkar’s pathology offices at TMH and ICRC.[1-3]Figure 2: Dr. Khanolkar (Source: https://actrec.gov.in/photo-gallery/dr-vr-khanolkar-founder)He trained many of the founding staff of these institutions, imprinting on them a drive for excellence and consistent quality. Khanolkar’s association with TMH and ICRC is remembered as a period of significant advancement in cancer research in India, solidifying his reputation as the “Father of Pathology and Medical Research” in the country.[3,5] By a cruel twist of fate, the brilliant Prof Khanolkar spent the last few years of his life suffering from senility and dementia. He passed away peacefully at KEM Hospital on October 28, 1978.[1-3] Despite his transformative impact on Indian medical research, Prof. Khanolkar remains less recognized than popular figures in politics or cinema. It is a sad fact that the Indian government has never issued even a postage stamp in his honor. A hundred and thirty years after his birth, one hopes that, in time, he will be recognized alongside visionaries like Homi Bhabha and J.R.D. Tata as one of the builders of a modern India. His contributions to medical research and pathology deserve a lasting place in the collective memory of India’s scientific and healthcare legacy. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.