Lives of the fellows

Sardari Lal Malhotra

b.5 December 1919 d.10 September 2004
BSc(1939) MB BS Punjab(1944) MRCP(1947) DCH(1947) DPH(1952) DIH(1952) FAMS India(1967) FRCP(1967) FACC(1967)

Sardari Lal Malhotra, 'Lal' to his friends, was born in a part of the Punjab that is now in Pakistan. He qualified in medicine in 1944 at the King Edward Medical College in Lahore. He later went to England to gain further qualifications and worked at the Postgraduate Medical School, Hammersmith, and the London School of Hygiene and Tropical Medicine.

He returned to India and, from 1957 onwards, served successively as chief medical officer of three Indian railways. He made an outstanding contribution to the training of railway medical officers, and to the establishment and organisation of railways hospitals all over India. His unique position and authority enabled him to conduct epidemiological studies and clinical research projects covering almost the whole of India, covering subjects such as peptic ulcer, gall stones, ischaemic heart disease, hypertension, diabetes, carcinoma of the colon and of the breast, and varicose veins. He was able to organise clinical trials and at the same time to conduct laboratory research.

He was interested in the effect of staple diets on the epidemiology of diseases, and particularly in the low prevalence of duodenal ulcer in the Punjab, where the staple diet was unrefined wheat, compared with the high prevalence in rice-eating areas of south India. His authority was such that he was able to order his medical officers in Bombay to instruct a group of railway employees with proven duodenal ulceration to change from a rice diet to a Punjabi diet and to check that they did so. Over a period of five years this group had significantly fewer relapses than a similar number continuing on a rice diet.

He developed the 'masticatory hypothesis', postulating that the extra mastication required to eat the more solid Punjabi diet resulted in a greater flow of saliva than the sloppier rice diet. He suggested that the alkaline saliva reduced the stomach acidity and that the mucus in the saliva plus its content of epidermal growth factor protected the gastric and duodenal mucosa from ulceration.

In all he contributed over 100 original papers to international literature, covering a wide field, and gained a wide reputation for his original thinking. He made valuable contributions to the whole field of gastroenterology.

Following his retirement from the railways in 1977 he was appointed as associate professor of family and community medicine in Benghazi, Libya, for a two year period, and then for a year as professor of preventive and social medicine in Maidugiri, in Nigeria. He then retired from medicine and accompanied his wife Gabriella, who works in the Italian Foreign Service, to appointments in Italy, Japan, New York and finally Austria.

From September 2003 he was dogged by recurrent illness, which he bore courageously with the great support of his wife. He sadly died in Vienna. He was cremated in Vienna and his ashes were taken by his wife to India and scattered on the river Ganges in Kolkata, in the presence of members of his family.

Frank Tovey

[Brit.med.J.,2004,329,981]

(Volume XII, page web)

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