Upendranath Brahmachari: The Cure That Never Won a Nobel

Upendranath Brahmachari was an Indian doctor and medical researcher. Calcutta was his working home for decades.

Where did he start?

• He was born on 19 December 1873.
• Sources differ on his exact birthplace, so exams rarely test it.
• He took a BA with honours in 1893 and a master’s in chemistry in 1894.
• He then studied medicine at Calcutta Medical College and took his MD in 1902.
• He joined Campbell Medical School in Calcutta in 1905.

When did he die?

He died on 6 February 1946.

What is the memory hook?

Think “1873 born, 1905 Campbell, 1946 gone”. Campbell was his workplace for about twenty years.

Kala-azar is a serious disease caused by a tiny parasite. Its medical name is visceral leishmaniasis. It attacks organs deep inside the body.

Where did it strike?

• Reports of a deadly fever in Bengal go back to 1824.
• It returned around Burdwan in 1860 and caused many deaths.
• It spread along the Gangetic plain and the Brahmaputra valley.
• Leonard Rogers later named the disease as kala-azar.

What was the old treatment?

• Doctors in India used tartar emetic from about 1915.
• Tartar emetic is a compound of the metal antimony.
• It was very toxic.
• Patients also had to finish a long course of injections.

Why did that matter?

Many patients could not finish the course. A safer, shorter cure was badly needed.

What is the memory hook?

Think “old drug harsh, new drug gentle”. Brahmachari’s task was to make the cure safer.

Brahmachari built on an earlier drug called atoxyl. Atoxyl is an arsenic compound used against sleeping sickness. He tried a similar idea with antimony.

What did he make?

• He made a compound called urea stibamine.
• It joins urea to para-amino phenyl stibnic acid.
• Most reviews date the discovery to 1920.
• Some sources give 1922 instead.
• He worked in a small room at Campbell Hospital.

Why was it better?

It was safer than tartar emetic. Fewer patients dropped out of treatment. That made large treatment drives possible.

What is the memory hook?

Think “1920, urea, antimony”. The 1920 date is the one most reviews use.

Dermal leishmanoid is a skin disease. It can appear after a patient recovers from kala-azar. Brahmachari spotted it in 1922.

What did he find?

• Some recovered patients developed skin eruptions.
• He scraped the skin nodules and examined them.
• The same parasite was present in the skin.
• He was the first to see that it could appear even during treatment.

What is it called today?

• Its modern name is post-kala-azar dermal leishmaniasis (PKDL).
• It was once called Brahmachari’s leishmanoid.
• Another doctor, J. W. D. Megaw, praised the finding.

What is the memory hook?

Think “cure first, skin disease second”. Two separate discoveries, both by him.

Urea stibamine changed the fate of kala-azar patients. The results were large and well recorded.

What do the numbers say?

• By 1925 the death rate among treated patients had fallen to about 10 percent.
• The recovery rate was about 95 percent.
• Assam’s Director of Public Health reported over 328,000 patients treated by 1933.
• Sir John Kerr said about three lakh lives were saved in Assam over ten years.

Did it reach beyond India?

Reviews say the drug also worked in other countries. Doctors in Greece, France and China are named in one review.

What is the memory hook?

Think “10 percent deaths, 95 percent cured”. The drug turned a deadly disease into a treatable one.

Brahmachari was nominated for the Nobel Prize in Physiology or Medicine. He never won it. Reviews give several reasons.

What honours did he get?

• He won the Minto Medal in 1921.
• He received the Kaisar-i-Hind Gold Medal in 1924.
• He was given the title Rai Bahadur.
• The British government later knighted him.

What about the Nobel nominations?

• He was nominated in 1929.
• He was nominated again in 1942.
• One review says the nominations were weak.
• It also says he had little global exposure.
• His Royal Society nomination was stopped by the Second World War.

What is the memory hook?

Think “nominated, never named”. A nomination is not a win.

Four mix-ups come up again and again. Learn each pair.

What are the traps?

• Which disease? Urea stibamine treats kala-azar, not malaria.
• Which year? Most reviews say 1920. Some say 1922. Dermal leishmanoid is 1922.
• Nobel Prize? He was nominated but never won.
• Which parasite drug? Tartar emetic was the old, toxic drug. Urea stibamine replaced it.

How do you remember them?

Think “cure 1920, skin 1922, no prize”. Keep the three apart.