ANNA S. KUGLER, M. D. A Pinnm i91p&tcal fKiBStanary Anna S. K.ugl er, M. D. By MRS. CHARLES P. WILES Into the home of the Hon. Charles Kugler and Mrs. Harriet Sheaff Kugler there came one April day a wee, brown-eyed baby girl. This little girl, Anna Sarah, as she was called, when of proper age, started to public school in her home town of Ardmore, Pa. Later she attended the private school of Miss Markley, at Bryn Mawr, and the Friends’ School at Philadelphia. Always a serious-minded child, she was sensitive to impressions, so it was not strange that when a Baptist missionary, home on fur- lough from India, addressing a Lutheran Sunday School one Sunday afternoon, made an appeal for more mis- sionaries, little Anna said within herself, “I’ll go.” As she and her sister were performing some household tasks one day, she told her sister what she purposed doing with her life. In her resolution she never wavered. The strong quality of her nature was manifested by the fact that she decided to fit herself, not to enter a line of work al- ready established, but to blaze the trail for a work the foundations of which she herself would have to lay. Graduating from the Woman’s Medical College, of Phila- delphia, with honor, she was appointed First Assistant Phy- sician at the State Asylum at Norristown, being one of the first women in this country to receive such an appoint- ment. A future bright with promise lay before her in her own land, but she could not escape from the conviction that her work lay in India. In 1882, she made application to the Board of Foreign Missions to be sent out as a medical missionary. Her ap- plication was referred to the Executive Committee of the Woman’s Society who decided they were not yet ready to undertake medical work, but would send her out to teach and do general work until such time as medical work Could be begun. About the middle of the same year, Dr. Kugler received a letter from Rev. A. Rowe telling of the great need and urging her to come out before the close of the year. The following year Dr. Kugler was appointed to India, having accepted the conditions of the Executive Committee with certain mental reservations, knowing that a qualified physician would not be long in a country so greatly in need of medical relief as India without being called upon to help. She sailed from Philadelphia, August 25, 1883, and reached India on November 29 following. Before leaving Philadelphia, a devoted woman, Miss Re- becca White, a member of the Society of Friends, gave into the hand of the young physician one hundred dollars for instruments and medicine, and this sum, with one hun- dred dollars additional, furnished her simple equipment. Upon her arrival in India it was announced in the Madras papers that there was “no other woman physician in the Presidency.” She was not long in finding patients. Her first patient was a Brahmin widow, needing an operation for cataract. The second, the wife of a Sudra inspector of vaccination, was an invalid of five years’ standing with a chronic dis- ease of the joints which no amount of treatment could re- lieve. The third was a Brahmin woman suffering from chronic indigestion. It did seem that more hopeful pa- tients than these first three could have been had, but soon acute and more hopeful cases appeared. It seemed as if the people wanted it proven to them that she had miracu- lous power and not just the skill of the regular physician. It was not long before the demands upon her time and strength left little for the regular teaching and visiting in the Zenanas to say nothing of the study of the language. The realization that she was fulfilling God’s plan for her helped carry her through these early trying days. It required no little amount of heroism to undertake to es- tablish a work so entirely at variance with ancient Hindu customs. Many indignities had to be suffered before the mountain of superstition, prejudice and ignorance was overcome and medical work firmly established. It was not pleasant upon entering a high-caste Hindu home to be reminded that she was an unclean object, defiling every- thing she touched. Sometimes a very sick patient was even removed from bed and carried into the courtyard, the doctor being considered too unclean to be permitted inside. Neither was it pleasant to reach and stoop for her ov/n instruments and medicines, the doctor being too un- 3 clean to receive them from the hand of a Hindu. But these things were all in the way of opening up the path for those who came later. Such treatment is now compara- tively rare, the confidence of the public having been won. In the beginning of the work all medical attention, as well as medicines was given gratuitously. Later a small fee of two cents a bottle was charged for medicine. Where the patient was very poor no charge was made. Dr. Kug- ler discovered also that a call in the home was more greatly appreciated if a small fee was charged. As few of the women in India can read, and fewer have spoons, a novel method of marking doses of medicine was in- stalled. A strip of paper, with notches cut in the side to mark the size of the dose, was pasted on the side of the bottle. Very explicit the directions had to be, for the patient was likely to chew and swallow the paper and throw the powder away. The town of Guntur had at this time 16,000 to 18,000 in- habitants. The go-down of the Zenana Home was fitted up with a small closet, a table and a few shelves. The east veranda, with the doctor’s dressing room, served as treatment rooms and the work was begun. All classes availed themselves of the services of the doctor — Brah- mans, Sudras, Mohammedans, Pariahs, coolies, outcastes, Parsees and Christians, besides Anglo-Indians. During this first year she treated six hundred patients, some of them being brought from twenty and thirty miles away. In her journal we read: “Oct. 9, 1884, have determined to have a hospital within the next two years.” And adds, “Little did I know of the long years of waiting ahead.” In November, a note shows that the supply of medicine was exhausted, no funds were on hand and no money had been received from America. She then decided to take one year for the study of the language. When the announce- ment was made that no new calls would be received there were many unhappy hours for her. The following year, 1885, she was notified that she had been regularly appointed as medical missionary, and that money would be supplied for the rental of a house as a dispensary. How happy she was when she had a house in which to receive her patients instead of simply on a veranda! A meeting had been held the previous year in the interest of a hospital. Although but four or five mis- sionaries were present, R. 1000 was subscribed for the purpose. From 1889-91 the work was closed owing to the 4 absence of the missionary. She gave much time during these years to the study of hospital buildings and equip- ment, so that when the time came she was ready with ideas and plans. A tract of eighteen acres of land was purchased in the north end of the town, and here the first building erected, which was the dispensary, was opened in February, 1893. The same day that saw the dispensary opened saw ground for the hospital broken. Dr. Kugler herself removing the first spadeful of earth by torch light. A meeting in the interest of a wall around the Hos- pital Compound was held in July of 1893. At the meeting of the Zenana Conference the following February, Dr. Kugler was authorized to make a tour in the interest of this wall. She spent the months of February, March and April in touring Vinukonda, the Palnad, Bapatla and Tenali Taluks. The tour through the Palnad resulted in little except the creating of interest in the hospital that was to be. The results in Bapatla and Tenali Taluks were more encouraging, the officials in .Tenali accompanying Dr. Kugler from door to door urging the people to give. When Dr. Kugler returned on April 28 circumstances com- pelled her to abandon all further touring for the time, and it was not until 1897 that she could again take up this special task, making a tour of a few days down the Old Madras Road. Three thousand of the five thousand rupees needed for the wall had been secured through her efforts. The entire amount could doubtless have been obtained had it not been necessary for her to take up such addi- tional school work as to make further touring impos- sible. The wall was completed by the gift of a friend of Dr. Kugler. Having been invited by the Woman’s Congress of Mis- sions to make an address in Chicago, she came to America that same year, and the dispensary had to be closed. During her stay of two and a half months she appeared before twenty-eight audiences in the interest of our medi- cal work. Four years later, in 1897, upon the occasion of the Diamond Jubilee of Queen Victoria, the original hospital building was formally opened. The year 1883 saw medical work for women through women begun, the year 1893 the first of the group of hos- pital buildings completed. The second decade saw the arrival of the first trained American nurse. Miss Katherine Fahs, who reached Guntur, December, 1894, and the sec- ond and third medical missionaries in Dr. Mary Baer, 5 December, 1895, and Dr. Elsie Reed Mitchell in December, 1903. The third decade, or the years 1904-1914, was marked by the addition of a numiber of buildings — a diet kitchen and laboratory annex in 1907, the hospital chapel in 1909, the gift of a friend who visited the hospital and saw the need; the Hugh Hencken Ward for Children, a special gift given Dr. Kugler by Mrs. Hencken in memory of her son, opened on Christmas Day, 1911, and the beautiful nurses’ home and training school, made possible by the gifts of the 'women of Maryland Synod, opened Decem- ber, 1912. The third decade brought to the mission another medical missionary. Dr. Eleanor B. Wolf, and the second American nurse. Miss R. Hoffman. The motto chosen for the hospital, “Ourselves your ser- vants for Jesus’ sake,’’ might well be taken as the motto of the physician in charge, for quietly, unassumingly, pa- tiently, she has given of herself until her services have been recognized, not only by the missionaries and the people of the community, but by the government, as was manifested by the bestowal of the Kaiser-I-Hind Medal, a decoration given only for specially distinguished public service in India. Dr. Kugler was one of the first women to be thus honored. In March, 1917, she was summoned to appear before Lord Pentland, the Governor of Madras, to receive a second recognition for distinguished service, this time the bar to the Kaiser-I-Hind Medal. Dr. Kugler has, from the beginning of the work of the Tuberculosis Sanitorium, an interdenominational en- terprise, been on the committee, and for a time was in charge during the absence of the superintendent. She has, for many years, been a member of the Council of the “Association of Medical Women in India,” this Association being composed of medical missionaries and other physi- cians. In addition, she represents the Guntur Mission on the Council of the Medical School of Vellore. She has the distinction of being the head of the largest hospital in South India. Dr. Kugler, in her work, never forgets that healing of the soul is of greater importance than relief of the body, and she uses her professional skill as a means to that end. Many shall rise up and call her blessed, not only because of restoration to health, but because she has shown them the Christ, their Saviour. Many have heard of Jesus that would perhaps never have heard otherwise. Perhaps 6 7 DR. KUGLER IN THE HUGH HENCKEN WARD FOR CHILDREN. none have appreciated the services of Dr. Kugler more than the Rajah of Ellore, who, in gratitude for the res- toration of his wife to health, gave to the hospital a gift of a choultry, or inn, where relatives of hospital patients may stay. This building was opened April 17, 1914, the donor making the principal address. In his address the Rajah, after enumerating the build- ings erected thus far and giving the total cost of the same as R. 233,000, giving also the number of patients treated in the dispensary between the years 1900 to 1914 as 100,779, operations performed, 7,739, and children born in the hospital, 1,541, paid a high tribute to Dr. Kugler when he said, in effect; “A single woman at an early age became proficient in medicine, obtained a diploma, left her home and came to Guntur to serve her Lord. Do you think it possible for one soul to accomplish such a tremendous work that wrought good to so many souls without the help of God? Those benefltted by this doctor are scattered far and wide. It is an instance of what one soul can do for the good of humanity provided it is in- spired with love to God. It is needless to say that she is a sympathetic surgeon and physician. She takes only moderate charges from any, and her services to the poor she gives gratis. Not any gifts will she accept for her- self, but credits everything to the hospital account. She manages a staff of sixty subordinates and none are al- lowed to accept any gifts from patients.” The Rajah named his youngest child Annamma in honor of the doctor. As a mark of respect he caused to be distributed on opening day five hundred copies of the Epistle to the Galatians which he had translated into Telugu verse. In conclusion he said: “We shall be praying the Lord Al- mighty God, Dr. Kugler, that He may grant you long life and sound health to carry on the labor of love begun by you. May the Lord our God bless you and your in- stitution, that you may serve as an example to us to follow.” Women's Missionary Society of the United Lutheran Church in America Literature Headquarters, 844 Drexel Building, Philadelphia 5 cents each; 50 cents a dozen.