While they are a unique source for the study of public health in Tibet, the annual reports from the British dispensaries tended to be brief and formulaic. They also reflect the impact of individual medical officers, some of whom were far more active than others in terms of both medical practice and record keeping. These annual reports seem hastily compiled, with numerous errors and inconsistencies clearly apparent. Conditions reported as common in one report may not be mentioned in the next, and there are also wide fluctuations in dispensary attendance figures that are not always explicable in terms of known historical developments and events.

These medical records do, however, enable us to analyse specific aspects of biomedical practice and its reception in Tibet. They indicate, for example, the emphasis that the IMS officers placed on surgery. This partly reflected their participation in the heroic ‘cult of the surgeon’ discussed in the Introduction, and in their complaints over the conditions in which they had to operate there may be detected a note of pride in their capacity to achieve successful outcomes under such adverse circumstances. Dr. Kennedy, for example, wrote from Lhasa that; ‘I have done 41 cataract operations here and a number of other operations as well – not bad for a singlehanded effort.’ But this emphasis also reflected the fact that surgery – at least in the non-invasive form – was a practice known to indigenous medicine, but one in which the British were confident their abilities were superior. It was thus a field in which the IMS officers could demonstrate the superiority of Western biomedicine. Thus we read that on the Younghusband mission, Captain Walton, ‘by preference … selected cases requiring surgical treatment’.

The conditions under which they operated there made it difficult for the IMS officers to carry out major invasive surgery or other advanced procedures. This was particularly true of the early period, therefore they restricted surgery to such operations as correcting hare-lip conditions and removing growths. But there was a particular emphasis on cataract surgery, which had the advantage of being a simple operation requiring only local anaesthetic, but producing spectacular results.