Born in Barbadoes on October 10th, 1858, the son of Henry Pilgrim, a planter. He is said to have been educated at Cheltenham, Boyce's House, but his name does not appear in the College Register. He then went to University College and St Bartholomew's Hospitals, as well as to Edinburgh University, and passed into the Indian Medical Service second in a very long list. He was gazetted Surgeon on September 30th, 1886, Major on September 30th, 1898, Lieutenant-Colonel on September 30th, 1906, and placed on the selected list from December 25th, 1911. He served in the Lushai Campaign on the North-East Frontier in 1889, receiving the Frontier Medal with Clasps; otherwise he was in Civil employ in Bengal, to which province he was posted in June, 1890. After two years as Civil Surgeon of the Nadiya District, he was appointed 2nd Resident Surgeon of the Presidency European General Hospital, Calcutta; he became First Resident Surgeon in 1896. On the retirement of Lieut-Colonel Alexander Crombie in the spring of 1898, Pilgrim was appointed to succeed him, although only a Surgeon Captain, in a post previously held by senior members as one of the most important, professionally, in the whole service. He proved himself to be a first-class man, both as a physician and surgeon. He had great business ability, and supervised and in part planned the construction of an entirely new and up-to-date hospital, at a very large expense to the Government of Bengal - the most important hospital in Eastern India. After twelve years' work he took, in April, 1912, two years' furlough, and at the outbreak of the European War was selected for appointment to the Medical Charge of one of the two hospitals in England for Indian sick and wounded, but died before he took up his duties. On October 1st, 1914, he was speaking through the telephone at Brighton, when he had a cerebral haemorrhage and died in ten minutes.