Abstract
The four books under review represent recent scholarship on the social history of medicine in colonial India. They cover different medical practices ranging from Ayurveda, Unani, Siddha and Homeopathy to folk medicine, and different social groups including the Indian army, labourers, prisoners, women, educated elite, female native medical professionals, nationalist and middle class, and the common populace. Apart from the archival records, the authors have used a variety of new sources in order to investigate the other side of the story such as literature and poetry (Hindi, Urdu, Magadhi, Bhojpuri), journals, newspapers and biographies.
The first book under review, Deepak Kumar and Raj Sekhar Basu’s edited Medical Encounters in British India, has articles by several eminent scholars writing on the subject of medical encounters between the metropole and British India. Centres of innovation in Europe existed in a dynamic relationship with one another and with the colonies, linked by networks of long-distance trade, correspondence and a plethora of new medical journals. Mark Harrison notes in this volume that we are only beginning to be aware of the scope and importance of these connections, but there remains the need to revise conventional and Eurocentric narratives of the rise of modern medicine. Even within state institutions there were significant variations in the practice and character of Western medicine as experienced in day-to-day encounters in small dispensaries and clinics. It was adapted and taken up by non-Western people in varying degrees, reflecting their preoccupations, cultural preferences and government policies. The articles in this edited volume draw out this connection of exchange and perceiving knowledge before Western imperialism. They highlight the path of transmission, interaction and assimilation from ‘periphery’ to ‘centre’ (China, Arabs, India and Europe) and from ‘ancient’ to ‘modern’.
The articles in Deepak Kumar and Raj Sekhar Basu’s edited volume deal with several themes, with a section each on ‘the multiplicity of domains’ (which considers exchanges between ‘East’ and ‘West’ in the transmission of medical knowledge) and ‘differing perceptions’ (British and Indian approaches to various conditions). The first few essays show the reverse transmission line from ‘periphery’ to ‘centre’ (M. Harrison, in case of calomel or mercury), how European medical knowledge developed historically in amalgamation with the Eastern elements of sameness and difference (J. Bhattacharya), and how the use of calomel and opium adopted by British physicians for the treatment of cholera helped in the origination of homeopathy in India despite opposition (Dhrub Kumar Singh). Sunil Amrith’s chapter documents the decline and re-emergence of the ‘tropicality’ in the debates over the development of Asia. He focuses on the competing narratives of environmental conditions versus under-nutrition as causes of ‘biologisation of poverty’ (as a ‘disease’). He suggested that despite the nationalist critique of the ‘new knowledge of nutrition’ the colonial discourse of tropicality was always present in the post-colonial vision of development. Mridula Ramanna’s chapter talks about the control of malaria in Bombay presidency in the early twentieth century. The author delineates the role of the Municipal Corporation, native rulers, Indian Government and the Rockefeller foundation. David Arnold talks about the revivalism of Ayurveda in colonial India, on the basis of ‘Western’ medicine. Ayurveda revisits itself focused on the modern scientific basis and sidelined its traditional focus on diet. Arnold highlights the manner in which Ayurveda was incorporated into Western medicine. The educated middle class became mediators of new medical knowledge in India. The educated sections of people were not just passive recipients but were also trying to secure a respectable social status within the newly created professional structure of medicine. (Madhuri Sharma). The chapter on Travancore illustrates state-supported medical services as the main means of extending European medicine to the poor people (Raj Sekhar Basu). B. K. Choudhary’s essay concerns how British medical practitioners in India tried to locate the incidents of diseases within certain cultural practices and traditions, especially in the case of women. A. Samanta talks about the social construction of tuberculosis in colonial and post-colonial India. Indira Chowdhury delineates the ways through which colonial rule portrayed Indian sexual practices and how colonial knowledge system incorporated selected information about Indian culture, and the criminalisation and legalisation of abortion in the context of growing concern for population control by the European reformers.
Poonam Bala in her edited volume titled Contesting Colonial Authority also raises the question of Western medical ‘hegemony’ and ‘universalism’. The author emphasises the limitations, compromises and negotiations of the ‘modern medical hegemony’ in colonial India, which created a space for the revivalism of traditional and folk medicine, which she calls ‘paradigms of defence’. Bala argues, ‘various alliances were formed between the traditional sections of the Indian population and the colonial state alliances which also facilitated extensions of hegemonic power directed towards transforming indigenous tradition into the universal forms of a rational and scientifically ordered social life’ (p. xii).
The various chapters of Poonam Bala’s edited volume weave together multiple issues involved in the process of engagement of indigenous and ‘Western’ medicine marked by accommodation, adaptation and contestation. The adoption/accommodation was not determined by only medical needs but political, economic and social concerns as well. The volume also highlights that healthcare practices, both indigenous and Western, were transposed in accordance with changing notions of power and authority within Western and indigenous contexts. The contestation of Western with the indigenous (Ayurveda and Unani) forced the former towards revivalism, institutionalisation, professionalisation, pharmaceuticalisation, causing radical changes within existing paradigms. N. Quaiser sees these changes in Unani medicine as an ‘internal logic of renewal’. The rapid political changes in the late nineteenth and early twentieth centuries led to the development of daktari as a natural medical intervention on the bodies of native subjects. The rise of a politically conscious, educated middle class forced government to adopt structural changes and the Indianisation of Indian Medical Service. The chapters on Lady Dufferin Fund raises the issue of marginalisation of native female doctors, dais, and midwives from the service in India and Burma. Indian nationalists resisted this and aspired to control the administration of the Fund. The colonial notion of racial superiority and cultural distance were major reasons for the opposition, disbelief and suspicion against the government health and sanitation policies. As A. Samanta argued, without the involvement and support of the local population it was not possible for the government to achieve success against epidemics in India (p. 143).
The two books raise the pertinent theoretical question: How Western is Western medicine? Pursuing the theme of the ‘encounter’ between ‘Eastern’ and ‘Western’ medical practices in British India, in Indigenous and Western Medicine in Colonial India, Madhuri Sharma studies medical pluralism, patterns of patrons and patronising medical system in colonial India. Through her case studies on Banaras region, she has shown how different healing systems co-existed and were patronised at the same time by the same patrons. Poonam Bala similarly demonstrated how students educated in European medicine or in any other ‘traditional’ system were often familiar with other healing traditions too (p. 13). The traditional medical practices in India reshaped and redefined themselves according to the needs of the social, political, economic and cultural aspects of the country and especially with the aim to reach out to the common masses. The ‘traditional’ systems established their educational and training institutions and organisations at the national and the provincial level. In the Kumar and Basu edited volume (p. 6) it was argued that ‘Western’ medicine was prevalent amongst urban dwellers (10%), and the rest of the population were dependent on ‘other’ medical practices. Madhuri Sharma extends the thought by arguing that in these changing circumstances, ‘users’ turned into ‘consumers’, while the traditional medical practitioners transformed into entrepreneurs.
While Deepak Kumar and Raj Sekhar Basu delineate the limitations in the writing of a Global History of Medicine, in Colonial Medical Care in North India, Samiksha Sehrawat defines the terminology of ‘Western Medicine’. Sehrawat highlights very important aspects of imperialism, namely the political-economy of health in India. She analysed the role of the state in medical care and what role it has assumed in ideological framework of the British Raj. She also focused on the shifting role and purpose of colonial medical policy in India according to political, economic and administrative needs of the Raj. She has chosen two broad categories: Indian army and Zanana (secluded Indian Women) for her study. Sehrawat argues that in the nineteenth and twentieth century, the provision of medical care was an obligation for the government. Initially the government was willing to spend resources on medical institutions to inculcate the ‘public spirit’ of voluntarism and philanthropy among Indian elites. This was an attempt to include Indians in the municipal organisation and also to withdraw the government from the responsibility of funding medical care for its subjects. This policy compelled provincial and local governments to generate funds through voluntary donations rather than from the central government’s treasury. This book also highlights the relationship and interaction of the Home Government (London), the Indian government and the provincial government, thereby reflecting the political challenges and practical problems in such situations. The chapters on women’s healthcare show how issues of medical care for the women raises questions on the gendered ideology of British rule and led to the formation of the Women Medical Service of India. The author argues that the Colonial government’s indifferent attitude towards Indian sepoys, martial race theory and Indian rigidity towards customs lost its validity during the First World War and compelled the government to introduce medical reforms for the Indian sepoys. The financial constraints of the government kept on dominating the medical care policy in the colony.
The four books under review are complementary to each other. In the edited volume by Deepak Kumar and Raj Sekhar Basu, despite the emphasis on the ‘exchange’ between ‘East’ and ‘West’ the evidence provided in the volume suggests imbalanced exchanges. It leaves the reader unsatisfied and wanting to know more about the resistance of the ‘East’ against ‘Western’ hegemony. The editors self-acknowledged limitations of the present book provide further line of investigations to future researchers. Similarly, although the title of Samiksha Sehrawat book includes the word ‘society’, it does not record the impact or the responses of government policies on society. While Madhuri Sharma’s book is titled Indigenous and Western Medicine in Colonial India she has chosen a case study of Banaras region, and hence the reader is left to wonder why only Banaras, unless by a sleight of hand the author equates Banaras with India. These quibbles do not belittle the interesting and lucid readings in this, as well as the other books. Likewise, the quality of these volumes and the detailed evidence they present will provide a rich resource for students, historians and sociologists seeking to understand the historical basis of medical formation in India.