Systems of medicine and nationalist discourse in India: Towards “new horizons” in medical anthropology and history

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Abstract

While accepting medical “pluralism” as a historical reality, as an intrinsic value inherent in any medical system, and as an ideal or desired goal that any multicultural society ought to achieve, this paper argues the need to go beyond the liberal pluralist tendencies that have dominated the debate so far. It holds that while documenting or dealing with the “co-existence” of varied medical traditions and practices, we must not ignore or underplay issues of power, domination and hegemony and must locate our work in a larger historical, social and political context. With this perspective, and based essentially on Assembly proceedings, private papers, official documents and archival materials from the first half of the 20th-century, this paper identifies three major streams in the nationalist discourse in India: conformity, defiance and the quest for an alternative. It shows that while the elements of conformity to biomedicine and its dominance remained more pronounced and emphatic, those of defiance were conversely weak and at times even apologetic. The quest for alternatives, on the other hand, although powerful and able to build trenchant civilizational and institutional critique of modern science and medicine, could never find adequate space in the national agenda for social change. The paper further holds that although the “cultural authority” and hegemony of biomedicine over indigenous science and knowledge were initiated by the colonial state, they were extended by the mainstream national leaderships and national governments with far more extensive and profound implications and less resistance. In light of the growing global networking of “traditional”, “complementary” and “alternative” health systems on the one hand and the hegemonic and homogenizing role and presence of multilateral organizations (such as the World Bank and IMF) in shaping national health policies on the other, such insights from history become extraordinarily important.

Introduction

Since the late 1960s, the idea of medical “pluralism” has been debated both within and outside the forum provided by Social Science & Medicine, and, indeed, never has the concept been so popular as in the last one and a half decades. While accepting medical pluralism as a historical reality, as an intrinsic value inherent in any medical system, and as an ideal or desired goal that any multicultural society ought to achieve, this paper argues the need to go beyond the liberal pluralist tendencies that have dominated the debate so far. It holds that while documenting or dealing with the “co-existence” of varied medical traditions and practices, we must not ignore or underplay issues of power, domination and hegemony and must locate our work in a larger historical, social and political context (Ernst, 2002). In this sense, this paper responds to the call by Waltraud Ernst for a “critical and informed pluralist perspective” and intends to make some contribution to “new horizons” in medical anthropology and history (Ernst, 2002; Nichter & Lock, 2002).

In particular, I focus here on systems of medicine and mainstream national politics in India in the first half of the 20th century. The purpose is to explore varied shades and trajectories of the nationalist discourse and their struggles for hegemony; and to examine how different (or not) were the nationalist perceptions, policies and programs towards different systems of medicine in India from those of the British colonial state. Such an exercise not only helps us understand different patterns of contemporary politics in this field but also throws light on important and longstanding issues of the decline of “indigenous” systems of medicine (particularly Unani and Ayurveda), the nature of their interactions with biomedicine in the first half of the 20th century, and, most importantly, with hindsight, their subsequent status in the post-colonial period in India.1 Moreover, a study of this nature may also provide a far more concrete ground for testing Indian nationalist positions than the domains of politics, art and literature. While not an uncharted territory, medicine as a part of social history and medical anthropology is relatively new ground for assessing Indian nationalism and anti-imperialist struggle in India.2 In the context of “globalization” and the hegemonic role and presence of multilateral organizations such as the World Bank and IMF in shaping national health policies, such insights from history become all the more relevant.

This paper—based essentially on Assembly proceedings, private papers, official documents and archival materials—identifies three major streams in the nationalist discourse. The first falls in the category of conformity to biomedicine (or what is usually identified as the Western system of knowledge) and its dominance, as well as to its wide application to Indian systems of medicine as a sign of modernization. The second consists of elements of defiance against the dominance and alleged superiority of the Western system of knowledge and its wide application. The third involves a quest for an alternative based on India's own experiences. The paper argues that the zeal for conformity to biomedicine and the Western system of knowledge remained more pronounced and emphatic, while the elements of defiance were weak and, at times, even apologetic. The quest for an alternative, on the other hand, although powerful and able to transcend Western hegemony, could never find adequate space in the national policy for social change. The dominance of the voice of conformity to Western “science” and “progress” did not simply mean an inherent acceptance of western superiority and a fractured, dislocated version of “colonial governmentality” (Prakash, 1999), but also a continuation of the colonial legacy of subordination and subservience of Indian systems of knowledge, a situation fundamentally not different from the colonial past.

Section snippets

The state of knowledge

Before we deal with these three major strands in detail, it is important to note that in the last few decades, there has been a surge of interest in the medical history of India under colonial rule. In particular, works of Arnold (1985), Arnold (1993), Arnold (2000), Harrison (1994), Pati and Harrison (2001), Jeffery (1988), Ramasubban (1982), Chandavarkar (1992), Kumar (1997a), Kumar (1997b), Bala (1982), Bala (1991), and Anil Kumar (1998), among others, are of great relevance. However, most

On methods, background and sources

As indicated above, I focus here on systems of medicine and mainstream national politics in India in the first half of the 20th century, particularly the 1930s and 1940s. There is more or less a general consensus among scholars that by the late 1920s and 1930s, the idea of India getting political freedom had become quite widespread, so much so that the Indian National Congress (INC), the main organizing nationalist body, had instituted a National Planning Committee to prepare blueprints on

The voice of conformity

The voice of conformity is best represented by “The United Provinces Indian Medicine Bill, 1938,” passed by the United Provinces (U.P.) Legislative Assembly in 1939. The Congress ministry that had formed the first mass elected representative government in the province introduced the Bill. Briefly, it proposed reconstituting the Board of Indian Medicine as a statutory and representative body consisting of experts and public men and women with adequate funds and power to coordinate the system of

Elements of defiance

Against the zeal for conformity to the Western model of scientific medicine, the voice of dissent within the nationalist ranks could never evolve into an effective opposition. The debates within the legislative assembly reveal that those who represented the voice of dissent were mostly defeated in the arithmetic of votes. There were very few members within the Assembly who protested against the voice of conformity. Moreover, the voice of dissent, it seems, was caught in the dilemma of the

Quest for an alternative

Mohandas Karamchand Gandhi (1869–1948), popularly known as Mahatma Gandhi, was the central figure who in the midst of this discourse adopted a third path, one that could be termed as the quest for an alternative. His quest in medicine and health evolved from his general critique of modern civilization. Since the West is proclaimed as the birthplace of modern civilization—the system of allopathy or biomedicine being a part of it—Gandhi's critique was also a defiance against the West, and

Conclusion

A study of mainstream national politics and nationalist discourse on systems of medicine in colonial India reveals a plurality of ideas ranging from conformity to defiance to the quest for an alternative. While the elements of conformity to the Western system of medicine and its dominance remained more pronounced and emphatic, those of defiance were conversely weak and at times even apologetic. The limits of defiance are apparent in its arguments—their ambiguities and ambivalence over the issue

References (62)

  • P. Bala

    Imperialism and medicine in Bengal: A socio-historical perspective

    (1991)
  • P. Brass

    The politics of ayurvedic education: A case Study of revivalism and modernization in India

  • D. Chakrabarty

    Provincializing Europe: Postcoloniality and the critique of history

    Cultural Studies

    (1992)
  • R. Chandavarkar

    Plague panic and epidemic politics in India, 1896–1914

  • P. Chatterjee

    Nationalist thought and the colonial world: A derivative discourse?

    (1986)
  • The Collected Works of Mahatma Gandhi. (1920–21, 1925, 1946). New Delhi: Publications Division, Ministry of Information...
  • A. Cunningham et al.

    Western medicine as contested knowledge

    (1997)
  • Ernst, W. (Ed.), (2002). Plural medicine, tradition and modernity: Historical and contemporary perspectives: Views from...
  • A. Escobar

    Encountering development: The making and unmaking of the third world

    (1995)
  • M. Foucault

    The birth of the clinic: An archaeology of medical perception

    (1975)
  • M. Foucault

    Discipline and punish: The birth of the prison

    (1977)
  • M.K. Gandhi

    Hind swaraj or Indian home rule

    (1938)
  • (1946)
  • National policy on Indian systems of medicine & homeopathy-2002

    (2002)
  • B. Gupta

    Indigenous medicine in nineteenth and twentieth century Bengal

  • D. Gupta

    Indian national movement

    (1970)
  • S. Harding

    Is science multicultural? Postcolonialisms, feminisms, and epistemologies

    (1998)
  • M. Harrison

    Public health in British India: Anglo-Indian preventive medicine, 1859–1914

    (1994)
  • P. Howard

    The confrontation of modern and traditional knowledge systems in development

    Canadian Journal of Communication

    (1994)
  • I. Illich

    Medical nemesis: The expropriation of health

    (1976)
  • R. Jeffery

    Recognizing India's doctors: The institutionalization of medical dependency, 1918–1939

    Modern Asian Studies

    (1979)
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