Ayurveda Made Modern

Political Histories of Indigenous Medicine in North India, 1900-1955

R. Berger

• Publisher: Palgrave Macmillan
• Year: 2013
• Print ISBN: 9781349329687, 9780230284555
• eBook ISBN: 9781137315908
• Topic: History
• Subtopic: Asian History
• Index: History

This book explores the ways in which Ayurveda, the oldest medical tradition of the Indian subcontinent, was transformed from a composite of 'ancient' medical knowledge into a 'modern' medical system, suited to the demands posed by apparatuses of health developed in late colonial India.

1

Historicizing Ayurveda: Genealogies of the Biomoral

Over the course of ancient and post-classical Indian history, ‘Ayurveda’ evolved from a textual term for the knowledge of life into a medical tradition with a literary canon, recognized health practices, and practitioners asserting their expertise and expecting elevated social status. The pre-colonial development of Ayurveda reflected a holistic approach to the natural world, uniting beliefs about the physical structure of matter with metaphysical and religious insights. In Ayurvedic texts, medicine is closely associated with philosophy and ethics; similarly, medical practice was located within a wider context of ritual and social behaviour. Ayurveda gained coherence and influence as a collection of medical practices that were in harmony with, and indeed reinforced, both Sanskritic learning and the structure of the Indic societies that sustained it.

Consequently, the assertion that Ayurveda is an Indic and Sanskritic tradition is more than just a statement about its geographical and linguistic heritage. The processes through which Ayurvedic medicine was consolidated influenced later developments for two principal reasons. The first is that the creation of patterns for determining what constituted authentic Ayurveda resulted in the establishment of channels of textual, political and economic legitimation for practitioners and practices in the modern period. Ayurvedic practitioners came to stress their medicine’s unbroken lineage from the Vedas and from ancient practice, emphasizing in particular its Aryan, Sanskritic and Hindu roots. A second reason for dwelling on the pre-modern history of Ayurveda is that, as a body of medicine, it actually drew on a multiplicity of sources and influences. This hybrid history not only reveals the inadequacy of Hindutvic accounts of Ayurveda but also points to the interactions and overlaps between several different medical traditions that came to necessitate a more aggressive demarcation of Ayurveda in the modern period.

This vague delineation of Ayurveda as caught somewhere between science and faith is encapsulated in the discourse of medical historiography through the identification of Ayurveda as a biomoral tradition. At its most simplistic, this label is employed to differentiate Ayurveda ideologically from allopathic or ‘Western’ biomedicine. The biomoral becomes a catchall phrase solely marking its distinction from Western medicine, with vague references to the moral frameworks of embodiment that characterize South Asian life. The applied association in this literature is that Ayurveda has something to do with religion, or the realm of the spiritual or transcendental, thus moving it firmly out of the scope of rational medicine. In essence, the possibility of Ayurvedic adherence to a logic that moves away from the evidence-based medicine forms the ground of the system’s dismissal from taxonomies of rational science, a categorization that rendered it ‘inappropriate’ and ‘unreliable’ in the context of medical modernity. The biomoral parameters of Ayurveda can be deduced precisely, however, and oriented around several of the major moral questions associated with the social, cultural and political life of South Asians.

This chapter thus attempts a historicization of Ayurveda in both theory and praxis, dynamically located both within the historical record and also within the conceptual imaginings of social relations in the subcontinent. It begins with an overview of Ayurveda’s evolution through realms of textuality in the Sanskritic tradition, highlighted to reveal its foundational linkages of embodied medicine to the broader evolution of Hindu political life in the subcontinent. It then moves towards the realm of the conceptual in a discussion of the evolving notion of the biomoral in anthropological thought, in which the vague category of ‘religion’ is replaced by the demands of social relations and, ultimately, the inevitability of biopolitics. Finally, it explores the political possibilities of the biomoral in action, framing Ayurveda’s deployment in colonial times and arguing that Ayurveda came into modernity through a political articulation of embodied indigeneity. Taken together the genealogy of biomoral possibilities reveals the foundational political impetus that frames Ayurveda’s rich and complex history.

Ayurvedic systems in time and space

The antiquity of the Ayurvedic tradition in Sanskritic literature has been an important source of cultural and medical authority for practitioners. It acquired particular importance during the Orientalist resurgence in Vedic scholarship in the early nineteenth century. Ayurveda is derived from the terms Ayus, life, and Vidya, knowledge. Although there are references to medical science in the Rig Veda, which appeared circa 1200 BCE, the first literary codification of a medical tradition is thought to have come much later in the final chapters of the Atharvaveda, the fourth Veda, which is the oldest Sanskrit text to deal with the physical sciences at length. This text describes the use of poisons in warfare, gives a list of therapeutics for certain diseases and attributes certain diseases, including leprosy, to external infectious agents.¹ Ayurveda as described in the Atharvaveda and elsewhere is considered to be an upaveda, a secondary Veda, putting medical practice at the centre of Vedic thought.²

This ancient pedigree was much emphasized by medical practitioners who wanted to support their status in society with the weight of Vedic authority. For instance, Debiprasad Chattopadhyaya has used the Rig Veda to argue for the eminence of practitioners in the Vedic period.³ However, the information presented in the Atharvaveda weakens practitioners’ claims to Vedic authority, since the first text to deal with Ayurveda at any length actually minimizes the role of practitioners in the dissemination of medical knowledge.⁴ Moreover, scholars have argued that there are important discontinuities between the fragments of medical knowledge contained within the Atharvaveda and the dominant medical traditions that evolved into classical Ayurveda.⁵ This raises the question of how far the Atharvaveda can be considered a reliable guide even to contemporary practice. Dominik Wujastyk argues that the system of humours (dosas), which is a central principle of classical Ayurveda, is not mentioned in the Atharvaveda, nor are the other constituents of the body with which these dosas interact. However, the cultural historian A.L. Basham identifies in this textual history larger social and cultural shapings of medical traditions by contemporary values.⁶ Regardless of the medical details, the cultural ethos of the tradition is inherently linked to the social structures and cultural mores that emerged in the classical period.

This tension between textuality and social mores characterizes attempts to historicize traditions of the ancient Indian past. A canonical literary tradition with strong ties to later Ayurvedic practice began with the Caraka Samhita. Though attributed to the scribe Caraka, it is most probably the effort of several scholars who worked together to compile its content. It was composed in the first decades of the second century CE, during the reign of Kanishka. The text is framed as a discussion between the sage Atreya and his pupil Agnivesa and is divided into eight sections: sutra (rules), covering pharmacology, food, diet, some diseases and treatments, physicians and quacks, and varied topics in philosophy; nidana (causes), describing the causes of eight main diseases; vimana (arrangements), discussing various topics such as taste, nourishment, general pathology and medical studies; sarira (relating to the body), treating philosophy, anatomy and embryology; indriva (the senses), describing diagnosis and prognosis; cikitsa (therapies); kalpa (pharmacy); and siddhi (completion), outlining further general therapy.⁷ While the text has often been considered to embody an exclusively Indian tradition, the similarities with Chinese, Persian and Greek medicine are noteworthy.⁸

The second major canonical text of Ayurveda is the Susruta Samhita, which follows the model put forth by the collators of Caraka’s text. Though a grammatical rule recorded in 250 BCE mentions it in passing, a re-edited version of the compendium is thought to have been produced in the sixth century CE.⁹ It takes the same lyrical form as the Caraka Samhita, in this case recounting a discussion between Dhanvantari, a king of Banaras, and his student Susruta. Dhanvantari’s name came from the term Dhanuh, or surgery, and a grammatical shaping of the name to imply that he is fully skilled in it.¹⁰ Despite a lack of evidence about Dhanvantari beyond this source, his name has become associated with the practice of Ayurveda, and many contemporary texts pay homage to his perceived wisdom. The sections of this work are similar to the Caraka Samhita, omitting only the vimana, indriva and siddhi, but including a section called Uttara (‘last’), covering ophthalmology, the care of children, diseases ascribed to demonic attack, dentistry and aspects of medicine not dealt with elsewhere.¹¹

The enduring centrality within Ayurveda of the principles outlined in the classical texts ensured that mastery of their content, familiarity with Sanskrit and appeals to ancient precedent remained important means of generating legitimacy for practitioners and practices into the modern period. The contents of these texts have together constructed an understanding of the Ayurvedic system of medicine based on several basic principles. The primary organizing feature is the interconnection of the dosas (humours), the dhatu (body tissues) and mala (waste products). The three dosas of the body (wind/vata, bile/pitta and phlegm/kapha) act together with the dhatu (chyle, blood, flesh, fat, bone, marrow and semen) and the mala. This is called tridosa-vidya, the doctrine of the three humours, and underlies theoretical approaches to the body in the canonical Ayurvedic texts. The impetus behind the theory of the dosas is the foundation act of attempting to balance them. For instance, a vaid’s tasks are divided into two categories linked inherently to the balance of dosas: his first recourse against an imbalance of the dosas is to calm the dosas through dietary or pharmaceutical regimens; his second is to turn to clinical therapies to externally purify the overexerted dosa to correct the imbalance.¹² Chapter 15 of the Susruta Samhita guide reveals the importance of ‘decrease and increase of dosas, dhatus and malas’ and teaches students how to recognize the characteristics and functions of these entities through observation of the colour, smell and texture of patient’s bodies and excreta, and through an appraisal of the sensations patients can recall.¹³ Chapter 4 provides a lesson in ‘interpretative discourse’, in which vaids are taught about the means through which to distinguish between symptoms, and also how to read and learn. Susruta relays this wisdom by way of inspiration: ‘An ass carrying the load of sandalwood feels only the load and not the (fragrance of) sandal, (similarly) those having gone through many scriptures but ignorant of their ideas only carry like an ass.’¹⁴

The second tenet of Ayurveda is the identification of digestion as a central process of the body. Understood in the literature as ‘cooking’, the digested food then becomes dhatu of the chyle variety. The pitta in the body, what allopathy understands as stomach acid, transforms the chyle first into blood, then into flesh and into all of the other forms of dhatu until the food finally becomes semen.¹⁵ This also explains the transformation of food into mala, including sweat, urine and mucus.¹⁶ The third tenet of Ayurveda explains the physical constitution of the human form, conceptualizing the body as a series of tubes through which the dosas flow to the various dhatu. Propelling them is ojas, energy, which is the source of strength for all bodily functions. Taken together, this understanding of the different components of the body, their constitution and the method by which they digest and excrete food matter together constitute the basis for the Ayurvedic tradition.

Reference is made to these Ayurvedic principles in a variety of contexts, most notably in descriptions of other aspects of physical culture. David G. White, for instance, has studied in detail the link between the body and its maintenance in the Yogic and Tantric tradition.¹⁷ Ayurveda is further shaped by the interventions it makes as a coherent system in discourses that rely only partially on conceptions of physicality and that take into account other factors and phenomena. A key theme of this sort is the relationship between the human body and the environmental landscape. The most pioneering work on this subject remains Francis Zimmerman’s The Jungle and the Aroma of Meats, in which he traces the evolution of the Sanskrit conception of Jangala, the dry terrain of the Indo-Gangetic plain (as opposed to its corruption in Hindi as Jangal – and the Anglo-Indian term jungle – which refers to the ‘tangled thickets’ of a luxuriant, marshy terrain), and the ways in which it is made meaningful to humans.¹⁸ The study began for Zimmerman in a series of entries in medical treatises – most notably, the Susruta and Caraka Samhitas – which listed the properties of meats, dividing animals into a variety of categories ranging from jangala (dry terrain) to anupa (marshy terrain), as well as into herbivores and carnivores, game and predators, like from like and so on. He argues that the identification of species of animals discussed in the pages of ancient medical texts together constitutes a classificatory system that acts as an ancient practice of zoology, a mode of enquiry absent in other Sanskrit writings of the ancient world.¹⁹ Encompassed in the Ayurvedic text, he argues, are detailed classifications of geography, vegetation and animal specification. However, what interests Zimmerman about the particular nature of classification at work here is the way in which the medical literature consistently discusses these three categories in tandem; for instance, ‘in a single landscape, thorny shrubs, bushes, and gazelles may be associated, or again, a teak forest may shelter lions and antelopes’.²⁰ This can be further exemplified from what Dalhana says to Dhanwantari that ‘satmya are those which in spite of being naturally contrary in terms of place, time, race, season, disease, exercise water, day-sleep, rasas etc … do not afflict’, which he glosses as being not only a characteristic of those from arid land but also characterized by having certain varieties of insects present.²¹

It is possible for Zimmerman and those after him to locate in the modern sciences of classification a series of articulations into which to ‘subsume the empirical data’ of his study, and to privilege a mode of conceptualizing nature in a particularly local, indigenous and ‘ancient’ articulation.²² Furthermore, the notion of interconnectedness as a mode of understanding natural habitat brings to light the effect of the medical approach: nature is primarily understood through a human’s encounter with it; further to this, it is described in the text in the context of illness. A medical understanding of the natural world thus relies upon the lived environment of the human. In the Indian context, the premise of Ayurvedic medicine served as a mode for interpreting and ordering the natural world. Following in this tradition, the Tantric scholar David G. White has elaborated this notion of interconnectedness by identifying commentaries within the traditional texts of Ayurveda on the effects of seasonal change, adding time to the space continuum identified by Zimmerman.²³

The textual basis for understanding the importance of Ayurveda in pre-colonial society tells a significant part of the story but, if discussed in isolation, reifies Vedic culture and Brahmanic customs as representations of normative practice. Exploring the popular practice of Ayurveda throughout its history contextualizes this consolidated tradition within the wider practice of medicine in the northern subcontinent. With its ties not only to Sanskrit learning but also to Indic culture, Ayurveda is considered to be the oldest and most established of the indigenous systems of Ind...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Preface and Acknowledgements
• Introduction: Ayurveda in Motion
• 1. Historicizing Ayurveda: Genealogies of the Biomoral
• 2. Situating Ayurveda in Modernity, 1900–1919
• 3. Embodying Consumption: Representing Indigeneity in Popular Culture, 1910–1940
• 4. Ayurveda’s Dyarchic Moment, 1920–1935
• 5. Planning Through Development: Institutions, Population and the Limits of Belonging
• 6. Reframing Indigeneity: Ayurveda, Independence and the Health of the Future
• Conclusion: Ayurveda’s Indian Modernities
• Notes
• Bibliography
• Index