music: “Jibano Jakhano Sukhaya Jay” from the movie “Arogya Niketan” (1969)
Mary-Rose Abraham: This is a song from the 1969 Bengali movie “Arogya Niketan.” The songwriter and composer is India’s most-loved artist of modern times, Rabindranath Tagore. The movie tells the story of a clash between two medical professionals. One is an allopathic doctor, the other a vaidya, or Ayurveda practitioner.
Gayathri Vaidyanathan: The film was based on a 1953 novel by Bengali author Tarasankar Bandyopadhyay. But the movie cut out a lot of the details and nuance to present an unrealistic picture of the traditional medicine vs. Western medicine clash.
Projit Mukharji: Part of the reason why we get these kind of weirdly dichotomized stories is because we’ve just got a market that will lap up this kind of clash between pure tradition and some kind of evil, exotic modernity coming from the outside.
MRA: Take it from someone who’s not only read the book and watched the movie but researched its characters and their real-life inspirations.
PM: I’m Projit Bihari Mukharji. I’m an associate professor at the University of Pennsylvania. I teach in a department called history and sociology of science. I’m also particularly interested in how medical knowledge changes over time, but also how different medical knowledge traditions interact with each other.
GV: Throughout history, medicine has always changed and evolved. Sometimes it’s influences from other medical systems, sometimes from other cultures.
MRA: In this episode, Projit is going to tell us about the influence of technology on Ayurveda. It’s a little window into the transformation of India’s indigenous medical system — beginning in the 1860s.
MRA: This is Chatroom 11, your bonus episode of “Scrolls & Leaves.” I’m Mary-Rose Abraham.
GV: And I’m Gayathri Vaidyanathan. We have a small request. We’re an independently funded podcast, so if you like our work, please consider donating. Every little bit helps us to continue telling “stories from the margins of history, science and cultures.” You can find details on our website, scrollsandleaves.com/support. And of course, if you have feedback, do let us know! Thank you.
MRA: Let’s go back to that so-called “epic clash” between Indian traditional medicine and Western medicine in the second half of the 19th century. Well, in reality, it was anything but when it came to treatment.
PM: The metaphor that I like using is braiding. I feel that if you think of the systems not as kind of homogenous essences that are kind of facing off against each other. But if you think of them as kind of spools of threads that they have lots of individual diverse things within them, some of which don’t line up with each other, even within those so-called traditions. And then what happens is that at particular places, particular actors, be they Indian practitioners of Western medicine or practitioners of some version of indigenous medicine, they creatively pull strings from both sides, and then mix them together, braid them together, to create a repertoire of practice that works for them and for their patients.
GV: Projit says part of the braiding process is incorporating “small technologies” into Ayurveda. They helped vaidyas re-imagine the human body and changed the way they, diagnosed and treated patients. So what does he mean by a small technology? One is the microscope. Then there’s the pocket watch and the thermometer.
MRA: If you see photographs from the late 19th century, every man — middle class and above — is wearing a jacket with a gold chain attached. And hanging from its end will be a pocket watch.
PM: That doesn’t strike us as being a medical technology but it is one because one of the most iconic things about Ayurveda is pulse diagnosis. So diagnosing people by what in Sanskrit is called Nadi Pariksha. Now Nadi Pariksha, it gets translated from the 19th century as pulse because they see that Western doctors are doing it as well. However, the Western pulse-taking and the various versions of South Asian Nadi Pariksha are very, very different things as is like, you know, people feel for some kind of palpation at the wrist in many different healing traditions. Western pulse is, in the 19th century, largely a quantitative thing, you measure the number of beats and that is connected to a theory of circulation. So, it’s connected back to like is your heart beating right or not? So you’ll see that when they take the pulse they keep watching their watch, their wristwatch, because they want to count the number of beats in a minute. When a vaidyan takes your pulse, he is usually using three different fingers and he is looking for other stuff. So the three fingers are placed in different points on the wrist. And what they’re looking for is often expressed very visually, so you will have things like the pulse felt like a frog jumping, or the pulse felt like the gait of a deer. The pulse felt like a marsh snipe flying. So you get these very visual metaphors of how they express it. So it’s a qualitative pulse. It’s not about counting, there is no kind of what I like to call a hydraulic system in Ayurveda, which is this kind of model that Western anatomy has that basically the heart is a pump and the whole body is a kind of water circulation system and that’s the core of what you’re getting from the pulse. The Ayurvedic or larger kind of Sanskritic physicians are getting something very different. Some of them at times, almost veered into mystic things. So there was a whole aspect of pulse-taking, Nadi Pariksha, that was to do with predicting death. So apparently, the really virtuoso Nadi Parikshak could tell you, like, exactly when you were going to die even if that was 20 years, 30 years later. So it’s not exactly the same thing as this Western pulse. And yet what happens is that because these vaidyans are also now carrying pocket watches and they see pocket watches are used in pulse-taking, they too start thinking of how does this data, this quantitative data, which obviously you can get by using the watch, how does that shift our ideas of the body? So they now have a very non-hydraulic image of the body but because they have watches, they start getting a kind of more quantitative data on the pulse as well, and so there are many creative efforts to kind of braid together this quantitative data and qualitative data about pulse which is kind of associated with older Sanskritic ideas of what the body is, how it works, etc.
GV: The first modern thermometer, using mercury, was invented in 1714. And that medical thermometer we all use these days? English physician Sir Thomas Allbutt invented that in 1866. It was six inches long and could read a person’s temperature in about five minutes.
PM: Thermometers are brought to India from the very late 18th century but not as medical instruments but as meteorological instruments to monitor weather changes and then gradually from around the middle of the 19th century their medical use starts to grow which is kind of the time when it starts to grow in Europe as well. And again these become something that, it changes what do we understand by fever. Fever was basically in most Ayurvedic texts or sort of pre-colonial medical texts that we have, fever would be the very first chapter and it’s often the most important and largest chapter, because so many things get classified as fever that today we would give different names. We would see fever as only being maybe a symptom of some other disease, but they classified fever by itself. So fever is a huge category. But how fever is understood varies a lot. There is an idea that heat is involved with fever, but it’s not clear what this heat means. Does it mean the mind getting heated up so that you start to babble and hallucinate? Does it mean you feel warm? If you’re the patient, you’re actually cold, you’re shivering, but it might be somebody else who touches your forehead and finds it warm. Temperature is not this quantifiable thing which we can just, you know, stick a thermometer in your mouth and then read a number off of. So that starts to happen and that’s another thing that creates a much narrower range of what body heat means. Body heat is a very important concept in any kind of physiology in the 19th century. And it’s not that central in South Asian medicine till the middle of the 19th century. And what is also important is that even when heat is mentioned, what is mentioned by tej or thap is different and that it’s much more varied. All of that gets narrowed once it becomes popular to use thermometers.
PM: What also happens then is that so much of medicine, even today, does not depend actually on the doctor per se, but on the kind of people who provide the kind of care to the patient during convalescence. So nurses, once you’re in hospitals, nurses are very important. But before people started to go to hospitals, friends and family who usually cared for you at home were very important and the kind of things they did. Now once the thermometer becomes important, so much of that work gets reorganized around constantly checking the temperature and monitoring this thermometric idea of heat. So that’s again something that has, like, huge repercussions not just for the epistemology of medicine, but also the sociology of how actual care is done for people who fall ill and that’s all organized around this little thing, the thermometer.
MRA: You were listening to Projit Mukharji on Chatroom 11 on Scrolls & Leaves. For episode notes, visit scrollsandleaves.com/chatroom 11. We’ll be back in two weeks. See you then!