Interweaving theory with narrative, Langford explores the strategies of contemporary practitioners who reconfigure Ayurvedic knowledge through institutions and technologies such as hospitals, anatomy labs, clinical trials, and sonograms. She shows how practitioners appropriate, transform, or circumvent the knowledge practices implicit in these institutions and technologies, destabilizing such categories as medicine, culture, science, symptom, and self, even as they deploy them in clinical practice. Ultimately, this study points to the future of Ayurveda in a transnational era as a remedy not only for the wounds of colonialism but also for an imagined cultural emptiness at the heart of global modernity.
About the Author
Jean M. Langford is Assistant Professor of Anthropology at the University of Minnesota.
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fluent bodiesAyurvedic Remedies for Postcolonial Imbalance
By JEAN M. LANGFORD
Duke University PressCopyright © 2002 Duke University Press
All right reserved.
Chapter One(Re)inventing Ayurveda
I was sitting with Dr. Vijayan in my room, shaded with coconut fronds, at the small hospital run by him and his family in a South Indian fishing village-cum-suburb. We were discussing my treatment. I was sodden and fragrant with herbal oils, skin silky from gritty daily massages. The night before, rain had drummed in a steady rhythm against the hospital roof. Now the morning air was yellow and steamy, full of smoke and rain and milky gold sunshine. It was monsoon, the best time, according to received wisdom and classical texts, for Dr. Vijayan's specialty, pancakarma, a purification regimen that is part of the centuries-old set of South Asian healing practices known collectively as Ayurveda. Yet there was only one other patient at the clinic, a South Indian man. The Europeans and North Americans to whom Dr. Vijayan increasingly directed his practice came only during the cool winter months. When we had finished talking about my treatment, I asked him whether his experience with foreign patients had changed the way he thought about Ayurveda. I was startled by his answer. "Yes definitely," he replied. "Now I know the true essence of Ayurveda." What might this mean? How had hediscovered the "true essence" of Ayurveda through his work with foreign patients, whose treatments were timed not by the recommendations in ancient texts, but rather by the seasonal attractions of a nearby beach resort?
Dr. Vijayan's treatment of foreign patients is a very recent and transnational moment in a much older story about the modernization of Ayurveda, a story that is the subject of this book. Nonetheless, his comment starkly directs us to a central question threaded through this story. How does it happen that Ayurveda, with all its claims to antiquity, is being most clearly delineated in its cultural distinctiveness in an era when it is also most intensely marked by encounters with other medical understandings? Over the course of the last two centuries, Ayurvedic practitioners, like other healers around the globe, have confronted their marginalization in the face of the global ascendance of modern European medicine, or biomedicine, as it is called by anthropologists. Practitioners have met this challenge by reinterpreting and reshaping their knowledge and practice for a modern era. Yet simultaneously, like Dr. Vijayan, they have turned their very marginalization and their struggle against it in into an opportunity to (re)invent Ayurveda. This book, then, is partly concerned with the paradoxical process through which Ayurvedic practitioners recover the "tree essence" of Ayurveda even as they define its modern relevance. In illuminating certain moments in this process, I am not suggesting that contemporary definitions of Ayurveda fall short of "true" Ayurveda; nor am I arguing that there is or is not any such thing as "true" Ayurveda. Instead I am arguing that what needs to be understood is not what "true" Ayurveda might or might not be but rather what is involved in establishing a realm of Ayurvedic "truth."
To some extent the recovery of Ayurvedic essence is linked to a recovery of Indian "culture." For instance, during my many conversations with Dr. Vijayan, I realized that his account of Ayurveda's "true essence" was intricately intertwined with an account of Indianness. Like tourist-industry entrepreneurs everywhere, he strategically employed a discourse of authenticity and antiquity, seeming to understand that for foreigners, the healing power of Ayurveda rests not only in its medicinal powders and extracts, but also in its cultural difference. His explanations of his practice therefore worked to sustain a neo-orientalist mystique of India as a land of spiritual esoterica. He told me, for instance, that only certain foreigners manage to overcome all the obstacles necessary to come to India. These obstacles are not the superficial obstacles of geography or plane fare, but more obscure obstacles that filter out those who are less sincere and less ready for what India has to offer. In this way, he said, Indian thought patterns are protected from too much foreign influence. Indians, he asserted, "function on specific energy levels" While Western thinking is very rational, Indians' thinking is more "subtle." Those foreigners who do manage to come, he continued, are changed forever. On returning home, they are less consumerist, less competitive.
In such comments it becomes clearer that what is at play in Dr. Vijayan's treatment of Westerners is not only a story of Ayurvedic essence and Indian subtlety, but also a story of Western shallowness and fragility. "Westerners," Dr. Vijayan said, "have a lot more psychological problems than Indians. These problems sometimes surface during treatment." Pancakarma, he went on, touches "something on a development level." Many of his foreign patients recall painful incidents from their past on the massage table. Such "psychological" reactions, he emphasized, are not seen in Indian patients or mentioned in the Ayurvedic texts. Therefore it is only through his work with foreign patients that he has realized that massage can have effects that go beyond the bodily tissues, to the "subtlest level." Notice how fluidly the figure of "subtlety" moves through this discourse. It is Indians whose thought patterns are most subtle. Yet on the massage table it is only foreigners who can make visible the subtle effects of Ayurvedic treatment. For Indians themselves apparently have no need of these subtle effects.
Why not? Dr. Vijayan explained that Westerners, unlike Indians, do not receive proper attention as children. Therefore, as adults, they are in constant states of "stress" or "worry" or "helplessness." "Westerners' laughter," he said, "often sounds like crying." Interestingly, then, even as Dr. Vijayan's healing theories construct an Indian and Ayurvedic essence, they also work to unravel an orientalist logic within which such an essence is often located. Indian irrationality becomes, in his talk, not a sign of weakness but a sign of strength, whereas Western independence becomes not strength but weakness. Moreover, the Western universalism that needs no cultural essence to supplement its all-too-real and globalized power appears in Dr. Vijayan's talk as a form of impoverishment, an absence of cultural nourishment. I will return to Dr. Vijayan's treatment of foreign patients in the epilogue. For now, however, his discourse of Ayurvedic essence and foreign emptiness helps to crystallize a crucial concern of this study. For even as Ayurvedic practitioners involved in recovering a "true essence" of Ayurveda seem to participate in colonial and neocolonial modes of knowledge, such as the framing of Ayurveda as Indian tradition, they also, at unexpected moments, work to subvert such modes of knowledge in inventive ways. Redefinitions of Ayurveda over the course of the twentieth century can therefore be interpreted in part as ways of creatively addressing an epistemological "imbalance" of late colonial and postcolonial times. This is the larger story I want to tell in this book.
Before beginning this story, a few words are needed about the word Ayurveda itself and its vast and expanding field of referents. Ayurveda can be translated simply as knowledge of life or of long life, although for strategic reasons having to do with its promotion as medicine, it is more often translated now as the science of life. For thousands of years the name has been used across South Asia to refer to an eclectic range of healing practices. While there is some discussion of healing practices in the early Vedic texts collectively known as the Atharvaveda, the word Ayurveda is associated today with three ancient Sanskrit texts that are the extant works most fully devoted to praising and prescribing Ayurveda. These three texts are Caraka Samhita, Susruta Samhita, and Astanga Samgraha. (Caraka and Susruta are the authors of the first two texts.) Of these the Susruta Samhita is oriented toward surgical treatment, while the other two are oriented more toward other therapies, ranging from herbal and mineral medicines to Dr. Vijayan's specialty, pancakarma, which classically includes oil massages in preparation for cleansing enemas, emesis, and purgation, as well as nasal drops and bloodletting.
The ancient texts provide a baseline, setting certain parameters for Ayurvedic practice. For the most part, however, this book is concerned with contemporary Ayurveda rather than with the Ayurveda of the ancient texts. In the world today the practices that a particular patient or healer might consider Ayurvedic range from urban South Asian home remedies based on an understanding of "hot" and "cold" foods; to medicinal herbal lore of the countryside; to standardized Ayurveda as taught in Indian or Sri Lankan colleges; to eclectic practices taught in workshops in Europe, North America, and elsewhere and geared to an international clientele. At least one common thread running through these diverse practices is the idea that illness develops through the aggravation or increase of one or more of the three bodily dosa (often translated as humors)-vata, pitta, and kapha. As discussed further in chapter 5, the dosa are treated alternately as substances (loosely associated with air, bile, and phlegm), processes, or principles. While the dosa are bodily forces, they are closely related to forces in the environment and can be influenced by food, climate, seasonal changes, and even social activities. A central purpose of most treatment that is considered to be Ayurvedic is to calm or remove the aggravated dosa that is responsible for the illness. The chapters to follow offer glimpses of the complexity and flexibility of this pursuit.
A telling entry point for our story of Ayurvedic modernity is in 1836, when British officials ordered a fifty-round cannon salute to celebrate the first dissection of a cadaver by a group of Indians at Fort Williams Medical College in Calcutta (B. Gupta 1976). What significance did this celebratory blast of cannon fire hold for Ayurveda? For one thing, the event marked the end of a brief period of British sponsorship of Ayurveda, which had been studied side by side with European medical science at the Native Medical Institution during the previous decade. This dual educational program had been legitimated by a scholarly interest in classical Indian texts, including important Ayurvedic works. Now it was overturned by T. B. Macaulay's 1835 Minute on Indian Education, which declared that all Indian higher education would be conducted in English and modeled on the British system. The Minute is sometimes represented as a victory of Anglicism over orientalism, a dramatic about-face in British policy, when a sympathetic interest in Indian knowledge gave way to an insistence on the superiority of European knowledge. The event is, however, better understood as an adjustment in colonial tactics than a turning point in colonial policy, which was, in any case, always ambivalent. Both before and after the Minute, British intention was to champion European medicine and expose the errors of indigenous knowledge. The purpose of teaching Ayurveda alongside European medicine had never been to develop Ayurveda per se, but rather to allow Indians to observe for themselves the superiority of European medicine. The superintendent of the indigenous medical college, Dr. John Tytler, explained this superficially tolerant position in 1834, noting that "Coercion always produces the direct contrary effect to what is intended" (quoted in Arnold 1993, 55). The Minute thus marked a shift from a noncoercive to a coercive policy, which indeed, as Tytler predicted, motivated prominent vaidyas (Ayurvedic practitioners) to organize against the increasing dominance of European medicine.
Nonetheless, the cannon blast memorialized an important moment in the colonial enframing of indigenous science. It decisively ended a brief period during which an Indological interest in classical medicine was allowed to intermingle with the introduction of modern medicine. It placed British military might behind an order of academic disciplines in which the study of Ayurveda and other indigenous healing practices was Indology or ethnology but not medicine. Orientalism had not been so much displaced as more strategically placed to differentiate Indian knowledge. Even as Ayurvedic practitioners began to resist the invalidation of Ayurveda as medicine, they also, as I will elaborate in the coming chapters, judiciously began to accommodate the validation of Ayurveda as culture.
The cannon fire is, therefore, a more complex sign than it first appears, marking both the confinement of Ayurveda to the realm of cultural belief systems and the opening of European medicine to creative appropriations by Indian scientists, including Ayurvedic practitioners. Modern medicine and its bodily disciplines would be enforced by the economic and military might of the colonial regime. Both before and after the cannon salute Indian bodies were subjected to hospitalization, vaccination, quarantine, inoculation, and autopsy. Yet simultaneously and paradoxically, like other colonial exercises of science, the practice of European medicine in the subcontinent would also recruit and require Indians as co-knowers (Prakash 1992). Indeed many of the students attending the new nineteenth-century medical colleges were sons of vaidyas (Leslie 1976a, 362). In the mid-nineteenth century there was also a group of hereditary practitioners in Bombay who referred to themselves as "English doctors" and who dispensed European medicines without formal medical education (Leslie 1973, 219). Over time, then, those who had been recruited as scientific co-knowers began to position themselves to revise scientific knowledge. Later generations of Ayurvedic practitioners would argue, for instance, that Ayurveda was the original medical science, influencing Greek and later European medicine. British celebrations of the "first Indian dissection" notwithstanding, contemporary practitioners often point out that Susruta, considered the father of Indian surgery, described a method of dissection a few thousand years ago.
Homi Bhabha (1984) has suggested that the motive behind Macaulay's Minute was to create a "mimic man," an Indian elite that would be almost the same as the English ruler but not quite, not white. In the medical field this mimic man was to be the Indian practitioner of European medicine. The military salute explicitly inaugurates this medical mimicry, which is intended to confirm the universality of European science. Yet if the official mimic was to be the Indian biomedical doctor, another "mimic" soon arose. By the end of the nineteenth century Ayurvedic practitioners widely recognized that in order to combat the increasingly widespread mimicry of European bodily practice, it would be necessary to copy certain forms of European institutional practice. They therefore began to found professional associations, colleges, and pharmaceutical firms (Leslie 1973, 1974, 1976a, 1992; Brass 1972). In establishing parallel institutions, Ayurvedic practitioners established a parallel medicine, a parallel science, a professional Ayurveda that was increasingly separated from a wider field of healing practices.
Initially, a newly professionalized Ayurveda seemed too out of step with modernity to appeal to the elite who were designing the independent nation. One practitioner, Vd. (Vaidya) Shukla, who had joined the nationalist movement in the 1930s, bitterly recalled to me that most of the original members of the Indian National Congress favored European medicine over Ayurveda. Nonetheless, by the 1920s the Indian National Congress had already passed its first resolution in support of Ayurvedic medicine. The inclusion of Ayurveda in the nationalist program exemplifies that peculiar ambiguity of nationalism, the contradictory need to fashion institutions commensurable with those of other nations while simultaneously constructing a unique national-cultural identity (Chatterjee 1986; Anderson 1991). For Ayurvedic practitioners this ambiguity was both an opening and an imperative to create a medicine that was not only parallel to modern medicine, but also in contrast to it. Vd. Shukla told me that when he joined the Indian nationalist movement, he quit dispensing quinine and other European medicines despite their effectiveness because he was determined that his Ayurvedic treatments would reflect his political sentiments. His story, like other that will be told in these pages, suggests how Ayurveda was gradually transformed from an eclectic set of healing practices to a quintessentially Indian medicine.
Excerpted from fluent bodies by JEAN M. LANGFORD Copyright © 2002 by Duke University Press
Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Table of ContentsAcknowledgments
1. (Re)inventing Ayurveda
2. Ayurvedic Interiors
3. Healing National Culture
4. The Effect of Externality
5. Clinical Gazes
6. Medical Simulations
7. Parodies of Selfhood