Power, Knowledge, Medicine: Ayurvedic pharmaceuticals at home and in the world
By Theresia Hofer
Bridging the disciplines of Indology, medical research, history and medical anthropology, Power, Knowledge, Medicine is a unique contribution to the growing number of studies on the transformation of Ayurveda in colonial and post-colonial India and an ever more globalised world.
The protagonist of the book is the ‘Ayurvedic pharmaceutical’, which has now become ubiquitous in Indian markets and high-street stores in urban centres and small towns. It has also made its long way to Europe and America, where it is predominantly sold as ‘nutritional supplements’, part of a growing market for complementary and alternative medicines.
After a well-informed discussion of the plurality of classical Hindu medicine, including its fruitful encounters with other medical systems, Madhulika Banerjee locates the birth of the Ayurvedic pharmaceutical in the late 19th century. This was a time when Indian medical practitioners had been encountering hostility from the colonial state towards their practice and the ‘unscientific’ nature of their knowledge, epitomised by the closure of indigenous medical colleges and the Medical Registration Act of 1853. By the 1890s, the colonisers’ consolidation of power made political responses to the state unfeasible. Various practising vaidyas began instead to compete with biomedicine through the manufacture – and mass production – of Ayurvedic drugs and cosmetics (some firms that were established in this period, such as Dabur and Arya Vaidya Sala, still exist). Banerjee interprets this as a ‘political’ response.
Policies towards medical practice, education and production from Indian independence to the early 21st century are summarised clearly. Then Banerjee discusses the role, responses and resistance to state policies from civil society. Two of its sectors – the market and non-governmental organisations (NGOs) – are described with respect to how they influenced the further journey of the Ayurvedic pharmaceutical. Here, Banerjee draws attention to NGOs working in primary and community health initiatives incorporating traditional knowledge as part of a larger critique of ‘development’. Later, she brings to the fore the question of to what degree use of traditional knowledge (when brought together with selected and already-established health-promoting measures) may be able to counter the trend that has been set in motion. That is, that the Ayurvedic pharmaceutical caters increasingly to an upper-class and foreign consumer, thereby taking traditional health and medical knowledge away from people on the fringe of the global market. A central irony is that this latter group have for centuries transmitted the very knowledge that now serves as the basis for others to make profits and have ‘alternative’ health benefits.
Two chapters discuss the commercialisation, standardisation and ‘pharmaceuticalisation’ of Ayurveda. Dabur, founded in 1884, serves as a case study, before Banerjee discusses intersections of these processes with the logics and “ill-logics” of the global market, and international standards of safety, quality and efficacy in the making of modern Ayurvedic medicines.
Banerjee’s book reflects the current imbalance of power over the future course of Ayurveda and local medical knowledge in India, between big money and a biomedically or at least ‘science’-dominated health and education system as opposed to people’s power and knowledge in the many grassroots and other social and health movements. The author makes us think about the impact there would be in bringing Ayurveda and traditional knowledge on a larger scale back to the people: as an inexpensive healthcare option, as a way to generate local income and regain control over local environments, and as a sustainable natural resource.
As a student of 20th-century transformations of Tibetan medicine, I appreciated Banerjee’s book and enjoyed how it made me think anew about the similarities and differences in the transformation of traditional medicine in India, China and Tibet. Banerjee also carefully situates a host of sources and debates in their historical, social and economic context. Like few others she speaks with authority on the links between the politics, economics and cultures of medical systems in India, and also weaves into the account her own experience and acute perception of trends in Indian culture and society. This book will of course be of interest to medical anthropologists and historians of South Asia; however, it deserves to be read by those working in development, public policy and medical research as well.
Banerjee M. Power, Knowledge, Medicine: Ayurvedic pharmaceuticals at home and in the world. Published in: New Perspectives in South Asian History. Hyderabad: Orient Blackswan; 2009.
Theresia Hofer is a doctoral candidate at the Wellcome Trust Centre for the History of Medicine at UCL.