On 23 February 2021, the Indian Medical Association (IMA) came down heavily on Dr Harsh Vardhan, the Union minister of health for endorsing or perhaps for releasing
the research work on Patanjali's Coronil for treatment of COVID-19 infection. The attack was particularly sharp but, at the same time, IMA’s press release raised some tough questions.
As a general observation and uninfluenced by general politics and technicalities of clinical research, to an ordinary person like this author, who has great regard for both systems of medicine, an attack on Ayurveda is quite baffling.
This brings us to more critical questions: what has shaped the thinking of the public on 'modern medicine' in India and why is there such contempt or scepticism for the indigenous system, which, in conjunction with yoga, is an important part of India’s soft power projection.
Allopathic system in India has colonial origins and its present position of dominance is a product of medical discourse which occupied an extremely important place in the entire process of colonisation of India. This discourse took shape over a hundred years, between 1800s to 1920—a period which not just marked the ascendency of the British in the sub-continent, but also witnessed the ravaging impact of epidemics and pandemic
on Indian population.
The history of India largely acknowledges the pollical developments but is less appreciative that in the atmosphere of repeated disease outbreaks, making money out of the diseases was a profitable enterprise, which made the stamping European supremacy over indigenous medicine system a top priority.
The British strategy of managing and eventually controlling the discourse of medical system may be described as twin strategy consisting of trying to change the narrative using ‘good cop’ and ‘bad cop’ strategy and co-opting the urban elite population to gain acceptance for the western medicine and eventually marginalising and finishing the indigenous system consisting of Ayurveda and Unani systems. (See Being Different by Rajiv Malhotra for more general and detailed discussion).
The initial British encounter with the Indian system of medicine produced works of J Johnson (1813), B Heyne (1814), H Wilson (1825), W Ainslie (1826), W Twining (1832), G Playfair (1833), JR Martin (1837, 1856), JF Royle (1837), TW Wise (1845), and many others who praised the Indian system’s vast body of medical knowledge.
At the same time, the political process ensured through its mass inoculation experiments (although inoculation is well documented in Ayurveda) involving both coercion and persuasion to force the general public to adopt the western system of medicine. The British would formally institutionalise Western medicine in laws from 1840.
The early efforts did see some success. Urban, propertied and educated classes were quick to change and adopt Western medicine. One SC Chuckerbutty would become the first Indian to graduate in Western medicine and was sent to England for higher studies in 1845. Upon his arrival back his work would consistently take adversarial position against the indigenous practitioners. However, the rural population continued to be firmly rooted in the traditional system.
Probably because of demand outpacing supply or pure greed, the commissioner of Punjab in 1867 tried to onboard native doctors by training them in Western medicine. The move was strongly opposed by the allopathic doctors.
Then in 1882 the British government examined the proposal to register all (Western + indigenous) medical practitioners and give equal right to both in terms of signing government certificates. This created a furore and the British Indian government virtually excluded indigenous practitioner from government medical services.
Another Act passed in 1912 would finally exclude indigenous system from any state patronage thus making the indigenous system a voluntary and private affair.
It was around this time that in 1883 that the Bombay Medical Union
was formed, the very first society of medical professionals. Association would later become the western branch of the IMA which came into existence in 1928. Through regular conferences and other efforts, the IMA would cement its position in the period 1883 -1920.
Some of its members who were active in the freedom struggle would succeed in Indian National Congress (INC) to take up the cause of parity between Indian and European doctors between 1893 and 1907. The health system would gradually come into Indian hands by 1919 but did no good to the marginalised indigenous system.
But for the dedicated efforts of people like Raja Serfoji, the last Maratha, Hakim Ajmal Khan, KC Sen, Pandit Gopalchari of Madras, Vaidya PS Varier of Kottakal and others, the indigenous system would have been extinct by now. That it survived and continues to face similar tirades shows the deep scars colonialism has inflicted. This may well be the most important motivation to narrate this well documented history again and set the discourse right.
What can we conclude from this history? First, perception of tension between the allopathic and ayurvedic systems created by the event is not a healthy sign, given the vast needs for health services. Even in 1876, the Indian Medical Gazette reported one assistant surgeon of Peshawar Chetan Shah acknowledging that ‘hakims are not so ignorant as doctors believe them to be’.
In today’s time, stalwarts like Dr BM Hegde have been more objective and supportive of indigenous system. For affordable health services the country needs the best of both systems as both have something unique to offer.
Second, at the deeper level the co-opting process that British started among urban elites is slowly withering. With urban middle class now more educated and open to trying the indigenous system, commercial concerns are the driving thing at the time of the pandemic. The global herbal medicinal market is estimated at $120 billion and the domestic market is assumed to grow at over 35%.
India being the inventor of Ayurveda must seize the opportunity to position this system not just domestically, but also abroad, just as Chinese medicine thrives in West. Thus, while disagreeing to aggressive exchange of language, the author agrees that solid home-grown standards are needed to help in the expansion of the indigenous system.
Last, the idea of making profit from human suffering that the British implanted has today made the dominant system unethical and way beyond the means of common man. This cost paradox is true even when Indian medicines are one of the cheapest in the world.
Thus, it is imperative that government corrects the colonial excesses on indigenous system, creates a level playing field, as it can offer treatment of many common aliments at one fiftieth the price of allopathic medicine.
Indeed, the battle of Atamanirbhar Bharat will also be fought on medical discourse in the 21st century.
History has strange ways of repeating itself!
(The author is an economist and works the banking industry. Views are personal.)