Cult Med Psychiatry (2014) 38:335–339
DOI 10.1007/s11013-014-9391-x
INTRODUCTION
Learning Institutions in South Asian Medicine
Laurent Pordié
Published online: 9 August 2014
Ó Springer Science+Business Media New York 2014
Introduction
The development of European medicine in nineteenth-century ‘India’ gradually led
to the exclusion of local therapies from medical educational institutions. For
centuries, the colonizers showed interest in local plants and the knowledge of local
therapists (often for their own ends), but the rise of scientific skepticism shaped the
direction of institutionalized Ayurveda and Unani, the two major learned medicines
on the Indian subcontinent.1 The famous Native Medical Institution of Calcutta, for
instance, where medical staff received lessons in both ‘scientific medicine’ and
vernacular therapies, was closed shortly after it was founded in 1822. From 1835
onwards, the creation of diverse schools of medicine did not pursue this type of
pluralistic approach (Pati et al. 2001, pp. 7–8) and the institutions of learning in
colonial India began to be refashioned.
The hostility of the colonial policies toward Indian medicines and the growing
influence of nationalist discourse in the pre- and post-independence periods
prompted traditional therapists to mobilize. They formed associations and spread
their knowledge, thanks to the new printing methods. Specialized colleges of
1
Ayurveda, the ‘‘science (skt. veda) of longevity (skt. āyus)’’, is a form of learned medicine originating
in Brahmanic tradition and set in Sanskrit texts as far back as the early centuries of the Christian era. The
medical theory is based on humoral physiological and pathological principles that explain both the
healthy body and its malfunctions. Unani is a Greco-Arabic medicine, introduced into the Indian
subcontinent with the Muslim conquest. It derives its doctrinal principles from the medical traditions of
Hippocrates and Avicenna. In South Asia, this practice took on the name of Unani (yūnanı̄)—generalized
since the nineteenth century—which means ‘‘Greek’’ (Ionian) in Arabic.
L. Pordié (&)
CNRS, Paris, France
e-mail: laurent.pordie@ehess.fr
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‘indigenous medicines’ were established. Subjects borrowed from European
medicine, such as modern anatomy, were re-integrated into the institutional training
courses, and numerous aspects relating to the traditional sciences were removed
from the curricula. In some cases, the modern innovation of medical pedagogy as
seen in Europe at the turn of the twentieth century was considered worth emulating
(Habib and Irfan 2000). This took place under colonial dispensation, which led to a
number of tensions and negotiations (and therefore co-productions) between
governing bodies and ‘indigenous medicines’ (Attewell, this volume; Chakrabarty
2013). This situation led to some modification of the learning environments in the
medical realm, a process that continues today. For a great part, the pedagogy and
practice of contemporary South Asian medicine was framed through its encounter
with biomedicine, which functioned as referent, model, judge, and cannon. Students
in Ayurvedic colleges in today’s India learn the fundamentals of biomedicine, and
their ‘Ayurvedic curricula’, from which Sanskrit has gradually disappeared, now
integrates biomedical concepts, tools and diagnostic methods, as well as nosological
and etiological categories. In many ways, this configuration limits the range of
choices for the students who find themselves largely dependent on the institution to
imagine their Ayurvedic future. As we learned from Mary Douglas’ seminal
theoretical work on the role of cognition in the formation of social order (1986),
these institutions essentially do the work of thinking and choosing for them.
The encounter between South Asian medicine and biomedicine resulted in the
recasting of traditional medical practices in India, which are institutionalized in
universities as ‘medical systems’ in an attempt to bring them in line with biomedicine.
This process of institutionalization represents a move away from community-based
organizations that embody traditional and charismatic authority, in a Weberian sense,
toward bureaucratic organizations that uphold rational legal authority, as exemplified
by the biomedical model. This kind of reconfiguration does not only provide a fruitful
ground for the study of the formation, transmission and hierarchical relations of
knowledge forms, but it also offers a privileged position from which to examine the
fabric and dynamics of social ties and their institutionalization. This is how medicine
itself appears to be both a social institution and an adequate prism for the study of
state-driven institutions such as medical schools. These modern institutions must be
considered as processes and not as fixed entities (Abélès 1995). In this way, they
become fertile objects of anthropological enquiry. As Foucault remarked (2004, pp.
120–121), institutions mask the historical and ontological—and, we should add,
epistemological—reality of power relations. Observing institutions as (historical and
current) processes provides a means of examining the day-to-day making of
institutions, including—but not limited to—the dynamics of power.
While the transformation of South Asian institutions of medical learning offers a
productive framework for the study of governance in India, it also opens research
avenues in identity politics. This is exemplified by the fact that the main traditional
therapies in India emerged as national ‘canonical’ forms (Alter 2005), partly based
on religious or linguistic identities, resulting in the now well-known ‘systems’ of
Ayurveda (Hindu, Aryan, Sanskrit), Unani (Muslim, Arabic, Persian), or Siddha
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(Hindu, Dravidian, Tamil).2 Although it has been officially recognized as an Indian
system of medicine since 2010, sowa rigpa, the Tibetan ‘science of healing’, also
remains strongly associated with Tibet(ans) and Buddhism. These religious and, to a
lesser extent, linguistic boundaries are verified in practice today by the
demographics of students in learning institutions. For the greatest part, Tibetan
medicine is learned by Buddhist students, Ayurveda by Hindus, and Unani by
Muslims.
This collection thus not only offers a commentary on religious, ethnic, linguistic,
class, or regional identities, but it also intends to grapple with the norms and values
that characterize learning institutions and methods. These norms and values lead to
the creation of codes of conduct and nomenclatures for each specific medicine,
which is situated in a normative framework that conditions learning patterns and
knowledge transmission.3 These processes have long been described as political, as
they usually take place in relation to central governing structures and entail
remarkable transformations of therapeutic power (Foucault 1963). Medical knowledge and practice are thus subjected to a profound reorganization. This
reorganization, however, cannot be reduced to a mere political reading. It also
touches the moral foundations of medicine and therapeutic power, since they
concern values and the nature of right and wrong (Fassin 2000; Stengers 1997). The
normative framework in which medicine is to be learned demonstrates both political
and moral elements.
This special section uses three case studies to examine how these situations and
transformations have influenced South Asian medicine from the colonial times to
date and to examine their social, practical, and epistemological consequences
through both historical and anthropological lenses. These repositioned South Asian
medical ‘systems’, with the text and the written word at their center and the
classroom as the pedagogic site, with prose rather than prosody as the new form, and
with materialism as the metaphysical premise, find causal schemes based on either
planets or dreams, for example, untenable. Astrology is relegated to ‘literary’
studies and has been taught for over a century in colleges or departments of Sanskrit
or Oriental Studies, although the nationalist government of India did attempt to
ideologically reposition astrology as a form of ‘scientific knowledge’ (Guenzi
2013). Similarly, the oneiric, as either a pedagogic or therapeutic form, is altogether
jettisoned and ‘languishes’ as folk-practice (Mukharji, this volume). This results in
all the binaries of Textual-Oral, Great-Lesser, etc. that anthropology and history
have been saddled with, often leading one to see South Asian social reality as a
series of heterogeneous, and worse, eclectic practices.
2
However, the centuries-old coexistence of Ayurvedic and Unani medicines has generated a host of
exchanges, involving, for example, the writing of erudite texts in Persian, Urdu, or Sanskrit on clinical
practice, surgery, pharmacopoeias, and the fields of health administration and development. Unani
medicine forms an integral part of the Indian Islamic culture, but that does not prevent the historical and
contemporary existence of Hindu practitioners, including some scholars who wrote numerous texts of
Greco-Arabic medicine in Persian. Writings inspired from this medicine have also been created in
Sanskrit and in a variety of vernacular languages such as Telugu and Tamil.
3
On a reading of institutions as ‘normative elements’, see the work by Parsons (1990).
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This collection proposes to re-assemble some of these fragments. It first offers an
exploration of three distinct educational settings of contemporary sowa rigpa in
Himalayan India. Laurent Pordié and Calum Blaiklie show that these institutional
forms coexist in constant interaction with one another. Currents of continuity and
transformation flow through and between each of these settings, following circuits
and networks that cross all kinds of apparent boundaries. The authors render this
visible by examining the ‘taskscapes’ that characterize each learning context and
define what a skilled practitioner should know and do. They trace the evolving
dynamics between coexisting but unequal forms of knowledge in a particular sociopolitical setting and historical moment, and show how the current scenario
corresponds to a shift away from enskilment, which involves a form of ‘learning
through doing’, and toward education, as represented by institutional learning. Guy
Attewell then examines the emergence of new institutional arenas for Ayurveda and
Unani in the semi-autonomous State of Mysore in late colonial India. He argues that
the characteristic dimensions of this process were compromise and misalignment
between ideals of governance and modes of pedagogy and practice. Running
counter to a narrative that the Princely States such as Mysore were instrumental in
the ‘preservation’ of Ayurveda, his study analyzes the process of negotiation and
struggle between a variety of actors. The following article demonstrates how the
discarded oneiric form can fully function as a pedagogic and therapeutic format,
questioning and expanding the way in which the history of medical innovation has
thus far been conceptualized. Projit B. Mukharji thus examines dream-revealed
therapies as dynamic institutions that enable and sustain therapeutic change. He
delineates various forms of such dream-medicine (swapnaushadhi) as a specific
corpus of therapeutic technologies within the larger medical landscape of South
Asia.
This special section is not a collection of oral and written ‘traditions’, or paths to
South Asian therapies under the rubric of medical ‘pluralism’, but a modest reassembling of a cognitive and epistemic fragmentation, without of course claiming
that they may not also represent local ecologies, identities, contestations, and
asymmetries.
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