How do medical concepts travel? What about medications, to say nothing of the abstract intellectual parameters of medical practice? Is it possible to separate pharmaceuticals entirely from their place of origin or from the practitioners who know how to administer them? This wide-ranging volume provides a dozen contrasting examples of how medical objects are constituted, valued and transmitted within and beyond the Indian Ocean world.
Originating at a Wellcome Trust-supported workshop on Health, Medicine and Trade across Cultures, the case studies span more than four centuries. Editors Burton Cleetus and Anne Gerritsen offer material-culture studies as a unifying framework. In their view, ‘therapeutic objects’ merit analysis because they are ‘subjected to multiple layers of negotiations brought about both by colonial dominance as well as nationalist upsurge’ (p. 11). Although there may be no way to completely isolate objects, concepts or practices from their original cultural context, Cleetus and Gerritsen argue that this very fact makes them invaluable tools for ‘highlighting important historical changes in context’ (p. 17).
Roughly half of the chapters focus on specific objects, and these deep dives are tantalizing. The authors move beyond spices and textiles to explore commodities that have received less scholarly attention, some native to India and others imported. For instance, Amrita Chattopadhyay unpacks the culturally specific ways in which perfumes were used within India, and how class, caste and gender shaped their meanings. Greeshma Justin John explores how soap was constituted in Keralam. This seemingly simple product raises questions not only of modernity and gender, but also of religion and politics. John outlines the popularity of vegetable-based soap compared to other brands that included tallow, traces the evolution of its therapeutic and swadeshi (anti-colonial, self-sufficiency) associations and highlights the radical liberation that soap offered low-caste Dalits (p. 161).
Specialized medical objects often have layered meanings. Anne Gerritsen suggests that we should ‘approach rhubarb less as a commodity and more as a concept’ (p. 65). This allows her to highlight competing understandings of the plant’s roots, stems and extract in Chinese, Indian and Western contexts, ultimately concluding that the ‘stories told about … its remote origins and its complex itineraries were key to its appeal’ (p. 80). David Arnold presents brief portraits of an intriguing trio of poisons. He argues that nux vomica, arsenic and kerosene are all examples of a ‘pharmakon’, a substance that could both poison and cure (p. 127). Like rhubarb, the meanings of these border-crossing ingredients changed as they travelled across the oceans and entered into new social contexts. The chapter by Suparna Sengupta demonstrates that ideas moved around the Indian Ocean just as objects did. In her chapter on criminals in the Andaman Islands, Sengupta demonstrates that even definitions of old age were culturally constructed.
Another subset of chapters explore aspects of Ayurvedic medicine. Burton Cleetus discusses the tensions between tradition and modernization in the late nineteenth century; Jane Buckingham investigates chaulmoogra as a leprosy treatment native to India that was administered in the South Pacific in the 1910s and 1920s; and KP Girija describes how a particular herb, Arogyapacha, was transformed into a commercial medication in the twenty-first century. Sociologist Harish Naraindas concludes the volume with ethnographic episodes that underscore the ongoing conflict between Western and Ayurvedic medical approaches. He then invokes Reformation cleric Ulrich Zwingli’s views of the Eucharist to challenge the volume’s emphasis on materiality. Materia medica is only one aspect of therapeutic practice – can we recover, and respect, the immaterial aspects?
Overall, colonial extraction, or bioprospecting, emerges as the volume’s key theme. Several contributors extend Londa Schiebinger’s influential Atlantic-focused work Plants and Empire (2007) into the Indian Ocean world. They offer a corrective: although admittedly asymmetrical, the extraction from India was not an entirely unidirectional ‘transfer’ of knowledge. Malavika Binny surveys early modern European botanical works (Da Orta, Van Rheede) alongside Ayurvedic texts, tracing how each incorporates information from the other. Like Schiebinger, Binny finds instances of ‘non-circulation’ instructive, suggesting that botanical information was shared more readily than medical practices (p. 52). Pratik Chakrabarti, in tracking the eighteenth-century European missionaries who investigated South Asian materia medica, finds another instance of ‘non-circulation’. When they sought recognition from compatriots for their scientific pursuits, they were told ‘Europe does not want you’ (p. 35); both person-to-person and textual transmission of medical knowledge were blocked.
Moving forward more than two centuries, in the penultimate chapter Kaushiki Das investigates present-day bioprospecting. Even as she invokes ‘Colonialism 2.0’, she warns that labelling these processes as neocolonialist would be an oversimplification (p. 241). Rather than reifying a binary between colonizer and colonized, she introduces a new dimension within India: between a codified system of medicine, Ayurveda and a non-codified system, tribal medicine. In their quest for new ‘miracle drugs’, she contends, Indian pharmaceutical firms are equally complicit in expropriation from tribal communities (p. 234). Das calls for scholars to ‘move away from grand narratives … towards a more fine-grained ethnographic engagement which takes into account the microprocesses that constitute the techno-politico assemblage of power’ (p. 235). Even with their disparate approaches, the chapters in this anthology provide admirable examples of such fine-grained attempts to use objects – and their networks – to decentre Western medical practices.