Refiguring Unani Tibb (Plural Healing in Late Colonial India)

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About the Book

Refiguring Unani Tibb examines the ways in which unani tibb reconstituted its identity in the light of modernising trends at the turn of the twentieth century in India. It brings out the heterogeneity of unani tibb in late colonial India that frequently defies its commonly ascribed label as a ‘traditional Muslim system’ of medicine. Through an analysis of interconnecting themes Guy Attewell draws attention to the tensions manifest in different spheres of unani activity as practitioners reconfigured their knowledge and practices through the prisms of biomedical concepts, language, nationalist and communitarian politics, changing social and moral norms, and colonial-inspired models of legitimacy. The book shows that while tibb has always been a cosmopolitan profession, the late nineteenth and twentieth centuries saw a fundamental transition from a principally localised, personalised practice to one that had to engage and be represented in a mass, public arena for status, recognition and custom. This transition, the book argues, was neither complete nor uniform. The study draws on a range of material in Urdu, Arabic and Persian, including texts, pamphlets and journals, in addition to archival records in Hyderabad and London, to draw out the complexity and contingency in the evolution of a plural and extraordinarily dynamic tradition of healing.

About the Author

Guy Attewell is a Research Fellow at the. Wellcome Trust Centre for the History of Medicine in London researching the neglected sphere of tibb in Tamil.

Preface

There is so much to do! This is the feeling that has accompanied me on every step of the journey that is this book. It began as a Ph.D. thesis. But really it began before then, when my wife Malvika turned me eastwards beyond the West Asian and European studies which had till then consumed me. In the writings of Garcia d’Orta, a sixteenth-century Portuguese physician who travelled to Goa, I found an openness towards learning about the therapeutic use of roots, leaves, fruit and other substances-whether from the maid-servant, the gardener or the court physician-which inspires me to this day. He was the catalyst that made me want to look beyond what Europeans thought about medical practices in India, although I cannot escape the paradox of my own position and trajectory.

During my long stays in India, visiting practitioners of unani tibb and talking with their patients, I have been continually struck by differences in outlook and practice, a heterogeneity which reflects the large number of stakes that people have had in practising and producing ‘unani tibb’. The stacks of brightly packaged unani and ayurvedic over-the-counter products lining the druggists’ stores contrast with the home-made remedies of the practitioner who prepares his or her own medicines from raw materials bought in local markets. The graduates of unani colleges who wanted to train as biomedical doctors but did not make the grades are on a different career path than the graduates for whom the courses were a formality, who anyway had learnt the particular skills of their profession in their family’s hereditary practice. This was evidently not ‘a traditional medicine’ surviving in a ‘modern’ world, although I framed my thoughts in this way when I first learnt of the continuation of a Greco-Arabic-Persian medical tradition in contemporary South Asia. On reflection I came to understand tibb as diverse sets of practices that continually collapsed the traditional/modern paradigm. The ‘authenticity’ associated with particular inherited diagnostic and therapeutic modalities could itself be deployed as an intervention to subvert the powerful scientific-technological-cultural claims of universalist ‘modern’ (orthodox, western, allopathic, cosmopolitan, or whatever you wish to call it) medicine. In other instances, the boundaries between the well-springs of therapeutic knowledge in tibb and orthodox medicine might be demolished entirely. One early-twentieth-century practitioner in Delhi made this clear when he reframed the ‘traditional’ knowledge of tibb (tibb qadim, or old tibb) as the ‘holy progenitor’ of ‘western’ medicine (maghribi, tibb), by elevating the Greco-Arabic medical legacy in Europe and his own country. We see here a tension at the heart of the professionalisation of tibb between local and universal modes of, and claims to knowledge. We follow this thread throughout the book. The all-embracing mass formations of modernising India were changing forever the ways that tibb had been transmitted and practised-through new media, communications, political mobilisation and representation, large-scale measures to control epidemic disease, colonial policy interventions, pharmaceutical production, universalist science. Language, print, pharmacy, professional organisation and disease conception are thus themes in this book which bring out some of the contestations and constraints encountered by practitioners of tibb as they reshaped their knowledge and practices of tibb in their changing environments. The decades at the end of the nineteenth and beginning of the twentieth century emerged as key formative times for the evolution of new professional consciousness in tibb, and are therefore the focus of this study. The limitations of the study are obvious when one considers the hugeness of India and the need to look further back in time for seminal developments than I have done. This work really only develops themes in parts of north India and Hyderabad. Where it lacks in not being even more localised in its orientation, it perhaps gains from its relative spread, and its attempt to see common threads in diverse realms of practice and activity.

I engaged with a wide variety of sources, at one point placing adverts of my research interests in local newspapers in Hyderabad in order to make contact with those people willing to help, who otherwise would have been unknown to me. When I started out, it quickly became clear that although much has been written, in Urdu, on tibb in India, a lot of it was of a certain kind, namely brief accounts of the lives and works of certain practitioners. This is an extremely rich genre, but does not give much insight into process in the shaping of medical knowledge and practices. As for English-language historical studies of tibb, these are very few and fragmentary. Although, some work is being done that is challenging our assumptions about Indian medical ‘systems’, their construction, methods and practices, interrelationships and contingency in the social, economic, technological and political frames that gave them shape. I see my work as a step towards a deeper understanding of the interwoven worlds of tibb and the other streams of medical knowledge and practice in India. There is still so much to be done.

I may have spent the better part of four or five years working on the themes and the material of this book, but many people have helped to bring this work about, contributing their time, thought and energy. I am now happy to have the opportunity to say thank you to them all, or, if this is not possible, to thank most of them at least. The research for the original Ph.D. was funded by a doctoral studentship from the Wellcome Trust. I thank them for their generous support, in particular Tony Woods and Hal Cook. Sanjoy Bhattacharya has encouraged me to get the thesis moving into book form. It would not be happening now if it weren’t for his tireless energies and unstinting enthusiasm.

The prime research for this book took shape when I had the good fortune to be supervised by David Arnold at SOAS. His insights helped me to make sense of the range of material we discussed together. I thank Charles Burnett at the Warburg Institute in London for his support as supervisor of my M.A. dissertation, which launched my interest in indigenous medical practices in India. I am very grateful for the interest Dominik Wujastyk, former curator of Sanskrit manuscripts at the Wellcome History of Medicine Library, has taken in my M.A. dissertation and subsequent studies over the years. My next thanks goes to Claudia Liebeskind, who generously gave me details of a number of her contacts in India and leads to follow up. These I found tremendously useful and helped me to establish links with unani practitioners on my first trip to India. Hakirn Zillurrahrnan of Aligarh was one such, from whose knowledge, experience and generous spirit I have benefited. I would like to thank the staff at the Central Council Research in Unani Medicine in New Delhi, in particular Mehr-e Alam Khan, and also the staff at the Jamia Hamdard in Delhi. My sincere thanks go also to Sadia Rashid, director of the Hanidard Foundation in Karachi and daughter of the late respected Hakim Muharmnad Said, for welcoming me to Madinat al-Hikrnat, to Dr Zubairi for his interest in my work, and also to Dr Usman Ghani for helping me with some specific enquiries. Thanks, too, to Nausheen, Rafiq and Menaal for their warmth and hospitality.

In Hyderabad-Deccan, I would firstly like to thank the tireless Syed Ali Yadullahi, who, on my first research trip to Hyderabad, led me from the library of the Henry Martin Institute to many of the fascinating, rich second-hand bookshops near Charminar, and generously devoted much of his time and energy trying to find materials for me. I am also endebted to the generosity of S. A. Hussain at the Indian Institute of History of Medicine in Hyderabad, and to its former director Momin Ali. I thank the director of the Henry Martin Institute and the staff in its well-catalogued library. I thank Dr Murali .and the director of the Sundarayya Vignana Kendram for introducing me to their rich collection in the process of their miraculous restoration efforts following the disastrous floods of the summer of 2000. The staff at the Government Unani Hospital and Nizamia Tibbi College were also helpful, especially Dr Bashir Ahmed and Dr Abdulqadir. I would also like to thank the many graduate and post-graduate students whom I met at the College for the interest they showed in my work and the willingness with which they answered some of my questions. I thank Sultan at the internet cafe near Birla Mandir for introducing me to Hakim Muharmnad Ismail, who generously allowed me to sit, many evenings a week, in his clinic, observing his treatment of patients and learning from his knowledge. For this experience I am very grateful. I thank the helpful staff at Hyderabad’s daily newspaper Siasat, in particular the editor Zahid Ali Khan, for running a small piece about my research interests, which helped me to make contact with a number of practitioners and members of the public who generously shared their knowledge and materials with me. I am particularly thankful to Mohiuddin and Hakim Muhammad Khairuddin, who let me and my wife benefit from spending some time at his clinic, provided an exhibition of raw medicinal drugs at his home and introduced us to his supplier of medicinal substances; to Dr Hashrni for giving me access to his private library; to Hakim S. A. Qadri in Balapur, who let me consult his private library and photocopy some of his material.

I am grateful to the director and staff of the Andhra Pradesh State Archives in Tarnaka, and especially to Shankar and Qamr ul-Nisa Begum; I thank V. K. Bawa for his interest in my work and his suggestions for approaching the archives, and Margrit Pernau, even though it was too brief an encounter. My thanks are also due to the director and the librarian at the Urdu Hall in Himayatnagar, to the most cooperative staff at the Idarah-i Adabiyat-i Urdu in Somajiguda, and the librarians of the Osmania University, State Central and Salar Jung Libraries.

I thank the bone-setters Hakim Ghulam Rasul and Sons in Shah Ali Banda for sharing their time and expertise with me and my wife. I am very grateful also to Muhammad Siddiq Ahmed, who passed on to me a useful document (and had a delicious shir khurma prepared for us). I thank also Sadiq Naqvi, Hakim Syed Qudra-tullah, Hakima Kesar Mohini, S. M. Mustafa and the grandson of Hakim Syed Ali Ashufta. I am yery grateful to my Urdu teachers, Tahsin in Hyderabad and Simon Qadri in London, for helping me cover texts more efficiently and correcting my early misinterpretations. I thank also the photocopiers beside the Public Gardens and on Hyderguda Main Road for their patience and skills in carefully making copies of sometimes delicate materials. A very special thanks is due to Fazluddin Ahmed of the Osmania University Library for his friendship, generosity, dedication and interest in my work, and for his expertise as a librarian. A hearty thanks to Giri, Rekha, Rahel, Viju and Hoshang for the lively companionship which they brought to our stay in Hyderabad, and also to Buchamrna for offering a place for us to stay. Thanks to Ravi and Bhanu for their great-spiritedness.

In London I wish to thank Lawrence Conrad for his insights into the history of medicine in West Asia. I am grateful to the help given by the knowledgeable librarians at the British Library, especially the curator of Urdu materials Leena Mitford. At the Wellcome Library for the History and Understanding of Medicine, Nigel Al1an formerly curator of the Oriental Collection, and to Nikolai Serikoff, his successor, have made me feel very at home in the library’s collections, especially of Urdu printed works. I owe my gratitude also to Mark Harrison, Francis Robinson and Avril Powell for their constructive comments on my work; to Siobhan Lambert-Hurley for her interest in my work, to Markus Daechsel and the many others who raised thought-provoking questions at the Tuesday evening South Asia History seminars at SOAS; to Nilanjan, Rpsie and the rest who started out on Ph.D.s at SOAS at the same time as I did in the winter of 1999. A big thanks to Brian Black for his companion-ship, the animated discussions and for his enthusiastic support of good food and local north London traditions. I also would like to acknowledge Seema Alavi’s thought-provoking studies of tibb in the nineteenth century-the perspectives of her current work in progress will add greatly to the understanding of tibb during this period.

I thank my father and Angelika for all their support over the years, which enabled me at the outset to develop my research ideas on my first trip to India and to complete the original Ph.D. I thank my mother for her wishes for me. And Malvika-without her nothing of this would have happened. She gave me the strength to ride times when nothing was working out. This book has been a journey for us both, and, I admire her forbearance, and her perspicacity, which she has applied from the beginning and in every stage to my work. The shining presence of Jalin and Ameya daily menaces my work routine, and they may also, I expect, be happy that his father their bringing to an end some long-enduring Arbeit.

In spite of all the thoughts and contributions of others, I take full responsibility for any errors and omissions in this work.

Introduction

The names ‘unani tibb’ or ‘unani medicine’, as this medical tradition has come to be known in South Asia, are at once suggestive of a history of great translocation in time and space. Tibb has been embraced and shaped by peoples over the last thousand years in cultures stretching from the Eastern Mediterranean and West Asia to North Africa, Hispano-Arabia and Western Europe in the west, to Central, South and South-East Asia to the east. Tibb has also been practised in an ad hoc manner in pockets of the South Asian diaspara, such as in East and South Africa, the Gulf States, Malaysia, the UK and the USA, and tibbi institutions and organisations have emerged in the diaspora as well. Interested individuals and practitioners set up the Graeco-Arabic Medicine Society Inc. in Australia in 1976,2 the Mohsin Institute was founded in Leicester (U.K.) in 1978, and other institutions offering tuition in tibb have been set up in the United States’ and most recently in South Africa where the Ibn Sina Institute has been offering training in tibb and health care from January 2005. This institute, initiated by Dr Rashid Bhikha, is affiliated to two of the main centres for tibb in South Asia, the Hamdard Foundation (pakistan) and Jamia Hamdard (India), South Asia remains the hub for activity in tibb: in practice, commerce, print and institutional structures. It is in South Asia that tibb acquired the appellation ‘unani’ (Greek), for it was mostly known as just tibb (medicine) or hikmat in medieval Arabic sources. These trajectories of translocation from West and Central to South Asia and beyond, raise the fundamental questions of how to frame the relationship between the various streams of knowledge and practice at specific times and places within a broadly defined tradition of tibb, and how to identify the processes (political, social, economic, technological) that have either motivated or inhibited the elaboration of certain forms of knowledge. In this book, these themes will be approached through the prism of authority, as we examine the transformation and the fracturing of authoritative knowledge and authoritative practices in tibb.

The late nineteenth century and early twentieth century present us with a time of critical importance for the development of tibb in South Asia, for exploring its heterogeneity and the tensions of its transformations. It was a period of conjuncture. Political and religious upheaval and mobilisation combined with crises of epidemic disease, social and economic change in the negotiation of modernity and the increasing use of lithographic print technology. The authority of elite, principally the learned hereditary, practitioners was being challenged by the proliferating use of lithographic print by hakims (practitioners of tibb) new to the profession, in new forms of commercial enterprise. Printing in Urdu became essential for the dissemination of tibb to attract wider constituencies, as a new technology which mediated authority. The privileged place accorded to hereditary practice was also being eroded by the emergence of new forms of professional structures and accreditation in the drive to modernisation that large numbers of practitioners advocated. Medical practices, technologies and knowledge imported from Europe and North America or developed within the Indian colonial context were also being reworked and adopted or contested in various unani circles during this period. There were then a number of competing pressures that revolutionised the ways that unani knowledge was transmitted, constituted and translated into practice.

Recent scholarship, as we discuss in greater detail below, has begun to grapple with aspects of these tensions, but has not sufficiently engaged with important dimensions of the reform of tibb. Notions persist in specialist and non-specialist media of unani tibb as a ‘system’ of medicine which, without a nuanced theoretical definition, reveal little about its dynamism and heterogeneity, let alone the processes by which change takes place. Tibb continues to be unproblematically characterised with reference to a set of key figures, texts, theories and practices elaborated in tibb’s textual tradition. Its status as a Muslim profession in this period has gone unquestioned. And of great importance, the reform of unani tibb in the twentieth century has been viewed as primarily an engagement with western forms of knowledge, power and practice. What we shall see, in fact, is that the very notion of ‘unani system of medicine’, as it has been unreflectively termed throughout the twentieth century, is itself a product of the colonial era, of the will to systematise, demarcate, represent knowledge and practice as a coherent whole. Where debates with colonial/western medicine have been investigated they have in some cases resulted in the unfortunate polarising of ‘reformists’ and ‘purists’, which understates the complexity of reform and modernisation. These processes were inescapable for urban practitioners of tibb, even if they negotiated them in different ways. The book attempts to move beyond the impact-response and accommodation-resistance paradigms adopted by some ethnographers and historians for the analysis of indigenous-colonial interactions in order to characterise the development of medical thought and practice in India’s ‘indigenous’ medical traditions across a range of spheres of professional activity. The interactions between the ‘colonial’ and the ‘indigenous’ were highly varied and differentiated to the extent that it becomes difficult to be satisfied with this dichotomy at all. Although practitioners of tibb seeking to recast their profession were in many cases inspired by colonial-derived models-organisational, educational, conceptual, technological-it is Important to recognise that their adoption of these models was not a straightforward process, and cannot be characterised by the notion that the modernisation of tibb was inevitably framed by the parameters of western medicine and science.

The five chapters that follow develop a number of different themes, each one being in effect a case study examining a particular disease complex, a new form of professional organisation, a new form of professional engagement, in which the linkages between medical authority and medical knowledge and practice in the sphere of tibb are examined. The book explores domains that were of acute public concern, such as epidemic outbreaks (where it focuses on plague in particular) but also matters of everyday life and intimacy, where it discusses unani tibb and the treatment of women’s and men’s disorders and their societal contexts. It explores unani culture in Hyderabad and in north India, in relation to emerging institutions, new forms of professional organisation and print culture. The composite strands of the book are not intended to provide a comprehensive analysis of the state of unani tibb in early-twentieth-century India. Each one of these domains could be amplified as new materials from different regions in India-Bengal is an obvious omission in my work-are researched, and there are of course other themes which could have been investigated. Notwithstanding these limitations, the structure of this book reflects the overarching ambition both to draw attention to diversity, complexity and contingency in early-twentieth-century tibb as well as to be able to point to the threads which link apparently diverse domains of theory and practice.

The conceptual starting point of the book is not to reify tibb as meaning ‘such and such a body of knowledge and practice’, but rather to examine, in a number of diverse scenarios, the different ways that unani knowledge has been constituted and the social or political conditions in which this happened. It will be made clear in the exploration of these domains that the evolving tibbi profession was engaged in various forms of dialogue: with itself (evident in the articulation of the competing interests of its own practitioners), with healing practices and traditions that adhered more closely to Islamic doctrines, with a variety of other medical practices-folk, private and state western (allopathic/colonial medicine) and ayurvedic-and most importantly with the public. The public were its patrons, and practitioners of tibb sought to reach out to them, projecting in the process varied perspectives on authentic and legitimate unani knowledge and practice.

Contents