Construction of Medical Construction of Medical Hegemony: An Exploration Hegemony: An Exploration into Colonial Encounters in into Colonial Encounters in Anatomical Knowledge in Anatomical Knowledge in

IndiaIndia

JayantaJayantaBhattacharyaBhattacharya

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How medicine has evolved since How medicine has evolved since antiquityantiquity

Since antiquity the study and Since antiquity the study and practice of medicine hinges around practice of medicine hinges around a few ontological and a few ontological and epistemological questions. epistemological questions.

(1) (1) OntologicalOntological –– what is health? what is health? What is disease and illness?What is disease and illness?

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Contd.Contd.

(2) (2) Epistemological Epistemological –– how to face disease how to face disease and illness?and illness?

(3) (3) Epistemological Epistemological –– how to get over how to get over disease and illness? How to preserve disease and illness? How to preserve health? health?

While addressing these issues questions of While addressing these issues questions of the human body, the environment in which the human body, the environment in which human beings are enmeshed and the human beings are enmeshed and the influence of cultural distinction come up.influence of cultural distinction come up.

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Contd.Contd.

For the time being, putting aside all For the time being, putting aside all other civilizations, we shall focus on other civilizations, we shall focus on two distinct paradigms of medicine two distinct paradigms of medicine and health and health –– (a) Greco(a) Greco--RomanRoman--European, and (b) European, and (b) ĀĀyurvedicyurvedic..

Both these paradigms/systems have Both these paradigms/systems have differently dealt with the above differently dealt with the above mentioned questions.mentioned questions.

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Modern European medicine is a Modern European medicine is a definite disjunction from the Grecodefinite disjunction from the Greco--Roman lineage, occurring during the Roman lineage, occurring during the 1616thth--1818thth centuries. centuries.

HumoralHumoral theory of Grecotheory of Greco--Roman Roman medicine was replaced by pathological medicine was replaced by pathological anatomy and organ localization of anatomy and organ localization of disease.disease.

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ContdContd..

In tandem, medicine made its journey from In tandem, medicine made its journey from Bedside medicine to Hospital medicine to Bedside medicine to Hospital medicine to Laboratory medicine (and, now, on to Laboratory medicine (and, now, on to TechnoTechno--medicine). medicine). Anatomical knowledge was the key Anatomical knowledge was the key transformatorytransformatory factor. factor. SymptomsSymptoms to be to be verified by verified by signssigns. Doctors were to extract . Doctors were to extract signs from within the body. In stead of signs from within the body. In stead of subjective symptoms truth had to come out subjective symptoms truth had to come out of signs extracted by doctors.of signs extracted by doctors.

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ContdContd..

Vedic Vedic daivadaiva--vyapvyapāāśśrayaraya--bhesbhes ajaaja gotgottransformed into transformed into ĀĀyurvedicyurvedic yuktiyukti--vyapvyapāāśśrayaraya--bhesbhes ajaaja. Mode of . Mode of reasoning/understanding of disease reasoning/understanding of disease metamorphosed metamorphosed -- the causes of disease the causes of disease believed to being explained with believed to being explained with tritri--dosdos aatheory located inside the body.theory located inside the body.But anatomical knowledge did not undergo But anatomical knowledge did not undergo any change at all in its transition from Vedic any change at all in its transition from Vedic to to ĀĀyurvedicyurvedic period.period.

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ĀĀyurvedayurveda: Expression of Indian : Expression of Indian SubjectivitySubjectivity

ĀĀyurvedayurveda literally means literally means –– the knowledge the knowledge ((vedaveda) of the life span () of the life span (āāyusyus): it teaches how ): it teaches how one may utilize the span of life apportioned one may utilize the span of life apportioned by nature by nature –– traditionally taken to be a traditionally taken to be a hundred years hundred years –– fully and optimally. It also fully and optimally. It also teaches how to behave in private as well as teaches how to behave in private as well as public life, even how to conduct onepublic life, even how to conduct one’’s s sexual activities.sexual activities.

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As such, As such, āāyurvedayurveda has to apply itself has to apply itself mostly to medical matters, and thus it mostly to medical matters, and thus it is justified to speak of it as is justified to speak of it as ‘‘medicinemedicine’’provided one regards this term as an provided one regards this term as an approximation and not as an exact approximation and not as an exact equivalent of what one normally equivalent of what one normally understands as medicine (Western understands as medicine (Western medicine) today.medicine) today.

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Contd.Contd.

Ethnographers argue thatEthnographers argue that in in stead of stead of conceiving the body as solid and bounded conceiving the body as solid and bounded (as in biomedicine), (as in biomedicine), ĀĀyurvedayurveda conceives the conceives the body as fluid and penetrable, engaged in body as fluid and penetrable, engaged in continuous interchange with the social and continuous interchange with the social and natural environment.natural environment.

This particular characteristic perhaps forms This particular characteristic perhaps forms the core of the core of ĀĀyurvedicyurvedic/Indian subjectivity./Indian subjectivity.

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Body and Body and AnatomicalAnatomical Knowledge in Knowledge in ĀĀyurvedayurveda

Scholars have found, Scholars have found, ““The interest of the Vedic The interest of the Vedic Indians seems early to have been attracted to the Indians seems early to have been attracted to the consideration of questions connected with the consideration of questions connected with the anatomy of the body.anatomy of the body. [[A. A. A. A. MacdonellMacdonell and A. B. Keith, and A. B. Keith, Vedic Vedic

IndexIndex, Vol. II (London: John Murray, 1912), 358., Vol. II (London: John Murray, 1912), 358.]]

In a diachronic perspective, however, one may In a diachronic perspective, however, one may safely assume that quite a number of different safely assume that quite a number of different body concepts were current at the time of the body concepts were current at the time of the CSCS’’ss((CarakaCaraka--sasaṃṃhithitāā) composition.) composition.

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ŚŚalyaalya (surgery), according to (surgery), according to SuSuśśrutaruta--samsam hitahita), is ), is declared to hold foremost place as it is predeclared to hold foremost place as it is pre--eminent on account of its quick action, owing to eminent on account of its quick action, owing to the use of sharp and blunt instruments (the use of sharp and blunt instruments (śśastraastra, , yantrayantra), caustics (), caustics (ksks aarara), and ), and cauterycautery ((agniagni) ) –– SSSS, , 1.171.17--18.18.

In In CarakaCaraka--samsam hitahita (CS) (CS) ––

śśāārrīīramram sarvathsarvathāā sarvaisarvaisarvadsarvadāā vedaveda yoyo bhisbhis akak / / AyurvedamAyurvedam sasakkāātsarnyenatsarnyena vedaveda lokasukhapradamlokasukhapradam //// ((ŚŚāārrīīrara--SthSthāānamnam, 6.19) , 6.19)

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[The physician who is always conversant [The physician who is always conversant with the various aspects of the entire body, with the various aspects of the entire body, is the very person who is proficient in the is the very person who is proficient in the āāyurvedayurveda which can bring about happiness which can bring about happiness to the humankind.]to the humankind.]Two issues should be mentioned here. Two issues should be mentioned here. (A) (A) SuSuśśrutaruta’’ss marmanmarman--theory seems to be a theory seems to be a synthesis of different and partly overlapping synthesis of different and partly overlapping systematic and anatomical concepts, systematic and anatomical concepts, among which the theory of bodily among which the theory of bodily constituents as the most comprehensive constituents as the most comprehensive one became the model for one became the model for marmanmarman--theorytheory..

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(B) In (B) In SuSuśśrutaruta--samsam hithitāā (SS) (SS) –– pratyaksapratyaksa totohi hi yadryadr ss tamtam śśāāstrastradrdr ss tt anan caca yadyad bhavetbhavet / / samsamāāsatastadubhayamsatastadubhayam bhbhūūyoyojnjnāānavivardhnamnavivardhnam // [// [The practical The practical knowledge along with theoretical knowledge along with theoretical knowledge is very essential. Whatever is knowledge is very essential. Whatever is seen while doing practical study and going seen while doing practical study and going through through ŚŚāāstrastra, adds the knowledge, when , adds the knowledge, when both are applied togetherboth are applied together.] (.] (ŚŚāā, 5.48) , 5.48) The place of The place of ŚŚāāstrastra is too important where is too important where text text becomes becomes authorityauthority. For example, in . For example, in CSCS, , nnāānnāāryamryamāāśśrayetrayet [Do not take recourse to [Do not take recourse to ananāāryarya--ss (non(non--Aryans). Su, 8.19]Aryans). Su, 8.19]

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Moreover, it is also stressed that the Moreover, it is also stressed that the vibhuvibhu((āātmantman), being extremely subtle, cannot be ), being extremely subtle, cannot be perceived with (normal) eyes, but only by perceived with (normal) eyes, but only by means of (the sight acquired through) means of (the sight acquired through) spiritual knowledge (spiritual knowledge (jnjnāānana) and ) and penacepenace((tapastapas) ) –– SSāā, 5.50 [, 5.50 [MeulenbeldMeulenbeld, , History of Indian Medical History of Indian Medical

LiteratureLiterature, IA, 253, IA, 253]]It becomes evident that practical It becomes evident that practical anatomical knowledge of the body is anatomical knowledge of the body is interpellatedinterpellated by (i) by (i) ŚŚāāstrastra, and (ii) spiritual , and (ii) spiritual knowledge. To add, since 600 AD onwards knowledge. To add, since 600 AD onwards anatomical practices were in complete anatomical practices were in complete disuse.disuse.

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Transformation of the body in European Transformation of the body in European medicinemedicine

The fundamental change which European The fundamental change which European medicine saw was medicine saw was symptomssymptoms (perceived (perceived within a twowithin a two--dimensional body) to giving dimensional body) to giving way to way to signssigns (conceived within the volume (conceived within the volume of the threeof the three--dimensional body).dimensional body).Comparison between the following pictures Comparison between the following pictures only thirty years apart may help us to get at only thirty years apart may help us to get at the issue. The 1513 the issue. The 1513 SitusSitus figure is from figure is from PeyligkPeyligk’’ss CompendiosaCompendiosa capitiscapitis physiciphysiciDeclaratioDeclaratio, Leipzig., Leipzig.

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TwoTwo--dimensional body of 1513dimensional body of 1513FiveFive--lobed liver clutches at lobed liver clutches at the stomach as if with the stomach as if with fingers. Intestines are fingers. Intestines are intertwined in an elegant intertwined in an elegant knot. Traditional heartknot. Traditional heart--lung representation is so lung representation is so corrupt as to be virtually corrupt as to be virtually unidentifiable. Both are unidentifiable. Both are presented on a presented on a background of the background of the stomach. Importantly, the stomach. Importantly, the localization of organs localization of organs inside the body is twoinside the body is two--dimensional, all lying on dimensional, all lying on the same plane.the same plane.Courtesy: Courtesy: Leipzig: Leipzig: MelchiorMelchiorLotterLotter, 1499., 1499.

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Contd.Contd.

zodiac signs were also zodiac signs were also used for bodily organs. used for bodily organs. Johannes de Johannes de KethamKetham’’ssFasiculoFasiculo de de medicinamedicina(1493) is an example. The (1493) is an example. The crabcrab--shaped stomach lies shaped stomach lies just below throat. On the just below throat. On the left side in Latin, left side in Latin, ““The Crab The Crab is the sign of June; avoid is the sign of June; avoid treating the stomach, the treating the stomach, the spleen, the lungs or the spleen, the lungs or the eyes.eyes.””Courtesy: Courtesy: National Library National Library of Medicine, US of Medicine, US ––Historical Anatomies on Historical Anatomies on the Webthe Web..

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ThreeThree--dimensional body of 1543dimensional body of 1543

This picture is from Andreas This picture is from Andreas VesaliasVesalias’’ De De humanihumani corporiscorporisfabricafabrica librilibri septemseptem ((BasileaeBasileae[Basel]: Ex [Basel]: Ex officinaofficina JoannisJoannis OporiniOporini, ,

15431543), 268. Any one can ), 268. Any one can perceive the threeperceive the three--dimensional nature of the dimensional nature of the body frame. All the body frame. All the lymphatic vessels are laid lymphatic vessels are laid bare. bare. Courtesy: Courtesy: National National Library of Medicine, US Library of Medicine, US ––Historical Anatomies on the Historical Anatomies on the WebWeb..

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Bodily organs in Bodily organs in ĀĀyurvedayurvedaIn In SS SS ((SSāā, 5.11),, 5.11),––nakhanakha (nails) are the terminal offshoots of the (nails) are the terminal offshoots of the kandarkandarāā--ss(tendon) of the hands and feet. (tendon) of the hands and feet. MedhraMedhra (penis) is the (penis) is the offshoot of offshoot of kandarkandarāā--ss which bind which bind grivgrivāā (neck) and (neck) and hrhr dayadaya(not heart, its position is indeterminate) together and run (not heart, its position is indeterminate) together and run downwards. downwards. BhBhāāvaprakvaprakāāśśaa differs with differs with SS SS –– here here kandarkandarāā--ss are big are big snsnāāyuyu--ss (?ligaments). While in (?ligaments). While in SuSuśśrutaruta’’ss account account simantasimanta--ss (?suture) are 14 in number, in (?suture) are 14 in number, in AsAs tt āāńńgahrgahr dayadaya,,ArunadattaArunadatta and and BhojaBhoja they are 18 in number. These facts they are 18 in number. These facts point to the contradictory and differing modes of counting point to the contradictory and differing modes of counting organs.organs.To add, To add, ĀĀyurvedayurveda does not have any single conception of does not have any single conception of the body, but a dominant one.the body, but a dominant one.

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Contd.Contd.Problems arise in measurement of time, space Problems arise in measurement of time, space and quantities too. and quantities too. Bodily constituents are Bodily constituents are measurable in measurable in aańńjalisjalis. Quantities mentioned are: . Quantities mentioned are: ten ten aańńjalijali of watery fluid (of watery fluid (udakaudaka), nine of ), nine of rasarasa as a as a fluid resulting from the digestion of the food, eight fluid resulting from the digestion of the food, eight of blood etc. According to of blood etc. According to CarakaCaraka –– individual individual human height is 84 ahuman height is 84 ańńgulagula--ss, while in , while in SuSuśśrutaruta it is it is 120 120 aańńgulagula--ss..In In ŚŚāārrńńgadharagadhara--samsam hithitāā ––jjāāllāāntaragatentaragate bhanaubhanau yatyat ssūūksks amam drdr śśyateyate rajahrajah / / tasyatasya trimtrim śśattamoattamo bhbhāāgahgah paramparamāānn uhuh sasa ucyateucyate//// ((PPūū, 1.15) [When the rays of sun enter through , 1.15) [When the rays of sun enter through the window and the minute particles are observed the window and the minute particles are observed thereby, the thirtieth part of that very particle may thereby, the thirtieth part of that very particle may be called as an atom.]be called as an atom.]

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Contd.Contd.

In In CarakaCaraka--samsam hithitāā, time (or, , time (or, kkāālala) in relation ) in relation to diseaseto disease--production, is described as of two production, is described as of two types: types: nityaganityaga and and āāvasthikavasthika. . –– KKāālolo hi hi nityaganityagaśśccāāvasthikavasthikaśścaca; ; tatrtatrāāvasthikovasthikovikaramapeksvikaramapeks ateate, , nityagastunityagasturr tustusāātmytmyāāpekspeks ahah //// (Vi. 1.22.6)(Vi. 1.22.6) NityagaNityaga is is thought to be related with season and thought to be related with season and āāvasthikavasthika is related with disease. In is related with disease. In SSSS, , time is perceived as both an end to life and time is perceived as both an end to life and actions going on. Quanta of time are actions going on. Quanta of time are aksaks nimesnimes aa, , kaskas tt haha, , muhmuhūūrtarta etc.etc.

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Contd.Contd.In Indian practice, burial of the children below the In Indian practice, burial of the children below the age of two years is customary. So, the scope of age of two years is customary. So, the scope of studying the human body was possibly limited to studying the human body was possibly limited to observing the children below two years of age observing the children below two years of age (when all the bones not formed and the joints not (when all the bones not formed and the joints not fused properly) or the injured and wounded in fused properly) or the injured and wounded in wars. Taken together, these might have led to wars. Taken together, these might have led to false counting of number of bones and joints.false counting of number of bones and joints.Also, in Hindu custom there remains the practice Also, in Hindu custom there remains the practice of collecting bones after cremation and immersing of collecting bones after cremation and immersing the body into river. Hence, the body into river. Hence, osteologicalosteological knowledge knowledge is wellis well--founded but knowledge about the viscera founded but knowledge about the viscera below the diaphragm is ruefully deficient. below the diaphragm is ruefully deficient. Moreover, some vital organs like the brain and the Moreover, some vital organs like the brain and the heart are not explored and given attention at all.heart are not explored and given attention at all.

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Contd.Contd.In actual practice there was most likely no real In actual practice there was most likely no real largelarge--scale surgery. What was anatomically scale surgery. What was anatomically conceived was a bodyconceived was a body--frame (twoframe (two--dimensional), dimensional), not the real body, through which not the real body, through which dosdos aa--ss, , dhdhāātutu--ssand and malamala--ss flow. The standing puzzle of Indian flow. The standing puzzle of Indian anatomy is the classification of anatomy is the classification of śśirirāā--ss, , dhamanidhamani--ssand and srotasrota--ss and and ojaoja..Knowledge of Knowledge of marmanmarman--ss (lethal/vital points) (lethal/vital points) –– as as discussed before (discussed before (slide 13slide 13) ) –– served as regional served as regional anatomy that contributed to the phenomenal anatomy that contributed to the phenomenal excellence of Indian surgery despite their excellence of Indian surgery despite their knowledge of anatomy being none too accurate or knowledge of anatomy being none too accurate or profound.profound.

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Contd.Contd.In In SS, SS, ŚŚāā, 7.3, 7.3 –– saptasapta śśirairaśśatatāānini bhavantibhavanti; ; yyāābhiridambhiridam śśararīīramarramarāāmama ivaiva jalahjalahāārinrin īībhihbhih kedkedāārara ivaiva ca ca kulykulyāābhirupasnihyatehnugrbhirupasnihyatehnugr hyatehyateccāākukuńńcanaprascanaprasāāranran āādibhirbidibhirbiśśeses aihaih //drumapatrasevandrumapatrasevanīīnnāāmivamiva ttāāssāāmm pratpratāānnāāhh , , tastasāāmm nnāābhirmbhirmūūlamlam , , tatatataśścacaprasarantyurdhvarmastiryakprasarantyurdhvarmastiryak ca // ca // [There are 700 ducts. The body is irrigated by [There are 700 ducts. The body is irrigated by these, just like a garden by water channels, and a these, just like a garden by water channels, and a field by ditchesfield by ditches……their ramifications are like veins their ramifications are like veins on the leaf of a tree. Their root is the navel. From on the leaf of a tree. Their root is the navel. From there they spread out upwards, downwards and there they spread out upwards, downwards and horizontally.]horizontally.]

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Contd.Contd.DominikDominik Wujastyk notes, Wujastyk notes, ““SuSuśśrutasamrutasam hithitāādoes not use a concept of fluid circulation, does not use a concept of fluid circulation, but rather works with a centripetal fluid but rather works with a centripetal fluid distribution starting from the navel.distribution starting from the navel.”” [[““A Body Of A Body Of Knowledge: The Knowledge: The WellcomeWellcome AyurvedicAyurvedic Anatomical Man And His Sanskrit Anatomical Man And His Sanskrit ContextContext””, , Asian Medicine: Tradition and ModernityAsian Medicine: Tradition and Modernity 4(2008):2114(2008):211--248.248.] ]

In In ŚŚāārrńńgadharagadhara--samsam hithitāā (5.40(5.40--44) and 44) and SuSuśśrutaruta--samsam hithitāā ((ŚŚāā, 7.3) we note that all , 7.3) we note that all the the śśiraira--ss which are found in the human which are found in the human body are linked with body are linked with nnāābhibhi (to note, not the (to note, not the HarverianHarverian heartheart) and there from they are ) and there from they are spread all over the body.spread all over the body.

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Whatever was the actual practice, we must not Whatever was the actual practice, we must not read back these texts with our present state of read back these texts with our present state of contextcontext--specific, specific, ‘‘scientificscientific’’ notion of notion of HarverianHarverianphysiology or modern medical anatomy. physiology or modern medical anatomy. MeulenbeldMeulenbeld has discovered at least 8 different has discovered at least 8 different meanings of meanings of klomankloman, including the meaning of a , including the meaning of a small fleshy organ, the root of the channels small fleshy organ, the root of the channels carrying water. (carrying water. (The The MMāādhavaniddhavanidāānana, pp. 457, pp. 457--458458) )

What these terms originally meant to our What these terms originally meant to our ancestors is but a conjecture. Following colonial ancestors is but a conjecture. Following colonial epistemological encounters these terms were epistemological encounters these terms were metonymically reconstituted to suit to the metonymically reconstituted to suit to the hegemonic paradigm of modern anatomy. hegemonic paradigm of modern anatomy.

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In In ŚŚāārrńńgadharagadhara--samsam hithitāā ––nnāābhisthabhistha prprāānn apavanahapavanah sprisspris tt vvāāhrhr tkamaltkamalāāntaramntaram / / kantkant hhāādd vahirviniryvahirviniryāātiti ppāātumtum visvis nn upadupadāāmrmr tamtam //// (P(Pūū, 5.43, 5.43--44) 44) During nationalist revival, at least since 1885, During nationalist revival, at least since 1885, visvis nn upadupadāāmrmr tamtam was translated to be was translated to be oxygenoxygen. But . But in a different translation, in a different translation, ““The breath of life The breath of life located in the navel, touches the inside of the located in the navel, touches the inside of the lotus of the heart, and then exits from the throat lotus of the heart, and then exits from the throat to the outside to drink the nectar of the sky.to the outside to drink the nectar of the sky.””[[WujastykWujastyk, , The Roots of AyurvedaThe Roots of Ayurveda, Penguin Books, 1998, 325, Penguin Books, 1998, 325.].]Such was the trope of epistemological Such was the trope of epistemological reconstitution of terms and, consequently, reconstitution of terms and, consequently, knowledge to make it consistent with positivist knowledge to make it consistent with positivist colonial scientific logic and reasoning.colonial scientific logic and reasoning.

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This is the first This is the first illustration employing illustration employing ĀĀyurvedicyurvedic anatomical anatomical knowledge. With so knowledge. With so many scribal errors, all many scribal errors, all the terms used here are the terms used here are from from BhBhāāvaprakvaprakāāśśaa. . All the channels and All the channels and viscera lying twoviscera lying two--dimensionally on a dimensionally on a single plane. The single plane. The volume of the body volume of the body remains absent.remains absent.

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The previous picture is the illustration of the The previous picture is the illustration of the ĀĀyurvedicyurvedic ManMan (now famous through (now famous through DominikDominik Wujastyk). Wujastyk). Anatomical study of a man standing with Anatomical study of a man standing with Nepalese and Sanskrit texts showing the Nepalese and Sanskrit texts showing the AyurvedicAyurvedic understanding of the human understanding of the human anatomy. L0017592 anatomy. L0017592 CreditCredit:: WellcomeWellcomeLibrary, London Library, London Pen and watercolourPen and watercolour c. 18th c. 18th Century. Century. Iconographic CollectionsIconographic Collections Library Library reference no.: reference no.: Iconographic Collection Iconographic Collection 574912i.574912i. Courtesy: Courtesy: WellcomeWellcome Library, Library, London.] London.]

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PrePre-- and Postand Post--colonial Encounterscolonial Encounters

In In MeulenbeldMeulenbeld’’ss keen observations regarding keen observations regarding ĀĀyurvedayurveda ––(1) Statements that appeared to jeopardize the (1) Statements that appeared to jeopardize the tridostridos avavāādada caught the eye of the commentators caught the eye of the commentators and gave them much food for thought in their and gave them much food for thought in their effort to avert any danger to the prevailing theory. effort to avert any danger to the prevailing theory. The obvious meaning of some discordant The obvious meaning of some discordant utterances was twistedutterances was twisted until concurring with until concurring with the system.the system.(2) Passages which were ambiguous and (2) Passages which were ambiguous and susceptible to various interpretations were made susceptible to various interpretations were made to conform.to conform. [contd[contd..]]

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Contd.Contd.And, more importantly, (3) a conspicuous aspect And, more importantly, (3) a conspicuous aspect of the of the reasoningsreasonings met with is the tendency to met with is the tendency to avoid the acceptance of any bodily constituent as avoid the acceptance of any bodily constituent as a factor capable, independently of a factor capable, independently of dosdos aass, of , of initiating physiological and, more especially, of initiating physiological and, more especially, of pathogeneticpathogenetic process. (process. (Traditional South Asian MedicineTraditional South Asian Medicine

8(2008): 168(2008): 16--3131))

Following colonial encounter the Following colonial encounter the ĀĀyurvedicsyurvedics began began to indicate physiological phenomena to indicate physiological phenomena cartographically which was never present in cartographically which was never present in centuriescenturies--old old ĀĀyurvedicyurvedic practice.practice.

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The The ““modernmodern”” ĀĀyurvedicsyurvedics began to copy began to copy anatomical diagrams to be found in English anatomical diagrams to be found in English handbooks, replacing the English captions handbooks, replacing the English captions with Sanskrit names.with Sanskrit names.The revival of The revival of ĀĀyurvedayurveda thus led to the thus led to the construction of a unitary and coherent construction of a unitary and coherent model of Indian medicine, weaned from model of Indian medicine, weaned from inconsistencies and untenable concepts.inconsistencies and untenable concepts.The ancient terms for The ancient terms for pathopatho--physiological physiological processes etc. were diligently reprocesses etc. were diligently re--interpreted interpreted to bring them in line with terms derived to bring them in line with terms derived from Western medicine.from Western medicine.

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““ModernModern”” ĀĀyurvedicyurvedic pictures following pictures following colonial encounter in anatomycolonial encounter in anatomy

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Picture on left is from Picture on left is from ĀĀyurvedayurveda SamSam grahagraha, , revised by revised by KavirajKaviraj D. N D. N SenguptaSengupta and and KavirajKaviraj U. N U. N SenguptaSengupta (Calcutta: C. K. (Calcutta: C. K. SenSen, 1902, 18.)., 1902, 18.).Picture on right is from the same book, p. 88.Picture on right is from the same book, p. 88.In the first picture internal details of the brain, In the first picture internal details of the brain, which was a completely unexplored area in which was a completely unexplored area in classical classical ĀĀyurvedayurveda,, are illustrated. In the second are illustrated. In the second one authors dare to give accurate details of the one authors dare to give accurate details of the internal ear which is inconceivable in classical internal ear which is inconceivable in classical texts.texts.In In ĀĀyurvedayurveda, position and function of , position and function of hrhr dayadaya (not (not the postthe post--HarverianHarverian heart as discussed before) is heart as discussed before) is undefined, more so of the brain, and better not to undefined, more so of the brain, and better not to speak of the internal ear, inconceivable to the speak of the internal ear, inconceivable to the wildest guess of the ancient healers .wildest guess of the ancient healers .

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Concluding RemarksConcluding RemarksConstruction of medical hegemony occurred Construction of medical hegemony occurred through multiple processes through multiple processes –– very intricate, very intricate, intersecting and insidious ones. Some of intersecting and insidious ones. Some of these processes can be understood, more these processes can be understood, more are in need of better grasp.are in need of better grasp.PolysemousPolysemous, context, context--sensitive speculative sensitive speculative anatomoanatomo--pathopatho--physiologicalphysiological and and nosologicalnosological terms of terms of ĀĀyurvedayurveda were were metonymically reconstituted by metonymically reconstituted by circumscribed, contextcircumscribed, context--neutral and neutral and universalizeduniversalized scientific terms.scientific terms.

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Mnemonic verses for organ description were Mnemonic verses for organ description were replaced by anatomical atlases and replaced by anatomical atlases and practical dissection.practical dissection.

Organ localization of disease gave birth to Organ localization of disease gave birth to surgical excellence which, in the truest surgical excellence which, in the truest sense, resulted in marvelous sense, resulted in marvelous ““speedy speedy efficacyefficacy”” as avowed by as avowed by SuSuśśrutaruta (Slide 12).(Slide 12).

Consequently, prognosisConsequently, prognosis--dependent slow dependent slow ĀĀyurvedicyurvedic recovery turned out to be recovery turned out to be inefectualinefectual..

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Emergence of Emergence of secular social hierarchysecular social hierarchy in a in a positivist, utilitarian milieupositivist, utilitarian milieu generated (a) awe for generated (a) awe for new clocknew clock--timetime--based social system, (b) victory of based social system, (b) victory of scientific and technical education, and (c) a scientific and technical education, and (c) a perpetual sense of perpetual sense of ““lacklack”” with respect to the with respect to the ladder of civilization.ladder of civilization.

Reconstruction of timeReconstruction of time--space perception > space perception > individual patients (individual patients (casescases, not , not personperson per se) in per se) in hospital (not domestic) setting > production of hospital (not domestic) setting > production of clinical chartsclinical charts consistent with scientific temporal consistent with scientific temporal swings (not seasonal rhythms) occurring inside the swings (not seasonal rhythms) occurring inside the body > postmortem dissection to clinch body > postmortem dissection to clinch organ organ localizationlocalization of disease.of disease.

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On their behalf, On their behalf, ĀĀyurvedicsyurvedics were caught within a were caught within a twotwo--edged sword. On the one hand, edged sword. On the one hand, ĀĀyurvedayurveda was was concerned more with prognosis which could be concerned more with prognosis which could be efficiently resolved by efficiently resolved by tritri--dosdos aa theory without theory without having any knowledge of actual anatomy of having any knowledge of actual anatomy of internal organs.internal organs.Anatomical knowledge and surgery were Anatomical knowledge and surgery were relegated to the lower castes of society. High relegated to the lower castes of society. High caste caste ĀĀyurvedicyurvedic practitioners were content with practitioners were content with philosophy, theory and philosophy, theory and herboherbo--chemical knowledge chemical knowledge and practice of and practice of ĀĀyurvedayurveda..On the other, if On the other, if ĀĀyurvedayurveda were to be established were to be established as a valid and eternally as a valid and eternally ““modernmodern”” repository of repository of knowledge of the body, health and healing, knowledge of the body, health and healing, learning of modern anatomy became mandatory learning of modern anatomy became mandatory for the high caste for the high caste ĀĀyurvedicsyurvedics..

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Printing Printing technology technology rendered rendered manuscript manuscript culture of preculture of pre--colonial India colonial India marginal.marginal.

““MimicryMimicry”” and and ““hybridizhybridiz--ationation”” of of

modernmodern”” ĀĀyurvedayurveda..

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