The
Nature of Indigenous Knowledge and its social
relevance, a personal journey:
As
an urbanite, I had studied the natural sciences in school, college and
university. However, these were all of Western origin: I was not
exposed to any other form of knowledge. I did not know that other
useful knowledge systems –– indigenous ones –– existed in an organised
form in our society or that they were still functional and used
regularly by a vast number of people.
Insights
into Tribal Medicine:
Later,
while working as a social activist, I lived in the Karjat tribal block
for 12 years. There, for the first time, I encountered medicinal plants
and forests. I could not fail to notice, often with amazement, that the
local Thakur, Mahadev Koli, and the Katkari tribals
used many local plants and animals for health care. The methods of
treatment I saw first-hand were incredible and impressed me deeply.
Lactating mothers used Ipomoea mauritania (vidari kand) to
enhance breast milk. The leaf of the common plant Calotropis
gigantea (arka patra) was used to reduce a testicle swollen to
twice its size (presumably hydrocele): the treatment worked in four
days! The latex of the same plant applied on the skin could draw out a
thorn from deep within. The fruits of
Terminalia bellirica (bibhitaka) were used to treat dry cough. The
roots and bark of Holarrhena pubescens (kutaja) could cure
dysentery. Helicteres isora (muradasinge in Marathi)
could stop diarrhoea. The ‘touch-me-not’ plant (Mimosa pudica
or lajjavanti) was used to stop uterine bleeding, and the juice
of durva grass (Cynodon dactylon) could dissolve gall
bladder stones.
I
discovered that the tribals of this area knew the uses of over 400
plants, animals, birds and reptiles. The people who had access to and
used this kind of knowledge were ordinary householders as well as more
specialised village healers. Often, households knew of home remedies
for managing more than 30 common health conditions. Every village had a
birth attendant (called sueen) and at least one other socially
recognised healer whom the villagers called vaidu (healer).
There were vaidus who specialised in treating snakebites,
others specialised in treating broken bones, and there were those who
treated veterinary problems. None of the vaidus depended on
healing for their livelihood. They had other occupations and healing
was only a social service.
Once, when
a colleague of mine was suffering from a severe bout of jaundice, I
consulted a vaidu. He promised to get me a remedy the next day.
In fact he did not show up for two days. He then cheerfully explained
that he had to go deep into the neighbouring forests to locate the
herbs he needed. He had spent two whole days looking for the plant,
which was used by my colleague with dramatic results. The healer,
however, did not ask to be compensated for the trouble he had taken. It
was left to us to express our satisfaction in whatever way we could
afford. In the tribal culture, no patient expects ‘free service’ and
they show their gratitude by giving the healer some grain, a hen, or a
bottle of the local brew; but all this is not demanded as a
precondition for the service.
Limitations
of Western Science in Validation:
I asked
university-based phytochemists and pharmacologists their opinion of
these practices and if they could scientifically verify these remedies.
They had no clinical data on the applications of these materials. In
few cases, the chemistry of a plant was known and the biological
activity of an active compound had been studied on rabbits or mice.
This information was not sufficient to validate tribal practices. The
tribals did not just use active compounds –– they used flowers, fruits,
bark, root, latex and gum, either in combination or in their entirety.
Chemists and pharmacologists unfortunately did not know anything of the
biological activity of the entire plant, only of certain chemicals
derived from it. The scientists I approached worked in reputed
institutions. However, they could not help. They needed huge funds and
several years of research to carry out systematic studies. Hence in my
pursuit of validation for local health practices, I was led to the
traditional physicians of Ayurveda (the word itself means ‘Science of
Life’).
The
capacity of Indigenous Medical Science:
The
Ayurvedic physicians I met impressed me. They knew the materials the
tribals had used and had books on indigenous pharmacology (Dravya
Guna Sastra) in which the materials had been studied using 10 to 15
different parameters. They could therefore confirm the validity of
tribal treatments. At times, they could suggest modifications to the
local practice, or even substitute plants in cases where the original
plant was not available. These doctors knew the systemic effect of
plants, their metabolic effects at different stages of ingestion, and
their action on body tissues, organs, etc. They also knew the side
effects and contraindications as well as how to cancel them by adding
other natural substances to balance, synergise or improve their
assimilation.
“Prayogahsamayethvyaadhim
yo-anya-manyam udeerayeth
Na asau
visudha sudhasthu
Samayeth yo na kopayeth”
(Ref:
Ashtanga Sangraham
sutrasthanam chap 21:29th verse).
Proper
treatment is that which pacifies the disease without any untoward
effect. On the contrary if a treatment that besides curing the existing
disease, gives rise to a new one, then it is termed as improper
treatment.
I was
surprised by the depth of their knowledge, which included processes
required to convert plants into various dosage forms and
strengths.
I was
deeply impressed by the attitude and conduct of an eminent Ayurvedic
physician from Pune. He was publicly felicitated for curing a case of
leukaemia: the patient, who had been given a few weeks to live, had
survived without remission for five years and was still healthy. While
speaking at the felicitation, the physician declared:
Ayurveda
does not have a term equivalent to ‘cancer’ and there is no mention of
a condition called leukaemia. I did not bother to study the case sheets
and the diagnosis from the cancer hospital that my patient presented to
me for scrutiny because I have not studied biochemistry and therefore
do not understand the subject. I examined the patient afresh and
diagnosed his condition using Ayurvedic principles. The patient’s
status had to be classified under a provisional diagnosis that was not
described in the diagnostic literature of Ayurveda (Ayurvedic
science does enable physicians to make provisional diagnoses of new
health conditions that have not been previously described). I then
designed a treatment to suit my diagnosis. The patient was thus cured.
He
added:
I do not,
however, claim to be able to cure cancer. But I do claim that I have
the capacity and willingness to look at any new health condition for,
with the help of Ayurvedic science, a physician may be able to diagnose
and treat, and perhaps even cure the disease.
This
statement gave me an insight into the dynamic nature of Ayurvedic
science.
Indigenous
pharmacy and Clinical skills of traditional physicians:
In
the context of
pharmaceuticals, I observed that
although the manufacturing technology behind indigenous medicine was
pre-industrial, the logic behind dosage forms like wines, bhasmas
(baked powders) and oils was sophisticated. The number of traditional methods of processing was far more
than those available in other medical system. I appreciated the range
of the diagnostic acumen of traditional healers –– their reading of the
pulse, for instance, appeared incredibly sophisticated. Their acute
clinical observations, even for a simple condition like a cough, were
impressive: according to them, a dry cough was a wind disorder, a cough
with heavy congestion and expectoration was due to an imbalance of
water and earth, and a cough with inflammation and sore throat and mild
congestion was due to an imbalance of agni or fire. These are
all expressions of a scheme of ‘systemic’ diagnosis. In this scheme it
is not important to identify a causative agent like a virus or
bacteria, which may in fact be present, but to read from the symptoms
the specific nature of systemic imbalance that has taken place and to
choose for treatment natural products that will restore the balance.
Scientists may subsequently discover that this scheme of treatment
might also inhibit the growth of bacteria and virus in unexpected ways.
The
social characteristics of Folk Medicine:
As an
Indian citizen, my exposure to the rich culture and knowledge of my own
people both inspired as well as angered me. I felt inspired by the
decentralised nature of folk health knowledge. Rural India already
appeared to have the futuristic ideal of ‘health in your own hands’
that social thinkers dream of. Every village household had the
knowledge of dozens of common ailments and also of preventive and
promotive health care aimed at introducing practices that result in
total health rather than only in fighting individual illnesses. Along
with this, every village has its own folk healers who have the
appropriate skills to manage most primary health problems.
It is
extremely important to note that folk traditions are not only rooted in
the community, they are also supported by the community. The size of
the folk tradition in any locality, and thus all over India, is so
large that it is only the whole community that has the capacity to
sustain the tradition. In the 1980s the Health Ministry made the
mistake of declaring that they would pay Traditional Birth Attendants
(TBAs) for every delivery conducted. It soon found out that state
governments could not afford to pay thousands of TBAs. Nor was it easy
for them to monitor such a process. So today, the estimated 600,
000-plus TBAs of India continue to be paid by their own
communities.
As we
know, community-based, oral health traditions are embedded in the
lifestyle, diet and health practices of thousands of local communities
all over India.
“Ucito yasya yo desa
tajjam tasyausadhamhitam
Desenyatrapi vasato
tattulya guna karma ca”
(AS, Su, 23/34)
The
drugs which is grown
in the in the same region in which a person resides is ideal for that
person. Those drugs that possess properties similar to the drugs of
native land are good for a person even though living elsewhere.
Like music
and agriculture, health care also flourishes
as a folk tradition. It is estimated that there are around 1.4 million
folk healers as well as millions of rural (and to a much lesser extent,
urban) households who possess immense knowledge of home remedies. They
are also well informed about local foods, their availability and
nutritional value. The health traditions of all these healers are based
on local resources. According to an All India Ethno-biological Survey
carried out by the Ministry of Environment and Forests, Government of
India, over the period 1985-1995, around 8,000 species of wild plants
were listed as being used in health care by rural and tribal
communities. These account for almost 50 per cent of the known
flowering plants of India (17,5000 species). Apart from plants, local
animals, metals and minerals are also used.
The most
fascinating features of local health traditions are their wireless
(non-institutional) transmission and the fact that they are
self-sustaining. They exist in millions of homes and thousands of
villages, town and cities, without the aid of any institution or
external source of funding. They are transmitted through family or
community traditions via a person-to-person process. Folk gurus
(teachers) guide their sisyas (students) in cultural and
ethical codes, which evolve, adapt and alter in time. They
embody the knowledge of the human mind, physiology and anatomy as well
as of food and nutrition. This knowledge extends even to the
pharmacological properties of plants, animals, metal and minerals.
Though community health practitioners have no legal status, they enjoy
much social legitimacy in their localities.
It must
be noted that folk healers do not generally
undertake medical service as a full-time vocation, nor are they
dependent on their health services for a livelihood. The typical healer
may be a farmer, a barber, a shopkeeper, a blacksmith or even a
wandering monk. And while the medical services they provide are not
free of charge, they are offered in an ethical and non-commercial
spirit. So though the community (patient) pays the healer for his/her
services following local cultural norms, the income earned is usually
incidental and supplementary. This low sustenance cost is one reason
why the tradition is so large, widespread and decentralised, and has
over million foot-soldiers. If folk healers were to depend on such
earnings for their livelihood, their numbers would have been much
smaller, as not every village can sustain the livelihood needs of
full-time healers.
The
Sophistication of the codified traditions:
The
composition of the
Codified Stream:
This
consists of medical
knowledge systems like Ayurveda, Siddha, Tibetan &
Unani. The content of the ayurvedic knowledge systems for
instance covers eight broad areas: Kaaya chikitsa
(general medicine), Bala chikitsa (paediatrics), Gruha
chikitsa (psychiatry), Oordhwanga chikitsa (ENT & Eye),
Salya chikitsa (surgery), Damshtra chikitsa
(toxicology), Jara chikitsa (rejuvenation) and Vajeekarana
chikitsa (virilification). The codified stream has sophisticated
theoretical foundations. It has special understanding of physiology;
pathogenesis; pharmacology and pharmaceuticals, which is different from
western biomedicine.
The
size & carriers:
There
are currently 6,50,000
licensed
practitioners of these systems that are recognized and registered by
the state governments under the Indian Medicine practitioners Act.
Ocean
of Knowledge:
There
is an ocean of
knowledge in the codified stream. The extent of knowledge is reflected
in the large number of medical manuscripts, and the range of subjects
they cover. The classical medical knowledge has been
generated by physicians, scholars and seers. The codified stream has
also drawn upon the empirical knowledge of the folk stream. Apart from
the knowledge of pharmacy and drugs, there is an extensive knowledge of
diagnostic methods, therapeutic techniques, surgery, specialized lines
of treatment, physiological concepts, understanding of the body-mind
relationship etc. There are an estimated 25,000 herbal
formulations in the traditional formularies of Ayurveda alone.
This figure of 25,000 seems astounding when we take note of the fact
that the total repository of modern drugs in the world today is of the
order of 4,000 formulations.
The
indigenous scientific
method (way of knowing of Ayurveda):
To gain
an understanding of the sophisticated knowledge system underlying the
indigenous health systems, such as Ayurveda, it is necessary to
be familiar with its epistemological traditions. The Ayurvedic
worldview is based on the Sankhya school in which the manifest world
(vyakt) emerges from the unmanifest world (avyakt). One flows
into the other. Observer and observed are one, just as subject
and object are one. The way to understand nature is, therefore, to
become one with it. This is achieved by the five senses and the
mind. Sight, hearing, touch, taste and smell make it possible to
decipher the world around while the mind moves both inwards and
outwards. A mind free of prejudice is both perfectly objective and
subjective. This is perfect oneness with nature and is termed as the
mental state of Brahma from which Ayurvedic Shastra was pro-pounded.
“Dvividhameva khalusarvam
sat ca asat ca.
Tasya Caturvidhaa pariksa
– Aptopadesa,
pratyaksa, anumana,
yuktisceti” (CS, Su, 11/17).
All
can be divided into
two – existent and nonexistent. Their examination is four fold –
authoritative statement, direct perception, inference and logical
reasoning.
In the
western tradition, the scientific temper is limited to the use of
analytical disciplines. But in Ayurveda it means freeing the mind of
the six prejudices of kam (lust), krodh (anger), lobh (greed),
madh (intoxication), moh (delusion) and matsar (jealousy). The
western tradition restricts itself to the concepts of matter,
time and space. But Ayurveda is based on the recognition of
fundamental padarthas or existential principles such as dravya
(existential principles of 9 types), guna (qualities of 41 types),
karma (action of 5 types), samanya (generality), vishesha
(distinctiveness) and samvya (inseparability).
Dravya
encompasses nine categories of being from atma (soul) to prithvi
(earth), which means it covers a range from subtle to gross, from
consciousness to solid earth. They are simultaneously different
and linked, one devolving into the other. Consciousness devolves into
the mind, because the mind's qualities like innumerability (sankhya),
magnitude (parimana), uniqueness (prthaktva), conjunction (samyoga),
disjunction (vibhaga), nearness (paratva), remoteness (aparatva),
impression (samskara) causal relations (yukti) and repetitive
expression (abhyasa), create the notions of time and space or the
mental plane. The mind further devolves into the five states of matter:
akasha (space like), vayu (wind like), agni (fire like), ap (water
like) and prithvi (solid earth like).
“Samanyam ca
visesam ca gunan dravyani
Karma ca
samavayam ca tatjnatva tantroktam
vidhimasthitah”
(CS, Su, 1/28).
Generality,
specificity, inherent qualities, existential principles and effects are
essential to know both separately and in totality in order to
understand a phenomenon in a logical and systematic way.
An
understanding of the world is not limited to the five senses, which
only convey reality in its grossest manifestation. Complete
awareness only comes from a level of perception at which the observer
both reaches out and looks within, thereby establishing a subjective
flow, which connects the observer and the observed.
The
western tradition in theoretical sciences is founded in the logic of
Aristotle and the deductive and axiomatic method of theory construction
as evidenced in Euclid's elements, which have been further refined in
the course of work in logic and mathematics during the last hundred
years. The Ayurvedic Shastras (sciences), by contrast, are based on the
Indian school of logic called the Nyaya-Vaisesika Darsanas.
Western logic deals with a study of 'propositions', especially their
'logical form' as abstracted from their 'content' or 'matter'. It deals
with 'general conditions of valid inference'. Whereas one of the
main characteristics of the Indian 'formal' logic is that it
refuses to totally detach form from content. It takes great care to
exclude terms that have no referential content, from logical
discourse.
The
difficulty in making arbitrary comparisons between Indian and Western
epistemologies can be illustrated when one attempts to compare their
internal parameters. For example, there is no conceptual correlation
available between the three basic physiologic parameters of
Ayurveda: kaph, vat and pith and western physiologic parameters
like hormones, blood pressure, lipid levels and blood. Quantitative
parameters in Ayurveda are also not given the same importance as they
are in western traditions. Although measurement and quantification are
used, they differ in form from western systems of knowledge. Most
measurements in the traditional medical science are made using units
'normalised' to an individual. That is, while assessing a person's
height or the length of his or her limbs, the measurement is expressed
in units of anguli, the dimension of a finger of the individual
concerned rather than in an arbitrary standard external to the
individual, such as the international meter. Such normalized units
exist not only for measurement of length but also for volume and time.
Qualitative parameters and natural language have been given far more
importance and support the rigour and accuracy of Indian tradition.
Efficacy
of Indian Medical
Systems:
The
fact that both the folk
and codified health culture, have “living” health traditions and
practices, used by millions of people & implemented by thousands of
physicians and the fact that the Indian Medical Heritage has an
unbroken and evolving tradition which is more than two millennia old,
is irrefutable evidence of its basic classical efficacy.
In
the recent years there is
limited western science supported data generated by very limited
research investments in the form of a few hundred “scientific” studies,
which have evaluated traditional health practices on the parameters of
western biomedicine. Such studies have been conducted in India &
abroad mainly on drugs but also on traditional diets & diagnostic
and surgical procedures. It is important to understand the reason for
this limited data. The limited scientific data is the output of
sub-critical financial and human investments in collaborative research.
If more substantial data were needed then much larger investments
should have been made. The responsibility for mobilizing funds for such
collaborative research rests with the western scientific community and
policy makers.
How
was the ocean of
knowledge generated?
It is
important to ask this question and “learn” from the answer. Traditional
medical knowledge both in the folk and codified stream was not
generated by western knowledge systems.
They
have had their own
theoretical foundations, worldview, methods, logic, principles,
concepts and categories. This indigenous knowledge system was active
and functional till the beginning of the 20th century. This is
borne out by the Ayurvedic studies recorded in Nighantus on
properties of exotic plants like tea, coffee, green chillies, tomato,
potato, pineapple etc. that entered Indian soil from foreign countries
only during the last 200 years or so. It is the “suicidal” attitude of
Indian elite and policy makers that ignores and in fact discourages
“serious research” on the theoretical foundations of indigenous
medicine. Ironically serious researches on theoretical foundations of
Indian medicine are under way in western universities.
Summing
Up:
Non-western
knowledge systems
have so far failed to establish their right to endogenous development.
Their epistemology, or ‘the method of knowing’, lies unexplored outside
of their traditional worlds. Their universal attributes lie
unrecognised. It may be alarming to learn that they are, in fact, being
rapidly eroded and face destruction due to the political and economic
effects of a globalisation process that has thus far been promoting a
monoculture. This destructive process began with colonisation and
continues today.
All
cultures have a potential stake in supporting the revitalisation of the
world’s many indigenous cultures because world civilisation as a whole
stands to gain from a state of ‘flourishing’ cultural diversity. It is
necessary to appreciate the historical fact that various knowledge
systems have had their genesis and basic evolution in specific cultural
spaces in time. Modern science, as we know it today is, in this
context, definitely, a product of European culture, with its Greek
antecedents. Science, despite its universal attributes, which are also
a feature of non-western knowledge systems, is a cultural product.
Science, therefore, cannot be viewed, except from a Eurocentric
viewpoint, as the only universal way of studying and knowing
nature.
In the
medical field, particularly in the countries of Asia, Africa and Latin
America there are living medical knowledge systems that are indigenous
and have been evolving in these societies for generations. These
medical cultures have epistemological foundations that are very
different from western biomedicine. There is an urgent social reason
for promoting these indigenous cultures because, in the context of
public health, the ‘modern’ health system, based on western
biomedicine, is unable to solve all the health needs of the people. In
the Indian context even the outreach of the modern medicine health
system is limited and it is only able to offer primary health care
services to about 30% of the rural population. Revitalisation of
indigenous health cultures based on locally available biological
resources and local knowledge has the potential to both improve the
quality of the healthcare as well as provide health security to
millions.
The concern
for revitalisation
of indigenous cultures and their ways of knowing must, not be viewed as
a concern for reviving the past. It should rather be seen as a serous
attempt to broaden and deepen the scope, quality and content of modern
civilisation. Unfortunately, this process has, over the last two
centuries, become wedged in a narrow monocultural track and resulted in
worldwide cultural uniformity. This cultural uniformity is extremely
dangerous for the survival and evolution of civilisations. Uniformity
narrows down the alternatives and options available to the peoples of
the world and their capacity to cope with the present and the future.
It should encourage the understanding that just as
bio-diversity is critical for biological evolution, a flourishing
cultural diversity holds the key for civilizational evolution.
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