Smallpox has a long history in India. Science and philosophy were both highly developed discipline in ancient India. It is therefore highly expected to have an Indian Medical response to the disease. To its rescue, Hindu scriptures do mentions the disease along with its inoculation treatment and even has a goddess devoted exclusively to the cause. The paper will focus on differentiating the popular as well as formal culture amongst the Indians and try to find out the linkages between the two. Intelligentsias of today’s world are often skeptical about the personification of the disease and its worship to have something to do with relating it to the supernatural power driving the universe as the ancient people did to natural activities such as rain, thunder when they had no reasoning to answer it. But it’s possible that these practices were the code of conduct issued by the academic class to handle the giant epidemic and communicate the measures effectively to the general public in a way they are more familiar and bound to. The article will also try to find if any rationale practices of treating smallpox have changed overtime into superstitious belief in contemporary India. It will try to dwell the fact of coexistence of medical treatment as well as religious practices.
Religion holds a place of paramount importance when it comes to viewing pattern of life of the people in different parts of India. Smallpox is usually identified with the goddess Sitala (literally, ‘the cool one’), or mata (mother) in northern India. A similar framework is seen in the worship of Tamil deity Mariamman (and also amma). Anjum Katyal [13], an editor in Bengal argues the Sitala worship to be pre-Aryan, done by the tribes of Bengal, Assam, Bihar and Orissa. It was latter on Brahminised or gentrified. Rulers and religious leaders of early India often used to take the help of local tradition to spread the religious message. One such context can be seen in Sitala Sastri Yatra that happens in Sambalpur, Orissa. It is a folk drama indicating the cultural elements of tradition. The popularity of this folk drama has attracted people from diverse areas of Orissa and neighbouring state of Chhattisgarh. Having seen the popular culture prevalent even today in Indians, let’s explore the formal societies of ancient India.
Caraka-samhita [1] is an early text on Ayurveda (Indian traditional medicine), which existed even before the Christian era, but were put to writings only in the 4th century AD. Smallpox was described under the name of masurika (roots from a type of pulse masur, which happens to look like the pustules eruptions due to the similarity in color, shape and consistency) in the text. Arab Physician Al Razi [8] refers Caraka as the authority for statement in Plants and drugs and described the way Indians prepared syrups of pearls in a different manner that is known to only them; and claimed that if nine pustules have come out and one drinks this syrup, tenth will not appear. Alongside the same timeline, another text Susruta-samhita [2] provides more elaborate description in his Bhishagratna. Later in seventh century, the physician Vagbhata [4] provides significant description of masurika in his Astangahrdaya-samhita. This was the first attempt in Indian medicine, were Smallpox was shown to be fatal. In eight century, Madhava-kara [5] composed a more extensive chapter in masurika in his book Nidana. Along with describing the numerous types of pustular eruptions, he also provided the humoral and dietary explanation of its various forms.
An anthropologist, Nicholas [11] argued that nature of Madhava treatment was exclusively biological, until late fifteen or early sixteenth century, when parisista (appendix) on ‘The Pathology of Sitala’ was introduced to his text. Unlike the existing text, this part pictured Goddess Sitala as the cause of disease. Following this in the very same century, Bhava Misra compiled a medical text Bhava-prakasa by repeating everything from the Madhava’s text including the parisista and further included both recommendation on medical treatment and worship of the goddess Sitala. Otherwise, there is no such account of worship in the Atharva-veda [3], or any other ancient texts. Thus, the sixteenth century India saw two very different interpretation of smallpox: one based on Ayurveda and other on Sitala worship. One can relate this to the Thucydides account [7], where he mentions that Plague was no longer thought to be regarded as the something given by God as misfortune leading to the end of traditional religious belief, but some survivor of the plague started healing cult of Asclepius, the son of Apollo, who became the embodiment of the conventional religious sensitivities. Skandapurana [6], a text written in 18th and 19th century mentions her to be born out of the mind of Brahma and that he asked Shiva and Vishnu to worship her, granting her the power of visiting sickness. It also mentions about her attendant, specially her son Jwarasur (the fever demon). To add more credibility to the sacredness of the performance of Sitala worship, Nityananda wrote Sitalamangala text. Adding to the same, various performing troupe, like that of New Loknath Opera, led to the wide spread nature of the Sitala worship.
The onset of Smallpox is considered to be the manifestation of the goddess as if it were her khel (play), and so it should be tolerated with respect and honour. It is said that the patient becomes the abode of Sitala. The patient and the goddess are fed basora (cooling food) such as cold rice, plantains, and yoghurt. Cooling drinks are officered to the patient and heating foods are banned, sexual activity is minimized and all other heating activities are abstained from. The patient’s body is rubbed with neem patta (leaf of a cooling neem tree) by a mali (gardener). If the disease progressed, a cooling mixture of turmeric and flour is applied. Finally, when the boils of smallpox ripen, a small thorn is used to prick them and give relief to the patient. When the fever subsided, prayers are offered to the Sitala along with cooling offering of coconut, rice,and flowers. Thus, smallpox was treated as a case of being possessed by Sitala. The best physician could do was to prescribe cooling drafts, use purgatives to relieve the body of its poisons, and to prescribe items that could prolong the pittam (bilious humour, generates the heat which is responsible for metabolism) imbalance in the body. The rest was under the control of Sitala.
The one other practice was that a special vaidya (medical practitioner) or tikadars (innoculator) could use was varolation, which was latter largely taken over by vaccination. Arnold [14] argues how the practice was locally understood as a way of invoking the protective power of Sitala’s right over the patient’s body, instead of violating it. This allowed the practice to be viewed as a celebration of the Goddess compared to violation. Holwell [8], a British EIC physician mentions the prevalence of inoculation technique (Intentionally mildly infecting a person with no pox history in order to achieve immunity) in Bengal during the eighteen century India, even before the introduction of Jenner Vaccine (1798) came in. This was popularly known as tika (derived form of vatika, which means a small globule). There was no such use of inoculation in the western world before the tenth century. It is now used to refer vaccination. It was based on the theory of bija (seed) mixed with the blood of a person, which was not present in the Ayurvedic explanation of the disease. An Indian historian, Dharampal [9] found that the inoculation was to be prevalent in Bengal in the mid eighteenth century. It was pointed out that the inoculators were the low class of both Hindu and Muslim people such as small cultivators, garland maker, barbers, low ranking astrologer Brahmans and not as esteemed as physicians. It was later found that a text called Vasanta-tika (smallpox inoculation) existed amongst the Napit (barbers).
One can’t deny the fact of coexistence of the both the Medical practices of inoculation as well as its view in term of Sitala worship. There is a sharp bonding between the two. The Hindu scriptures also seemed to support the same eventually. Probably, this was the way the elite academic class used to propagate the idea of handling the disease amongst the people. It seemed to be coded version of rational practices. The propagation of the idea in terms of storytelling definitely has a much wider impact to the society and spreads with a faster pace. Some of the contemporary practices might look like superstition but beholding the rationality behind some of the practices shows that it’s not just blind faith but has some essence of science and philosophy embedded in it.
References
[1] Loon, Gabriel Von, “Caraka-samhita” 2 vols, P V Sharma and Chaukhamba Orientalia Publishers, 2002-03
[2] Bhishagratna, Kunja Lal, “An English translation of Susruta-samhita” 3 vols, Calcutta, 1911
[3] Whitney, William Dwight, “Atharva-veda samhita”, Harvard Univ, 1905
[4] Hilgenberg, Luise, and Willibald Kirfel, “Vagbhata’s Astangahrdaya-samhita”, Leiden: E J Brill, 1941
[5] Madhavakara, “Madhava-nidanam”, Edited by Yadava-sarmana, Bombay: Nirnaya-sagara Press, 1920
[6] “Skanda Mahapuarana”, Bombay: Venkatesvara Sream Press, 1908-09
[7] Thucydides et al, “History of the Peloponnesian War”, 1954
[8] Holwell, J Z, “Accounts of the Manner of Inoculation in East Indies”, London, 1767
[9] Dharampal, “Indian Science And Technology In The Eighteenth Century”, Delhi: Impex India, 1971
[10] Greenhill, William Alexander, “A Treatise on Smallpox and Measles by Abu Bakr Muhammad ibn Zakariya al-Razi (Rhazes)”, London: The Sydenham Soceity, 1847
[11] Nicholas, Ralph, “The Goddess Sitala and Epidemic Smallpox in Bengal”, The Journal of Asian Studies, 1981
[12] Holwell, J Z, “An account of the manner of inoculating for the smallpox in the East Indies”, London College, 1767
[13] Katyal, Anjum, “Performing the Goddess: Sacred ritual into Professional Performance”, The MIT Press, 1988
[14] Arnold, D, “Colonizing the body”, UC Press, CA, 1993
