Body, Illness and Medicine in Kolkata (Calcutta)
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Digesting Modernity: Body, Illness and Medicine in Kolkata (Calcutta) S t e f a n M . E c k s London School of Economics and Political Science University of London Ph.D. Thesis Social Anthropology 2003 UMI Number: U615839 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI U615839 Published by ProQuest LLC 2014. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 T H £ S F &! 62 Abstract This Ph.D. thesis presents an anthropological perspective on popular and professional concepts of the body in Kolkata (Calcutta), with special reference to ideas about the stomach/belly and the digestive system. By altering the routines and practices of daily life, changes brought about by modernization, globalization and urbanization are often associated with a decline of mental and physical well-being. In this context, the aim of this study is to juxtapose popular practices of self-care with professional views on illness and medicine. How do people in Kolkata perceive their bodies? How do they speak about health problems linked to digestion? What are the perceptions of health and illness among different medical professionals? How does this discourse reflect anxieties about the consequences of modernity in Kolkata? The data of this study are drawn from ethnographic fieldwork carried out between July 1999 and December 2000. Interviews and participant observation were conducted with a cross-section of the Bengali Hindu population in a local area in South-West Kolkata, and in selected other areas of the city. Data collection focused on metaphors around stomach/belly (Bengali:pet), and on popular practices of self- care in relation to bodily well-being. For research on professional medicine, interviews and participant observation were carried out with healers from thee different medical systems: allopathy (biomedicine), homeopathy, and Ayurveda. From each of these systems, fifteen to twenty healers were interviewed on how they perceive their patients, and how these perceptions influence their medical practice. 2 Table of Contents Illustrations 5 Acknowledgements 6 Introduction 8 I. The belly in social theory 13 1. "King Tongue" and the lack of self-control 13 2. Friedrich Nietzsche: Genealogy of Morals (1887) 17 3. Norbert Elias: The Civilizing Process (1939) 35 4. Michel Foucault: The "care of the self' ca( . 1976-1984) 5. Ethnographic perspectives 49 n. Research methodology 54 1. The initial research question 54 2. Research setting and sample 59 2.1. Community-based research 59 2.2. Health care settings 64 3. Study design 68 4. Data analysis 70 IQ. Popular perceptions of the belly 74 1. The belly in popular language and practice 74 1.1. Survey of the word fieldpet (belly) 74 1.2. The belly as container of (limited) goods 81 2. Popular epidemiology of digestive illnesses 85 2.1. Bengali terminology of digestive illnesses 85 2.2. Hot/cold classifications 88 2.3. Risk behaviour 98 2.4. Risk groups 109 2.4.1. Social groups 110 2.4.2. Gender 114 2.4.3. Age groups 117 3. Keeping the belly (and the mind) cool 122 IV. Allopathic gastroenterology 132 1. The gap between professional allopathic and popular perceptions 2. Doctors' perceptions of patients' "bowel-obsession'' 139 3. Doctors' reflections on patient aetiologies 145 4. Doctors on patients' perceptions of therapy 149 V. Homeopathy 160 1. An Indian system of medicine 160 2. ''Sour, sweet, salty, spicy?": Food dis/likes in diagnosis 166 3. The "vital force" 171 4. Immaterial ingestion 174 5. "No toothpaste allowed!": Antidotes to medicine 177 6. Disease in "the modem world of suppression" 179 1. How to deal with the modem (biomedicalized) patient 183 VI. Ayurveda 190 1. "No problem, it's just acidity": Akaviraj’ s illness narrative 190 2. The relation between Ayurveda and popular ideas 193 3. Ayurvedic views of digestion 195 4. Digestion according to Kolkatakaviraj 198 5. Pollution and corruption 205 6. Diagnosis and therapy 208 1. From hero to zero? 217 VH. Conclusion 223 Glossary with transliterations 236 Bibliography 241 Illustrations Plate 1: A modem view on human digestion (Poster, 60 x 42 cm) Plate 2: Environmental education message on Rabindra Setu (Howrah Bridge), Kolkata (Photograph, 1999) Plate 3: A wall with Tollywood film posters (Tollygunj, Kolkata) (Photograph, 2000) Plate 4: The theme of indigestion (bad hajam) in popular health journals (Title page ofShucikitsha , 1 November 1999) Plate 5: A packet of TK Das's Digestive Amla (15 x 10 cm) Plate 6: Environmental conflict in South-West Kolkata (Ghosh 2000) Plate 7: Advertisement for astrological and herbal therapy in central Kolkata (Photograph, 2000) Plate 8: Baidyanath Ayurvedic children's tonic (Newspaper advertisement) Plate 9: AUM, Ma Kali, Ramakrishna, Sharada Devi (Poster, 60 x 42 cm) Plate 10: Brilliant Tutorials for medical entrance exams (Newspaper advertisement) Plate 11: Britannia biscuits with Isabgol (Newspaper advertisement) Plate 12: "The clear choice," Fujinon endoscope (Business advertisement) Plate 13: An International Standards Organization (ISO)-certified homeopathic clinic (Newspaper advertisement) Plate 14: Dr. Sarkar's tonics for liver, head, and hair (Newspaper advertisement) Plate 15: Ramakrishna's realization of "different paths, one goal" according to the comic series Amar Chitra Katha (1982: 22) Plate 16: Ayurvedic capsules for weight gain (Newspaper advertisement) 5 Acknowledgements I would like to say a few words of thanks to all the people who, over the last years, gave me so much support. I am greatly indebted to my Ph.D. supervisors at LSE, Chris Fuller and Jonathan Parry. Without their unwavering support I would have never finished this thesis. William Sax made it possible for me to take up a teaching position in Heidelberg without having fully completed the dissertation, for which I am very grateful. The people whose knowledge and kindness made my time in Kolkata so enjoyable deserve my heartfelt thanks: Bonani Roy, Jokesh Francis, Jhunu, Suhasini Kejriwal and family, SK Mukheijee, Rajlakshmi Ghosh and family, PK Sarkar, Manju Sarkar and family, Tapati Guha-Thakurta, Debdas Baneijee, AK Biswas, Gautam Chakraborty, Shrimoy Roy Chodhury, Bhaskar Mukhopadhyay, and of course, Anirban and Rumila Das, Anup Dhar, and all the members of From the Margins. I would like to thank two colleagues and friends for keeping me connected to the London school of rationality: Henrike Donner and Indranil Chakrabarty. Special thanks go to Annu, Fran^oise, and Leo Jalais; and to Shanu and Damayanti "Dodo" Lahiri. The greatest thank must of course go to all my informants, whose time and patience made this study possible at all. I would like to thank those who gave me invaluable comments on parts of this work, from the first version of the proposal to the final draft: Partha Chatteijee, Lawrence Cohen, Georg Elwert, Christoph Emmrich, George M. Foster, Richard Fox, Robert Frank, Heather Hindman, Markus Hofiier, Martin Kunz, James Laidlaw, Mattison Mines, Mark Nichter, Stacey Pigg, Chris Pinney, Malabika Sarker, David van Sickle, Dominik Wujastyk, and Francis Zimmermann. Special thanks go to Mukulika Baneijee and Roger Jeffery for giving the thesis a very detailed and thorough reading. The lively debates with members of the LSE Department of Anthropology also left their mark on this work; for all the people that could be mentioned here, I would like to thank Peggy Froerer, Kriti Kapila, Lucia Michelutti, and once more, Annu Jalais. For being my affiliate supervisors at the Delhi School of Economics, I thank Andre Beteille and Abhijit Dasgupta. My colleagues at the South Asia Institute Heidelberg deserve heartfelt thanks for accepting me in their scholarly community, and for giving me much encouragement during the last phase of the dissertation. 6 Last but not least, I would like to thank the two organizations that funded my research: The Economic and Social Science Research Council (ESRC), and the Studienstiftung des deutschen Volkes. The Studienstiftung deserves special thanks for supporting me not only during my doctoral studies, but also during the undergraduate years that led me there. The debt to my parents is too great to be put into words. This work is dedicated to them. 7 Introduction In his famous preface toThe Protestant Ethic , Max Weber (1988 [1920]: 1) maintains that one can only study "universal history" if one tries to explain the uniqueness of "occidental culture." Only occidental culture developed a stance towards the world that was both culturally uniqueand able to transcend all cultural boundaries. Weber seeks to show how values of rational conduct, hard work, and this-worldly asceticism were, at first, specifically Protestant, but went on to become universal standards of behaving. For Weber, "modernity" is the phase of history when the Protestant ethic has shed its religious implications and has become the required way of relating to the world. The capitalist mode of production, the professionalization of work, the rising power of state bureaucracies, urbanization, the individualization of the person - all these processes first emerged in the West, but went on to become the criteria of "modernity" the world over. As Chris Fuller (2002: 14) notes, not even recent writings about "multiple," "alternative," or "Other" modernities could fully dispel all ethnocentric misconceptions about "modernity" and its alleged opposites ("tradition," "pre- modernity," and so on). Neither could these writings resolve the paradox of how modernity can be both culture-specificand culture-transcendent.