MEDICAL SYSTEMS:

Many people would argue that medical systems from India are repositories of tradition, a deep and spiritual understanding of the human system, and ancient lineages which are unbroken and carefully preserved. In contrast, Western biomedicine is rational, modern, scientific, and evidence-based. The issue of description and definition of these systems is in many ways tantamount to the context of their relationship and the power dynamic inherent in the very way each has been constructed in contrast to the other. In other words, medical systems are not monolithic entities, but rather a shifting and somewhat amorphous amalgamation of multiple alliances.

In addition, a medical system, like any other living system, is subject to all of the processes of growth, change, and even decay. Some components within medical systems include the physicians, patients, knowledge via written and oral tradition, centers for treatment, and the treatments and medicines themselves. More importantly, the relationships between these various aspects of the system function within certain limits and have multiple qualities and possibilities for exchange.

Though it is often practiced side-by-side with Western biomedicine, the epistemological and ontological foundations of Siddha medicine are vastly different than those of Western biomedicine. Historically speaking, the contemporary interaction between Siddha medicine and biomedicine can be treated as a specific outcome of various trajectories. These include the history of colonial and imperial domination, anthropological research, pharmaceutical corporate interests, and many other dynamic forces that have created the system as it exists today.

The influence of biomedicine is perhaps the most pervasive and certainly the earliest in the history of Siddha medicine. Empiricism, science and the power to know for oneself are key in understanding many 20th century discourses. Science and empiricism are often classified as the dominant “gazes” within the West. These ways of knowing depend on reason and locate truth in that which can be measured. Further, one of the most important concerns of both the Siddha medical system as well as the biomedical system is to define itself articulately in contradistinction with other systems.

Though it is beyond the scope of this paper to examine Siddha medicine or Western biomedicine in-depth, we can briefly classify some of the key components of each. The biomedical, or “technocratic” model of medicine is defined by the following features:
1. mind/body separation
2. the body as machine
3. the patient as object
4. alienation of practitioner from patient
5. diagnosis and treatment from the outside in (curing disease, repairing dysfunction)
6. hierarchical organization and standardization of care
7. authority and responsibility inherent in practitioner, not patient
8. supervaluation of science and technology
9. aggressive intervention with emphasis on short-term results
10. death as defeat
11. a profit-driven system
12. intolerance of other modalities
(Davis-Floyd 1998, 16).

In contrast, the “holistic” model is described in this way:
1. oneness of body-mind-spirit
2. the body as an energy system interlinked with other energy systems
3. healing the whole person in whole-life context
4. essential unity of practitioner and client
5. diagnosis and healing from the inside out
6. networking and organizational structure that facilitates individualization of care
7. authority and responsibility inherent in each individual
8. science and technology placed at the service of the individual
9. a long-term focus on creating and maintaining health and well-being
10. death as a step in a process
11. healing as the focus
12. embrace of multiple healing modalities
(Ibid., 110)

An important disclaimer is necessary here, as expressed so cogently in From Doctor to Healer: “People think; paradigms provide templates for thought” (Ibid., 20). In this discussion, looking at the theoretical foundations assists in understanding the system as a whole. It is not the case that all people who adhere to one or another system will necessarily follow the pattern or template of that system, but rather tend to follow these guidelines as a model of praxis.

Here there are at least two radically different ways of looking at disease and health. The above lists show the broader concerns of each system and their orientation. Applying a post-colonial medical anthropological perspective to these categories forces a closer look not only on the definitions, but on the way in which they operate within the infrastructure of healthcare delivery. In the same way that biomedicine was able to create the language used to describe itself and other systems, it is able to set values upon the orientation to knowledge within each system.

In other words, biomedicine uses the terms to assign payment schemes, such that its priorities and abilities are prioritized economically and clinically. In practical terms, biomedicine uses its power to make the models outlined above operate under different billing schedules, so that the most scientific is also the most expensive. Conversely, the most traditional is the least expensive and potentially the easiest to access. This is but one example of the way medicalization, i.e. the dominance of biomedicine over other systems, is reminiscent if not identical to imperialism. Richard Weiss echoes this sentiment in his dissertation: “The history of the introduction of biomedicine in India and throughout the world is as much a history of imperialism as it is one of the spread of rationality” (Weiss 2003, ii-1).

Altogether, the overarching theme of the history of the interaction between the system of Western biomedicine and Siddha medicine is one where the power dynamic is unbalanced. That is, Western biomedicine has become a totalizing discourse, a system which negates all other ways of knowing so forcefully that it threatens to eradicate entire models of knowledge and healing.