three therapies of south india 59
and the religious therapies as the term refers to the treatment of illness by
opposites, refl ecting an approach that involves attacking an illness—for
ex ample, using toxic substances that will kill a disease pathogen—and employ-
ing invasive techniques. Allopathic medicine is likewise seen as aggressive by
many in India. Its treatments are considered powerful and heating, which
has positive and negative connotations: allopathic treatments can be highly
eff ective, bringing quick relief for many problems, but the powerful medicines
can be dangerous, presenting the possibility of unwanted and injurious side
eff ects. Allopathic medical services, including psychiatric facilities, are broadly
accessible in Kerala due to the state’s public health programs which have made
medical facilities available on even the village level while in many other rural
areas of India, people have to travel far to visit a doctor.^15
For decades now, “Western” medicine has been the cosmopolitan medi-
cine of most regions of the world, and the practice of allopathic psychiatry
in India is similar to the practice of this form of healing in other places.
Farmer’s (1992) analysis of biomedical psychiatry in Haiti reveals an aware-
ness among Haitian psychiatrists of a dissonance between the middle-class,
Euro-American assumptions in biomedical psychiatry and the context in
which they were practicing. Th ese therapists thus attempted to adapt their
practice to the cultural, class and religious backgrounds of their patients—
for example, by utilizing explanatory styles from voodoo religion. Farmer
claims that this marked ability to discern cultural contingency stems from a
Haitian revolutionary tradition of looking skeptically at European ideologies.
Allopathic psychiatry likewise has unique traits in Kerala, although psych-
iatrists there showed less of a critical consciousness of this diff erence than did
their Haitian counterparts.
Western biomedicine arrived in India in the seventeenth century, but was
confi ned to the practices of physicians who worked on ships and in facto-
ries for the British East India Company, primarily to maintain the health of
company employees. In 1763, after the East India Company expanded across
Bengal and other parts of northern and eastern India, the Bengal Medical
Service was established, and in the 1860s sanitary commissioners were added
to this service to expand public health programs (Arnold 2000: 58). In the early
nineteenth century the Company developed training programs that combined
European medicine and ayurveda, but this was discontinued in 1835 because
of a change in colonial education policy that had begun to assert the superior-
ity of Western knowledge and encourage the explicit promotion of allopathic
medicine over ayurveda as a separate and superior science. In southern India,
Christian missionary groups, such as the London Missionary Society, played
a major role, along with the colonial state, in promoting Western medical