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Subject: H-ASIA: CONF REPT CORRECTION Medical Pluralism & Homoeopathy in
India and Germany (1810-2010). Practices in a comparative perspective.
> H-ASIA
> August 8, 2011
>
> Conference report by Marion Baschin on "Medical Pluralism and Homoeopathy
> in India and Germany (1810-2010). Practices in a comparative perspective".
> Stuttgart: Institute for the History of Medicine, Robert Bosch Stiftung
> Stuttgart, 30.06.2011-02.07.2011.
>
>
> (x-post H-Review)
> ************************************************************************
> Ed. note: H-ASIA members will be familiar with my practice of reposting
> the excellent reports on conferences, as in the case of the following
> report. I have copied these reports from the H-Net Review site. In the
> case of the present report, either at its original posting on the
> H-Soz-u-Kult list, or in processing at the H-Net Reviews office, the item
> was incorrectly attributed. I am reposting the item with the corrections,
> and have notified H-Net Reviews regarding the matter. My apologies to
> Marion Baschin for initially perpetuating the error in attribution.
> FFC
> ---------------------------------------------------------------------------
> From: H-Net Reviews:
>
> Medical Pluralism and Homoeopathy in India and Germany (1810-2010).
> Practices
> in a comparative perspective. Stuttgart: Institute for the History of
> Medicine,
> Robert Bosch Stiftung Stuttgart, 30.06.2011-02.07.2011.
>
> Reviewed by Marion Baschin
> Published on H-Soz-u-Kult (July, 2011)
>
> Medical Pluralism and Homoeopathy in India and Germany (1810-2010).
> Practices
> in a comparative perspective
>
> The question of whether we face a "new medical pluralism" these days has
> been
> asked frequently. Undoubtedly, "biomedicine", as the dominating modern
> medicine
> taught in universities and practiced by the majority of all physicians, is
> no
> longer - but was in fact never - alone in offering medical treatments to
> sick
> people. Amongst so-called "complementary and alternative medicines" (CAM)
> today, there are such different therapeutic methods as homoeopathy,
> naturopathy, ayurveda, yoga or traditional Chinese medicine. Since its
> foundation, research in the history of homoeopathy has been one of the
> main
> focuses of the Institute for the History of Medicine of the Robert Bosch
> Foundation in Stuttgart. For several years, this focus was broadened to
> the use
> and the history of "alternative" medical methods in general, dealing with
> questions concerning the "new medical pluralism" asked today and
> delivering a
> historical perspective to these questions. India is the country in which
> homoeopathy has received an amazing reception and developed a main role in
> the
> medical market. Since 1937, the therapeutic system, founded by the doctor
> Samuel Hahnemann at the beginning of the 19th Century, has even been one
> of the
> officially-accepted methods in India. In general, the tradition of medical
> pluralism is more evident there than in other Asian countries. Moreover,
> the
> official equality of "biomedicine" and the "other" therapies, ayurveda,
> yoga
> and naturopathy, unani, sidha and homoeopathy (AYUSH), is unique, giving
> medical pluralism in India a governmentally-supported basis. For all these
> reasons, a comparative perspective of India and Germany, specially
> focusing on
> homoeopathy, seemed very promising and therefore gave birth to the idea
> for
> this unrivalled conference. Scholars from very different disciplines were
> invited to Stuttgart to discuss the features of medical pluralism in those
> two
> countries.
>
> In his introductory remarks, MARTIN DINGES (Stuttgart) sketched out the
> historical and current situation of the therapeutic landscape in India and
> Germany. Quoting the German ethnologist Pfleiderer, he defined "medical
> pluralism" as a "juxtaposition of medical systems, which is a historical
> result
> of cultural and social developments leading to institutionalized forms of
> medical care". Dinges then divided the historical development into three
> sections: the "old medical pluralism" until the 1880s/1900, followed by
> the
> "modern medical pluralism" up to the 1970s and the "new medical pluralism"
> from
> the 1980s onward. Dealing also with the different motivations for the
> patients'
> demand for CAM, he focused on the systemic thresholds, on the one hand
> limiting
> the patients' choice, and, on the other, personal preferences.
>
> The first paper presented the world of the "old medical pluralism" dealing
> with
> the patients' choices in 19th Century Münster. Based on patient journals,
> MARION BASCHIN (Stuttgart) was able to describe how and why sick people
> used
> the treatment of the two homoeopaths Clemens and Friedrich von
> Bönninghausen.
> As the majority of all the patients had only short-term therapy, the use
> was a
> sporadic one in most cases. But this is, by no means, a purely
> "homoeopathic"
> phenomenon. The same applies to "allopathic" practices in the 19th
> Century,
> which had already been under investigation. Homoeopathy cannot be seen as
> a
> real "alternative" in the medical market of Münster. Moreover, it was used
> as a
> "complementary" concept by most of the sick people, who searched for a
> cure,
> whatever it might have been.
>
> SILVIA WAISSE (São Paulo) presented the pluralistic views of the 19th
> Century
> from the point of view of Johann M. Honigberger (1795-1869), a lay healer
> from
> Romania. In his publication, Honigberger discusses the state of medicine
> in the
> West and in the East at that time. After meeting Samuel Hahnemann in
> Paris,
> Honigberger even introduced homoeopathy in India. However, not satisfied
> with
> the healing successes of any of the current medical systems of his time,
> he
> decided to combine the best of all of them into his own medical system,
> being
> pragmatically rooted in experience, experiment and the use of small doses.
>
> Some of the reasons why homoeopathy experienced such a warm welcome in
> India
> and could develop such a strong role in the medical market were shown in
> the
> paper of SHINJINI DAS (London). The advantages of homoeopathic therapy,
> such as
> the simplicity of learning it and the quick possibilities for self-help,
> as
> well as the philosophical ideas of the system fitted perfectly with the
> positive self-perceptions of Bengali families in the 19th Century.
> Therefore,
> the use of homoeopathic remedies could guarantee the preservation of
> familial
> health in Bengal by ensuring the well-being of various family members
> while
> looking after the overall structure of the institution of family itself,
> as the
> referee pointed out.
>
> AVI SHARMA (Chicago) then posed the question of whether the "whiggish" way
> of
> writing history prohibited a proper view of medical pluralism in general.
> Focusing on progress or what is thought to be progress in medical history
> leaves all the "alternatives" that were available at a given time behind
> and
> neglects them. Specially referring to the example of "Naturheilkunde" in
> Imperial Germany, Sharma dealt with the interdependences of power and
> resistance, professionalisation and popular opinion, law and scientific
> authority, showing the different motivations and interests of the elite in
> handling an "alternative" system during the last decades before World War
> I.
>
> Leading to the actual situation in "new" medical pluralism, HARALD WALACH
> (Frankfurt an der Oder) presented the medical possibilities available in
> the
> German medical market. By taking into account the possibility of choice
> for or
> against CAM from doctors as well as the patients, he stressed the role of
> patients' demand in the German system. But the main problem still is that
> the
> German health care system supports intervention and not time, a factor
> that is
> crucial for CAM therapies, which are often more time-consuming.
> Fortunately,
> insurance companies are slowly starting to rethink their strategies for
> dealing
> with illness and health, backed by the patients' demands and the knowledge
> that
> CAM could save money, especially when dealing with chronic diseases, as
> Walach
> said.
>
> In their papers, AMEETA MANCHANDA and RAJ MANCHANDA (both New Delhi)
> focused on
> the practice of medical pluralism in hospitals and primary health care
> units in
> India today. In many hospitals in India, "biomedicine" and AYUSH therapies
> are
> now offered at the same time. As A. Manchanda pointed out, the patients
> often
> choose the therapies according to their accessibility, affordability and
> personal preference. Moreover, the success story of the AYUSH therapies is
> explained by the support of the political administration, the financial
> satisfaction und active participation of the patients. To this, R.
> Manchanda
> added the interesting fact that the number of patients in homoeopathic
> dispensaries was still increasing and indicating the growing popularity of
> the
> system. His study proves that homoeopathy is a popular, affordable and
> efficacious system of medicine at primary health care level - especially
> seen
> from the patients' side. Therefore, homoeopathy has the potential to
> minimize
> the health care expenditure.
>
> Staying in the field of everyday practice, HARISH NARAINDAS (New Delhi)
> raised
> the question of according to which nosology remedies are prescribed.
> Obviously,
> "biomedicine" nosology delivers such a strong basis that this is also used
> in
> the AYUSH medical encounters. This cognitive and epistemic duality results
> for
> example in a conception of an "anatomical" heart and an ayurvedic
> "hyrdayam".
> This can be particularly observed during the anamneses, with regard to the
> types of question the doctor asks and the answers given. Naraindas showed
> how
> the practitioners attempt to straddle two seemingly disparate cognitive
> universes and the translations which occur.
>
> HUGUES DUSAUSOIT (Namur) described his experiences in the encounter of the
> practice of a homoeopathic doctor, working in primary health care in South
> India for three months. During this ethnographical study, he was
> astonished by
> the fact that, although homoeopathy claims to have intensive and
> time-consuming
> contact with the patients, reality showed a very different situation. His
> results especially provoked critical reactions from the participants who
> were
> practicing homoeopathy themselves. Nevertheless this paper was followed by
> fruitful discussions about the difference between theory and practice of
> health
> care providers.
>
> In his report about the use of different medical systems in India, RAHUL
> TEWARI
> (Noida) challenged the finding that wealthy people seem to use ayurveda
> more
> often. In his study, wealthy patients tended to use "biomedicine". In
> general,
> homoeopathy and "biomedicine" are used for all sorts of illnesses, as
> could be
> proven by the data. But mainly in rural areas the choice of treatment
> depends
> on the availability according to time and distance as well as cost
> effectiveness.
>
> Dealing with letters that were written to the German organization "Natur
> und
> Medizin e. V", PHILIPP EISELE (Stuttgart) presented patterns of patients
> who
> actively searched for a CAM therapy in present day Germany. The more than
> 2,500
> letters provide a unique insight into the perspectives of patients who are
> both, skeptical towards "biomedicine" and open-minded about any other
> therapy,
> in particular naturopathy and homoeopathy. One of the main results is that
> the
> texts show that patients do not only turn to "complementary" medicine when
> "biomedicine" has nothing more to offer, but that there are various
> motivations
> involved in the decision making.
>
> According to patients' demand, homoeopathic "doctors" - in fact lay
> practitioners - not only prescribe homoeopathic but also "biomedical"
> remedies
> on a large scale, as NUPUR BARUA (New Delhi) showed in her paper.
> According to
> her findings, a lot of sick people from the slums also preferred a
> "less-qualified" doctor because they had the feeling that he was more
> competent
> and helpful than the "fully-organised" and "fully-trained" practitioners.
> Furthermore, it is interesting that, while the prescribed remedies were
> almost
> invariably "biomedical" combinations, the manner in which these were
> administered was clearly rooted in ayurvedic and homeopathic practice. In
> these
> cases, homoeopathy was used as adjuvant.
>
> In the last paper, KRISHNA SOMAN (Kolkata) shed light on lay practices of
> homoeopathy in India. This is a field which is very difficult to
> investigate,
> due to the lack of sources and documents. Homoeopathy is not only offered
> by
> trained doctors but also widely spread amongst lay people. Also encouraged
> by
> such famous examples as the Indian Nobel Laureate in literature
> Rabindranath
> Tagore (1861-1941), lay healers mainly practice in villages, where public
> health care delivery is not sufficiently developed. Sometimes this causes
> trouble with the local authorities but, again, patients' demand and search
> for
> a cure is so strong that more often these lay practices are ignored or
> tolerated.
>
> Summing up the main results of the conference, WILLIAM SAX (Heidelberg)
> firstly
> stated that there is obviously a strong dominance of "biomedicine"
> everywhere
> in the world. But this dominance is challenged in several ways. Moreover,
> in
> most medical systems, different sorts of mixtures exist. There is,
> secondly, a
> main clash between what people say that they do and practice and the way
> they
> actually act or practice. Therefore, in reality as well as in history,
> research
> work has to focus on these mixtures and the asymmetries which exist. The
> demand
> for CAM is obviously unbroken and what we are experiencing today might be
> some
> sort of "looping effect", in which this demand from the patients' side
> enforces
> CAM to challenge "biomedicine" in a totally new way.
>
> In general, the conference profited largely from the different
> disciplinary
> backgrounds of the participants, being medical practitioners,
> ethnologists,
> historians and philosophers. The discussions which followed all the
> pre-circulated papers focused on a very high level on the several
> questions of
> medical pluralism in theory and practice. It became evident that "medical
> pluralism" has always existed, but that it is quite difficult to define it
> at a
> present stage, as the definitions of what is "alternative" at a certain
> time
> are shifting. Parallels as well as differences concerning the medical
> systems,
> the education of medical staff in "biomedicine" and "CAM" and everyday
> practice
> were highlighted. The chosen comparative approach was most useful for
> discovering the differences between Germany and India and what they both
> have
> in common with regard to an expanding medical pluralism. A selection of
> the
> papers will be published in 2012.
>
> Conference overview:
>
> Introduction and German Patients' Choices During the 19th Century
> Chair: Robert Jütte
>
> Robert Jütte (Stuttgart, Germany): Opening
>
> Martin Dinges (Stuttgart, Germany): Introduction
>
> Marion Baschin (Stuttgart, Germany): The Patients' Choice - How and Why
> Sick
> People Used Homoeopathy in 19th Century Münster
>
> Medical Encounters During the 19th Century
> Chair: Harald Walach
>
> Silvia Waisse (São Paulo, Brazil): East Meets West: Johann M. Honigberger
> and
> Medical Pluralism through the Eyes of a 19th Century Transylvanian Saxon
> in
> India
>
> Shinjini Das (London, United Kingdom): Curing Familial Ills, Ensuring
> Familial
> Wealth: Quotidian Domesticity, Homoeopathy and the 'Indigenous' in
> Colonial
> Bengal
>
> Regulated Medical Pluralism in Germany and Practiced Medical Pluralism in
> India
> Chair: Harish Naraindas
>
> Avi Sharma (Chicago, USA): A Chinese Wall' on the Road to Scientific
> Discovery:
> Regulating 'Other Healers' in Wilhelmine Germany
>
> Harald Walach (Frankfurt an der Oder, Germany): Medical Pluralism in
> Germany
>
> Ameeta Manchanda (New Delhi, India): Homoeopathic clinic in a
> multispeciality
> hospital. The example of the Holy Family Hospital, New Delhi
>
> Raj K. Manchanda (New Delhi, India): An attempt towards Symbiosis:
> Homeopathy,
> Allopathy and Indian Systems of Medicine in Primary Health Care Units of
> Government of Delhi (short presentation and discussion)
>
> Practices of Health Care Providers: Indian Physicians in the late 20th
> Century
> Chair: Rahul Tewari
>
> Harish Naraindas (New Delhi, India): Epistemic Mangling: The Modern Doctor
> of
> Traditional Indian Medicine
>
> Hugues Dusausoit (Namur, Belgium): The quest for a different recognition.
> Ethnography of an Indian homoeopath in Tamil Nadu
>
> Patients' Choices: Recent Developments
> Chair: Krishna Soman
>
> Rahul Tewari (Noida, India): Patients' trend in choosing the medical
> system in
> India
>
> Philipp Eisele (Stuttgart, Germany): Medical Pluralism and Patient's
> Perspective - Letters to Natur und Medizin (1992-2000)
>
> Practices of Health Care Providers: Lay Practitioners at the end of the
> 20th
> Century Chair: Marion Baschin
>
> Nupur Barua (New Delhi, India): Local Medicine in a Global Garb? Medical
> Pluralism in a slum in Delhi
>
> Krishna Soman (Kolkata, India): Pluralism, popularity and propaganda:
> Narratives of lay practices of Homeopathy in India
>
> Conclusion
> Chair: Martin Dinges
>
> William Sax (Heidelberg, Germany): Summing up
>
> If there is additional discussion of this review, you may access it
> through the
> list discussion logs at: http://h-net.msu.edu/cgi-bin/logbrowse.pl.
>
> Citation: Marion Baschin. Review of , Medical Pluralism and Homoeopathy in
> India and Germany (1810-2010). Practices in a comparative perspective.
> H-Soz-u-Kult, H-Net Reviews. July, 2011.
> URL: http://www.h-net.org/reviews/showrev.php?id=33842
>
> Copyright © 2011 by H-Net, Clio-online, and the author, all rights
> reserved.
> This work may be copied and redistributed for non-commercial, educational
> purposes, if permission is granted by the author and usage right holders.
> For
> permission please contact H-SOZ-U-KULT@H-NET.MSU.EDU.
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