36 HUMAN ORGANIZATION

Folk Medicine in a North Indian Village

R. S. Khare*

modern medicine in Indian villages. In this paper the

general characteristics of folk-medicine and the con-
T h e Indian peasant village represents a combination ceptualization of illness are considered. T h e observa-
and partial integration of diverse elements of Indian tions are based on material collected in the village of
civilization. T h e village draws on traditions both above Gopalpur in central Uttar Pradesh. T h e village has
and below it for cultural development. These character- three hamlets, two multi-caste (Gopalpur proper and
istics of village society also apply to the conceptualiza- Thakurpur) and one unicaste (Ahirpurwa or Rampur).
tion of diseases and their treatment: that is to say, these
notions are derived from both urban and tribal tradi-
tions. This paper will consider the above assumptions
with reference to a particular community. T h e religious culture of the people has particular
T h e folk-medicine of the Indian village is, of late, significancein our study of folk-medicine in the village
gaining more topical interest and can be studied in community. Places of worship, deities, and spirits which
fuller detail in relation to the importance of modern influence the life-way of the people must be taken into
medicine at the village level. T h e aim of the Indian account. T h e village has a large Vaishnava temple near
government of eradicating smallpox touches a sensitive the northern border of the hamlet of Gopalpur. There
area of village folk-medicine. T h e aim openly brings are two places for worshipping Devi. here are three
together two contradictory belief patterns: supernatural- Shiva temples for the same deity. There are places such
ism on the one hand and that of physical causation as trees, platforms, niches and enclosures, where the
(germ theory) on the other. Tenacious beliefs and re- deity is enshrined. There are also abodes for five local
lated behavior of the village people are to be encoun- spirits, Latiarey-bir Baba, Bhumiya-bir Baba, Hardeo
tered in the implementation of the scheme. Baba, Syed-bir Baba, and Pathak-bir Baba. These spirits
Recently several anthropologists have written about visit the houses of the villagers at will. Villagers have
the cultural factor in medicine.1 Such an exploration of certain obligations towards "all of these spirits at the
the nature of folk-medicine might help us in determining reaping of the harvests; they have to keep a portion for
what factors militate against the implementation of them of other commodities produced in the village. If
they neglect this obligation the spirits inflict disease,
possessing members of the family of the one who has
* R. S. K h a r e is in the Departm,ent of Anthropology a t Kanya broken the rule. But if these spirits are propitiated,
Kubja College, Lucknow, U. P., India. T h e d a t a included in this they help in curing various diseases in the village. Spirits
paper w e r e collected during the period, December, 1958 t o July, along with the old medicine-man-priest and a Kayastha
1959. exorcist, greatly influence the behavior of the people at
1. See, L. Saunders, "Cultural Factors in Public Health," Chey-
enne, Wyoming, (prepared for the Annual Meeting of Public times of illness. This complex is so valued in Gopalpur
Health Nurses), 1955; B. D. Paul, "Social Science in Public that sometime back the villagers came close to beating a
Health," American Journal of Public Health, XLVI, No. 1 (1956) ;
G. M. Foster, "Working with People of Different Cultural Back- smallpox vaccinator who insisted on the advantageof "
grounds," California's Health, X I I I , No. 14 (1956) ; R. S. Khare, vaccination. I t is the opinion of many of the villagers
"A Plea f o r 'Cultural Dimension' in Medicine," Eastern Anthro- that Gopalpur is especially protected by local gods,
pologist, X I I I , No. 1, (1959), Lucknow, U. P. India.
 HUMAN ORGANIZATION
goddesses, and spirits from the various epidemics and
diseases. Only trained and initiated medicine-men and
exorcists should be present in the village.
T h e nature and extent of the help rendered by these
deities in the hours of crisis has recently seemed to vary,
more in accordance with the economic level and edu-
cational attainments of a villager than with his hier-
archical position in the caste system. Yet this is not to
to deny the influence of social stratification. Thus the
people of the same caste in the same area have different
ideas about the efficacy of supernatural forces. Differences
in the economic and educational achievements of the
people in Thakurpur and Gopalpur lead to differences
in their ideas. Kurmis of Thakurpur, being more edu-
cated and economically better off, resort more frequently
to a doctor's treatment; they also try to show that they
are more "modem" than their fellow villagers by spray-
ing D.D.T. and by being vaccinated. However, this ten-
dency is only superficial in the sense that they readily
fall back on their indigenous beliefs and practices. They
follow "modern" practices because this is a way of
proving themselves to be ahead of their kinsmen and
castemen. They thus feel closer and equal to those
people who are designated by them as "Babus of the
city." A crisis such as illness reflects this attitude as
well as the opposite tendency to participate in those
rites and rituals which are regarded as the privilege of
the "twice-born." This bi-dimensional rise of the lower
and artisan castes more frequently expresses itself in
their day-to-day life. Particularly in such people, there
is a tendency to imitate and acquire things from both
the Sanskritic and Western traditions. On the one hand.
they think themselves competent to discuss their caste
status with the Brahmin priest and refuse to take water
from his house. On the other hand, they proudly de-
clare that they go to Lucknow, the neighboring city,
once or twice a week and take food in a restaurant. This
dual tendency may indicate why people will talk of the
efficacy of Western medicine, but practice the indigenous
system of treatment during actual illness.
In the minds of the people there is a hierarchy of gods,
goddesses, and spirits. Local spirits and Sitala are super-
seded in power and efficacy by the Goddess Durga, while
she herself is under the control of Shiva and ultimately
all of them submit to the wishes of Lord Vishnu. As
noted above, symbols and shrines of all these higher gods
have been present in the village for a long time; the
Vaishnava temple which was the last to appear on the
scene, is the biggest and most frequented.
Public health workers and also clinical doctors are
once again making efforts to realize the significance of
the social character of the village medical system. It may
be pointed out that the system of folk-medicine assures
the people that a) the system is their own and b) that it
provides the people with the "best" and "complete" and
"secure" ways of coping with their physical and mental
ailments. Modern medicine is looked upon by the people
as something foreign to their culture. I t is due to this
factor of felt-needs that increasing attention is being
37
given to the psychological factors relating to the accept-
ance of Western or urban medicine. Before it is ac-
cepted, Western medicine will have to become sensitive
to the cultural patterns of the villagers. The mechanical
behavior of doctors in clinical wards and the ignorance
of public health workers limits the popularity of the
system and conditions its success.
Naturally, effort directed towards solving the problems
of illness will be greater among those cultural groups
which often face epidemics and diseases. In Gopalpur,
for example, Jamoga (tetanus) is a prevalent disease and
therefore the villagers consider it necessaray to have at
least two or three persons on hand who cure the disease.
T h e prevalence of this disease imposes a strong limita-
tion on the power of the culture to differentiate it from
various other diseases of children having common symp-
toms. Any type of fever, cold, or weakness accompanied
by trembling of the limbs of the child is taken as a visit
by Jamoga. Any discussion about the condition of an
ailing child is cut short or carried on in a whisper by
the people. Womenfolk call in groups, sit for a while
and then go. They convey their feeling with their eyes
and gestures more than by talk or whisper. People feel
sad and helpless although the medicine-man-priest is
called in at once.
A village like Gopalpur is heavily dependent on its
religious beliefs and falls back upon them in hours of
supernatural, material, and bodily crisis. Oaths of com-
promise and peace before a deity in times of quarreling
serve to avoid those violent explosions which otherwise
seem inevitable. Violence is avoided and social behavior
is controlled by the awe aroused by the deities and
spirits of the village. Similarly, in various physical ail-
ments and accidents, it is religious belief and custom
which determines the measures which villagers adopt.
Diseases are usuallv ascribed to supernatural causes.
However, the extent varies from disease to disease.
Jamoga (tetanus) and smallpox are diseases which are
highly supernatural in their origin and also require a
corresponding supernatural treatment. Cholera, dysen-
tery and, in some measure, tuberculosis are also believed
to have at least partial causes seated in the body. Fever
is a broad category which creates great concern and
anxiety if it is protracted or periodic, but there is no
cause for anxiety if it is transitory. It is remarkable that
the zone of the causative agents of various diseases
widens and usually moves towards the supernatural with
the duration of the illness. There is a similar tendency
when people generalize about a disease. If a person suf-
fers for threeor four days, the cause given is
cold or indigestion, but if a person has been sick for a
fortnight or more, his illness is ascribed to the harmful
position of his stars or to the annoyance of some spirit.
Children are freauentlv victims of the evil eve. The
treatment changes in accordance with the diagnosed
cause. Again, if a person is asked about the general cause
38 HUMAN ORGANIZATION
of such diseases as fevers, tuberculosis, respiratory
diseases, and epidemics in his village, he is quick to
point out the inevitable pattern of supernatural control.
Only three or four persons of Gopalpur believe that
smallpox has a minor cause in the body also. These
people believe that it is the heat of the womb of the
mother transferred to the child while she was carrying it
which expresses itself in the form of smallpox, and so it
is advised for the good of the sufferer that it must be
allowed to take its own course. They are totally opposed
to the use of Western medicine in the case of smallpox.
In India, as every health worker knows, these trends of
belief and behavior pattern regarding smallpox and even
Jamoga are not characteristic only of these villagers but
are also widely prevalent among Indian middle-class
urban people. Women at both cultural levels, are afraid
to mention the name of the disease. They do not speak
about it in detail, and emphatically ascribe it to super-
natural causes.
T h e above account makes it clear that in a single
society, the degree of the villagers' faith in supernatural-
ism varies from one disease to another. Why? This is a
significant question; the answer could help in imple-
menting and assessing the receptivity of health programs.
T h e openess of the society to acculturation is one
factor. Immigration of a powerful exorcist or medicine-
man-priest in a village has not only immediate effects
but slowly and steadily engenders a belief and behavior
complex which with time becomes a dominant charac-
teristic of the community. In Gopalpur a powerful
Kayastha exorcist attained fame about sixty years ago.
He was known in the neighboring villages for his suc-
cess in curing certain diseases; for example, smallpox,
Jamoga, tuberculosis, and colds. He initiated in this art,
a relative, a village Brahmin, and a Pasi. Once again,
with the death of the Kayastha and the Pasi exorcist
and the emigration of other initiated people, there is a
want of professional people in Gopalpur and the neigh-
boring villages. As a consequence, the single medicine-
man-priest of the village is initiating his kin in the art of
curing diseases and controlling spirits. His sister's son
is taking special training in the treatment of Jamoga,
under the Sadhu baba, a saint at Ayodhya, which is 80
miles away. Thus there is a tendency of the people to
maintain the specialty of the village in the field of curing
diseases. In general, the cultural safeguards are always
reinforced, regenerated, and tenaciously held by the
people.
A detailed account of the concept of Jamoga clearly
reveals gradual elaboration and Sanskritization of ideas
regarding diseases as we move from lower to higher
castes. T h e higher castes think about a disease more
with the help of the ideas embodied in the greater tra-
dition, while the lower castes largely seek explanations in
spirits, impersonal forces, and tribal gods. These latter
beliefs are mostly local in content. There is a hierarchy
of powers which are progressively benevolent and power-
ful, finding their supreme expression in Vishnu. T h e
idea of the superiority of the greater tradition over the
local ones is firmly established in the minds of the
people. Several instances in support of this point can
be adduced. Whenever the local spirits continued to do
harm even after their propitiation and did not leave
the person or place, they were forced to leave the person
with the help of the goddess Durga (a goddess of Sans-
kritic tradition). This happened in the house of a
Kurmi where ten years ago, Latiarey-bir Baba (one of
the local spirits) possessed a newly married bride, while
she was defecating one morning in a field on the out-
skirts of the village. The late Kayastha exorcist drove
it away with the power of Durga.
Some people of the village regard the Jamoga as being
formless. They think that it is a kind of air (hava).
When the people speak of the disease, they generally
allude to it as hava, evidently fearing that some un-
known harm may come to them if they call it by the
name which properly belongs to it. As a matter of fact,
most of the lower-caste people and almost all women
have a supersitious fear of pronouncing the names of
snakes, spirits, certain diseases, and other inauspicious
objects.
Many of the people belonging to the lower castes
emphasized the "airy" aspect of diseases. We should note
one more characteristic feature of the ideas of lower-
caste people concerning this disease. Children are be-
lieved to be susceptible to the disease only under certain
ages. One extreme opinion, for instance, was that the
disease may attack them up to the twelfth year. Educated
people limit the period of attack to the duration of the
maternity confinement, usually only twelve days. There
are others who place the limit at the fifth or sixth year
of the child's life.
There is also a difference in the elaboration of ideas
as we move from lower to higher castes. The most en-
lightened opinion of the lower-caste people regards
Jamoga as a spirit which mysteriously attacks children.
There are also people who regard the disease as having
an indefinite form. However, the artisan castes think
that it has the shape of a calf which enters the village
at dusk every Sunday and Tuesday along with the herds
of cattle. There are others, however, who regard it as
having the form of an ox. A Muslim expert asserted that
Jamoga really is the spirit of a malevolent Muslim saint
who fell into hell owing to his bad deeds. He became
a Khabis (a category of tormented souls) and now tor-
ments children. It assumes the form of an ox and can
be driven away only by a powerful Muslim exorcist or by
the worship of a Pir (saint). Some other members of
artisan castes contend that Jamoga itself is neither a
calf nor an ox but simply its vehicle (savari).
The Jamoga itself has an enormously big body, fierce
eye and face, and carries a club in its hand. This descrip-
tion of Jamoga's form is sometimes thought to be similar
to that of Jamaraja, the god of death in the Sanskritic
tradition. Today Ahirs, Kurmis, and even Pasis speak
 HUMAN ORGANIZATION
of Jamoga as Jamaraja (the corrupt form of Yamaraja)
for children. It is interesting to note that the generalized
features of demons are attributed to Jamoga. This idea
is yet more completely Sanskritized when it reaches the
specialist, the medicine-man-priest who represents the
uppermost tier of the society and is a symbol of the
Sanskritic tradition. He informed the author that the
Jamoga is an old, old disease-a demon who was born
at the time when Krishna sucked the life out of Putana
(female demon). The latter had visited Krishna's house
to kill him by making him suck her poisoned breasts.
As Putana was dying, she cursed the women of Krishna's
land, stating that their children would suffer and die
because of a demon, named Jamoga, who would be born
from Putana's body after her death.
As mentioned above, this village has been famous for
the curing of Jamoga patients and has won a reputation
in the surrounding villages. Diseases showing analo-
gous symptoms are confused and treated as Jamoga
and lower strata of the society even emphasize that
Jamoga is the only spirit-demon which possesses children
and kills them in large numbers.
Channels of communication also influence the nature
of ideas about illness. Certain houses in the village,
irrespective of caste rank, can be marked out as centers
for dispersal of various kinds of news, anecdotes, and
past experiences. In addition, there are regular visits of
the mendicant singers, Sadhus of Ayodhya, priest friends
of the village medicine man and a Muslim exorcist who
are sources of information about disease. The new
ideas about disease which these agents introduce are
greatly appreciated and easily added to the body of
previous knowledge. Womenfolk are highly susceptible
to these suggestions, to which they attentively listen from
behind the doors. If men express contrary ideas about
the treatment or nature of a disease their womenfolk
quickly remind the men of the opinion given by local
experts on the matter.
An important factor in the treatment of diseases is
the kan Khodana, the specialist who removes wax from
ears. He is asked to treat all sorts of pains in the ear,
the eye, and the nose. When this man visits Gopalpur,
he plays on a stringed instrument and sings devotional
songs. He has fixed stopping places where he sits,
smokes, talks, and rests overnight. He is paid in grain or
cash for his services, the amount of remuneration de-
pending on the kind and duration of service. He also
carries ointments and herbs to be applied after the
operation. His knowledge of various diseases is an in-
teresting mixture of several types of information which
he has gathered during his itinerancy. Several informants
agreed that his information about various diseases was
both reliable and new. For example, he has lately been
emphasizing the importance of the physical dimension in
diseases such as dysentery, malarial and other fevers, and
all sorts of boils and sepsis. This man is, as it were, a
39
bond established among various regional villages and
townships. He is an agency who periodically receives,
transforms, and transmits his new knowledge to his
clients in various villages. For example, there is the
interesting case of his introducing patent medicines such
as Anacin and Vedna-Nigraha-Ras (an Ayurvedic medi-
cine) into the lower strata of society. He describes these
white tablets and powders as miracle drugs for many
types of ailments and will prescribe them even in cases
of dysentery. He is, however, mainly concerned with
his traditional ideas about diseases and their treatment.
In the above description, I have concentrated on those
agencies which are outside the village, regional in scope,
stable in relationship, and regular in frequency. These
connections open the society to the thinking of distant
people. All of these agents bring in a variety of informa-
tion and directly or indirectly they influence the vil-
lagers' ideas about disease.
There is another more formal type of extra-village
agency which is not given equal recognition by the
society. These agents are thought of as alien: officials
with doubtful motives, and imposed upon the village
by Sarkar, the government. Agents of this type are:
Village-Level-Workers, Panchayat Secretary, Lekhpal (an
officer who keeps village records), and other visitors like
vaccinators and D.D.T. sprayers. Village people are
receptive to these agents in varying degrees.
In addition, there are people residing in the village,
who, because of their higher socioeconomic position
have some special knowledge about various diseases.
They take pride and pleasure in giving knowledge to
those who lack it. This group is represented by people
such as retired railwaymen or teachers. There is also
a college graduate who is at present employed as a head
clerk in an educational institution in Lucknow and who
regularly visits the village to look after his property.
Several lines of thought enter the minds of the people
through these agencies. For example, the village priest
has to offer an explanation which is based on the ideas
and tenets of the Vaishnavite cult. The retired railway
employee, who has lived an urban life for decades is
emphatic about the natural and physical causes of
disease. The primary school teacher speaks ideally of
the efficacy of scientific medicine and public health, but
never disowns for a moment the control of diseases by
the established supernatural agencies. Several years ago,
a primary school teacher of Thakurpur took the initia-
tive in bringing a vaccinator to the village to prevent a
cholera epidemic. He vigorously advised everybody to be
vaccinated. But when the vaccinator actually arrived,
the people evaded him. Even when persuaded by the
school teacher, not more than ten people agreed to
undergo the inoculation. All others joined hands in
criticizing the teacher by saying that by following his
new-fangled ideas he was forfeiting the kindness of the
village Bhuinya (Goddess Sitala.) The villagers feel that
epidemics are not checked by inoculations because an
epidemic is air which cannot be bound and controlled
except through the great supernatural powers.
 HUMAN ORGANIZATION
Levels of medical sophistication range from super-
naturalism to modern medicine. Ideas of Ayurvedic and
Unani systems of medicine stand nearer the elements of
folk-medicine than Western medicine and therefore are
more communicable within the society. I n Gopalpur,
homoeopathy, as a system of treatment, is more accepable
to the villagers than the Ayurvedic or Unani systems.
This is due to the presence of a homoeopath-an ex-
zamindar-who has also been the leader of a powerful
political faction for the last twenty-five years.
Usually the villagers are hesitant to seek medical aid
outside the village, for the simple reason that they
cannot expect the same amount of sympathy and care
from external help as from that available in the village.
This together with the unfamiliar form of treatment
which they think they are likely to receive from the out-
side, makes them suspect these aids. As an instance, the
hospital in a nearby town remains unvisited and the
people from Gopalpur go directly to the house of the
ex-zamindar in Lucknow for they think that once the
case is entrusted to him, they can be sure of his un-
stinted sympathy. Such cases are taken to him when
they have reached a critical stage, and he usually takes
them to the famous medical college where the entire
party - the patient, the kin, and the escort - are be-
wildered by the maze of formalities through which they
have to pass before they can hope to get medical help.
In the unfamiliar and, to them, inhuman atmosphere,
they become painfully conscious of what strikes them
as apathetic, almost mechanical treatment.
Conclusion
Beliefs are patterned on religious sophistication
well as social hierarchy. There i s clear recopition
the functional hierarchy of spirits, gods, and goddesses
in various moments of illness. T h e role of religion in
a disease is regulated by the latter's virulence and inci-
dence. In desperate moments of illness religion is the
sole refuge; all sorts of treatments find their rationale in
it. On the other hand, ideas also tend to become more
and more elaborate and approximate the Sanskritic
tradition as they pass into higher strata of the caste
system.
On a wider theoretical level, an intensive study of
folk-medicine may help in the fuller and dynamic under-
standing of social cooperation in various normal and
critical conditions, because in critical situations the
quarrels, frictions, and group differences are eliminated,
or at least momentarily forgotten. Even the rules of
intercaste insulation and caste hierarchy are weakened
in favor of rendering or receiving help in such situa-
tions. T h e code of conduct, traditionally adhered to in
Gopalpur, obliges the specialist to give his services, even
when they have not been asked for, and irrespective of
the caste of patient. T h e behavior of the specialist under
such circumstances is more of sympathy and equality
than in the normal situation. Quite recently people of
opposite factions2 came together and helped the village
priest in cash as well as in kind, when he became para-
lyzed and was without kin.
T h e acquisition of indigenous knowledge about vari-
ous diseases goes on in critical as well as normal times.
Certain extra- and intra-community aids also play their
roles in the concept of disease formation. T h e charter
of taboos and abstentions, which varies with the disease,
is transmitted through verbal and other behavior. T h e
experiences of elders and the knowledge of local special-
ists contribute substantially towards the nature of folk-
medicine. I t tends to become heterogeneous with a) in-
creasing outside contacts, b) severity of disease and c)
education.
2. R. S. Khare, "Group Dynamics in a North Indian Village,"
H u m a n Organization, XXI, No. 3 (1962) 201-203.