CHAPTER 1
Malaria
ANTIQUITY AND INCIDENCE
Malarial fever was in fact not unknown to the Indian people. Indiaâs acquaintance with it can be dated back to the Vedic past, for some of the earliest references to this ailment occur in the Atharva Veda. The Atharva Veda classifies the fever according to the periodicity of its attack, i.e. sadandin or quotidian, tritiyakam or tertian, and vitrtyiyan or quartan.1 It also classifies the fever according to season: sitam or winter, graisman or summer, varsikam or monsoon.2 It appears from the Atharva Vedic evidence that such fevers were common in regions like Gandhara, Anga and Magadha.3 In all probability even the relations between mosquito and malaria were not unknown to the Vedic people, for the text gives details about mosquitoes such as the needle-like proboscis or kusala, the bloody mouth or lohitasyam, and visiting the dwellings in the dusk or salahparinrtyantisayam.4 There is also reference to the use of odorous or fumigating medications to ward off the insects.5
Later medical commentators like Charaka and Susruta used the word jwara for fever in general, and henceforth all diseases with temperature as the predominant symptom are described as jwara by the Ayurvedic authors. The Charaka Samhita, written in approximately 300 bc and the Susruta Samhita, written in about 100 bc, refer to diseases where fever is the major symptom. The Charaka Samhita compares the advent and periodicity of this fever to the seed sown in the ground.6 It takes a day to grow in case of the quotidian variety (anyedyuskah), two days in case of the tertian (trtiyakh) and three days in case of quartan (caturthakah). Mature seeds then invade the body and cause fever unchecked by any antibody. When the force of the invading elements is worn out, they return to their original habitat and again begin to grow. Susruta compares the advent of fever to the flood and ebb tides of the ocean.7 Both Charaka and Susruta refer to this fever as an ailment common in lowlands or in the foothills. In all probability, Indians were familiar with the use of mosquito nets as is evidenced by the accounts of Marco Polo in the thirteenth century.
It is therefore reasonable to believe that malaria as a disease and its association with the mosquito was known since the beginning of Indian civilization, but there is hardly any evidence to prove that the disease had ever been an epidemic prior to the advent of British rule.8 Unable to cope with the medicines at their disposal, people had learnt to live with it. But in the period under review the disease turned into an epidemic and caught the people unaware.
The predispoisng causes of malaria epidemic in Bengal emanated from the topography of the riverine areas of the province and the insanitary habits of the people. But the proximate causes stemmed largely from colonial infrastructuresâroads, railroads, embankments, system of labour migration, changes in the crop pattern, export oriented commercial crops, etc. Environmental decay stemmed from long-term evolution, but British colonial policy hastened the process and accentuated the epidemic.
Environmental decay could be observed in river decay and siltation. The process was quickened by obstructed drainage which again was caused inter alia by railways and embankments that came in the wake of so called British development policies. Increasing number of embankments and railways reduced the chances of flood and innundation, which meant progressive loss of fertility of the soil. The consequences were generally two-fold: first, impeded drainage brought in its trail large number of stagnant pools and marshes, which provided congenial breeding ground for mosquitoes, and second, loss of fertility of the soil due to cessation of inundation diminished the amount of winter harvest, which meant starvation to many. Scarcity of food grains was further aggravated by an incentive to increased production of jute, which held out a lucrative export market after the opening of the Suez Canal. Rotting of jute plants in stagnant pools or ponds made the water still more foul and unhealthy. Mosquitoes generally preferred breeding in stagnant pools, and if such rotten pools abounded in the vicinity of a homestead, spread of malaria was ensured.
This dramatic transformation of the incidence of the disease raises a few pertinent questions. How did the people react to the epidemic? Was it with an attitude of passivity and helpless resignation? Did people blame the government, or did they try to save themselves by propitiating the gods and goddesses? These are some of the questions the present chapter seeks to raise, and by way of explanation it will address the larger question of its location in popular imagination as a disease and its remedy.
There has been a remarkable spurt in literature on malaria in recent years. David Arnold, in his work on malaria and tribal India, reminds us that colonial medical and topographical texts repeatedly identified âfeverâ as a primary attribute of the environment.9 Ira Klein revived interest in malaria and mortality in Bengal through his painstaking research on the subject.10 Marking the Madras Presidency as his entry point, Muraleedharan has made some significant observations on the colonial governmentâs response to changing medical theories.11 Some recent scholars have questioned the very notion of âmalariaâ, arguing that in the second half of the nineteenth century in Bengal, âa malarial epidemicâ presented itself as a flexible medical metaphor: medical professionals frequently used the term to explain multiple varieties of physical ailment.12 There have also been some attempts to explain the resurgence in term of environment.13 More recently, scholars have also tried to invest multiple meanings with the term âmalariaâ in nineteenth-century Bengal.14 Yet, the historical trajectory of malarial fever in Bengal and its negotiation by colonial and indigenous medicine has not yet been adequately addressed. It is worthwhile to look at the functions of the disease at different locations.
POPULAR CONSTRUCTIONS
Let us identify four components among the people: the ordinary people, the rural gentry, the middle class intelligentsia, and the indigenous medical practitioners based in the villages. We shall examine the different perceptions of these four groups to the disease and how to cure it. The major emphasis will be on the perception of the ordinary people, the masses and the worst sufferers.
When the widespread epidemic malaria started taking its toll in the 1860s, popular reaction in Bengal did not differ sharply from that in other parts of the country. In fact, the identification of epidemic disease with divine wrath was almost a pan-Indian phenomenon. It took the distinctive form of belief in disease deities, especially goddesses. Hindu society, rightly observed by David Arnold, did not regard all diseases alike. Some were seen as the consequence of personal sins, others the result of sorcery. But epidemic diseases, due to their scale and nature, and the general ineffectiveness of conventional medicine against them, were readily identified with the wrath of gods and cosmic disharmony.15
In fact, most of the disease goddesses were associated with a particular disease or ailment. In Bengal, as we will notice later, the principal deity was Sitala, the goddess of smallpox. The worship of Sitala was timed to coincide with the beginning of the smallpox season.16 In deltaic Bengal, the specific cholera deity was called Ola Bibi by the Muslims and Olai Chandi by the Hindus.17 Most interesting, however, is that the people did not interpret the malaria epidemic as a heavenly intervention. And consequently one finds no socially acclaimed folk deity for fever epidemic, except of course, the cult of Jwarasura prevalent among the lower classes of people. Though it has been argued that the fever-demon Jwarasura is present in the textualized âclassicalâ traditions,18 it appears all the more certain from contemporary literary imagination that only the marginalized castes invoked Jwarasura, the fever demon, with the help of a Brahmin during malaria epidemics so that individuals and groups may recover.19Jwarasura was, in fact, never âveneratedâ, or âworshippedâ either like other disease deities for the simple reason that he was a âdemonâ or asura, and not a âdeityâ or deva as such. People worship devas or godhead out of reverence or fear; asura is invoked out of irreverence and disrespect. However, apart from the usual offerings of rice, sweets and fruits, goats were sacrificed in special instances for invoking Jwarasura. This being seems to have had no following among the upper-caste Hindus or well to do villagers. Nowhere in contemporary literary work nor in the official records could one find the reference to any widespread worship of this particular deity. In other words, this disease deity, unlike Sitala or Ola Bibi, never became a cult in the Bengali society. This provides an interesting exception to Arnoldâs general observation that almost all epidemics in India are associated with a particular disease deity.20 And this calls for an explanation.
The explanation may be two-fold: the lack of indigenous immunity, and the exceptional geographical range of the disease. The causes of malarial fever, and quinine, its supposed herbal remedy, were not known to people till the advent of the twentieth century. Until then, people sought solace in the popular adage: that which cannot be ended should be mended, and which could not even be mended should be accommodated within the regular pattern of life.21 Moreover, malarial fever might be remittent or intermittent; it abated at intervals. Its habit of periodic invasion provided the patient temporary respite from fever, and this helped reduce fear of it to some extent. Besides, this type of ailment was not unknown to the people. The affliction had accompanied them from cradle to coffin so that the disease had lost much of its shock element.
Secondly, epidemic malaria lost much of its edge due to its widespread spatial expansion. It traveled from Assam to Amritsar, from Bombay to Bengal. It was not an isolated ailment, afflicting a particular person or two. Particularly in Bengal, few districts could escape its ravages. The epidemic became almost a national phenomenon, visiting different regions simultaneously. Thus there prevailed an attitude of helpless resignation to conventional treatment and the epidemic was scarcely regarded as a sign of divine displeasure. Thus the worship or propitiation of a particular deity was ruled out.
On the contrary, people accused the colonial government of arbitrary interference with the river system in eastern India and consequently bringing about a virulent epidemic. Railway embankments, people argued, had converted large tracts of fertile land into perpetual swamps. Increasing numbers of embankments and railways reduced the chances of flood and inundations, and the reduced chances of river flood meant progressive loss of alluvial soil. The consequences, people argued, were generally two-fold. First, impeded drainage brought in its train large numbers of stagnant pools and marshes, breeding grounds for mosquitoes. And second, loss of fertility of the soil due to cessation of inundation had diminished the quantum of winter harvest, which meant starvation for a sizeable section of the rural masses.22 The government, they complained, was in no mood to adopt effective measures to drain out rivers, particularly the Damodar.
Though the people lamented acts of omission, they protested against the rulersâ acts of commission as well. Since many of ...