At the turn of the twentieth century, the reformist Islamic scholar Maulana Ashraf `Ali Thanawi produced a manual for respectable women, the influential Bihishtī Zēwar, extending to them the education, centrally enabled by print publication, to take on individual responsibility for reformed observance and piety as the key to worldly happiness and Divine reward.Footnote 1 Thanawi’s project fit with what can be called an “improvement ethic,” which flourished across religious traditions in India in these years, an ethic that emphasized women’s behavior.Footnote 2 As part of that improvement, Thanawi shared the fin de siècle anxiety over physical debility. India in these decades had seen grim evidence of human frailty with cholera and plague that decimated whole populations, as well as the everyday crises of illnesses, accidents, and childbirth. In Chapter Nine of his manual, Thanawi offered his response, teachings on health maintenance that were shaped by the humoral theories that long dominated the Old World. In his focus on women and printed text alike, he showed himself part of his times, stereotypes of the rigidity of classically educated Islamic scholars to the contrary.
At the same time, Thanawi understood this contemporaneity as fully grounded in the Islamic tradition in which he was so expert. He opened the Bihishtī Zēwar with the convention of praise of God that aligned the Divine with his own intentions, citing Quranic verses that called for teaching within the home. Every single person was accountable, the verse declared, and for each to be ready for that accounting, “the acquisition of knowledge was incumbent on every Muslim man and every Muslim woman.”Footnote 3 For Thanawi, properly caring for women (`aurton ko ihtimām karnā) required facilitating acquisition of knowledge, sacred and practical alike, the practical extending precisely to the health maintenance of this particular text. Once armed with knowledge, Thanawi’s reader, no longer an object of tutelage, could be a changed person. Sovereign over her own body, vigorous in health, and exercising emotional control worthy of worldly and divine approval, Thanawi’s reader was empowered for a life enriched with purposeful action.
Thanawi regarded competence in all parts of life, including in health maintenance, as a moral obligation. Good health made everything else possible, not least ethical behavior since humoral equilibrium and morality were understood as reciprocally interdependent. He considered the Bihishtī Zēwar adequate for a woman to acquire sufficient sacred learning to be equal to “a middling `ālim [Islamic scholar],” a status typically associated with males.Footnote 4 Now, in this text, he introduced the non-sacred knowledge classically conveyed to males in medical and ethical texts of tibb, adab, and akhlāq that had long been key to Indo-Persian civility. He urged women who had access to family members who were hakīms to learn from them, and he included two general compendia on medicine, not specifically written for women, in his list of seventy-seven books for further reading.Footnote 5 Women, like men, needed to master the bodily self-control that assured the balance essential to a virtuous life.
Thanawi included in his text health-related issues specific to women, a subject of increased general interest in this period. Women needed guidance on managing children and the household as men typically did not. Their bodies also posed distinctive issues because of their reproductive organs and because their essential constitution was understood to be cooler than men’s.Footnote 6 Thanawi’s overall summons to disciplined health management, however, was not gender specific. There is no suggestion here or, one might add, anywhere in the volume that women had a unique inner, spiritual, or civilization role in contrast to an outer/colonized/male world, as has been described in relation to elite Hindu social reform of the period.Footnote 7 Women had distinctive familial roles; they owed deference to husbands and male elders; but women and men alike were morally equal and morally responsible.
The historical interest of this text extends beyond its distinctive exemplification of the improvement ethic of the high colonial period, to representation of a key moment in the history of medicine. Written at the cusp of the far-reaching changes of the twentieth century in India’s indigenous healing traditions, the text catches a moment in time before the rigid and politicized delineation of institutionalized Hindu and Muslim “systems” of Ayurveda and Unani Tibb that followed, and before the “pharmaceuticalization” of traditional medicine in the context of the globalized industrial capitalism evident today.Footnote 8 Thanawi simply wrote about craft production and generic healing.
Thanawi’s imagined audience was Muslim. He noted prophetic approval of remedies and disciplined regimens (dawā aur parhēz). He referred to a few Islamic practices (reading the Qur’an and praying at night) as forms of brain and bodily exercise. And he provided a final section on intercessory Islamic strategies to deal with health as well as familial and other personal crises. In the main body of the text, however, Thanawi taught practices he understood to be effective and appropriate for everyone. The text does not “Islamicize” medicine.Footnote 9 Nor is it even “Muslim” in the sense of celebrating the Muslim civilizational tradition of healing.Footnote 10 Thanawi made no reference to any “system,” nor did he title the chapter, or even refer to his subject, as “Unani Tibb” (Ionian/Greek Medicine).Footnote 11 He did not even use the term tibb (“medicine”).Footnote 12 He taught the generic health maintenance, plain and simple, that was practiced by Hindus and Muslims and Sikh practitioners alike across broad swathes of the northern subcontinent. His teachings, albeit implicitly, were in fact heir to the Greco-Arabic healing traditions, but he himself demonstrated no concern with origin and boundaries. More than simply a text on “Unani Tibb,” as it is typically labeled, the chapter develops a significant dimension of Thanawi’s vision of a particular kind of woman—pious, conscious of individual moral responsibility, disciplined in bodily and emotional self-control, happy in worldly well-being, and hopeful of divine approval. And through its description of the household, the illnesses, and the crises his reader likely faced, it enriches our picture of the world in which she lived.
The Legacy of tibb in India
Thanawi was heir to a strong tradition of medical knowledge that dated to the Abbasid Empire in the ninth and tenth centuries, when classical medical texts, including those of Hippocrates and Galen, were being translated into Arabic. At the time, scholars and texts were already moving between the Arab capitals and elsewhere in the Old World. Interchange with India was particularly important.Footnote 13 Celebrated intellectuals like al-Tabari wrote knowledgably about Indian physicians. Al-Kindi’s medical formulary included plants and drugs of Indian origin, perhaps as many as one-third of the whole.Footnote 14 Al-Qanun fi’l tibb (“The Canon”) by Ibn Sina (Avicenna), the foundation for medical thought and practice in Europe for centuries, is remarkable for the large number of tropical plants and derivatives it includes. Interaction with Indian scholars flourished once again in India with the rise of Turko-Afghan dynasties that dominated the area for centuries beginning in about 1200 CE.Footnote 15 They patronized skilled physicians, built hospitals, and commissioned translations and compilations of medical works into Persian to a far greater extent, for example, than contemporaneous Iranian dynasties. Tibb was cultivated as part of the “Persianate” gentlemanly learning of the male elite, a practice observed down to the colonial period.Footnote 16 Tibb’s origin may have been in West Asia, but its history after the classical period is, arguably, richer in South Asia than anywhere else.
The continuing assimilation of the Indian pharmacopeia with its use of minerals and of local flora influenced medical practice as did, to a more limited extent, Indic humoral categories and concepts. Hindus in the precolonial period joined in the production of translations into Persian from Sanskrit as well as in the composition of new works on medicine. Medicine was simply medicine. Tazeemuddin Siddiqi, describing one seventeenth-century pharmacological study compiled from dozens of texts, notes in passing that the author had no interest in identifying whether a substance was known from a “Vedic” text or from one in Arabic or Persian.Footnote 17
The historian of medicine Fabrizio Speziale sums up this stimulating interchange “as one of the major movements of scientific translation that took place between various South Asian cultures, as well as the main scientific movement of this kind that took place in the coeval Muslim World.”Footnote 18 This scholarly productivity, he points out, was second only to the intellectual dynamism of the classical era, and he notes that it provides one of many challenges to the myth of decline of medical and scientific studies in the Muslim world. Tibb’s vitality down to the colonial era is substantially owed to its enrichment through cultural interchange coupled with the centuries of elite patronage it enjoyed.
Tibb’s continuity, and the transformation of indigenous medicine’s plural and fluid traditions into “systems,” is unquestionably linked to early colonial encouragement and subsequent challenges posed by biomedicine and the opportunities for identity politics presented by colonial rule. Colonial sociology made putative religious communities a building block of colonial society, what one historian labeled with a medical metaphor as “the pathological classification of the subject population in [Hindu and Muslim] binary terms.”Footnote 19 But even if the religious labeling obscured on-going integration and interchange, it also, undoubtedly, contributed to making traditional medicine a matter of cultural renewal and even competition that assured continuity at a time when the Greco-Arabic strand had largely disappeared in its place of origin.Footnote 20
Locating Thanawi’s Text
Thanawi was a product of the Islamic reformist movement centered in the town of Deoband.Footnote 21 He introduced the Bihishtī Zēwar with a medical metaphor: “If reform did not come soon,” Thanawi wrote, “the disease would be nearly incurable.”Footnote 22 The “cure” (`ilāj) was educating Muslims, and women in particular, in the rejection of deviant and extravagant customary practices in favor of religious fidelity and responsible everyday life.Footnote 23 Generally speaking, these were concerns that were true of religious traditions across India in this era. By Thanawi’s time, Islamic scholars had largely internalized the colonial boundaries of “religion” to the subjects recognized by separate religiously defined codes of law covering family law as well as the moral and ritual behavior that for the most part was beyond legal judgment.Footnote 24 Within those domains, `ulama like Thanawi, and the reformist movement of which he was a part, adopted new roles for themselves, establishing new kinds of schools and adopting new modalities of communication, like the printed book exemplified here, to guide their followers into responsible and pious lives.Footnote 25 The focus was on the individual, within the household, to restore health in all its dimensions from the ground up.
When it came to bodily health, Thanawi’s avoidance of labels may indeed be a case of Molière’s bourgeois gentilhomme speaking prose without knowing it, but this silence signaled his lack of concern with public policy. By the mid-nineteenth century, however, elite doctors trained in indigenous traditions saw their status and their livelihood at risk. Proponents of Western medicine in India (or daktarī as the vernacular had it) had begun to monopolize state medical colleges and public health programs. From the late eighteenth century, initially in Bengal, the British had sponsored the creation of an Urdu medical literature and a network of dispensaries with “native” doctors for their modest projects in public health. There was some degree of clinical testing and production of multiple compendia of local herbs and plants, an important example of the occluded role of “native informants” in producing colonialist knowledge, in this case, new therapies appropriate to India’s distinctive environment and possibly of use beyond.Footnote 26 But European work in surgery and anatomy, along with an incipient germ theory of disease, had called humoral theories into question. As early as the 1880s, there were efforts to require registration of medical practitioners who alone could give testimony in legal disputes, certify illness for workers, or perform other legally required functions. Hakīms and vaids asserted their authority in terms of the efficacy of their practices and of professional standards that distinguished them from those they deemed “quacks” of all kinds, including those who were, in their view, only partially educated thanks to newly available printed texts on medicine.Footnote 27
Spokesmen for “Unani Tibb” and “Ayurveda” claimed to represent legitimate systems that were particularly well-suited to India, even superior to Western medical knowledge.Footnote 28 They increasingly reimagined their practice within a discourse of evidence-based authority, one of the enduring transformations of the colonial era in medicine and beyond.Footnote 29 Scholars describe the creation of Ayurveda as a system masking the shamanism of Vedic times, the later Buddhist provenance of classic texts, and the incorporation of folk practices as an example of the “invention of tradition.”Footnote 30 The process of defining Unani Tibb was broadly similar.Footnote 31 The label “Unani,” newly current and used nowhere else, had potential appeal to the classics-besotted colonial rulers. It evoked Muslim science and civilizational hegemony and became a hallmark of an emerging “Indian Muslim” identity in public life, a matter of no concern in this period for `ulama like Thanawi.
The activists undertook translations, published vernacular medical guides, and founded formal educational institutions.Footnote 32 By the early decades of the twentieth century, they had organized professional associations and launched medical journals to advance research. Delhi’s Madrasa Tibbia, “The Medical School,” (1889) led the way in formal education as an alternative to earlier family-based education among the leading hakīms. Hakim Ajmal Khan, scion of the elite Sharifi family of physicians, was the college’s driving force.Footnote 33 When it acquired its formal campus in 1916, its name, tellingly, was no longer the “Madrasa Tibbia,” but “The Ayurvedic and Unani Tibbia College,” the fates of the two systems intertwined. This emphasis would continue in organizations and publications celebrating tibb and ayurveda as components of a nationalist “composite culture.”Footnote 34 Still, the old generic medicine lingered. The distinguished `Azizi hakīms of Lucknow in particular came into public life as regional rivals and opponents of the Delhi style of collaboration, holding out the possibility of formalizing a single indigenous healing tradition in tibb. Footnote 35 As late as 1924, half the students studying Unani at the College were Hindu. But that no Muslims studied Ayurveda (conveyed in the Nagri script) made its separate Hindu attribution ever clearer.Footnote 36 Separately or together, publications, colleges, and conferences were all part of the “new bottles” that Sivaramakrishnan evokes in her title, Old Potions, New Bottles (2006), alluding to the diagnoses, recipes, and bodily care that in many ways continued, now repackaged.Footnote 37
Thanawi shared with activists’ a fear of decline as well as the new interest in women’s health.Footnote 38 He also, like them, borrowed from British practices, though certainly not to the extent of teaching skills in surgery (a controversial compromise of tibb as gentlemanly practice), or engaging with European theories in the style of the incomparable Sayyid Ahmad Khan (who argued the case for homeopathy), or, as later thinkers did, trying to reconcile humoral theory with biomedicine.Footnote 39 Thanawi simply had his eye out for products that seemed useful, whether soft-boiled eggs and tea in cold weather, or “castor oil” and the “hot water bottle” (both transliterated). His cautious recommendation for cataract surgery from a skilled practitioner also suggests familiarity with British medicine, as, possibly, does diagnosis by tongue color and maybe even the suggestion of chicken soup for an invalid. Above all, he shared with the activists a campaign against ignorance, whether ignorant women and ill-trained midwives or quacks.
Thanawi’s “Other” throughout the Bihishtī Zēwar was thus not daktarīi, with which he would have had little interaction despite the colonizing force of Western medicine across India.Footnote 40 In the text’s final section, Thanawi added another set of rivals to ignorant women and quacks, namely, the dubious healers, often associated with charisma-charged shrines and temples of all religions, whose power may well have seemed far too real. Thanawi wrote for respectable Urdu-speaking Muslim families like his own, for many of whom questionable social ties now seemed to risk respectability. For Hindu and Muslim reformers alike in this period, reform drew class boundaries, eroding, in particular, women’s shared customary behaviors across class, like devotional transactions to restore health or fulfill other needs.
Women’s health mattered. The Delhi activists soon offered separate education for women students. Modernist social reformers in their novels, journal articles, and so forth urged women to adopt informed practices related to health. Thus, the heroine of the best-known Urdu novel of the era decried superstitions like the evil eye and had “a few hearsay prescriptions by heart.”Footnote 41 But Thanawi wrote on health with greater depth and larger vision than this. He taught his reader sovereignty over her own body, stabilizing its humoral balance for bodily vigor and the emotional control essential to Islamic righteousness. With a book in her hand, Thanawi’s ideal reader in the end represented a distinctive version of the day’s respectable woman. Thanawi’s “new bottles” were printed books and educated women. He even gave a nod to the new professionalization of his day by having his text endorsed by a professional hakīm. But, to repeat, that contemporaneity did not stretch to any public role for himself as defender of Unani Tibb or leader of an emerging “Indian Muslim” identity. That was for others. For Thanawi, the transformative education represented by this book was enough.
Tandurustī: Bodily Management for Health and Virtue
And for that transformation, maintaining a sound (durust) body (tan) was foundational. To do so was not Islamic, but “a matter of [generic] devotion (`ibādat) and morality (dīn).”Footnote 42 “Tandurustī makes a person joyful at heart—drawn to devotion and good work. It yields pleasure in eating and drinking and turns the heart to gratitude to the Lord (khuda). The body has strength for doing one’s own work and well rendering service to others. A person can fulfill obligations to those to whom any obligation (haqq) is owed.” “Illness,” Thanawi continued, “brings trouble upon trouble.”Footnote 43 Thanawi’s expansive view of good health thus not only encompassed freedom from disease and disability but also made possible emotional and moral health. He pictured a healthy household where children studied, obligations were fulfilled, meals were happy, ritual was faithfully followed, and celebrations were modestly observed. Bodies were balanced and financial accounts were balanced. A virtuous person, taking control of the physical self, nurtured a moral self with a heart that was joyous (dil khūsh rahtā hai) and eager to fulfill responsibilities (khūb jī lagtā hai).
Thanawi could take for granted that his readers to some extent knew the humoral theories that had characterized medical thought throughout the Old World for centuries, understanding that each person’s constitution (mizāj) or temperament (tabī`at) could typically be mapped on a grid of cold and hot on one axis, and wet and dry on a second, yielding four elements: blood (hot and moist), phlegm (cold and moist), yellow bile (hot and dry), and black bile (cold and dry).Footnote 44 The balance of those elements produced dispositions that are known to English speakers by terms like “choleric,” “sanguine,” “phlegmatic,” “bilious,” and “melancholic.” In the main, men were thought to be hotter than women; violent people were hotter and calmer people cooler. The young were moister than the old. That vulnerable and permeable self was open to the entirety of the environment, including air, food, and water. From that premise, the need for attentiveness to constitution and environment alike followed. Only then could a person exert the control that assured the equilibrium essential to good health and emotions alike.
Thanawi provided practical advice on matters like appropriate food, strategies for balancing the impact of the seasons, as well as a range of healthy behaviors. His list of “good” and “bad” foods made the latter mostly hot, to be used sparingly and with consideration of the eater’s constitution; he discouraged the consumption of several food combinations whose humoral composition made them incompatible. Foods were suitable for different personalities, seasons, and life stages. Hot weather called for cold foods and avoidance of hot foods like the pulse arhar and potatoes. The wrong foods could harm not only the body but emotions and behavior: lobiyā or black-eyed peas (hot and wet), he explained, would cause disturbing dreams. Thanawi’s caution on eating beef is worth noting given the accusation of widespread Muslim consumption used to inflame anti-Muslim sentiment today.Footnote 45 “Beef is hot and dry. It makes the blood thick and bad. It produces excess black bile. It harms people with skin diseases, hemorrhoids, melancholy, and those who are splenetic or bilious…. It is not particularly bad for people engaged in physical labor….” Beef at most was good for manual laborers in good health. Tea, which was still a relative novelty, was good for a person of cold constitution in cold weather. Carrots, which are hot and wet, posed a risk of excess blood flow for pregnant women. The humoral premise made the created world, and even new products in it like tea, into an intelligible place, all composed of the same primordial elements as humans.
A second premise of Thanawi’s teaching, likely shared by his readers, was the need for moderation. Moderation was Thanawi’s byword for several of what Guy Attewell lists as tibb’s “exogenous essentials,” all the elements beyond one’s own bodily constitution that shape health: “air, food and drink, action and rest, mental activity and rest, sleep and wakefulness, retention and elimination of waste.”Footnote 46 Thus Thanawi advised sufficient eating, sleeping, and exercising without too much, and, similarly, stimulating the brain with enough reading and reflection on “subtle matters” to avoid excess moisture yet not too much for fear of excess dryness. Thanawi did not imagine his reader as a woman waited on by servants or above working with her hands: “Do not rest so much that you get fat and lazy…. Do not dump the household work on others…. Busy yourself with the spinning wheel and grinding stone. We do not say that you need to earn money from this—though of course there is no harm in doing so—but rather that you should do it for your health…. Just look: working women are strong and alert … unlike those who … spend their whole life with a cup of medicine at their mouth. Activity for one’s health is called ‘exercise’” (riyāzat). The need for definition, suggests that here, too, Thanawi was on to something new.
Thanawi urged moderation over emotions like anger, happiness, and sorrow for the sake of physical health, and even provided a sample conversation to modulate the impact of bad news. Emotional imbalance, he claimed, would risk sickness or even death. No medicine worked, no diagnosis was accurate, he insisted, for anyone given to excess fear or happiness or grief. The relationship to the hakīm also called for steady trust, no matter any failure or excess cost, in order to create the emotional calm critical to a cure. Thanawi’s culminating advice was for forbearance with an invalid: “Put up with an irritable disposition (sakht mizājī). Do nothing … that causes loss of hope.” Mind and body, as we would say, were inextricably intertwined.
The text’s third implicit premise, already evident in the discussion of mizāj and moderation, was the need for scrupulous attentiveness to every element of body and environment. Different directions of the wind called for different responses. Air quality required care, for example by requiring specific places for bathing and defecating, or burning incense for its fragrance, or lighting camphor or sulfur during epidemics. Smells were a core element in humoral thought. A nineteenth-century Persian work written in India, for example, classified many of the ingredients that appear and reappear in Thanawi’s text: excessively hot odors come from musk, black pepper, ginger, black cumin, and castoreum; camphor and sandalwood are excessively cold; mild odors of even temperament include water-lily, violet, apple, cucumber, Rosa damascena, narcissus, and floral smells generally.Footnote 47 Perhaps those steeped in humoral “aromatherapy” develop a heightened ability to detect odors.Footnote 48 On the other hand, no skill was required to follow Thanawi’s reminder to avoid closed, smoke-filled rooms. Water, like air, also needed attention: taken from a full well, or strained of impurities, or, in a case of any doubt about its quality, boiled. Humoral theories long posited the unhealthy air of “miasma” as a major vector of disease, but the value of clean air and water stood, no matter the theory.
Above all, the text called for informed attentiveness to the components of one’s physical body. Its longest section provided a list of ailments with keys to diagnosis and instructions for treatment. The list was organized from head to toe, in the style typical for tibbī manuals.Footnote 49 Isolating and focusing on separate bodily parts put the reader on familiar ground. She may have been familiar with the head-to-toe arrangement from the poetic convention of thus describing a beloved’s beauty (sar a pa). She would in any case have encountered it in Bihishtī Zēwar’s opening poem disparaging silver and gold jewels in favor of the “jewels,” listed head to toe, gained by disciplined use of each body part: attentiveness to one’s work and obligations provided the “head fringe;” responsiveness to wise counsel became the “earrings,” and so forth. Chapters on rituals had enjoined heightened attentiveness to specific bodily parts in teaching correct postures and alignment of the body in performance of the canonical prayer. Moreover, Thanawi’s behavioral theory of moral improvement singled out the training of discrete organs, like correct and repeated use of the tongue to cure such faults as backbiting, and thought exercises focused on the heart to control anger and extinguish jealousy.Footnote 50
Now, in Chapter Nine, the reader was introduced to internal bodily parts including the abdomen, the liver, the spleen, the colon (its problems often mistaken by “common people” as the stomach’s), the kidneys (not to be confused with the colon), the bladder, the womb, and the intestines. This information was essential to proper diagnosis and treatment. Thanawi himself, one might note, was heir to Sufi training that attuned him to bodily learning through repetitive practices that required scrupulous attention to specific parts of the body as detailed as a meditation that called for pressing the kimas artery (located behind the left knee) with the right toe with a view to physically transforming successive layers of the heart. Scott Kugle, who has studied these teachings, offers the suggestive conclusion that the goal of these bodily practices in the nineteenth century increasingly shifted from personal formation to transformation in the service to the larger community.Footnote 51 Thanawi did not teach this esoteric vision of the body in the Bihishtī Zēwar, but his explicit goal in directing women toward bodily attentiveness was indeed societal cure.
Thanawi dwelt at length on issues specific to women with his characteristic sympathetic tone and directness. For the most part, he focused on the routine, identifying risks to humoral imbalance that reproductive patterns were understood to entail. A woman might need special hot foods after childbirth in winter, for example, like meat soup with the “hot” spices (spices like cardamom, pepper, cumin, coriander, cinnamon, cloves) and eggs. Such attentiveness was no doubt restorative in itself. Menstrual irregularity called for compensation for deficit or surplus heat, squatting over carrot seeds scattered over a small fire, for the former; bathing in cold water infused with pomegranate and oak gall for the latter. If these strategies failed, Thanawi added recipes for ointments, mixtures to ingest, or a treated plug for insertion. Excess bleeding, like fever, could also be treated by immobility from tying up the full body with bands of cloth from the underarms down (sīngiyān) as well as by lower leg massage accompanied by pouring a hot mixture (pāshwiya) from the knees down, a treatment he stood by: “People have mocked the power of [massage and wrapping], but their words are nonsense.” Thanawi’s concern with menstruation, a topic that he also discussed at length elsewhere in the volume in relation to ritual purity, is the more striking since today it is typically treated as taboo for public discussion.Footnote 52
Thanawi also defended two issues of contemporaneous social reform, both important across religious traditions, on explicit grounds of women’s health. Child marriage, he argued, risked the physical damage he called shiqāq al-rahm (tearing the womb). He encouraged women to speak out, and to use Arabic terms like this to mitigate embarrassment and likely convey expertise.Footnote 53 Vocabulary mattered. Thus, Thanawi did not use the routine term sharmgāh, “place of shame/modesty” for the pudendum, but “below the navel,” again, perhaps, a way of making women sound informed and scientific whether consulting a hakīm or facing possible challenge.Footnote 54
Secondly, Thanawi recommended the controversial reform of marriage for widows, here justified medically to spare them the horrific ikhtināq al-rahm, “strangulation of the womb,” known from classical tibbī texts and attributed to retention of female semen.Footnote 55 Its revival here was likely stimulated by contemporaneous European concerns with female hysteria. Following the conventional understanding that odors could control the mobile womb, Thanawi urged the use of foul-smelling aromas along with cold water and binding, foot massage, and the vaginal insertion of musk on a piece of paper (in seeming mimicry of hetero-normative sexual relations).Footnote 56 Some contemporary researchers identify the problem of “strangulation” as endometriosis, whose symptoms are controlled by pregnancy, hence the plausibility of the recommendation to marry.Footnote 57
On some subjects, women were on their own. Thanawi provided no information on abortifacients, typically included in classical tibbī texts.Footnote 58 He flatly said, “Never abort a child.” Since abortion was widely regarded as acceptable before quickening, he may have meant abortion after the initial trimester and implicitly left the subject in the hands of the excoriated midwives.Footnote 59 Nor, in fact, did he say much about childbirth apart from warning against midwives’ practices like indiscriminate use of gum and ginger for post-partum women and their application of a particular poultice he deemed dangerous. Nor did he cover in detail sexual relations except insofar as he made clear that a woman should reject sexual relations at specified points during pregnancy. Nawab Shah Jahan Begum in her advice book published a quarter century earlier wrote in much greater detail about these matters and, strikingly, emphasized the importance of physical pleasure in marital relations, as Thanawi did not.Footnote 60
What Thanawi did write on in detail was the frightening subject of fever. On this, he made his one use of the term yūnānī in urging resort to a yūnānī hakīm if all else failed. For intermittent fever, for example, days were to be meticulously counted and patterns predicted for crises. This cycle determined rest, medications, and response to bodily flows (nosebleed, elimination, sweating). Fevers mattered so much that they even stimulated the text’s one extended discussion of causation. Fever inside the veins was more intractable than fever in an organ, Thanawi explained, because it could find release through chills, an example of the way humoral theory had its own logic, particularly evident in treatments like these entailing bodily flows and temperature. Elsewhere that logic might be metaphorical: preparations using maidenhair fern to increase hair growth, or the classic tibbī ingredient of pearls in medications to treat eyes, both of which Thanawi recommended.Footnote 61
Thanawi’s reader could trust these teachings and, indeed, likely had her own experiences of their effectiveness. The power of some kind of action as a placebo is well known. Many procedures, moreover, as Charles Rosenberg has argued in relation to the long centuries of European/American humoral treatments, gained plausibility when they produced observable changes understood to be righting the body’s physiological balance.Footnote 62 Thanawi’s emphasis on moderation in eating, exercise, and so forth would have resonated with general societal guidelines for good behavior. Some teachings, like rejection of the widely practiced use of opium to quiet a baby, would have had recognizable advantages, as would, perhaps, his emphasis on avoiding medications whenever possible, including some like the metal preparations (kushta) that risked side effects, in favor of behavioral change.Footnote 63
Today’s researchers investigating traditional medicine typically focus not on humoral theory but on specific ingredients that address critical problems in biomedicine, like bacteria that have become drug resistant. There, too, in some cases people using preparations like Thanawi’s may well have seen positive results.Footnote 64 For example turmeric, used in many tibbī preparations, has recently gained great attention.Footnote 65 Thanawi’s reader may have encountered some empirical success since Thanawi included turmeric in treatments for rash, inflammation, swelling, asthma, dysentery, scalp disease, and treatment of wounds, where, for this last, it may well have stopped festering.Footnote 66
But much in this text may have struck readers then, like readers now, as opaque. Why hold one’s nose while drinking if very thirsty, or avoid water on an empty stomach or after defecating?Footnote 67 Why does going to sleep with a full stomach contribute to deafness? Or sneezing from snuff at the onset of a cold cause cataract? Or how can the mixture “Solomon’s Salt” serve the whole gamut from lightening the complexion, aiding digestion, improving eyesight, helping pain in the limbs or pain from a wasp bite, and strengthening one’s memory? And how do the two remedies for a head injury work? The first is to apply a piece of meat spread with turmeric. The unforgettable second strategy, intended to restore a person to consciousness when all else fails, is to pull an empty chicken carcass, still warm and the skin intact, over the patient’s head. European humoral medicine may be equally surprising. Physicians treating John Donne’s melancholy tied dead pigeons to his feet to draw out what were thought to be noxious vapors from his head.Footnote 68 In both cases, presumably the hope was to transfer properties of the animal to the patient or vice versa to manage humoral instability.Footnote 69 The non-specialist had to simply accept that the opaque, too, had its logic for experts.Footnote 70
In the end, the book’s remedies could enhance a woman’s sense of competence and her satisfaction in being part of movements of the day. The text’s teachings “worked” for her. The value of the text was the more for being issued by the learned and holy Maulana Thanawi, whether or not he himself had put pen to paper.Footnote 71 To be sure, he is listed as author, with a well-known hakīm affixing the imprimatur noted above: “This ignorant person has reviewed this section letter by letter and, in his opinion, it is completely correct. [signed:] The Servant of the Physicians, Muhammad Mustafa Bijnuri, currently resident of Meerut.” In the book’s third edition, however, we learn that in a world where authorship was porous, the good hakīm had actually written the text himself.Footnote 72 If so, it was in fact Thanawi who did the approving, perhaps adding the general statements and advising the overall content, even if the details of rattī, tōlā, and māshā had been left to Hakīm Mustafā.Footnote 73
Thanawi himself would have had a respectable level of tibbī expertise. Tibb, like bookbinding at one point, was taught at the madrasa at Deoband as a practical subject, not a sacred one.Footnote 74 Maulana Rashid Ahmad Gangohi (d. 1905), a founder of the madrasa and Thanawi’s revered teacher and lifelong guide, was regarded as expert.Footnote 75 Thanawi in his early years of teaching went to Delhi to study tibb. Footnote 76 He did not stay long—a choice made easier perhaps by the fact that many of the concerns of the activist Delhi doctors were not his.Footnote 77 Tibb for Thanawi was important only in service to his larger goal of endowing individual Muslims with the strength and knowledge to lead a pious and responsible life, free of deviant custom and resort to dubious healers and shrines.
Jhār Phūnk (On Incantations)
In the final section of Chapter Nine, Thanawi put into his readers’ hands a guide to specific actions (a`māl) intended to obviate practices that risked Islamic fidelity and, instead, acknowledge God’s omnipotence in hope of Divine aid and intervention. These included Qur’anic verses, numerical squares, and various procedures, all to be recited, worn, consumed, inhaled, or otherwise carried out.Footnote 78 This section crystalizes the entire book’s Islamic reformist message more clearly than any other. In a reformist movement that put Divine unity (tauhīd) and the believer’s individual, unmediated relationship to the Divine front and center, the reader had no need of intercessor or putative wonderworker; she had resources within. Even if she was desperate, when pious fidelity could be most at risk, she could resist the siren songs beckoning on every side, whether those of powerful goddesses or holy men or other intercessors she may have longed for.
“Incantations” does not do justice to the earthy term: jhār phūnk. The contemporaneous Farhang dictionary lists a baker’s dozen of glosses including “mantras and all that stuff” (mantar-jantar); blowing charismatic breath or circling the hand over the supplicant (dam kārnā or hāth phīrī); charms or amulets, magic squares or circles (afsūn o afsāna, ganda wa ta`wīz); magic (jādū, sihr); the deceit of conjurer’s tricks (sho`bdabāzī, bāzīgarī); and the outright fraud of makkāri. Footnote 79 In Thanawi’s view, behind the jhār phūnk lurked a whole world of dubious healers and claimants to holiness of all religions. Notably risky were the healing shrines dedicated to local goddesses and powerful pīrs who might endanger the core Islamic injunction to monotheism. Another set of potential healers thus joins the midwives and quacks in being set aside.
Thanawi named two especially powerful goddesses, Sītala, goddess of all pustules and poxes and known for healing smallpox, and Bhavānī, a manifestation of Lord Siva’s fierce wife, Durga.Footnote 80 Thanawi warned equally of the danger of caretakers of Hindu shrines and Muslim dargahs, who may require offerings, vows, or even, as he puts it, corruption of a woman’s honor. The text makes no judgment about efficacy. The tempters may well work their power, given deeply held cultural expectations that spiritual power knows no sectarian limit.Footnote 81 Indeed, Thanawi listed a procedure to thwart an evil spirit (dēv or dē’o, a common word for a “god”) who had caused illness or damage.Footnote 82
Thanawi had made clear at the outset that in the end God alone held recovery in his hands, a teaching meant to reassure someone who lacked means to purchase what might be expensive ingredients, and equally reassuring to a woman who might blame herself for nursing that failed. Allah was the reader’s only resort, and Thanawi provided powerful verses or letters or words to be breathed out, or read over oil used for massage, or recited over a food to be consumed, or inscribed onto a food (a biscuit or sweet, for example), or traced in water. Other verses were written on cloth or recited while tying a prescribed number of knots to be bound to an afflicted or related bodily part. Recitation over nails buried at the corner of a house could keep away a dangerous snake or some other risk. Just as the list of practitioners of jhār phūnk take one out into the era’s potent landscape of shrines, hospices, goddesses, and charismatic healers, the a`māl return one into the home where issues of health, fertility, and familial relationships were at the heart of a woman’s happiness. This section of the text brings the household to life, with all its problems, from a relative’s persistent headache to a child grievously ill, or a bride’s infertility, or even the reader herself facing the crisis of a husband’s disaffection.
Of the medical issues, nothing was more frightening than the virulent epidemics that spread across north India in these decades. For that, a woman could do three readings of the powerful Surah 97 of the Qur’an, breathing each time on all food and drink to be consumed whether as prophylactic or treatment. In an era before contagion was well understood, only the sacrality of words mattered, not the potential infection spread by breath.
Fertility, the dangers of childbirth, and the survival of offspring were also a central focus. For any woman in this society to be childless risked social standing, a lack of support in old age, and even sidelining as a wife. For infertility, the woman was enjoined to recite seven times a verse (Surah 24: 40) imploring God for light from the depths of darkness over each of forty cloves. After purification at the end of her menstrual period, she was to eat one each day at bedtime and whenever she was with her husband. Forty, that charged number in the Abrahamic tradition, served, one might think, as an incentive to more frequent sexual relations and thus enhance the chance of the desired goal.
Thanawi provided procedures to control anxiety and fear, emotions known to interfere with one’s bodily state. To alleviate worry that would endanger a fetus entailed eating caraway (ajwain) and black pepper prepared with recitation of Qur’anic verse and praises of durūd at least once a day until the time the child was born and nursing. As for childbirth, Qur’anic verses foreseeing the apocalypse (Surah 9), perhaps putting the discomfort of the moment in perspective, could obviate pain and excess emotion, whether tied onto the woman’s left hip or consumed on a sweet. Other remedies, one including the husband’s possible participation, could address the problem of only bearing girls in a patrilocal society, or poverty, or obstacles of any kind frustrating a person’s goals.
A particularly poignant procedure dealt with spousal displeasure and neglect. To undertake this procedure entailed a full forty-day commitment of multiple daily recitations of durūd over peppercorns and of rosaries calling God by two of his ninety-nine beautiful names, yā latīf, and yā wadūd—Oh Gracious One, Oh Loving One. These are names that would seem especially relevant to the disposition the woman longed for in worldly form, and she was to hold the thought of her husband’s kindness in her mind as she performed these repetitions. Perhaps he would respond in kind to this loving image as studies of the impact of stereotypes on those stereotyped suggest.Footnote 83 In all these strategies lay the potential, if nothing else, of helping a woman through crises by enhancing her ability to address the problem, an approach known to benefit anyone experiencing distress.
Thanawi’s reader, instructed in key matters of everyday life and health, and armed with strategies that honored the singular Divine of reformist thought, could ideally face health and personal crises like these with the steadiness that health and faith alike required. The literary scholar Laurel Steele has teased out from the shadows of Thanawi’s text an imagined woman in the midst of life, part of a comfortable family ranging in age and gender, a woman characterized by piety and vigilance and attentive to every detail of season, temperament, and actual or potential problems of health and well-being.Footnote 84 Season by season, she weighs her choices about what food to serve and eat, and how much and what sources of drinking water are best. She mixes preparations for headaches and crying babies; she searches far and wide for ingredients to prepare a restorative drink for a newly delivered sister-in-law. She intervenes in the case of a young relative unable to conceive and remains vigilant when pregnancy is attained. She knows when to consult a hakīm and she knows the importance of emotional equilibrium. She finds the words to urge fortitude to a distraught mother when her daughter’s child is stillborn. She keeps the house in order. As Steele points out, missionaries and colonial officials had long identified the Indian home, and especially homes where women were well-off enough to be secluded, as a fetid place of dirt and sickness. Its inhabitants, veering between ignorance and self-indulgence, needed reform that only outsiders could bring.Footnote 85 Thanawi’s text, Steele suggests, turns that view of the zanāna (the place where women are secluded in the home) on its head. And it questions scholarly and activist judgments that see only the limitations of colonial era Islamic reform for women and neglect the advantages of instruction that yielded both respect and self-respect.
Looking Ahead
The historic interest of Bihishtī Zēwar’s Chapter Nine is clear, but it seems to be of limited practical interest today. No complete translation of it into English has been published. Even in Urdu reprints, Chapter Nine may be substantially abridged.Footnote 86 To be sure, there are challenges for the translator, such as finding the right English-language equivalents for, say, the correct variety of a genus of plant, or the archaic measures, replaced since the 1960s by the metric system. Given the diaspora, some ingredients may be unavailable where readers live. The need for the text’s recipes, moreover, has been somewhat preempted by over-the-counter preparations. More fundamentally, readers reduce the text’s subject simply to Unani Tibb at a time when tibbī practitioners, and the officials who support them, feel the need to actively assert tibb’s secular, rational, and evidentiary base, and may not want to see a discussion of medicine nestled up against an appendix of Islamic prayers and recitations. Speziale sums up this view: “The surgical severance from all the elements connected to the sacred world is a crucial need for a discipline aspiring to justification according to the paradigm of Western science.”Footnote 87 In today’s world, where religion and science are often posed as alternatives, best to keep tibb on its own.
Whatever the currency of a text like this, the common sense about medicine it embodies, particularly issues of humoral constitution, continues as part of everyday life in large swathes of the population.Footnote 88 More fundamentally, many South Asians have little option but to turn to the more affordable care of practitioners versed in indigenous medicine, albeit likely deploying some traditional and biomedical bricolage, making any differentiation between healing systems “at odds with people’s everyday lived experiences of illness and healing.”Footnote 89 A different stratum of the population may opt for “Complementary and Alternative Medicine” (CAM), as it is now sometimes called, not out of necessity but from concern over the limitations of biomedicine. More ambitiously, spas for locals and medical tourists provide a range of traditional procedures and diets, including in some cases the intrusive interventions of bleeding and purges understood to rebalance one’s bodily composition.Footnote 90 Nostalgia may further clothe specific products and treatments alike, as illustrated in a series of articles on indigenous plants under the rubric “Grandma’s Remedies” in a Government of India publication. Using them followed “the law of nature” and was free of side effects.Footnote 91 As noted above, researchers worldwide carry out evidence-based studies in ethnopharmacology on specific ingredients as well.Footnote 92 The place and meaning of Unani Tibb in South Asia today is thus far different from what it was in Thanawi’s day.
Traditional medicine today is primarily dependent on industrially manufactured products, with the most successful of them effectively advertised and marketed internationally. Skilled practitioners prescribing treatment in light of individual constitutions may well play little role in their consumption.Footnote 93 By the early 1900s, print had given European companies the ability to advertise drugs that found their way across India. “…India was awash with patent and proprietary medicines, tinctures, tonics, powders, and [tablets] of every description.”Footnote 94 Indigenous producers and practitioners of varying credibility soon competed with them in manufacturing and print advertising. In the very year that Bihishtī Zēwar was published, a Delhi hakīm opened a small hospital and pharmacy in Delhi named “Hamdard,” which would go on to become the largest producer of tibbī products in the world.Footnote 95 If a person knows only one Hamdard product, it may well be one of its first, the “cooling” beverage, Rooh Afza, which, having advertised its way out of the competition of international beverages that came with economic liberalization in the 1980s, now provides something like half of Hamdard’s revenue.Footnote 96
Governments and pharmaceutical companies now play a major role in the regulation and patronage of traditional medicine. Not surprisingly, Unani Tibb, and with it Hamdard, took different directions after Partition. Hakim Muhammad Sa`īd (1920–1998), as long-term head of Hamdard in Muslim-majority Pakistan, made explicit what Thanawi had taken as a given, that tibb was not Islamic but the quintessential “Eastern Medicine,” in his view, an umbrella for Asian medical systems overall. It was marketed that way abroad.Footnote 97 In India’s official view, in contrast, Unani Tibb was exclusively Muslim, and it is Ayurveda that is universal and, simultaneously, a focus for Hindu majoritarian nationalism.Footnote 98 Both traditions are among several “Indian Medicines,” the official designation, that are regulated and patronized by a separate federal ministry formed in 1985 to oversee educational institutions, hospitals, dispensaries, and drug production. “AYUSH,” its acronym, includes Ayurvedic, Yoga, Unani, Siddha, and Homeopathic traditions.Footnote 99
Official policies make Indian medications part of “soft diplomacy” and a valuable product in international trade.Footnote 100 In India, Ayurveda is favored in this marketing, and, for many Indians, its use marks a person as a national subject. Ayurveda is imagined as rooted in Vedic sacrality with Dhanvantri, its (long little-known) god, now honored in an annual national holiday.Footnote 101 The nationalist edge was the more powerful for the argument that Muslims, always a foil for the construction of Indian nationalism, had been the cause of Ayurveda’s alleged decline. This attitude has only grown as “Hindutva” populism and Muslim marginalization increasingly hold sway.
Official policy shapes Unani Tibb’s marketing primarily to Muslim populations, especially in the Middle East, even if tibbī practitioners usually resist this view.Footnote 102 Hamdard (India) has to assert itself to claim tibb’s medical universality: “…entirely secular and for the benefit of the nation as a whole.”Footnote 103 Thus Rooh Afza, the beverage noted above, is marketed as natural, “scientific,” and “a great additive for mocktails and desserts.” It “maintains [and] adjusts the body’s water level.”Footnote 104 It also succeeds in evoking nostalgia and authenticity with its original label from over a century earlier preserved.Footnote 105 But, even if trendy and authentic, like Unani Tibb generally the beverage also has to fit into the iron cage of Indian communitarianism and be a symbol of Muslim difference, as tibb was with more benign implications for Hakim Ajmal Khan. Beginning under the leadership of Muhammad Sa`īd’s elder brother, Hakim `Abd al-Hamīd (1908–1999), Hamdard in India has patronized tibbī education and research as part of a menu of “Islamicate” cultural activities, like Sufi music and Urdu poetry. The use and cultural underpinnings of each component of AYUSH are not timeless.Footnote 106
The uses and meanings of traditional medicine in the Indian subcontinent today are not those of the long-ago Delhi activists, nor, assuredly, of Thanawi. When Thanawi wrote, the day when tibbī ingredients and medications were available on Amazon, and medical choices were integral to social identity, was still far away.Footnote 107 Even as late as the 1980s, when I visited the Hindustani Dawkhana’s wonderful old building in the winding Gali Qasim Jan of old Delhi, its drawers and containers of dark polished wood holding mysterious and precious ingredients evoked the legendary shop of the medieval `attār perfumer or apothecary, providing makings and medicaments from near and far. Pharmaceuticals have come a long way from Thanawi’s “craft production” as part of the disciplined practices of health maintenance that he taught to shape a woman’s pious and responsible life.
For all the changes of a century and more, though, Thanawi’s focus on individual faithfulness and practice in their Deobandi version remains an important theme in South Asian Islamic life, specific recipes and treatments aside. Sovereign over her own body, vigorous in health, and exercising emotional control worthy of worldly and divine approval, Thanawi’s reader then and now might be a changed person, more conscious of herself as a woman, and more focused on being a woman of a particular kind—informed, disciplined, and discriminating in her associations. She would be attuned to ensuring habits and environment and food and therapies to sustain her whole family’s vulnerable and porous bodies as well. Contrary to assumptions that Islamic leaders invariably advocate political control, Deobandis like Thanawi classically have emphasized that it was precisely in the personal domain that a person could know the satisfactions of divinely guided purposeful life, no matter the challenges of her immediate life, no matter the failures or even malevolence of the socio-political domains in which she might dwell, from colonial time down to the present.
Deobandi `ulama like Maulana Thanawi never wavered from this emphasis on individual reform from the ground up, even when many of the `ulama participated in nationalist movements in the interwar period.Footnote 108 As the century progressed, and Thanawi’s extensive popular influence continued, he would be honored by an epithet that evoked healing and simultaneously placed him in the ideal and undefined world of Muslims in all places and times, the umma. Footnote 109 There, he was nothing less than Hakīmul ummat, the Physician of the Community, fortifying health in its broadest sense for individuals, their families, and those around them. In the Bihishtī Zēwar, of which these teachings on health were an essential part, the Hakim put his vision of a pious, competent woman— sovereign in her control of her self and of all around her—at the very heart of that longed-for transformation.
