INTRODUCTION
The opposition of individualized creativity and ownership (which is modern, rational, and progressive), with common knowledge shared by a community (which is traditional, nonrational, and static) is a central underlying assumption of the so-called “efficiency arguments”Footnote 1 for the expansion of privatized IP into new and controversial domains. The rationalization is as follows: The most effective way to inspire innovation is for the state to confer property rights to individuals over their new and original creations. The inducement of profit, then, institutionalized by the legal apparatus of private property, can serve as the rational motivation for innovation. Thus, innovators are motivated to do so because their right to profit from their innovations is legally secured, and in consequence, the relationship between individual innovation and individual profit is stabilized as an emergent and rational feature of the market.
It has been argued that the concept of creativity employed in these efficiency rationalizations is based upon a rarified conception of the individual as a creative agent, who heroically works in isolation—separate from other persons, texts, and contexts—and thus, whose innovations are original manifestations of inner genius, encapsulated in the mind of the individual person.Footnote 2 Scientific discoveries are often represented in just this way, as flashes of insight within the minds of great scientists, but empirical research in their labs evidences the incremental character of the discovery process, in which innovations are based in part on historically prior research.Footnote 3 Innovators often, perhaps always, draw inspiration from other sources, many times explicitly so, and this social and intertextual nature of human creativity is reflected and originates in the social and intertextual nature of thinkingFootnote 4 and discourseFootnote 5 more fundamentally.
In spite of the dubious evidence for a heroic concept of the autonomous creative process, the commitment to high individualism has been ideologically central to the expansion of IP rights to encompass the knowledge of communities at the periphery of the capitalist world system. Knowledge in these societies is represented as shared, common, and traditional, and as part of the set of beliefs and practices that constitute how people produce a living. The socially transmitted and nonindividualized nature of knowledge is represented as an exemplification of precisely what is wrong with these traditional societies—they lack the inducement of private property and in consequence, they lack the pattern of innovation that characterizes modern, free-market societies.
The international legal response to the asymmetrical privatization of the knowledge of so-called traditional societies—as typified by the biopiracy of medical knowledge by pharmaceutical capitalists—has relied heavily upon a particularly exotic representation of the qualities of knowledge in such societies. Traditional knowledge is often represented in international legal discourse as disembodied cognition (i.e., pure ideation), for example as in the United Nations Education, Scientific, and Cultural Organization's (UNESCO) concept of “intangible culture heritage.”Footnote 6 While represented in that text as intangible, this culture, I argue, is only realized and known through its manifestation of material artifacts, embodied practices, and social relations. This idealist framing of culture is part of the basis of what the United Nations (UN) World Intellectual Property Organization (WIPO) and the Convention on Biological Diversity (CBD) has called “Traditional Knowledge” (TK)—that is, knowledge held by a homogeneous and deindividualized collectivity that is believed to be a characteristic of premodern societies.Footnote 7 The irony here is that the extension of IP rights to collectivized knowledge involves identifying a set of TK bearers—who are, of course, individual persons. There is a consistency of this logic in that the only kind of culture capable of being a feature of such a deindividualized collectivity is, of course, a generalized disembodied cognition (once knowledge is understood as embodied, it must also be understood as individualized, social mediated, and material). An additional irony of this idealist representation of TK is that the copyright laws designed to protect such knowledge often require that a material artifact form be tied to the claimFootnote 8—that is, the laws require as an authentication the very materiality—individualized and socially mediated as it is—that their own categories tend to obscure. As I argue below, neither the collectivity nor the disembodied knowledge has any ontological reality, but they form a tautological and mutually reinforcing ideological representation. It is this representation of individual creativity and its opposite, TK, which dominates the discourse of the expansion of IP rights.
Legal anthropologists and anthropologically oriented legal theorists have made excellent headway in documenting the effects of IP law on societies on the margins of the capitalist world system.Footnote 9 However, the response from anthropology in general to the privatization of TK has not been critical enough of the binary logic of modernization theory, with modern individuals with proper IP rights on the one side, and traditional collectivities with ironic and problematic IP rights on the other.Footnote 10 The Ayurvedic pharmaceutical practices that I observed in Kerala (south India) do not conform well to this private versus public, individual versus collectivity opposition. There, individual innovation is quotidian, and these individuals profit by constraining the circulation of those innovations as the “secrets” (rahāsya) of their “lineage” (prambara), or, conversely, they increase their “fame” (praśasta), and thus, their clientele, by the disclosure and wide circulation of their secret knowledge.
In this article, I document this case of creativity in Ayurvedic medicine by tracking some of the complexities of what linguistic anthropologists have called “entextualization”Footnote 11—that is, how practitioners appropriate and deploy the texts and talk of expert and lay individuals and groups, and in doing so, also innovate, inscribe, and circulate their own emergent medical knowledge. The role of texts as authorities and as tools of the trade has been well documented for the “scholarly medical traditions,” including Galenic, classical Chinese, and Ayurvedic medicines.Footnote 12 However, the concept of entextualization that I draw upon and develop here is not limited to the writing and deployment of text but rather the appropriation, circulation, and transformation of discourse more generally (that is, it includes but is not limited to text). For example, while contemporary Western biomedicine is excluded from the text-based “scholarly medical traditions” documented by Don Bates and his colleagues, it is, in fact, the case that clinical encounters in contemporary biomedicine involve a great deal of reports of other peoples' discourse. All participants in such clinical encounters, including patients, their copresent social relations, doctors, and other medical professionals, tell stories about themselves and about others that often reference or report prior discourse from other social domains. Participants report the discourse of prior clinical encounters or of encounters with other medical professionals and patients, and they cite research and other sources of medical knowledge to bolster their claims, including professional journal articles, the Internet, and TV, and what they have been told by other interlocutors. Clinical encounters frequently include a great deal of such talk about talk. The entextualization of talk in biomedical clinical encounters is often re-entextualized in other subsequent contexts, either through more talk about talk or through bureaucratic entextualizations, such as notes in the patient's file used to document the diagnosis and treatment for the purpose of billing an insurance company and/or to document that professional and legal ethical guidelines are being followed. Discourse from clinical encounters is also entextualized in research reports (and re-entextualized thereafter), and the present text that you now read is itself one such entextualization of Ayurveda discourse, as are the IP discourses that I will discuss below. So, while entextualization seems to refer to a process common to medical discourse generally,Footnote 13 we shall see that its processes and consequences take forms that are particular to the history of Ayurveda. This claim that the historical particulars of Ayurveda effect the circulation of medical discourse will not be too surprising or controversial. In this article, however, I make the additional argument that the particular process of this circulation of discourse in Ayurveda is itself a mechanism of historical change.
Entextualization is a concept that I use to describe moments of creativity, when the words and texts of other speakers and of other authors are joined with one's one voice. This is a generative process in that the act of entextualization itself is the production of discourse, and thus, creates the conditions for other future entextualizations. Indian medical practitioners entextualize in their daily clinical and intellectual activity by drawing upon and coordinating various sources, including their codified textual tradition, the talk and texts of their teachers and peers, and their own clinical experience.
There are two features of entextualization that I want to foreground as particularly relevant to the debate on the expansion of IP rights. One is that entextualizations involve a representation of the ultimate authority of an utterance, what Erving Goffman has called the “Principal.”Footnote 14 An utterance's Principal may in some cases contrast with the person who designed the utterance (the Author) and the person who utters the utterance (the Animator). Representations of Principal-hood are the basis of the production of value and of property claims over such value. The entextualizations of medical knowledge that I will describe below often involve hybrid projections of Principal status, combining the authorities of particular individuals, social groups such as lineages and tribes, institutions such as laboratories and temples, God, the tradition of Ayurveda, and the Indian state.
The second relevant feature of entextualization practice that relates to property claims is that entextualizations are not only representations of the Principal of a claim to knowledge, but they are authentications of the value of that knowledge. This is one of the important relationships between language and political economy argued by Judith Irvine as central to the development of a critical anthropology of value.Footnote 15 Language is multifunctional, and one of its functions is to refer to the world, that is, the property of reference. The authentication of reference is based on a “linguistic division of labor,”Footnote 16 which in this case is constituted by experts such as Ayurveda doctors, drug producers, and scientists of various sorts, who entextualize the value of that reference. These experts create documents or perform testimony that a particular drug is made of certain ingredients in specified amounts (and not of other ingredients in different amounts), and that the drug will help with a particular health problem (and not harm the person or do nothing at all). Entextualizations are thus discourse performances and text inscriptions that authenticate the value that is the basis of a property claim. As we shall see below, only some entextualizations of value produced by a linguistic division of labor are recognized by the current global patent regime.
This article will track the “natural histories of discourse”Footnote 17 created through the entextualization practices of Ayurvedic medical practitioners in Kerala. This analysis will make clear that creativity in Indian medicine is not well understood by the current discourse of privatization and its countercritique. The article also documents, however, two historical shifts in the entextualization of Ayurveda knowledge that have entailed a partial imposition of the public/private dichotomy. First, I describe a reification of the opposition between “codified received knowledge” (śāstra) and its “interpretation” (vyākhyāna) based on “experience” (anubhava) that occurred in the late British colonial period. The second shift in entextualization involves the dual adoption in India of the World Trade Organization (WTO) patent regime (through Trade-Related Aspects of Intellectual Property Rights [TRIPS])Footnote 18 and the CBD, which entail, respectively, the individual and the community as the units of ownership. These shifts in Principal-hood represent a partial imposition in Ayurveda of the public/private, collectivity/individual conception of knowledge that is indicative of the IP rights discourse. These shifts also demonstrate a key theoretical innovation of this article, that entextualization is not only subject to the particulars of history, but it has important historical consequences in itself. Thus, the concept of entextualization refers to a mechanism of historical action with particular consequences in the age of IP law and discourse.
I propose that more research on the intertextual character of innovation can shed light on the complexities of creativity in different societies—complexities that will likely trouble the received categories of modernization theory. I also argue that this focus on entextualization can expose the processes involved in the imposition of those categories on the knowledge-production practices of societies at the margins of global capitalism. However, before delving into the case of creativity in Indian medicine, we should consider in more detail the categories promoted by the discourse of privatization.
INDIVIDUALISM AND ITS OTHER IN THE DISCOURSES OF PRIVATIZATION
The imposition of the international patent regime in India through the adaption of TRIPS expanded a legal concept of individualized IP. The international legal response to this institutionalization has been to assert the predominately common and social nature of knowledge in societies situated at the geopolitical margins. The legal theorist James Boyle defended the intellectual basis for this collectivist framing of TK.Footnote 19 He argued against the heroic concept of innovation central to IP theory, that innovations can be understood as created solely by individual persons. Rather, inventors draw upon a “cultural commons,” the so-called public domain, which provides the raw materials out of which innovation is fashioned. He also suggested that TK is a form of cultural commons, and he developed the metaphor of “cultural environmentalism” to suggest that the conservation of this common knowledge was a benefit to humankind that was worthy of recognition and protection under IP law. Boyle's metaphor provided a needed basis for the legal recognition of the knowledge of the Global South. “Paradoxically, however,” as argued by Madhavi Sunder in her excellent critique, “the concepts of ‘traditional knowledge,’ the ‘public domain,’ and ‘cultural environmentalism’ are now proving to be obstacles to understanding poor people's knowledge as intellectual property.”Footnote 20 The reason for this unintended consequence is because these concepts assume a form of knowledge that is static and devoid of a generative process of innovation. These categories represent the possessors of such TK as the stewards of the raw materials that might form the basis of novel innovations. These stewards of the cultural commons are not themselves innovators, however. And the denial of innovation, as Vandana Shiva argued, is the central and defining feature of the act of biopiracy.Footnote 21 While the creation of the legal category of TK provided a basis for recognizing a previously obscured source of innovation, the particular static and collectivist framing of the concept left intact the opposition of tradition and modernity—that is, between knowers and innovators—at the basis of the asymmetrical structure of IP discourse.
Consider, for example, the definition of culture in the UNESCO Convention for the Safeguarding of the Intangible Cultural Heritage:
The intangible cultural heritage means the practices, representations, expressions, knowledge, skills—as well as the instruments, objects, artifacts and cultural spaces associated therewith—that communities, groups and, in some cases, individuals recognize as part of their cultural heritage (emphasis mine).Footnote 22
The individual is the marked and exceptional category in opposition to the unmarked and normative culture-bearer categories: communities and groups. The definition is not clear regarding how it is possible for intangible culture to be a definitive feature of communities and groups but for it to be only an occasional feature of the individuals within those communities and groups. I suspect that this privileging of the collectivity relates to the second problem in the definition, its idealist framing of culture. In fact, intangible cultural heritage is mainly described in ideational terms as “… representations, expressions, knowledge, skills…. ” However, such “intangible” ideation is only realized through its social-material forms of (1) “practices,” (2) in terms of the idea's objective and spatial materializations as “… instruments, objects, artifacts and cultural spaces …,” and (3) mediated by bodies in the context of social relations, “… communities, groups and, in some cases, individuals…. ” How does this idealization of culture affect the legal institutions designed to coordinate an international approach to IP rights?
UN WIPO aims to expand IP to reward creativity, which includes the international coordination of IP laws. Another goal is the extension of IP law to include what they call traditional knowledge (TK). WIPO amendments on the protection of TK have focused on ensuring that IP rights are not given to those who are not the customary TK holders. WIPO definitions of TK include the “know-how, skills, innovations, practices, and learning which is collectively generated, preserved and transmitted…. ”Footnote 23 Note the predominantly idealist framing of TK, which is produced “in a collective framework including codified knowledge systems…. ”Footnote 24 There is, however, an important material component to the WIPO framing of TK, which is its representation of TK as “part of a collective, ancestral, territorial, spiritual, cultural, intellectual and material heritage” (emphasis mine).Footnote 25 This last component, the “material heritage,” is part of the bio-ecological nature of TK, as “intrinsically linked to biodiversity natural resources.”Footnote 26 Thus, the link between TK, the collective, and the ecology is essentialized, and TK itself is represented as “inalienable, indivisible and imprescriptible”Footnote 27 from the people who have produced it. This last statement belies the rather obvious fact that knowledge produced in any context, including the TK context, can take a discursive form, and it is thus alienable, which is precisely the reason for the extension of IP rights to TK knowledge holders. The CBD has left the TK category undefined but encourages a conception of TK as a community's relationship to their environment. “Traditional lifestyles” and “[local] knowledge,” described in Article 8(j) of the Convention, is to be protected by national legislation because of its relevance “for the conservation and sustainable use of biological diversity.”Footnote 28 The Nagoya Protocol of the Convention on Biological Diversity specifically develops this theme of TK and TK holders as bound to nature (in effect, TK as nature).Footnote 29
These representations of TK approximate very closely the foundational concept of culture in the history of anthropology and sociology, classically defined by Emile Durkheim as a shared set of publically available symbols that serve the function of binding persons together in social solidarity.Footnote 30 In this framework, TK is acquired as common knowledge by members of the group and the role of the individuals within the group is to embody and reproduce that knowledge. All members of the society have equal access to the knowledge, and everyone has equal use rights. Of course, this Durkheimian perspective overemphasizes the shared and homogeneous qualities of culture. This problem became obvious to the first and later generations of anthropologists who attempted to develop Durkheim's ideas,Footnote 31 who found that individuals in other societies cannot be collapsed into pure collectivities and that a more complex and hybrid concept of social solidarity was required. Also problematic, however, is the idealization of culture at play in the concept of TK. Knowledge, represented as common, is a concept that lacks any embodiment within a social context. What are the social and material conditions of the entextualization of this knowledge, its creation, circulation, and use? This idealist concept of culture is based on the Cartesian conception of knowledge as pure cognition—separate from objective, tangible, bodily materiality. This idealization of culture has certainly been the subject of a rather sustained critique, especially from Marx and the traditions following him: Soviet psychology, literary studies, and British cultural Marxism.Footnote 32
In the history of American anthropology, a debate took place specifically about this issue of the ontology of culture, between the first-generation Boasians: Alfred Louis Kroeber and Edward Sapir.Footnote 33 Kroeber argued that culture is superorganic in nature, and thus, that it exists independently of the individuals in a society. Sapir responded, quite rightly from the perspective of current anthropology, that it is individuals who produce, change, and transmit culture, that there is considerable individual and social variation of culture within a society, and that individuals present their culture differently depending on the social context. Likewise, TK should be seen not as a superorganism but rather the embodied knowledge, skills, and practices that are realized in social and material contexts.
While there are strong conceptual grounds for a more materialist and individualized concept of culture, the empirical evidence of individualization in Ayurveda makes the case more clear. In the conclusion of this article I return to anthropology's potential roles in debates about IP, but first, in the sections that follow, I demonstrate the more complex nature of the relationship between individual and society in the context of Ayurveda. I first develop this case in terms of the practices and ideologies related to the codified, received tradition in Ayurveda—the domain of knowledge most closely associated with the community of medical practitioners.
BETWEEN “RECEIVED KNOWLEDGE” (ŚĀSTRA) AND “EXPERIENCE” (ANUBHAVA)
There is a rich literature in the anthropology and history of medicine that focuses on the processes of innovation in Indian medicine, particularly concerning the practice of cross-disciplinary appropriation between Ayurveda and other South Asian medical practices, and between Ayurveda and biomedical science and medicine. The work of the anthropologist Charles Leslie is particularly important to mention because he was the first to explicitly center medical pluralism as an object of study, specifically by foregrounding the processes of syncretism between medical traditions.Footnote 34 This was a radical insight when Leslie first documented the process of medical syncretism in the early 1970s. Anthropologists of that day had uncritically accepted a purist ideology of Western medical hegemony in India, assuming that plural medical systems were abnormal, historical survivals of a premodern culture. Leslie's countercritique framed some key questions about the history and practice of Ayurveda that continue to motivate a great deal of productive inquiry, including the present inquiry. Almost every anthropologist of Ayurveda has had to deal with the syncretistic nature of contemporary Ayurveda and the plural context of healing in India, and there are many excellent works that analyze specific syncretistic projectsFootnote 35 and plural medical systems.Footnote 36 Also, Jean Langford's excellent monograph provides us with an ethnographically detailed account about how various doctors, differently positioned, inhabit and contest the hegemonic discourses and boundaries of Ayurveda.Footnote 37 Leslie understood the asymmetrical nature of the relationship between Ayurveda and biomedicine, and thus, his work anticipated many of the events and social movements of twenty-first-century Ayurveda. These include medical tourism,Footnote 38 the New Age movement,Footnote 39 pharmaceutical industrialization and biotechnology,Footnote 40 and the globalization of Ayurveda knowledge.Footnote 41
So, it should be clear that the theme of medical innovation is well developed in the anthropology and history of South Asian medicine. However, such innovation is not limited to syncretism, and it is not only historically recent, as the overwhelming focus in the literature on the hybrid character of Ayurvedic modernity would have us assume. The anthropologists Gananath Obeyesekere and Margaret Trawick, for example, have documented the more quotidian forms of medical innovation, including experimentation with different drugs or combinations of drugs to treat patients with complex or novel symptoms, and the process of discussing and debating such treatments with colleagues.Footnote 42 Likewise, it is clear from the work of the Sanskrit medical historian Francis Zimmermann, that such quotidian and disciplinary forms of medical innovation were central to the historical development of Ayurveda's epistemology.Footnote 43 While it is the case in this epistemology that certain sources of knowledge are considered to be highly privileged (and even divine), they are not understood by practitioners to be beyond question and further development.
The most privileged of the epistemologically authoritative sources of truth in Hindu philosophy is the divinely authored and transcendent knowledge of the four vedas. Ayurveda is considered a “sub-Veda” (upaveda) of the third veda, the Atharvaveda, and like many other traditions of learning in India it claims a Veda-like transcendent authority by tracing an unbroken “lineage” (parampara) back to a divine source.Footnote 44 Contemporary practitioners of Ayurveda are not exclusively Hindu, but they nevertheless understand how Ayurveda is related to this historically ancient tradition. As such, their formal training in Ayurveda colleges involves the many hours of work necessary to acquire some competency in classical Sanskrit, and to study and to learn to interpret the authoritative texts of their tradition. The most respected sources of knowledge in Ayurveda are a set of “compendia” (saṃhitā) known as the “great three” (bṛhat-trayī), which are Carakasaṃhitā (c. 300–200 bce), Suśrutasaṃhitā (c. 200–100 bce), and Aṣṭāṅgahṛdaya (c. 600 ce).Footnote 45 These texts constitute Ayurveda's epistemologically authoritative corpus of codified knowledge. Such knowledge is collectively known as śāstra.
The term śāstra has a variety of meanings and, depending on both the context of use and the political orientations of the practitioner, the term can be translated into English in a number of ways that might seem contradictory. These translations include both “scientific knowledge” (in the cosmopolitan and historically Western sense) and “sacred knowledge” (in the Hindu religious sense), or simply “a discipline of knowledge,” scientific, sacred, or otherwise. Ayurveda practitioners, however, who would themselves deploy the term in these myriad ways, emphasized to me that śāstra is knowledge that is “handed down”—handed down from God, from their lineage, from the texts, and/or from prior vaidya trained in the tradition. Śāstra is thus time-tested knowledge. Practitioners with Marxist or modernist inclinations (both not uncommon in Kerala) tend to interpret this “history” (caritra) as the basis of Ayurveda's scientific status, whereas others interpret the time depth of Ayurveda as a sign of the knowledge's descent from a divine cosmological source (and in my experience, many practitioners hold some combination of both positions). Whatever an individual's orientation toward such issues, to become an Ayurveda practitioner, students must (quite literally) embody śāstra by committing large amounts of text to memory. This process can be seen depicted above in Photograph 1, which shows a group of female students at an Ayurveda college studying for an exam by repeatedly reciting the assigned verses, emphasizing with their steps the conclusion of each hemistich as they pace back and forth along the hallway. Students learn how to produce these verses in their distinctively metricalized form and to interpret them as key points of Ayurveda knowledge. The citation of such verses is a common practice in classroom pedagogy and scientific debate and is often deployed to evidence the speaker's “interpretation” (vyākhyāna) of the tradition.Footnote 46 Ultimately, and again this is a point made very systematically by the work of Francis Zimmermann, Ayurveda doctors embody their acquired knowledge of śāstra through their daily clinical practice.Footnote 47 This occurs whenever they apply the basic principles, such as the “three humors” (tridoṣa) and others of importance, to the work of healing patients from the uniquely “ecological” perspective of Ayurveda.Footnote 48
Śāstra—vaidya-śāstra (medical science) in particular—is different from other forms of sacred or “spiritual” (devika) knowledge that originated from or are understood to be a comment upon the transcendent authority of the vedas. The function and healing of the human body is a decidedly “worldly concern” (laukika). As a consequence, the śāstra of medicine must deal quite directly with the complexity and contingency of human persons, environments, and social contexts. Thus, vaidya do not (in fact, cannot) apply the knowledge of śāstra in a law-like manner, but rather, they must employ both “reason” (yukti) and their “experience” (anubhava) acquired through clinical “practice” (prayoga), to construct an “interpretation” (vyākhyāna) that is appropriate to the contingencies of the particular patient and context.
This process of particularizing śāstra to the complexities and contingencies of the clinical context is also the process of individuating the clinical style and creativity of particular practitioners. In Kerala, one common term for an expert practitioner in any field is an anubhavastan, meaning “one with experience.” Vaidya with decades of experience often acquire considerable “fame” (praśasta) within the “medical community” (vaidya sampradāya) and within the community at large. Still today, these individuals are shown great respect with rituals of bodily deference. Such vaidya are bhahūmanappettarar, or “respected persons,” who are often addressed by the respect term “(proper name)-sar” and referenced with the respectful third-person pronoun ādeham (lit., “that body”). The testimony of learned and sagely individuals (āptoupadeśa) is described in the classical texts as a valid source of true knowledge because the perception of these rare persons is not constrained by “delusion” (tamas) and “passion” (rajas).Footnote 49 “Experience” is thus a key concept employed by vaidya to cognize their individual relationship with their tradition and their particular interpretation and style of practice.
Some practitioners acquire a degree of local and regional “fame” (praśasta) as healers, and in consequence, they benefit from an expanded clientele. Their patients sometimes ascribe an enhanced mystical efficacy to the medicines of these special healers. One doctor I worked with was reputed by her patients to possess a considerable degree of this mystical efficacy, her “hand fruit” or “hand luck” (kaiphala). These patients would receive the drugs only directly from her hand, and they would come in droves on days of the week and month associated with increased auspiciousness in the Hindu calendar. This doctor encouraged and benefited from this stylization of her clinical practice, but she did not believe in the mystical concept of kaiphala or that drugs purchased on more auspicious days were more effective. Rather, the drugs were effective because she prepared them with expertise according to śāstra. The specific preparations delineated in śāstra are not always available, however, on account of supply shortages in medicinal plants or because the plant is no longer extent or its botanical identity is now unknown. In such cases, which were quite common, she would innovate by adding other ingredients with similar “qualities” (guṇa). Such innovations were commonly practiced by all but the most novice vaidya I knew in Kerala. This pharmaceutical creativity is based on “research” (gavēṣṇa) in the form of clinical experimentation and observation, and on the application of Ayurveda's “theory of material qualities” (dravya-guṇa-vijñāna), which relates an “action” (karma) of a substance to its “savors” (rasa), “qualities” (guṇa) and “properties of hotness and coldness” (vīrya).
This form of pharmaceutical innovation is facilitated by the material complexity of Ayurveda drugs. The ingredients themselves have several qualities and effects, and every drug is a combination or “juncture” (yōga) of multiple ingredients, which are processed together in different ways that change and enhance the drug's clinical effect. This resembles what James Boyle has referred to as the property of “high modularity,”Footnote 50 which allows for different individuals to contribute to different parts of a materially complex product (e.g., open-source software code). Based on experience, research, reason, and the novel extension and application of the theory of material qualities, doctors innovate by tailoring the drugs described in the codified tradition of śāstra to meet the contingencies of the healing context.
Such innovations are developed in the context of practice and repeatedly entextualized in subsequent clinical encounters and in discussions and debates with other practitioners.Footnote 51 Historically, one method used to inscribe the insights of clinical practice was the process of “redaction” (pratisamskara), which is the reproduction of a text while also filling in gaps and contributing new information to the text. The redaction of śāstra is a method for encompassing one's knowledge and innovation within śāstra. This is in contrast with the Ayurveda genre of “interpretation” (vyākhyāna), which makes a clear metatextual distinction between the śāstra as the ur-text and the interpretation-text. The three main texts of the Ayurveda śāstra are primarily associated with their most prominent author, but those individuals were themselves redactors of prior texts, and they are recognized as such. Caraka redacted the text of Atreya, for example, and the text now bears the name Carakasaṃhitā, which has been redacted since by Dṛḍhabala. There are likely many others who are unnamed who have contributed their knowledge to śāstra through the process of redaction. Pratisamskara is thus a process of entextualizing knowledge gained through various pathways and inscribing it as tradition. In some cases the authorship is identified, but in most cases it is not.
Redaction appears to have been a common practice in Kerala up until the printing of edited versions of the “palm-leaf manuscripts” (tali ōla grantha) of locally relevant Malayalam medical texts. For example, the edited and printed version of Cikitsamañjari (Collection of Treatments) was compiled from three main palm-leaf manuscripts that were in the possession of lineages of high-caste practitioners called Aṣṭaviadyan-s. The text went through two rounds of editing, and the first printed version of the Cikitsamañjari was published in 1934. The second editor of the printed Cikitsamañjari describes in the preface how each of the three manuscripts had differences because of redactions made by the practitioners in those lineages.Footnote 52 To my knowledge, this editor was the last redactor of that text. He compared the three versions to reconstruct the most complete text and then, without adding his own insights, he checked the reconstruction against a number of other versions of the text. Unlike the palm-leaf manuscripts, the printed text is inexpensive to reproduce and widely available in Malayalam bookstores that specialize in Indian culture.
The printed book became the privileged version of the text, which is used in Kerala in the education at Ayurveda colleges. Government Ayurveda colleges throughout India established publications departments charged with the task of editing, translating, and publishing rare Ayurveda manuscripts for the purpose of Ayurveda education. The Government Ayurveda College in Thiruvananthapuram and the Arya Vaidya Sala in Kōṭṭakkaḷ have been prolific in their publication efforts. Charles Leslie described the canonization of Ayurveda literature that occurred with the national standardization of Ayurveda education.Footnote 53 The required and recommended texts were delineated in the national curriculum. One consequence of this process was that the Carakasaṃhitā was nationalized as the pan-Indian text of Ayurveda for education in the colleges—and this was a historically novel innovation in Kerala where the Aṣṭāṅgahṛdaya continues to be the favored text.
Another important implication of this canonization, however, is more subtle than the standardization of the tradition taught in colleges. The cessation of the historical process of redaction closed an avenue for the expansion of the tradition and thus, led to the increase of the bifurcation between śāstra and its interpretation. It stabilized śāstra by closing down the process used to incorporate innovations within the textual tradition. The edited printed versions visually manifest the distinction between the original text and expansions and interpretations included through redaction. The text and commentary of the printed Cikitsamañjari have separate lines and margins on the page. I had been studying the printed text for some time, and this visual regimentation of text and commentary did not strike me as historically radical. This changed the moment I sat in the manuscript library at the University of Kerala and held my first palm-leaf manuscript. The scribe had used every available space on the leaf. Sentence boundaries were not marked, and there was no visual-spatial demarcation of the text and its commentary. Thus, the textual objectification of śāstra through printing also entailed an increased visualization of the opposition of text and commentary.
With this closure of śāstra, vaidya have had to develop new ways of entextualizing their experience. Since the colonial period, vaidya have used small handheld hardcover notebooks (note bookŭ) in which they enter their “research” (gavēṣṇa) notes from their observations of clinical practice. Doctors in Kerala can frequently be seen with a note bookŭ in hand, often a recycled datebook. In some cases, practitioners share these notes with novices in their lineage, or with students from the college in a practical study in their clinic. In the clinics and colleges where I conducted my fieldwork, I would occasionally observe a senior practitioner signal the students to gather and open their note bookŭ, and at these moments all students would do so promptly and with great bodily deference, recognizing the gift of experience that was being given. Part of the motivation behind such entextualizations of experience is the belief in the possibility of rediscovering lost panaceas, or “divine drugs” (divya-auṣadha), which are very “simple drugs” (oṟṟamūli) with miraculous healing effects. Carakasaṃhitā records the names and wondrous effects of such “divine drugs,” but their botanical identity is unknown to today's practitioners.
With the increasingly wide availability of print and digital technology, some practitioners have published their experiences, for example, K. D. Kuññurāman Vaidyan's Cikilsa Anubhavaṅṅaḷ (Treatment Experiences).Footnote 54 Likewise, professors at the Ayurveda colleges would sometimes type up their “anubhavaṅṅaḷ” (experiences) as handouts, and students would often treat the computer printout itself with an aura of respect that might be given a rare palm-leaf manuscript. Thus, with the closure of the textual tradition, vaidya have developed novel modes for entextualizing their experience. The continued expansion of the publishing industry in postcolonial Kerala caused the birth of many new genres of Ayurveda literature. This generic diversification includes Ayurveda “translations” (tarjama), “dictionaries” (nighantu), “encyclopedia” (vijñānakōśa), “textbooks” (pāṭhapustaka), “pamphlets” (laghulekha), and books oriented toward the public on special topics. None of these new genres are śāstra, but they all represent śāstra in new forms and thus provide new venues for authors to entextualize their knowledge.
So far we have addressed the local ideologies of truth in the Ayurveda practiced in Kerala and how experience is entextualized as tradition. It should be clear that Ayurveda is an example of TK that is common to the community of practitioners, and at the same time that individual innovation is viewed as central to the practice of that tradition. Importantly, both strategies of encompassing experience within tradition through anonymous redaction and through asserting individual authorship, either as a known redactor or as an interpreter, are historically ancient in Ayurveda literature. The institutionalization of Ayurveda colleges with national standardized curriculum and the development of an Ayurveda print industry were part of the historical process that caused a partial bifurcation of text and context, community and individual, public and private, and tradition and innovation. To be sure, colonialism, nationalism, print capitalism, educational bureaucratic institutionalization, and scientific modernity in India did not create authors and individuals where before there was only the total encompassment of tradition. However, the closure of the authoritative texts did cause significant changes in the entextualization of experience in Ayurveda, most notably, an increased externalization of the genres of experience and interpretation from the now unified genre of śāstra. But again, this is a partial bifurcation, and the next section addresses how it is possible to profit from the porous boundary between the individual innovation and traditional codified knowledge. I will focus in particular on the case of one highly successful Siddha Ayurveda practitioner. The case illustrates how practitioners encompass their innovations within the tradition, a representational practice that is an effective entrepreneurial strategy to profit from novel clinical insights.
ENTEXTUALIZATIONS OF INNOVATIONS AS “RECEIVED KNOWLEDGE” (ŚĀSTRA)
When Ayurveda practitioners in Kerala talk about the topic of Ayurveda they often speak in a voice that unifies śāstra, interpretation, reason, and experience into a singular perspective of “the tradition.” Examples 1 and 2 are utterances taken from a Malayalam television program where an Ayurveda doctor is discussing the procedures for insuring a healthy pregnancy. The ultimate authority for these utterances (that is, the Principal) is linguistically ambiguous.
Example 1:
in the first months nourishing food . . (I) am saying to eat clarified butter and milk
ādhyaṃ māsaṅṅal pōṣaṇaṃ āhāraṃ . . atāyiyatŭ neyi pal kaḻikkān paṟayunnuṇṭŭ
Example 2:
it is on the basis of the content inside it . . (I) am saying that it is MEDICATED ghee . .
atinakattŭ CONTENT anusariccŭ āṇŭ . . atuṃ MEDICATED ghee āṇŭ paṟayunnatŭ . .
(I) am recommending that it not be eaten without purpose
atŭ veṟute kaḻikkān alla uddēśikkunnatŭ
In my translation I have included the first-person pronoun in parentheses so that the English text will not sound awkward or overly vague. However, the pronouns are absent in the Malayalam utterances. Unlike in English, Malayalam pronouns may be easily dropped in situations where authority or status distinctions might be usefully left ambiguous. Thus, the doctor does not distinguish with pronouns her own authority as an Ayurveda doctor (as an experienced practitioner and interpreter of the tradition) and the authority of Ayurveda as a codified textual tradition. Furthermore, Malayalam has lost its person and number verb terminations, which contrasts with the closest related Dravidian language Tamil, as well as with the Sanskrit-derived languages of North India (Hindi, Bengali, etc.). In Example 1, the auxiliary and main verb forms “saying to eat” (kaḻikkān paṟayunnuṇṭŭ) lack any morphological or pronominal indicator of Principal. The same is true of the verbs in Example 2, “paṟayunnatŭ” and “uddēśikkunnatŭ,” which I have translated as “(I) am saying” and “(I) am recommending,” but which lack the linguistic determination of the speaker as the Principal (and the segments also lack any indication that the tradition is the Principal as well). Malayalam pronouns would distinguish the doctor as the authoritative voice, whereas a variety of institutional and social identity noun forms could be used to ascribe authority to the tradition itself.
Ayurveda doctors often speak in this voice, which is neutral or ambiguous as to whether the Principal of the utterance is the tradition of Ayurveda (that is, śāstra) or whether it is the individual practitioner. In utterances such as these, she does not separate herself from the received tradition—the textual tradition is not distinguished from her interpretation of it (i.e., context)—which is an authoritative style used to represent “the tradition” and one's expertise as unified. Similar to the epic voice of literature,Footnote 55 the voice of expertise in Ayurveda represents a unified tradition and collapses the tradition's multivoiced complexity. Certainly such differences exist—differences in the interpretation of texts, differences in applying the tradition in clinical experience—and practitioners often foreground them in debates and other contexts. However, there is a clear tendency for practitioners to represent their knowledge “as Ayurveda,” rather than their particular individualized perspective or interpretation. I asked a retired professor at an Ayurveda college why novel clinical insights are sometimes represented by practitioners “as śāstra” (śāstriyamāyiṭṭŭ), and she explained that this is an example of the conservative nature of the “Indian personality” (bharatīya svabhava), to attribute things of value (even apparently novel things of value) to the golden age of Indian history. There is a particular political orientation to this conservatism, which I describe elsewhere.Footnote 56 However, I focus here on the role of this practice of encompassing innovations within the tradition not as a sign of a particular type of person but rather as an entrepreneurial strategy. It is one important way in which practitioners profit from their innovations.
Ganesh Vaidyan is a lineage-trained Siddha medical practitioner, which is popular in Kerala's neighboring state of Tamil Nadu. He is also a pharmaceutical entrepreneur who lives in the rural hinterland of Kerala's capital city of Thiruvananthapuram. He makes a living as an itinerant drug hawker, and my attention was originally drawn to his pharmaceutical operation in large part because of its astounding success. In two large Humvee trucks, Ganesh Vaidyan and his staff would travel to the major cities of southern Kerala to hawk his drugs in markets, outside temples, and in large, crowded bus stands. I observed these events throughout the course of my research. As soon as Ganesh Vaidyan would start his sales pitch, a large crowd would invariably gather, and on such occasions commerce was often quite swift. His operation became so successful that he was able to start marketing his drugs in some of the “English” biomedical pharmacies in Thiruvananthapuram, where his drugs were shelved next to designer brand Ayurveda cosmetics such as herbal hair tonics and soaps.
In interesting ways, his operation is a marginal case in the region's plural political economy of medicine. Siddha texts are written in the Tamil language. The practitioners and apologists of Siddha who live in Tamil Nadu tend to emphasize the exclusively Tamil origin of the practice, which is linked with Dravidian nationalist conceptions of the primordial Tamil nation. This nation is constituted in opposition to the Aryan and Sanskrit civilization which, they say, spread southward throughout the subcontinent as an aggressor. In contrast, in Kerala, the Sanskrit tradition of Ayurveda is known to be among the most historically robust in India, and the practice is extremely popular throughout the region, which is one of the few places in the subcontinent where patients see Ayurveda doctors as their primary care physicians. So, in the Kerala context, the Dravidian nationalist representation of Siddha's opposition to Ayurveda and Sanskrit culture is a relatively ineffective entrepreneurial strategy, and the few Siddha practitioners that I observed catered to a mainly Tamil clientele. This is in large part on account of Ayurveda's ideological hegemony and popularity in the regional political economy of medicine. Thus, Ganesh Vaidyan has adapted a bivalent representation of self and his medicine, as a practitioner of Siddha Ayurveda, which in Kerala is both foreign and exotic, and local and culturally legible (the strategy is apparently common in the Kerala-Tamil periphery).Footnote 57
In Photograph 2, we see the spatial organization of Ganesh Vaidyan's performance of this bivalency, the staged drug-hawking event. The scene is being made ready for his arrival and performance. In the left corner, a worker is preparing Ganesh Vaidyan's main commodity, a medicinal oil used to treat vāta conditions such as rheumatism. In the center of the photograph are 108 medicinal-plant ingredients displayed in little boxes, reminiscent of a natural history collection without the labels. To the right of the photograph, a salesman interacts with customers. Ayurveda and Siddha medicines are famously complex, produced from a composite of a great number and variety of constituent ingredients. However, 108 constituents are far more than typical, and in consequence, the “medicinal oil” (tailaṃ) that results is a dark odorous viscos substance, full of many “qualities.” Ganesh Vaidyan was very clear in my discussions with him that he enhanced the drug taught to him by his father by adding common folk-medical ingredients that he learned about since moving to Kerala and other ingredients that he took from other drugs used in his tradition. His drug sales pitch referenced a few of the folk medicines included in the tailaṃ as a strategy to identify with the audiences' regional botanical “folk knowledge” (natŭ-aṟivŭ). He encompassed his knowledge within the codified tradition of Ayurveda, a point which was emphasized in the speech that he delivered to an audience of about 150 onlookers one night outside the main temple in Thiruvananthapuram's historic fort complex:
1This is Ayurveda. 2When I speak of Ayurveda it is often asked. 3“No dear Vaidyar … Who discovered this Ayurveda?” 4My father … my father's grandfather and so on were Vaidya. 5No one among us has discovered (Ayurveda). 6Who (then) discovered Ayurveda? 7In the (ancient) time when the Gods lived they had sickness. 8(When) all of these Gods ran together where did they arrive? 9They arrived next to (Lord) Brahmāvŭ. 10The advice given by (Lord) Brahmāvŭ to the Gods is the Veda…. Ayurveda. 11The Veda is … the advice that Vaḷḷŭ, Varakāsuri, Dhanvantari, Kūpaṃ, and all the rest of the 18 sages discovered. 12It was the Siddhars who discovered it. 13It is nature's treasure.
1itŭ āyurvēdamāṇŭ 2āyurvēdamennŭ ñān samsārikkumpōḷ cōdikkuṃ 3“alla vaidyarē … ī āyurvēdaṃ ārŭ kaṇṭupiṭiccŭ?” 4enṟṟe acchan … acchanṟṟeapupan okke vaidyanmārā 5ñaṅṅaḷārauṃ kaṇṭupiṭiccayallā 6āyurvēdaṃ ārŭ kaṇṭupiṭiccŭ? 7dēvanmāṟ jīviccirikkunna oru kālakhaṭṭattil dēvammāṟkkŭ āsukhaṃ 8ī dēvammāṟellāṃ kūṭi ōṭi eviṭe cennu? 9brahmāvinṟṟe aṭuttŭ cennu 10brahmāvŭ dēvammāṟkkŭ upadēśiccŭ koṭukkappeṭṭa vēdamāṇŭ … āyurvēdaṃ 11vēdamāṇŭ … upadēśamāṇŭ vaḷḷŭ varakāsuri dhanvantari kūpaṃ tuṭaṅṅiya patineṭṭŭ ācāryanmāṟ itŭ kaṇṭupiṭiccaŭ 12siddharkaḷāṇŭ … itŭ kaṇṭupiṭiccatŭ 13itŭ prakṛtiyuṭe sambattāṇŭ
This vision of śāstra emphasizes the practitioner's identity as a member of a lineage (parambra), which extends back to the original sages who were themselves taught by the God of creation. The name of the drug, Vātarōga Siddha Maṟmmāṇi Tailaṃ, which he references in the following transcript and elsewhere throughout the corpus, marks the drug as emerging from the Siddha tradition, which focuses on the treatment of vital spots (or maṟmmā). He also refers to the sages who received Ayurveda from God as Siddhars (lines 11–12), although the list includes individuals referenced in the Sanskrit canon, the most prominent of which is Dhanvantari, who is sometimes worshiped as the “God of Ayurveda.” At the same time, however, Ganesh Vaidyan identifies the drug as Ayurvedic, and his knowledge as descended from a lineage going back to the original sages who received the knowledge from Lord Brahmāvŭ. He thus encompasses his own knowledge within the divine origin narrative of Ayurveda. The drug, in this way, is represented as both the familiar, trusted, and popular Ayurveda, as well as the foreign and exotic Siddha.
On account of the passage of time and because of the limited and faulty nature of human persons in the present epoch—the “final and degraded epoch” (kāliyuga) of Hindu cosmology—much of the perfect knowledge of health and long life given by God to the original sages is believed to be lost. A claim of an unbroken lineage extending back to the original encounter with God suggest the possibility that some of this now-lost perfect and transcendent knowledge of health has survived as the “secret” (rahāsya) of the particular family and vaidya. Traditional vaidya such as this one are often suspected of possessing this secret knowledge—and they guard it carefully. Patients would sometimes complain about this reticence, explaining that it was typical for vaidya to withhold such knowledge even from the disciples within their lineage. They explained to me that vaidya would teach their disciples the craft but that they would omit the most essential ingredients of their most prized drugs, which they would disclose in a dramatic fashion just prior to the moment of their death. Local scholars lament this practice which, they argue, has inevitably led to a great loss of knowledge from the tradition.
Ganesh Vaidyan, as the embodiment of such secret knowledge, emphasizes to his audience how all 108 drugs are necessary, and that two full measures of each drug are added to the cauldron and prepared publicly right in front of the crowd's eyes. Through his disclosure of the ingredients—his “secrets”—Ganesh Vaidyan represents himself as a trustworthy person who prepares the drug publically, not in the privacy of his “hospital” (vaidyasala). His sales pitch itself, and also the performance context of the public manufacture of the drug, constitute an “authentication of value,”Footnote 58 that is, a performative certification of the authenticity of reference (i.e., the constituents of the drug):
1dear friends. 2should (we) not add these 108 medicines, let me ask that. 3can you substitute oil with water? 4mustard oil is needed … gingerly oil is needed … castor oil is needed 5all the medicines seen are needed. 6then this many medicines are added. 7I prepare the oil. 8each drug (I) take and make good. 9which ever part of the body there is a pain, sprain, dislocation, seizure, or frozen muscles. 10these 108 medicines (which you are) seeing right there … two measures (of each) are added together, taken and pressed. 11these 108 medicines (which you are) seeing, two measures (each) right in front of your eyes are taken (and prepared). 12publicly itself (they are) pressed. 13publicly itself (they are) powdered. 14publicly in it (the bottle) (they are) distilled and filtered. 15the name of this oil is Vātarōga Siddha Maṟmmāṇi Tailaṃ.
1suhṛttukkaḷē 2ī nūṟṟiyeṭṭŭ marunnukaḷ cēṟkkaṇṭē ñān cōdikkaṭṭē 3eṇṇakkŭ pakaraṃ veḷḷamoḻikkān okkūō? 4kaṭueṇṇa vēṇaṃ … nalleṇṇa vēṇaṃ … āvaṇakkeṇṇa vēṇaṃ 5ī kāṇunna muḻuvan marunnukaḷuṃ vēṇaṃ 6appō itrēṃ marunnukaḷuṃ cēṟttā 7ī tailaṃ ñān tayyāṟ ceytatŭ 8ōrō marunnukaḷ eṭuttōḷū 9śārīrattinṟṟe ētŭ bhāgattŭ oru vēdanayō vilakkamō uḷukkō piṭittamō kōccŭ 10ī kāṇunna nūṟṟiyrṭṭŭ marunnukaḷuṃ dā … ī raṇṭŭ kaḻañcŭ vītaṃ … cēṟkkayā eṭttŭ iṭikkū 11ī kāṇunna nūṟṟiyeṭṭŭ marunnukaḷuṃ ī raṇṭŭ kaḻañcŭ vītaṃ … dā niṅṅaḷuṭe kaṇṇinṟṟe mumpilvaccŭ eṭuttŭ 12parassyamāyi tanne iticcŭ 13parassyamāyi tanne poṭiccŭ 14parassyamāyi itil kācci aricceṭukkunna 15ī tailattinṟṟe pērāṇŭ vātarōga siddha maṟmmāṇi tailaṃ
Ganesh Vaidyan is a pharmaceutical innovator and the embodiment of a tradition of received knowledge. His entrepreneurial strategy for profiting from this knowledge is one of public disclosure and the presentation of himself as a local and trustworthy vaidya. Some in the audience were skeptical, noting to me that the oil in the caldron (see the left side of Photograph 2) was not the oil being distributed, which was itself premanufactured and bottled as a “readymade” medicine. Perhaps he had not revealed his secrets; perhaps he had. At a hundred Rupees a bottle (about US$2.20 at the time), many in the audience were willing to give the medicine a try—and Ganesh Vaidyan's rapidly expanding operation was plenty evidence of the success of his strategy.
Thus far this article has documented the ideologies of knowledge in Ayurveda and some patterns of pharmaceutical innovation employed commonly by practitioners. We have also documented strategies for representing such new knowledge as traditional and for profiting from innovations by the disclosure of “secrets.” Next, I present some recent shifts in the entextualization of knowledge and innovation in Ayurveda that were developed in response to TRIPS and the CBD.
BUREAUCRATIC ENTEXTUALIZATIONS OF INDIAN MEDICINE
At the start of my research, I found the Ayurveda institutions of the colleges, hospitals, and laboratories that were administered or sanctioned by the government of Kerala to be closed to outsiders such as myself. Prior to my identification of the proper gatekeeping procedures, my inquires at these institutions were constantly routed to vaidya in private practice or to the margins of the institutions. I described my experience of this to the State Director of Ayurveda Education. He explained that the reason for the reticence was that Westerners have been known to enter Kerala under the false pretense of an “interest” in Indian medicine and, later on, found to be misappropriating Ayurveda's knowledge of medicinal plants for personal economic gain. They behaved “as the Gopikas” (goppikamāyiṭṭŭ), the cow herdswomen of classical Hindu mythology who playfully sneak about and tease their lover Lord Kṛṣṇa. The director and his assistant, who was working at a PC in the corner, smiled and laughed at this clever characterization of the bioprospector as sneaky and motivated by desire but also, the analogy implies, playful, harmless, and, ultimately, all in good fun. Of course, while certainly motivated by desire, the main legal instrument of biopiracy—TRIPS—was imposed in India in the full light of day and with great public fanfare, as a requirement of all member states of the WTO.
I learned that the assistant in the corner was actually transcribing the handwritten contents of a notebook into an Excel document. The director explained that, when the computer was not being used for office business, his staff worked on building a medicinal plants database, “to prevent people from taking our knowledge.” Murphy Halliburton has documented the ambivalence of Ayurveda practitioners in Kerala associated with such projects of translation and documentation.Footnote 59 This ambivalence is apparently well warranted given the unintended consequences of TK documentation which, when made public, provides easy access to potential bioprospectors of previously secret medical knowledge.Footnote 60 If the CBD could be enforced, then such documentation would be necessary to certify a history of prior knowledge and use by the community, which in turn could protect Indian medical knowledge from international bioprospectors and patent claims. The threat of biopiracy under the global patent regime and the certification of prior ownership under the provisions of the CBD were two of the reasons given by the President of the University of Kerala, Dr. B. Ekbal,Footnote 61 for publishing the English translation of Hendrik Adriaan van Rheede tot Drakenstein's compendious 12-volume Latin compilation of Kerala medical knowledge, Hortus Malabaricus.Footnote 62 Databases compiled from such translations can also be used by researchers of the Indian state to develop and profit from the knowledge, which is the model employed by a government research lab that I will discuss below. However, medical knowledge translated and rendered into the database is more amenable to bioprospecting by international pharmaceutical companies with the scientific resources to profit from the knowledge and the legal resources to defend its IP claims. Inaction is often in this context preferable to active resistance—leave the knowledge where it is, untranslated and contained within out-of-print books and palm-leaf manuscripts.
Later, I was able to observe part of the chain of entextualization that resulted in this TK digital database. In a room in the Government Ayurveda College, a group of six doctors and a linguist sit around a table. Each has a palm-leaf manuscript or an old printed book, and each has a pencil and large note bookŭ. The notebooks are organized with columns for vernacular plant names, the scientific plant name, and the symptoms or illness that the drug is used to treat. Stacked in the middle of the table are medicinal plant reference manuals, such as the two-volume compendium of medicinal plants written in Malayalam titled Auṣadha Sasyaṅṅaḷ,Footnote 63 which was used to translate the botanical classification of the vernacular plant name. The linguist worked as the others, culling from the text the connection between drugs and symptoms, and then translating the plant name, and entering the data into his notebook. He also helped with problems of transliterating the script variants used to write old Malayalam into the contemporary script. Ultimately, this transliteration was again transliterated into the Excel file using a system facilitated by the English keyboard. This entextualization process detaches the knowledge from its social and historical context, and represents it as the common knowledge of an undifferentiated tradition of Kerala Ayurveda. A dramatic shift in Principal occurs, erasing the particular textual and social contexts of practice, and situating the government as the steward (i.e., the Principal) of this undifferentiated TK. This domain of decontextualized knowledge of traditional Indian medicine is a historically novel innovation, entailed by the entextualization practices employed at government institutions to safeguard Indian knowledge under the CBD.
The binary logic opposing the communal and the individual does not connect well with the complexities faced by Ayurveda doctors in India who work to protect their knowledge or to insure that they, rather than others, profit from it. Dr. George is an Ayurveda doctor who works at a government pharmaceutical laboratory. He and his colleagues are working to develop the medical “folk knowledge” (nāṭṭaṟivŭ) of “forest dwellers” (adivasi)—the tribes scheduled by the government of India for special recognition and protection—by using biochemistry and clinical trials to establish the “scientific basis” (śāstra-adhiṣṭhāna) of their medicines. This research might ultimately lead to the production of new “English marunnŭ” (cosmopolitan biomedicines) or ready-made packaged herbal drugs for consumption by the burgeoning Indian middle class and for circulation on the global industrial-pharmaceutical and New Age health-commodity markets.
During my first visit to his office and on subsequent occasions, Dr. George emphasized to me that although he worked as a scientist, he was actually trained in Ayurveda, both in an Ayurveda college, as well as in the lineage of a famous practitioner. His colleagues, who were botanists, chemists, pharmacologists, and biomedical doctors, would often mention his presence at the lab as a sign of the collaborative nature of their research, joining together cosmopolitan science and Ayurveda. However, his work did not involve the practice of Ayurveda. Rather, he was responsible for collecting pharmaceutical information from Kerala tribesmen and non-Ayurvedic folk doctors, and for the scientific development of their knowledge into pharmaceutical commodities. Below I present my translation of a speech Dr. George gave at a scientific conference focused on the scientific development of biomedical drugs based on Indian medical knowledge. It is clear in this example that, as a liminal figure between the worlds of cosmopolitan and Indian medicine, that the oppositional categories of IP rights discourse are not adequate to encompass the nature of creativity in Ayurveda. Such knowledge is not purely shared, public, or common, and it is equally not purely the private property of individuals. He describes the problems associated with diagnosing corporate versus individual authorship in the context of his recent investigations into a promising drug employed in a ritual vomiting practiced at a Goddess temple in Kerala:
1You need to see a three-minute case study. 2We want to look at cases in which knowledge is documented and studied scientifically. 3You are all aware of compendia of useless folk knowledge that have not recorded the name of the plant and its applications. 4After the new biodiversity policies arrived …5 After the new biodiversity policies arrived this knowledge is now of two types. 6Which types? 7There is the type that is said to be disclosed. 8There is the type that is said to be undisclosed. 9In the case of the disclosed form they cannot protect [the knowledge] when it enters the public domain. 10Whoever wishes may take the knowledge and make use of it. 11But because of this we are working out a new policy. 12What this means is that if there is some folk knowledge that was told to us, if whoever that was is documented and [scientific] research is conducted, then the profit of that study will be returned [to them]. 13That is like what we did in the case of Arōgyappacca. 14Then for that type [of undisclosed knowledge] we will record [in our notes] that in such and such a place there is a person who knows a medicinal plant that is good for a particular disease. 15Then, if research is conducted related to that plant, after following this approach the people of our research institute or in industry make a contract [with the person or group who provided the knowledge]. 16They [the scientists] may conduct a lot of research and make products, so in order to protect that [effort], we want to return the wealth to them. 17Now you are going to see that in this situation. 18There is a goddess temple where they are doing vomiting therapy. 19When we saw that treatment we thought it was very simplistic. 20But after doing research on the plant [there is a potential] that we may receive many very new benefits. 21Then if profit comes from that it will be given to the temple. 22If that is not the case then we need to decide who are the owners of [the folk knowledge]. 23What will be given from the temple to those owners? 24[The prescription] that they described [at the temple] included many ingredients that were all joined together indiscriminately. 25Then that is what needs study. 26These plants include Nilatāṅṅi and Nilakāññiraṃ but we do not have these in our Ayurveda. 27These are plants that are not used in our medical science. 28Then how do they [know how to] use them? 29When [I/we] investigated the origin of this [practice] there was a relation existing to the Uḷḷāḷr tribe of forest dwellers. 30Temple legend identifies when this relationship with the Uḷḷāḷr tribe occurred. 31But who [among the tribe] is it from? 32They [the Uḷḷāḷr] believe that a sidhan came there. 33He showed them [some people in the tribe] a long time ago, that is what [the Uḷḷāḷr] said [to the researchers]. 34After that he [the Sidhan] described the method [of preparation and application].
1oru mūnnŭ minutŭ oru CASE STUDY āyiṭṭŭ niṅṅaḷ kāṇaṇaṃ 2appam ā aṟivinē ādhāramākki entellāṃ śāstrīyamāya paṭhanaṅṅaḷ naṭattāṃ ennŭ nammaḷ nōkkaṇaṃ 3allāte veṟutē oru PḻANT-inṟṟe pēruṃ atinṟṟe upayōgavuṃ eḻutivaykkunnatallā naṭṭaṟivuśēkharaṇaṃ ennŭ niṅṅaḷe bōdhyappeṭuttān 4putiya jaiva vaividya niyamaṃ vannu kaḻiññappōḷ 5putiya jaiva vaividya niyamaṃ vannappōḷ ī aṟivukaḷe nammaḷ ippōḷ raṇṭŭ tarattilāṇŭ 6eṅṅane? 7DISCḻOSED paṟaññŭ tarunnatŭ 8UNDISCḻOSED paṟaññŭ tarāttatŭ 9DISCḻOSED FORM-ilŭ avarkkŭ atŭ PUBLIC DOMAIN varumppōḷ avarkkŭ parirakṣakiṭṭillā 10atŭ ārkkuṃ eṭukkān upayōgikkāṃ 11pakṣē putiya oru niyamaṃ nammaḷ entinŭ WORK OUT ceyyunnatŭ 12ennŭ vaccāl atŭ paṟaññŭ tanna nāṭṭaṟivukaḷ āṇeṅkiluṃ atine ādhāramākki āreṅkiluṃ paṭhanaṃ naṭattukayāṇeṅkil atinṟṟe guṇaṃ tiriccŭ koṭukkaṇaṃ 13nammaḷ ārōgyappaccāyil ceytatupōle 14celatŭ pinne paṟaññŭ tarāttatāṇeṅkil nammaḷeḻutuṃ inaṭattŭ orāḷuṅṭŭ inna inna auṣadha ceṭilkaḷekkuriccŭ ayāḷkkaṟiyāṃ inna inna rōgaṅṅaḷkkŭ koḷḷāṃ ennŭ paṟayuṃ 15appōḷ atumāyi bandhappeṭṭŭ paṭhanaṃ naṭattaṇameṅkil nammaḷuṭe gavēṣaṇa sthāpanaṅṅaḷō vyavasāyakarō ayāḷe APPROACH ceytukaḻiññāl oru dhāraṇāpatraṃ uṇṭākki 16avarkkŭ atineppaṟṟi kūṭutal paṭhikkukayuṃ ulppannaṅṅaḷ uṇṭākkukayaṃ ceyyāṃ enniṭṭŭ atinṟṟe parirakṣa uṟappuvaruttāṃ enniṭṭŭ atinṟṟe guṇaṃ namukkŭ tiriccŭ koṇṭuvarikayuṃ ceyyāṃ 17ini ippōḷ niṅṅaḷ kāṇān pōkunnatŭ 18oru (place name omitted) mahādēvakṣētrattile oru śadhippikkal cikilsayāṇŭ 19appōḷ ā cikilsa namukkŭ kāṇumpōḷ vaḷare SIMPLE āyi tōnnuṃ 20pakṣē atil gavēṣaṇaṃ ceytukaḻiññāl namukkŭ orupāṭŭ putiya putiya kāryaṅṅaḷŭ kaṇṭuvarān paṟṟuṃ 21appōḷ aṅṅane oru guṇaṃ vannāl atŭ ā ambalattilēykkŭ ā guṇaṃ eṅṅane koṭukkāṃ 22alleṅkil atinṟṟe uṭamakaḷ ārennŭ ādyaṃ niścayikkēṅṭi varuṃ 23atinṟṟe uṭamakaḷāya āttaraṃ āḷukaḷe ambalattil ninnŭ entŭkoṭukkaṇaṃ? 24 avarŭ paṟaññatŭ ellāṃ ceruṃ ennāṇŭ appōḷ vēṇṭunna cēruvakaḷ ellāṃ koṭukkāṃ 25appōḷ atinŭ paṭhanaṃ āvasyamāṇŭ 26ī ceṭi nilatāṅṅi nilakāññiraṃ pakṣē nammuṭe āyurvedattil paṟayunna nilatāṅṅiyō nilakāññiraṃō allā 27oru vaidyaśāstrattilluṃ upayōgikkātta oru ceṭiyāṇŭ 28appōḷ ī ceṭi avareṅṅineyāṇŭ upayōgikkunnatŭ? 29eviṭeyāṇitinṟṟe ulbhavaṃ ennŭ nōkki pōkumbōḷ uḷḷāḷr ādivāsikaḷumāyiṭṭāṇŭ itŭ bandhappeṭṭŭ kiṭakkunnatŭ 30kāraṇaṃ kṣētrattinṟṟe aitihyaṃ uḷḷāḷr ādivāsikaḷumāyi bandhappeṭṭŭ vannappōḷ 31oru pakṣē avaril ninnāṇō? 32atallā avar paṟayunna oru sidhan aviṭe vannu ennuṃ 33adēhaṃ ī ceṭi kāṇiccu koṭukkayāyirunnu ennum okke āṇŭ paṟaññatŭ 34atŭ kaḻiññiṭṭŭ avar ceyyunna rīti eṅṅane ennu paṟaññāl
This new model of profit sharing is vexed by the logic of property claims given by TRIPS. The knowledge cannot be protected as property without the proper authentication of its value using scientific procedures of biochemistry, pharmacology, and so on. The government of India, by virtue of having coordinated the labor necessary to authenticate the claim, becomes the claim's Principal, on behalf of bearers of the knowledge in its traditional form. The government, as a social institution of coordinated labor, becomes the owner of TK, which is represented as devoid of individual ownership. To whom, then, should the heads of the lab redistribute a share of the profits? Scientists and administrators become responsible for determining, and potentially, remunerating individual versus corporate interests. These shareholders include the scientists who developed the drug, but also the priests and administrators of the goddess temple, a few of whom will be the person or persons who disclosed the knowledge to Dr. George. There is the Uḷḷāḷr tribe, with medical practitioners and with its local political system, and then there is an unknown Siddhan and his lineage. All along this chain of circulations are potential owners with rights of remuneration based on the profit-sharing model emerging in the scientific community in Kerala.
One resolution to the trap of this dichotomy that I observed is for financial redistribution to be directed to the corporate governing bodies of the community, who are then encouraged to spend the money on community projects, and then stage highly public ceremonies of recognition for the particular individual practitioner(s) who disclosed the knowledge to the agents of the scientific institution. At the same scientific conference, for example, Dr. George introduced one folk medical practitioner from the hills outside of Thiruvananthapuram who had disclosed some of her knowledge, which was currently the subject of research. His introduction included flowery praise and significant deference, and he even referenced her using the third-person double-plural pronoun (avarkaḷ), which I have only observed in Kerala used to reference divine persons such as the yoginī, Mātā Amṛtānandamayī Devī. There was a standing ovation when Dr. George presented her with an award for her service to the community, and the press took photographs of the event and re-entextualized the story of the selfless practitioner whose TK was being authenticated by cosmopolitan science. In a sense, the profit-sharing model being developed by Dr. George and his colleagues has adapted a traditional model for the circulation of knowledge, exchanging praise for the disclosure of secrets. And, as we saw previously of the Siddha Ayurveda drug-hawker Ganesh Vaidyan, such good fame as the honest teller of secret knowledge can indeed be a lucrative presentation of self.
CONCLUSION: BETWEEN TRADITIONAL CREATIVITY AND INDIVIDUAL INNOVATION
Part of the logic of the discourse of modernity is its need for its opposite—a premodern, precapitalist, preindividualistic, corporate, traditional, primordial society. This ideology is central to TRIPS and the privatization discourse more generally. And then, the characterizations of intangible cultural heritage and of TK—by the UNESCO, WIPO, and the CBD—have articulated modernity's opposite. A few legal theorists are starting to come around to the idea that TK is at least in part a dynamic and innovative phenomenon (e.g., see Madhavi Sunder's critique of James Boyle's metaphor of “cultural environmentalism”Footnote 64). However, it is anthropology that is in the best position to develop an empirically robust critique of the binary logic that has controlled the IP debate so far. Anthropologists can force the debate beyond these categories by maintaining a commitment to ethnographic work that demonstrates the hybrid and complex nature of creativity, authorship, ownership, and the use and circulation of knowledge in all societies.
As I have shown in this article, the models of creativity and authorship employed in Ayurveda articulate rather poorly with the oppositional logic of the discourse of privatization and its liberal progressive countercritique. Individual innovation is common in the Ayurveda practiced in Kerala, and it is recognized as such. Vaidya do not blindly reproduce knowledge as anonymous units within a collectivity; and equally true, they do not create their knowledge from scratch, as the heroic inventor at the center of the privatization discourse. While this is clear from the evidence, it is also clear that historical and ongoing changes in the entextualization of Ayurveda knowledge have had consequences, some of which have accentuated the opposition between the individual and the collective that is central to the discourse of modernity. Shifts in entextualization entail new Principals and new linguistic divisions of labor to authenticate the value of those Principals' knowledge. These shifts in the circulation of discourse are both problematic and incomplete in contemporary Ayurveda, but they are also historically novel and significant.
Thus, the analysis presented in this article demonstrates for the case of Ayurveda's encounter with IP discourse that the discourse practices described here as entextualization are not only the subject of historical contingency (and they certainly are), but they are also methods of action that have produced significant historical consequences. Of course, as is understood of the concept of property more generally,Footnote 65 IP rights are projections of social relations, and as such, the analysis of such relations requires an account of their production and transformation. It is clear that the social relations of IP—like all social relations—are fundamentally and primarily mediated by discourse, and thus, I suggest that approaches to the relationship of language and political economy developed in linguistic anthropology should be seen as more relevant to debates on cultural and intellectual property in legal and economic theory. In particular, I argue that research on entextualization provides us with a methodological tool to enter into such debates. This is the case because a focus on the circulation of discourse highlights both the hybrid complexity of creative processes (contra the reductionistic dichotomies of IP discourse), and at the same time, it highlights the politics of imposing such ideological dualisms upon that creativity. It is on account of this possibility to provide an empirically robust critique of the categories and transformative effects of IP discourse that I suggest that entextualization has the potential to be a key concept in the analysis of the politics of knowledge production at the margins of the globalizing economy.
