From Medical Pluralism to Medical Marginality

In today’s world, patients have multiple choices in terms of adopting any health system for being healthy. Medical systems are generally divided into two major categories: science-based, modern medicine and alternative medicines. 

The alternative systems of medicine like Homeopathy claim that they provide an option to the patients that are efficient even without the use of chemicals and a strong dose of medicines. Leslie (1998) highlighted the existence of different types of medicine alongside modern medicine and termed it as medical pluralism. 

He argued that although the modern system exists in every country, most people continue to depend on the traditional alternative practitioners as well. Leslie and Young (1992) challenge the modernist dichotomy between tradition and modernity that people once exposed to modern medicine would not depend on ‘traditional’ medicine. Medical pluralism according to Sujatha and Abraham (2009) had become a ‘way of life’ by which people frequently chose multiple medical treatments.

By using Hardiman and Mukharji’s (2012) concept of medical marginality, this article attempts to explore the idea of medical pluralism and the shift towards marginality. The article tries to analyse marginality and power relations among different medical knowledge systems. 

It aims to understand the Unani system of alternative medicine and takes the Unani hospital as a case in point to analyse the position within the larger realm of healthcare.

The knowledge systems of India have been dominated by colonial modernity or Eurocentrism. The European narrative considered Europe and the West to be the centre of all the knowledge systems and the growth of modern civilisation, which was dominantly characterised by science and universal reason. The rest of non-European world was construed to be the periphery, which was considered to be traditional with no means to become scientific and modern. 

The entire debate on the West and the non-West/tradition–modern origin of science got embedded within the different medical systems. Biomedicine is considered to be the creation of the West and hence modern, scientific, logical and efficient. Ayurveda or Unani and the other alternative systems of medicine are considered to be traditional, unscientific and inefficient. 

Gusfield (1967) refutes the assumptions that traditional societies have been static, and that modernising processes weaken the traditional structure. India is seen as being illustrated by a complex procedure of cultural hybridisation encompassing both traditions and modernities. 

In such a situation, the boundaries between tradition and modern, rural and urban fade and lose their significance. Instead of being eradicated by modernity and development, many traditional cultures survive through their ‘transformative engagement with modernity’. 

It is argued actual development and progress in modernising societies has disproved the homogenising and hegemonic supposition of Western modernity. The western model of modernity is not the only prototype of modernity; however, they have a historical superiority and continue being the reference point for others, reinforcing Eurocentric viewpoint. 

This applies to the field of medicine where the traditional medical systems, to be a prominent healthcare system, are adapting to the new technological and scientific instruments used by modern medicine, without changing its dominant features.

Article details

From Medical Pluralism to Medical Marginality: Changing Dynamics Within Unani System of Medicine
Priyam Sharma
First Published June 1, 2020 Research Article
DOI: 10.1177/0038022920923208
Sociological Bulletin