Disease, Religion and Culture in Colonial India: Smallpox by Niketa Roy

Smallpox was one of the deadliest and the most destructive epidemic diseases in colonial India. It claimed around millions of lives in the late nineteenth century alone. The mortality of disease was not the only reason, it was seen through the lens of fear because of its morbidity and its horrific manifestation in the bodies of victims. An acute contagious viral infection produced intense fever and burning sensation, followed by multiple eruptions of pustules which clustered thickest at the face and limbs but in the severe case, it covered the whole body. A third or more of those seized by smallpox died, usually within a week but those who survived had to live the rest of their life with the scars of this menacing disease. It caused blindness in one eye or both eyes through ulceration of cornea and British authorities attributed that three- quarters of all blindness in India linked with smallpox. It is difficult to find out the full extent of devastation caused by smallpox before the 1870s due to lack of proper statistical data but investigating in the administrative regions or the well vaccinated areas of North India like Calcutta, North- Western Frontiers, Madras and Bombay results would show continual failure in controlling or preventing the disease. Popularity of this disease and its manifestation created a fear and madness among natives which pushed them to find a way to cure or control its menacing effects through rituals and religion. However, native conceptualisation of disease had a major intersection of culture and religion which couldn’t be ignored. Smallpox by its nature always came in four- five years which meant children were the main victims. There was a saying among the agriculture or the wealthier classes that they didn't count their newborns or toddlers as their permanent family members until they didn’t survive the next cycle of smallpox. Surviving smallpox by children was seen as a second birth and it was sort of universal for every class of society. One way through which indigenous population of India understood smallpox was the religious and ritualistic manifestation of Devi Sitala in the body. It was seen as a divine presence of a deity who wanted to be worshiped or was showing her wrath for foreseeable damages and warning natives to reform it before it's too late! Another way was variolation or inoculation which was an extension of rituals of Devi Sitala and similar to Jenner’s vaccination. Across northern India, from Sindh and Gujarat in the west and Bengal, Assam and Orissa, Smallpox was identified with the manifestation of Devi (goddess) Sitala (cool one) or simply called Mata (mother). The iconography of the deity reveals significant cultural beliefs. The deity is represented as holding a pot filled with sacred water to heal pustules, a broom to clean the air and riding a donkey. This image of Devi Sitala was widely celebrated and accepted. However, she didn’t appear in the original hindu pantheon and her probable origins were a folk deity who was only gradually and partially recognized in Brahminical Hinduism. Brahminical Hinduism has accepted a lot of elements of tribal traditions and practices, she is a rider of donkeys whereas donkeys are seen as ignorant hard workers and nothing ferocious about them. Another important deity of Hinduism, Devi Kali, who also rides a donkey, also traces her origin from the folk traditions. In Bengal, smallpox was quite prevalent and also known as Basant Rog ( spring disease) due to its major occurrence in the spring seasons, widely worshiped Mata Sitala and devoted few temples to her. Often small shrines were dedicated to her or sometimes just a small water pot under a tree or a wooden slab which signified her tribal heritage. Deity Sitala embodies femininity and motherhood, which highlights her potential healing powers and nurturing qualities, particularly with children. Although now smallpox is eradicated from India, few major temples are present in Gurugram, Haryana and Western India where annual fairs are organized for people, especially women, who seek blessings of Mata Sitala to protect their children from any kind of deadly diseases. The tribal origins of Devi Sitala reveals a significant shift in priesthood. Unlike the Brahmins, the priestly caste of Hindus, it was the Mallis (gardener), a 'clean' Shudra caste, who became associated with her and performed her rituals. This transition highlights the changing traditional priesthood in Hinduism, due to Devi Sitala's lower status within the Hindu pantheon. Her lower position in the hierarchy of deities reflects a broader societal structure, indicating that the highest caste, the Brahmins, did not associate themselves with her.

This relationship illustrates how both the deity and the Mallis, while positioned at the bottom of the social hierarchy, maintained significance within Hindu rigid caste system. Although firmly rooted in the Hindu traditions, in some parts of India, particularly Punjab and Bengal, some Muslim communities revered Devi Sitala during times of epidemics. It tells us about the popularity of deity and desperation of people to survive the deadliest days of the disease. Mallis were in charge of organizing the rituals to please the deity which manifested herself in the bodies of patients through offerings of ‘cool’ items, sprinkle of cool water to reduce the burning sensation, avoidance of oil and spices and use of neem (margosa) leaves, Sitala’s favorite trees. Once pustules had ripened, mallis gave physical relief to patients by piercing them with sharp thrones. But it was not always that Sitala manifested herself in the patient's body but sometimes she manifested in the bodies of healthy women through spiritual possession. It was quite common among women to get possessed and gain oracular powers. Women were marginalized but possessed women were respected and heard by the society. During the nineteenth century, they were resisting the alien practice of vaccination started by Britishers but some of them welcomed it too. Another method used by indigenous population to cure smallpox was the variolation technique or inoculation which was popular in Bengal, Punjab and Gujarat and well documented by Holwell in 1767. It was an extension of ritualistic practice of controlling the disease through the help of religion and indigenous therapeutic methods. He observed that certain tribes of Brahmins knew the craft of variolation and also cited its safety and positive results to the College of Physicians in London. He mentioned how variolation was not merely religious jingoism but was a medically sound method to prevent smallpox. Body was first introduced to a moderate and controlled form of infection and then it developed an immune response to it under a carefully regulated environment. Healthy children were inoculated with live matter of smallpox which were taken from the last epidemic. He mentioned dietary restrictions like avoidance of spices and use of ‘cool’ items like coconut water, curd which would help in reducing intensive heat in the body. In 1831, Radhakant Deb gave name to variolators, tikaders. Like Holwell, he gave no indication how widely variolation was practiced in India. Due to some unknown reasons, it wasn’t popular in the whole south India, Delhi and Avadh region. In the south, Sitala was replaced by Mariamma as a protector of people. This tradition was practiced among Hindus only but in Rajasthan, Muslims were closely associated with it. However, Untouchables were rarely inoculated due to their inferior status in the Hindu caste system or they didn’t have money to pay to inoculators. Women were far less inoculated than men due to their marginalized status in the society. Inoculators were typically male, and it was considered shameful for the women to show their face in their presence or to be touched by them. There were some women inoculators but their numbers were significantly lower than male. Radhakant Deb in contrast with Holwell, stated that tikaders belonged to many ‘lower’ castes, particularly from Mallis (gardeners) and Napits (barbers) because inoculation necessitated direct contact with patients, which could potentially compromise the purity of Brahmin bodies. Inoculation was considered as an extension of Devi Sitala’s rituals in the popular imagination of indigenous. Inoculators used sacred water of Ganges to sprinkle over patients and sang prayers. They used an extensive seven day ritual for inoculation. There was great variation in the status of the inoculators and the manner of their practice. Buchanan, a physician, stressed the ‘lower’ caste status of many inoculators practicing in Bengal and Bihar and called it ‘unscientific’ in nature without any rational temperament. But indigenous population didn’t disrespect tikaders and faithfully observed ritualistic rules to protect them from smallpox. In the late nineteenth century, the British authorities stated inoculation as ‘dangerous’ practice and suppressed it. They also imposed heavy fines on tikaders to practice this occupation and in the twentieth century, variolation was forsaken practice. The inoculation was not performed by ‘high’ Brahmin didn’t mean it was devoid of religious significance. Tikaders were aware about the rights of Devi Sitala over the bodies and they simply celebrated her significance and honored it.

The British introduced vaccination in the late nineteenth century to control the smallpox epidemic. This enterprise wasn't entirely enclavist in nature and was not only intended for white population. Unlike other diseases, Europeans were familiar with smallpox and didn't label it as ‘tropical disease’. Vaccination was taken up by state authorities and became a benevolent symbol of the Empire. The British authorities believed Indians would show them respect and compassion for their superior work in preventing smallpox. However, its progress was hindered by financial constraints and lack of commitment from higher authorities. Vaccination, despite its resemblance to variolation, was considered superior. It was an attempt by the British authorities to control the body and movement of indigenous populations with the help of vaccines as a tool and suppress their indigenous therapeutic majors. Until Holwell's time, inoculation was regarded as a respected practice among the British and was not entirely unfamiliar to them. However, the advent of Jenner’s vaccination marked a significant shift in their preference, leading to a decline in support for inoculation. This transition reflected an imperial agenda driven by the Britishers. But they faced prolonged resistance from the natives. Despite the effectiveness and feasibility of vaccination, it was a complex process with many practical and technical difficulties. First, cowpox was rare in India and second, the first vaccine reached India in 1802 through a relay of children vaccinated from arm-to-arm from Baghdad to Bombay. Subsequently, vaccine crust or sealed tubes of lymph were sent by sea or land and took months to reach, it was unfit for use. Once it was locally established, the arm to arm method was cheap but sometimes vaccines got ‘lost’ in human transmission. This method was mostly favorable in the winters and hilly regions of India. Vaccination was not well received by Indians. First, they felt it as an encroachment of Devi Sitala’s right over body and second, the arm to arm method was not accepted among natives. It was dependent on children and the upper caste would never send their children to volunteer in it. It was mainly lower caste or untouchables children coming to volunteer for money or forced by the authorities. Involvement of marginalized children in the vaccination made it less popular among upper caste society. Another major reason for its lack of popularity was avoidance of rituals and religion. In Europe, the arm to arm method caused syphilis and leprosy, despite it, the British authorities pushing vaccination as the most safest way to cure smallpox. The British government saw inoculators as a major barrier in the propagation of vaccination and used extensive methods to curb them like banning variolation in Bengal. Restriction on the movements of inoculators forced them to abandon their skills and traditional occupation. It was a heavy blow on their financial stability. It was only successful in Bombay and later Punjab but completely failed in Bengal. In Bombay, governor Elphinstone planned to give door to door vaccination in rural areas and free vaccination to children. Other regions developed deep distrust in the British authorities and their vaccinators. Natives started to believe all sorts of rumors related to vaccination like it was for converting them to Christianity and loss of their caste. To combat these rumors, British authorities request zamindars and princely states’ rajas to get vaccinated as a way to win the heart's of natives. The British authorities also enacted the Compulsory Vaccination Act in 1892 to strengthen the vaccination program. Eventually, the intellectual middle class started to show their support for vaccination with little touch of their culture. They incorporated vaccination in their cultural belief through specifying a sacred day, using water of Ganges before the vaccination and singing of prayers. However, a significant amount of the population was not vaccinated till independence. It was only after the efforts of the newly independent India which helped in propagation of vaccines to their people and in 1979, India declared itself smallpox free.