Disparate Remedies: Making Medicines in Modern India by Nandini Bhattacharya (review)

Reviewed by: Disparate Remedies: Making Medicines in Modern India by Nandini Bhattacharya Mrunmayee Satam Disparate Remedies: Making Medicines in Modern India . By Nandini Bhattacharya. Montreal: McGill-Queen's University Press, 2023. Nandini Bhattacharya's book Disparate Remedies: Making Medicines in Modern India is the outcome of her Wellcome Trust funded research project on the history of the pharmaceutical industry in modern India. The book broadly discusses the rise of medical consumerism, the growth of pharmaceutical companies and how laboratory-produced medicines competed with indigenous remedies in colonial India. Focusing on the period between the late nineteenth and mid twentieth century, 'this book analyses how medicines were acquired, produced, quality ascertained and sold in public spheres of modern India' (3). The book is divided into seven chapters and underscores a diverse range of themes related to the emergence and expansion of the pharmaceutical industry in colonial India, such as institutionalization of Western medicine; dynamism of Indigenous medical traditions; pharmaceutical commodities and their diverse consumer base; anxieties and debates surrounding availability, efficacy and quality of drugs; and role of the government, struggles for legislation and control in the drugs markets; and standardization of medical therapies during the final years of British colonial rule in India. The introduction focuses on the interaction between the public spheres of medicines and colonial state in India. Western scientific medicine was first introduced to Indians with the establishment of hospitals by the colonial state. The hospitals marked a disjuncture between Indigenous and Western medicine and served as the entry points for Western medical training, use of modern medical apparatus, and scientific physiology. This resulted in a competition between Indigenous medical systems, such as Ayurveda and Unani, and Western medicine for recognition, legitimacy and state support. Despite the autonomy extended to the public sphere, the colonial state constantly interfered, particularly in aspects related to medicine because it was the largest "procurer and distributor" of drugs, and the main mediator in debates around drug efficacy, standardization and quality assurance. In Chapter 1, Bhattacharya traces the proliferation of drugs, medicines and potions flooding Indian markets – urban and rural – a trend that coincided with the emergence of the middle class. The author argues that the medical market space emerged as a site of conflict between colonial modernity and Indian identity. This resulted in both admiration and a deep-seated distrust of Western influences. The expanding pharmaceutical market was supported by colonial infrastructure, such as protective tariffs and a well-established transport and communications network which included all India railway and postal services. With the onset of the Swadeshi movement at the turn of the twentieth century, an increasing presence of Indian traders, distributors and manufacturers was visible in the pharmaceutical market. This paved way not only for diversification, but also further intensified competition. Chapter 2 explores the resistance offered by the colonial state in recognizing and legitimizing indigenous medical firms. Consequently, some Indian pharmaceutical companies, within the nationalist discourse contested the dominance of British-Indian distributors and manufacturers. They did so by labelling themselves as "scientific and laboratory based", Indigenous pharmaceutical manufacturing facilities with the goal of achieving industrial self-sufficiency in colonial India. These companies also began hybrid treatments by blending formulas from Indigenous and western medicine (71). The result was the emergence of a complex "bazaar market" characterized by a diverse range of manufacturers and medical practices. Chapter 3 gives an account of the publication in 1955 of what could be termed "the impossible", that is, an Indian Pharmacopeia. The challenges were driven by commercial and ideological concerns, such as substituting cheaper alternatives for expensive drugs, standardizing drug potency and efficacy, asserting international significance and affirming India's status as a centre of rational and scientific medical practices. Bhattacharya argues that "the debate around the Indian Pharmacopeia became an ideological conflict that blended science with cultural and economic nationalism" (75). In Chapter 4, the author investigates the working of the Government Medical Store (GMS), "which was the largest producer, importer, and distributor of medical therapies in colonial India" (98). With the rise of the Swadeshi movement and as an effort on the part of the colonial state to reduce their expenditure, import substitution acquired greater attention. Both the colonial...

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