Sot. Sci. Med. Vol. 33, No. 2, pp. 153460, 1991 0277-9536/91 $3.00 + 0.

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AYURVEDA, MALARIA AND THE INDIGENOUS HERBAL

TRADITION IN SRI LANKA
KALINGA TUDORSILVA
Department of !Zociology, University of Peradcniya. Peradcniya, Sri Lanka

Abstract-Using key informants and available records, the way in which inhabitants of purana villages
in Nuwarakalaviya, Sri Lanka coped with malaria during the pre-DDT era is examined. Thii study found
that the Nuwarakalaviya peasants responded to endemic malaria through a localized herbal tradition,
which was to some extent independent of the scholarly ayurveda system common to the whole of South
Asia. The relevant herbal tradition, consisting of a combination of antiparasite and antive-ctorstrategies
using locally available natural resources, represented an effective adaptation to the local ecosystem.

Key words-ayurveda, malaria, folk medicine, Sri Lanka, South Asia

This paper examines how peasants in a malaria-
endemic region in the dry zone of Sri Lanka perceived
and dealt with malaria prior to the introduction of
western scientific ideas concerning the disease and its
control. In view of the recent resurgence of malaria
in many parts of the world and the absence of any
imminent technological breakthroughs that may en-
able the affected tropical countries to overcome the
disease in the near future, considerable attention has
been focused on the re-examination of the efficacy of
indigenous herbal remedies and the effect of certain
cultural practices like nomadism, clothing habits
etc., as related to malaria [l-5]. These studies found
that the relevant herbal remedies and the cultural
practices often constitute an effective adaptation on
the part of humans to endemic malaria. While
sharing the general theoretical orientation of these
studies, the present essay does not aim at assessing
the efficacy, medicinal properties or contemporary
applicability of the relevant indigenous ideas and
practices. Rather it examines the ways in which the
local peasants historically perceived and responded
to malaria and how it related to their ecological and
cultural milieu. More specifically, it explores the
relationship between the relevant herbal tradition and
ayurveda, which is generally viewed as the system of
indigenous medicine common to the South Asian
Region.
In anthropological accounts of folk health beliefs
and practices in South Asia, primary attention has
thus far been paid to the influences of the ayurvcda
system and its interaction with western biomedical
concepts [6-121. This is not surprising given the fact
that ayurveda is part of the great tradition in the
whole of South Asia [13]. It is, however, important to
remember that often the scholarly ideas of ayurveda
affected folk thinking and behaviour through diverse
indigenous herbal traditions, which, in turn, were
part of the little traditions representing various geo-
subcultural units within South Asia. Among the
Sinhalese in contemporary Sri Lanka terms such as
athbehefh (medicine-at-hand), goduzedukuma (local
therapies) and parampara vedakama (ancestral medi-
cine) are sometimes used to distinguish what remains
of the indigenous herbal tradition from pure
ayurveda (nyuruedaya) of North Indian origin [14].
Other widely used contemporary teRns, like sinhula
vealzkama (Sinhalese medicine) and deshiya vedakama
(indigenous medicine) refer to formal ayurveda, the
localized herbal tradition or a mixture of the two
depending on the context. As malaria is primarily an
endemic focal disease affected directly by the ecosys-
tem of a given area, the localized indigenous herbal
traditions can be expected to play a more important
role in shaping the local peoples perception of and
responses to this disease [l-3, s].
The data reported here were obtained as part of
the Sarvodaya Malaria Control Research Project
(SMCRP) aiming to develop a primary care approach
to malaria control. Among other things the SMCRP
sought to identify and evaluate suitable indigenous
practices [15]. The methodology used for data collec-
tion consisted mainly of indepth interviews with
selected indigenous practitioners and elderly lay in-
formants who were knowledgeable about customary
local practices related to the disease dating back to
the pm-DDT era. Some relevant secondary sources,
including indigenous medical texts and reports by
colonial administrators, were also consulted. Finally,
the data were checked with a few ayurveda scholars,
a malariologist and a medical entomologist.
THE STUDY AREA
The SMCRP study area lies in the eastern part of
the Anuradhapura District, formerly known as
Nuwarakalaviya. Covering about 80 km2, it consists
of aonroximatelv 17.500 oeonle distributed in some
60 Gilages. Bouhded by ;oa& linking Kekirawa in
the South. Galkulama in the North and Yakalla in
the East, ii forms a triangular area lying to the South
East of the ancient city of Anuradhapura. The ter-
rain, which is flat, is drained by Malwatu Oya and its
tributaries. This being a dry zone region, the annual
rainfall of about 1250 mm is largely concentrated in
the period from November to January, with possible
secondary rains around May each year. Due to the
above rainfall pattern an elaborate irrigation system

153
154 tiLINGA
had been evolved so as to ensure cultivation of paddy,
the staple food of the local Sinhalese.
The study area had been in the centre of an ancient
hydraulic civilization, which reached its peak around
the 12th century A.D. This civilization subsequently
collapsed due to foreign invasions and a variety of
other historical circumstances that cannot be spelled
out here, and a form of nucleated human settlements
gradually evolved in the midst of the ruins and a thick
forest cover. The efforts of successive colonial and
post colonial regimes to redevelop the dry zone
through irrigation and resettlement schemes have not
yet affected the study area. Hence, it remains a useful
setting for the study of folk beliefs and practices
indigenous to Nuwarakalaviya.
The village communities in this part of Sri Lanka
are known as purana (ancient) villages, signifying
their continuity over a long period of time. Relative
to comparable rural communities in the wet zone of
Sri Lanka the purana villages remain sparsely popu-
lated with a mean population size of 300 in 1986,
despite reports by some observers that there has been
a marked population growth in purana villages in
more recent years [la]. The communities are widely
scattered; each community is surrounded by a stretch
of jungle used by local peasants for a form of slash
and bum cultivation known as chena farming, which
together with rice cultivation constitute the main
elements of the subsistence economy of the purana
villages. For the purpose of conserving water for rice
cultivation each village has one or more communally
maintained local reservoirs (tanks) sustained over a
long period of time.
As for social organization, each village is a single
caste entity internally unified through kinship bonds;
for the most part interaction across villages tradition-
ally took the form of formalized exchanges of goods
and services between those of different castes. In his
classic study of a village in Nuwarakalaviya Leach
found that the local ecosystem inclusive of manmade
irrigation works largely determined the nature of
social organization in a purana village and its relative
stability [ 11.
The area under study is hyperendemic for malaria.
As elsewhere in Sri Lanka the commoner plasmod-
ium species found here is P. viva-x with P. falciparum
as the secondary, but more virulent species. R. culi-
cifacies, the known vector for malaria in Sri Lanka,
breeds in a variety of local habitats 1151. Table 1
shows recent malaria trends in the Kekirawa Malaria
Control Region which, with an estimated total
population of 225,000 as of 1986, includes the study
area.
As evident from Table 1, there is a marked fluctu-
ation in malaria incidence in the region from year to
year. In the high year of 1986, about 26% of the total
Table 1. Malaria Trends in the Kekirawa Control Region 1983 to
1986
Malaria species
No. of Total
Y.Sr blood smears Pv ff or mixed positivts SPR
1983 26,018 4197 167 4364 16.8
1984 26,617 10,535 120 10,655 39.9
1985 40,939 7270 602 7872 19.2
1986 97,829 49,491 9050 58,541 39.8
TUDOR SILVA
population of the region were found to be micro-
scopically positive for malaria with P. vivax and P.
falciparutn (including mixed) infections accounting
for 84.5 and 15.5 percent of the total incidence
respectively.
Figure 1 shows that while there is continuous
malaria transmission in this region throughout the
year, there is a marked annual peak in malaria
incidence from October to December which in turn
corresponds with the peak rainfall season. It has been
found that heavy monsoonal rains commencing in
October result in a proliferation of temporary ground
pools leading to a marked seasonal upsurge in vector
breeding in the months that follow [lS]. On the other
hand, the natural streams and irrigation systems
maintain a moderate level of vector breeding and a
resulting continuation of malaria transmission
throughout the rest of the year, thus giving rise to a
never-ending cycle of endemic malaria.
The government health facilities in and around the
study area are of a rudimentary nature. There is a
variety of traditional practitioners, including herbal-
ists in general practice (saroungaveda), snake-bite
specialists (&me&), bone setters (handiueda), and a
handful of college-trained ayurvedics (veubmhattayo
or doctor). Unlike college-trained ayurvedics who
possess formal medical qualifications acquired from
one or the other of the ayurveda colleges in the
country, the first three categories of practitioners
commonly practise purampora vedakama (ancestral
medicine) typically transmitted from father to son.
Often the parampara vedas proudly possess inherited
collections of ola-leaf manuscripts containing secret
medical prescriptions. The parampara vedas may or
may not possess a sophisticated knowledge of the
humoural theory (t&or vadoyn) of ayurveda.
While college-trained ayurvedics often prescribe west-
em medicine sometimes in combination with
ayurveda preparations [ 18-191, the parampara vedas
generally do not utilize any western medicine in their
practice. While the parampara vedas claim that only
they practice genuine sinhalu vedakumu, the
ayurevedics see themselves as more scientific and
more broad-minded compared to parampara vedas.
On the average a local purana village has 3 to 4
parampara vedas. The college-trained ayuredics, who
Legend
18,OCG - - - Malaria incidence
- Rainfall 250
16,000 t
14poo
200 p
l&~ 5
14~ 150 5
e
6000 C
100 p
6000
,. 0 0
JFMAMJJASONO
1986
Fig. 1. Monthly variation in Malaria incidence and its
. ..-. _~ --!_I-,. ~,_,.I______
__,__z____*.._,__A__ ICI*
 Ayurveda, malaria and the indigenous herbal ttadition
are often not from the local area itself, typically
operate from small towns in the area.
Before we examine the local folk beliefs and prac-
tices related to malaria, it is useful to.consider the
relevant historical context.
HISTORICAL BACKGROUND
Malaria has been a leading cause of morbidity and
mortality in the Anuradhapura District throughout
its known history. Its possible role in the fall of the
ancient hydraulic civilization of the dry zone is
subject to speculation and will not be considered here
[20]. The early colonial literature is replete with
references to agues and fevers prevailing in various
parts of Sri Lanka [21-261. After 1860 the term
malaria gradually became established in official
records.
Robert Knox, one of several Englishmen in captiv-
ity in the Kandyan Kingdom from 1660 to 1679, had
several attacks of agues and fevers during his efforts
to locate an escape route to the Dutch territory
through the wilderness of northern Sri Lanka inclus-
ive of Nuwarakalaviya [21]. He observed The Dis-
eases this land is most subject to, are Agues and
Feavours (sic.) and further referred to it as the
Countrey Sickness.
In this manner we went into these Northern Part eight or
ten times . . . . For these Northern Countrey being much
subject to dry weather, and having no springs, we w&e fain
to drink of Ponds of Rain water. . . . This did not axree with
our Bodies, being used to drink pure Spring water%nly. By
which means when we first used these parts we used often
to be sick of violent Feavours and Agues, when we came
home. Which Diseases happened not only to us, but to all
other People that dwell upon the Mountains, as we did,
whensoever they went down into those places; and com-
monly the major part of those that fall sick dyes. At which
the Chingulays are so scared, that it is very seldom they do
adventure their Bodies down thither.. . . Our Countreymen
and Neighbours used to ask us, if we went thither purposing
to destroy ourselves. . . . At length we learned an Antidote
and Counter-Poyson against the filthy venomous water,
which so operated by the blessing of God, after the use there
of we had no more Sickness. It is only a dry leaf; they call
it in Portuguese Banga, beaten to Powder with some of the
Countrey Jaggory; and this we eat Morning and Evening
upon an empty Stomach. It intoxicates the Brain, and makes
one giddy, without any other operation either by Stool or
Vomit [21].
From the account of Robert Knox it is clear that the
17th century inhabitants of Kandyan Hills, among
whom Knox was living, took care not to visit the
northern plains in order to protect themselves against
what was then understood as agues and fevers. It is
not clear whether his theory linking the disease to the
drinking of filthy venomous water of the dry zone was
influenced by any prevailing indigenous ideas. The
antidote referred to may be cannabis, and probably
the practice of using it as a prophylaxis against
malaria was introduced to the country by the Por-
tugese [22].
Malaria conditions in Sri Lanka evoked many
responses from successive colonial powers. Often
the early European commentators attributed it to
foul air from the marshes following the western
tradition. Others attributed it to environmental or
155
behavioural causes, such as sudden changes in
atmospheric temperature, environmental pollution,
imprudent exposure to tropical sun and intem-
perance [22-261. These ideas only slowly disappeared
following the modem scientific discoveries during
1880 to 1900 concerning the mode of transmission of
malaria.
From a much publicized debate instigated by Sir
Henry Blake, the governor of Ceylon in 1905, it is
evident that the colonial administrators were also
curious about the indigenous health beliefs. In his
address to the Ceylon Branch of the Royal Asiatic
Society in 1905 Blake reported that some old
ayurvedic texts brought to his notice by a certain
Native Medical Association of Mutwal postulate a
connection between malaria and mosquitoes long
before the role of mosquito in the transmission of
malaria was discovered by Manson and Ross (221.
However, a thorough re-examination of the relevant
medical texts revealed that the passage in question
possibly refers to some other complications at-
tributed to insect bites.
Further certain colonial administrators sought to
identify and determine the efficacy of indigenous
herbal remedies for agues and fevers. For instance,
Ondatjie, who was the Assistant Colonial Surgeon in
Uva, reported in 1861 that after extensive studies he
found the local herb dummella (Trichosanthes cu-
cumerina) to be an effective medicine for fever,
containing one of the active ingredients of the cin-
chona bark [24].
Apparently the British raj had identified and
sought solutions for three separate problems of ma-
laria control as related to Ceylon. First, there was the
problem of malaria control among the British and
other European residents in Ceylon, including the
colonial administrative staff, planters and military
troops. By virtue of their background they were
highly susceptible to malaria. Further, it is likely that
the British gave highest priority to overcoming their
own malarial problem. It appears that whenever
possible the European residents avoided visiting en-
demic areas as a precaution against malaria (23-251.
Where they did venture out into or were posted in
endemic regions it was customary for them to self-
medicate with quinine as a prophylaxis or cure [23].
Cinchona bark was first introduced to Ceylon during
the 16th century by Jesuit missionaries who used it to
treat fever [22]. In 1860 Moss advised against indis-
criminate use of quinine by British residents in Cey-
lon and recommended two or three grains with the
morning coffee only when visiting a malarial district
[23]. Finally, the provincial administrators resident in
malaria-endemic regions were permitted to move out
to safer places temporarily during the peak season of
malaria transmission in each year as stated in the
following passage.
Situated in a vast plain which is covered with dense wood,
and in which there is a multitude of neglected tanks, the
place (i.e. Nuwarakalaviya) is certainly no sanitarium, but
still I think that during nine months of the year it is fully
as healthy as most stations. The unhealthy season lasts from
the beginning of December till the end of February, and
during this portion of the year the establishments are
allowed to remove elsewhere. As the jungle round the
station becomes cleared away, and as the place becomes
 156 KALINGATUDOR SILVA
more healthy, there will probably be no occasion for an
annual interruption of public business [25].
Thus even before the mode of transmission of malaria
and its relation to weather conditions were estab-
lished scientifically, the British residents in Sri Lanka
had clearly and correctly identified the seasonal pat-
tern of malaria transmission and had devised an
effective way of escaping its worst consequences on
themselves.
Secondly, the British, specially planters, were con-
cerned about the health of the plantation labourers
who were of Indian origin. By virtue of their location
in wet zone hilly areas, plantations were relatively free
of endemic malaria. However, the estate workers
were exposed to malaria during their long and ardu-
ous journey from India to Sri Lanka as well as during
their annual pilgrimage to Kataragama located in the
dry zone. From the early days the planters had noted
that annually the work in the plantations was dis-
rupted, as the labourers who returned from
Kataragama became ill with what was referred to as
Kataragama Fever [27]. Later the government
malariologist found that the so-called Kataragama
fever was indeed malaria. The steps taken to control
malaria among the plantation workers will not be
discussed here as it is outside the scope of the present
study.
Last but not the least, the British raj had to address
the problem of malaria among the native inhabitants,
especially in the endemic areas. Apart from humanis-
tic and welfare considerations, the British were well
aware of the constraints to dry zone development and
revenue collection arising from endemic malaria.
However, it is clear that of the three categories of
malaria victims, natives received least attention in the
malaria control efforts of the colonial regime.
The Government Agents for Nuwarakalaviya re-
peatedly noted in their annual reports and diaries the
unhealthy condition prevailing in the district due to
widespread prevalence of fever, cholera and parungi
(yaws). Of these parungi and cholera were seen as
diseases newly introduced to the local population by
the Portuguese colonizers and Indian estate coolies
passing through the area respectively [28]. Malaria
fever, however, was clearly recognized to be indige-
nous to the area as implied by the local Fever of
Nuwarakalaviya [25]. Ivers described it as the dis-
ease par excellence of the district [26].
Although the government Anti-malaria Campaign
started in 1911 and became a national programme
in 1925, its distribution of quinine in parts of
Nuwarakalaviya was only sporadic until the great
epidemic of 1934/X [29]. During the great epidemic
several malaria control and relief measures, including
distribution of quinine, oiling or draining of pools
and swamps and clearing of jungle where necessary
were carried out by the government in local villages
through health services as well as through civil ad-
ministration. Regular indoor spraying of DDT began
in this area after 1945.
In this context it is pertinent to ask how peasants
in this remote malaria-endemic region perceived and
dealt with the disease before they became affected by
modem scientific ideas and control measures relevant
to the disease.
FOLK TEEMS, PERCEPTIONSOF ILLNESS
AND SYMF+TOMOLOGlES
Although the term malaria had been used by some
officials since the latter part of the 19th century, it was
translated into a widespread folk category (ma-
leriyawu) in Nuwarakalaviya much later, probably
during the great epidemic of 1934/X The folk tra-
dition in Nuwarakalaviya recognized many febrile
conditions, including unahembirissuwu (fever and
cold), unukuhihembirissuwu (fever, cough and cold)
guhenu unu (shivering fever), kufa MU (jungle fever),
mura unu (fever that recurs at fixed intervals), unasan-
nipuruyu (fever caused by upsetting of three hu-
mours), sunniyu (chill, coma), koleguyu (chest pain)
and wuhppuwu (fits).
As is usually the case with folk illness categories (91,
it is rather hazardous to attempt a translation of the
above terms into western disease categories as defined
today. Of the different febrile conditions, unahembiri-
i.~uwu was considered the least serious and wufippuwu
the most serious. As was also reported for South
India, it was generally held that if not treated prop-
erly less serious conditions would rapidly deteriorate
into more serious ones [30]. Most probably unuhem-
birissuwu and unukuhihembirissuwu referred to differ-
ent states of common cold. In Nuwarakalaviya the
terms guhenu unu, kulu MU and mura unu were used
more or less synonymously, and it appears likely that
mostly, if not exclusively, they referred to malarial
conditions. It is significant that fever (una) is men-
tioned in all three terms. As accompanying symp-
toms, guhenu unu refers to shivering and muru unu
refers to periodicity of fever. The term kulu unu
(jungle fever) probably postulates an association
between malarial fever and chena cultivation in the
jungle, which throughout the dry zone normally
coincides with the peak season of malaria trans-
mission in a year.
Of the remaining febrile conditions identified in the
local folk tradition, unasunniputayu was considered
an acute condition caused by the simultaneous upset-
ting of all three humours. Sunni-kola-wullipu in turn
were seen as further complications arising from
unusanniputuyu. In addition, physiological and men-
tal derangements of a specific nature, such as un-
uvikaru (deliriums), were commonly attributed to
sunni-kolu-wulippu. Some indigenous medical texts
mention 18 types of sunni, 18 types of kolu and 18
types of wulippu giving this illness complex an om-
nibus character (311. It may well be that several
unrelated western disease categories, such as pneu-
monia, typhoid, encephalitis, or even acute cases of
falciparum malaria were included within the sunni-
kola - wulippu complex.
In Nuwarakalaviya it was widely known that there
was a sharp seasonal increase in the incidence of fever
during certain months of the year. Over the years the
local people had come to recognize an association
between the fever season and certain cyclical changes
in their environment. The people used to say Fever
breaks out when the flowers of the thoru plant begin
to appear. This ubiquitous local plant (Cassiu tore)
flowered annually following the onset of monsoon
rains, the peak season of malaria transmission in the
area [32]. Whether or not and in what way the thoru
 Ayurveda, malaria and the indigenous herbal tradition
plant was implicated in any folk etiology of the
disease is not clear from the present-day accounts of
past perceptions.
In folk symptomology malaria fever (guhena una)
was necessarily associated with agues. A folk phrase
widely used to describe malarial fever was shivering
and vibrating like the coconut flower (polmala wage
sum sofa gala gahenawu). The analogy of the coconut
flower possibly referred to the rhythmic whipping of
ones forehead with a coconut flower and the accom-
panying bodily movements by a possessed healer
during some local rituals. Thus it is significant that
the folk perception of the disease was much influ-
enced by environmental and cultural markers specific
to the local area.
At this point it is important to consider what role
ayurveda and related metamedical ideas played in the
folk beliefs and practices relating to malaria in
Nuwarakalaviya. It appears that, with the exception
of a few college-trained ayurvedics practicing in the
area, neither the local herbalists nor the lay peasants
were familiar with the ayurvedic terminology com-
monly applied to malaria, namely uisamujwuru (inter-
mittent fever) and santulajwuru (remittent fever) and
the relevant treatment formulae [33]. Even the few
local practitioners who had a knowledge of relevant
ayurveda ideas and practices did not use them widely
in the diagnosis and treatment of any of the locally
prevalent disease conditions. The only ayurveda term
encountered in the local illness terminology is sunni-
patu, referring to upsetting of the three humours.
However, it appears that the ayurvedic humoural
theory of disease causation did not play any signifi-
cant part in the local perception of malaria. On the
other hand, the ideas, practices and even the termi-
nology used in the local sunni-kolu-wulippu illness
complex have been commonly attributed to the South
Indian Siddha tradition [31]. Accordingly, to the
extent the scholarly ayurveda system impacted the
folk concept of malaria and possibly other local
illnesses, it seems to have done so indirectly through
the popular Siddha tradition.
The available evidence does not indicate that there
was any unified and universally valid perception of
malaria throughout Ceylon during precolonial and
early colonial periods. It is possible that malarial
conditions were known by different terms in different
malaria-endemic areas in Sri Lanka. Perhaps this
explains why early European writers identified fevers
by the names of the respective regions, i.e., Fever of
Nuwarakalaviya, Kataragama Fever, Wanni Disease,
etc. This view is also supported by contemporary
ethnographic research in another part of Sri Lanka
r341.
Table 2. Components of pastel tambuma
Oils
I.Kohomba tel (oil extracted from the
seeds of the plant Azadirachta Mica)
2. Tala tel (oil extracted from the seeds
of the plant Sesumum indica)
3. Mce tel (oil extracted from the seeds
of the plant Madhuca longtfilia)
4. Erandu tcl (oil extracted from the
seeds of the plant Ricintu commmic)
5. Gital (nhcc1
157
FOLK REMEDIES AND JITHNOPHARMACOPOEU
A basic home remedy widely used in Nuwara-
kalaviya villages as a first level of treatment for
unakahihembirissawa (fever, cough and cold) was a
preparation made from ginger and coriander (ingu-
rukotrumafli). Until recently more serious febrile con-
ditions including suspected malarial fevers (i.e. muru
una etc.) were locally treated with a specific herbal
preparation called pastel tumbuma (lit. brew made
from five types of oil). This preparation in fact was
made by adding five types of vegetable or animal oils
to a brew made from five types of local herbs as given
in Table 2.
Its method of preparation consisted of pounding
all five herbs together in a mortar, steam-boiling the
preparation using an indigenous device (oanduwa),
squeezing its essences (swurasaya) and finally adding
the required quantities of the five types of oils. The
preparation was consumed two or three times each
day together with one of the local sweeteners-bee
honey of jaggery.
Being a popular home remedy and an athbeheth
(medicine-at-hand), the ingredients ofpasrel tambuma
and its method of preparation were widely known
among the local peasants. One important feature of
this preparation was that all its ingredients were
readily available and indigenous to the local area. All
of the five herbs used were to be found in ones own
home garden or its immediate surroundings. Four of
the oils used were extracted from the seeds of com-
monly found local plants. Of these sesame was (and
still is) an important food crop grown in the local
chenas. Moreover, the techniques of extracting oils
from the relevant seeds, using a locally made wooden
crusher and an accompanying mat container (paha),
had been known in this area for generations. As
raising of cattle too is an important ingredient of the
rural economy of Nuwarakalaviya, ghee is also
readily available. Finally, of the sweeteners used with
pastel tambuma, bee honey was readily collected from
the local jungle in some months of the year.
On the whole, pastel tambuma preparation was
firmly rooted in the local ethnopharmacopoeia. In
contrast to ayurvedic preparations called kashaya
(decoction), also typically containing numerous ex-
otic substances such as dried grapes, dates etc., the
tambuma preparations belonging to the indigenous
herbal traditions almost always utilized locally avail-
able substances. The local parampara vedas as well
as the elderly key informants admitted that in the
past pastel tambuma was widely used as a home
remedy for malaria in the local area and claimed
that it gradually fell into disuse following the intro-
Herbs
1. Yakinaran leaves
(AtlanticI ceylanica)
2. Lime leaves (Citrus atrant(,Wia)
3. Roots and tender leaves of ginger
4. Kuppamcniya leaves
(Acalypha indica)
5. Pavatta leaves Lidhatcdo vcuica1
 158 KALINGA Tuooit
duction of western antimalarials with effect from the
1930s.
It must be noted that several of the antimalarial
herbal substances used in Nuwarakalaviya were also
typically used as food items. Ginger and coriander
were commonly used as spices. Sesame, ghee and
mee tel were added to a variety of food preparations.
The same substances were also used as medicine
for a variety of other commonly occurring illnesses.
As Etkin and Ross have shown for the Hausa
of Nigeria, this varied and repeated use of the
same herbal substances as food and as medicine
for a variety of illnesses may have produced
both a curative and prophylactic effect against
malaria.
It is important to consider whether there was any
conception of a disease vector among the local
people. None of the locally prevalent diseases was
directly or indirectly attributed to mosquitoes. There
was, however, a curious local belief which held that
there was a marked proliferation of mosquitoes
during the flowering of the rhora plant since it
was held that the mosquitoes actually bred in the
pollen of the relevant flower. Given the association
between the peak rainfall season and flowering of the
thora plant noted earlier, the perceived peak in
mosquito breeding corresponds with reality. The
local peasants, however, saw no relationship whatso-
ever between proliferation of mosquitoes and the
annual outbreak of fever despite the fact that they
considered both events to be associated with the
annual flowering of the rhora plant. Thus they
had correctly identified the peak seasons of both
mosquito breeding and fever incidence, even though
they did not perceive any relationship between these
two events.
Even though the mosquito was not seen as a
disease vector, the local peasants considered it a
major nuisance. In some folk poetry (pafknvi) the bite
of the mosquitoes is presented as more menacing than
the life-threatening dangers from certain wild ani-
mals. Hence, in Nuwarakalaviya as in the rest of Sri
Lanka, there has been a long-established practice of
burning certain local herbs as a method for driving
away mosquitoes from homes and temporary watch
huts in chenas at night. Some local plants such as
mudururala (lit. mosquito plant, i.e. Ocitnum sunitum)
were widely known for their mosquito repellent qual-
ities [35]. Using a discarded earthenware vessel one or
more of the substances such as madurutala, kohomba
leaves, pungiri (pangiri grass), kohomba muru (a
fibrous leftover from the process of extracting oil
from the seeds of Azadirachta indica) mee muru
(fibrous leftover from the process of extracting oil
from the seeds of Maduca longifalia), cashew nut
husks etc. were burnt all night in many local homes.
In order to facilitate and prolong the smokes, co-
conut or paddy husks placed at the bottom of the
vessel were burnt along with the herbs. The smokes
which normally started at dusk continued till the
dawn of the following day with herbal and other
ingredients being added from time to time. It is likely
that these smokes considerably helped the local
people to protect themselves against the mosquitoes
including the vectors during critical times of the
night. Unlike other aspects of ethnopharmacopoeia,
SILVA
the practice of using smokes as a mosquito repellent
continues to be important in purana villages in the
Anuradhapura District even today.
As in pastel tambuma, the ingredients used in
mosquito repellent smokes were all essentially indige-
nous to the area. For the most part they were waste
products such as coconut or paddy husks and ko-
hombu or mee muru. It is also interesting to note that
to some extent different products of the same locally
available herbs (e.g. kohomba tel and kohomba muru;
mee fel and mee muru) were used in herbal medication
for malaria on the one hand and as mosquito repel-
lents on the other. This shows that while the local
peasants did not recognize any connection between
fevers and mosquitoes, at the practical level there was
some degree of integration between folk medication
for malaria and the devices used locally for mosquito
control.
Finally, we may consider ritual practices related
to malaria. It does not appear that locally malarial
conditions came under the purview of any elaborate
healing rituals such as pattini cult or sanni rituals.
However, with the onset of any fever two relatively
insignificant ritual acts, namely applying chanted
oil (ref matirima) and tying a chanted thread
around ones neck (nuf badima), were usually per-
formed. Both of these practices were seen as protec-
tive (uraksauotu) rather than curative devices as
those with any physiological ailments such as fever
were thought to be specially vulnerable to demonic
attacks. In sum, locally malaria was perceived and
dealt with largely through a localized secular herbal
tradition.
CONCLUSION
The peasants of Nuwarakalaviya traditionally per-
ceived malaria as one of several related conditions
characterized by repeated attacks of fever and fits. It
was seen as a moderate disorder which could lead to
further complications. There was a clear conception
of both periodicity and seasonality of the disease.
Though mosquitoes were viewed as a nuisance par-
ticularly acute in the malarial season, it was not
recognized as a disease vector.
The relevant perceptions and practices in
Nuwarakalaviya and, as far as we can determine, in
certain other malaria-endemic regions in Sri Lanka
were determined by localized herbal traditions, which
though in some ways affected by the scholarly
ayurveda system were less sophisticated in conceptu-
alizing causation of illness and choice of medications,
but more firmly rooted in the local culture and the
local ecosystem. In contrast to abstract and universal
conceptions contained in ayurveda such as the hu-
moural theory and ayurveda therapy which is par-
tially dependent on imported medicines, the local
concept of disease and the relevant preventive and
curative practices were very much influenced by the
specifics of the local ecosystem. It follows that the
indigenous health belief systems in South Asia may
be more diverse and less internally consistent than is
commonly assumed.
Just like many other aspects of the social structure
and culture of purana villages described by Leach and
 Ayurveda, malaria and the indigenbus herbal tradition
other observers [ 11.1617, the localized herbal tra-
dition described here may be seen as an adaptive
response to endemic malaria on the part of gener-
ations of local peasants assuming that the herbal
remedies used had a curative, preventive or at least
a mitigating effect on malaria. The main strength
of the relevant herbal tradition was that it mobili-
zed locally available natural resources in the forms
of herbal medicines, food and mosquito repellents
in a diversified and multifaceted attack on
malaria.
The herbal medicines for malaria have now been
more or less completely replaced by western anti-
malarials and related concepts even in most remote
villages in Nuwarakalaviya. For the most part this
can be attributed to vigorous efforts under a vertical
malaria eradication programme carried out by the
state over the past four-and-a-half decades. However,
it is significant that despite long years of residual
insecticide application, the local peasants continue to
rely on mosquito-repellent smokes using herbal ingre-
dients. Moreover, the indigenous herbal tradition is
continued by the local parampara vedas in the treat-
ment of other locally prevalent ailments, such as
snake bites, worm infestations and bone injuries. In
this context it is important to note that, unlike the
college-trained ayurvedics who have become more
or less converted to western medicine as also reported
by several other observers [18-191, the local param-
para vedas whose practice is firmly grounded in the
local culture, the local ecosystem and the related
ethnopharmacopoeia, remain conscientious noncol-
laborators of powerful western medicine.
Finally, the efficacy of these varied herbal remedies,
including the herbal preparations traditionally used
as a cure for malaria in various parts of Sri Lanka,
must be scientifically assessed through future re-
search. A comparative study of various herbal tra-
ditions in different malarious regions in South Asia
may be necessary in order to identify the full range
of variation as regards the local remedies for malaria
and their relation to ayurveda. The corpus of
ayurveda, in turn, may be re-examined in the light
of data on various herbal traditions in South Asia,
with a view to evolve an ayurveda doctrine and
practice that build upon accumulated knowledge,
experience and health resources in the whole of South
Asia.
Acknowledgemenls-This investigation received financial
support from the UNDP/World Bank/WHO Special Pro-
gramme for Research and Training in Tropical Diseases
(TDR). Earlier versions of this paper were read at the
Annual Congress of the Sri Lanka Association for the
Advancement of Science held in Colombo in December
1987, and the Third International Congress in Traditional
Asian Medicine held in Bombay in January 1990. Mr
Piyadasa Wanninayaka and Mr S. Doolwala of the Sarvo-
daya Malaria Control Research Project assisted in data
collection. The author gratefully acknowledges constructive
comments on an earlier draft of this paper by Dr Sarath
Edirisinghe (Department of Parasitology, University of
Peradeniya), Dr P. Amarasinghe (Department Zoology,
University of Peradeniya), Dr H. M. Senadheera (Ayurvedic
Physician, Kandy Municipal Council), Dr Satish Jayanetti
(Ayurvedic Physician, Kandy) and Mr Ajith Silva (Depart-
ment of Community Medicine, University of Peradeniya).
159
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