Article

Medicine

From Munshipedia, the MBRAS digital historical encyclopedia

Medicine

Medicine in the Malay Peninsula and Borneo has historically existed as a plural and layered system, in which indigenous healing traditions, South Asian medical lineages, and Western biomedical practice have coexisted, competed, and occasionally interpenetrated across more than a century of colonial administration. The region’s medical landscape was shaped by the economic demands of the plantation economy, the public-health imperatives of tropical disease, and the persistent vitality of local therapeutic cultures that operated outside—and often in parallel to—formal colonial institutions. From the pawang (hereditary village medicine-man) of the Malay countryside to the estate hospitals of the rubber boom, and from the babalian (female healer) of the Murut highlands to the colonial medical schools of the Straits Settlements, the history of medicine in this region is inseparable from questions of labour, sovereignty, and cultural authority [1, pp. 91–92], [2, p. 68].

Traditional and Indigenous Medical Systems

The earliest sustained documentation of indigenous medical practice in the Society’s literature comes from colonial administrators who encountered these systems in the course of their official duties. C. Otto Blagden, writing from Malacca in 1896, identified the pawang as the legitimate successor to the primitive “medicine-man” or “village sorcerer,” a hereditary functionary whose authority extended across all agricultural operations, fishing, mineral prospecting, and cases of sickness [3, p. 5]. Blagden recorded that the pawang was entitled by custom to five gantang of padi, one gantang of rice, and two chupak of emping (candlenut) from each householder after a good harvest, and 7½ cents after treating a sick person [3, p. 6]. His ordinances, known as pantang (customary prohibitions), included restrictions on working in the rice-field on certain lunar days and on the use of the sickle for cutting padi—rules Blagden interpreted as preserving older agricultural forms against innovation [3, pp. 6–7].

W. W. Skeat’s 1898 first-person account from Negri Sembilan provides one of the earliest verbatim records of Malay ritual healing. He documented a ceremony in which a male pawang, after being “shampooed” in incense smoke, entered a trance state, was possessed by a tiger spirit, and licked the patient’s body from head to foot before letting his own blood over the prostrate form [4, pp. 22–23]. Skeat also transcribed the bhasa hantu (spirit language) used by the pawang during possession, recording seventeen Malay-to-spirit-language correspondences, including anak (child) rendered as demit and mati (dead) as merat [4, pp. 23–24]. His interpretive framework, drawn from Frazer’s Golden Bough, identified the healing sequence as an instance of sympathetic magic [4, p. 4].

In Kelantan, the Residency Surgeon J. D. Gimlette distinguished the bomor (the general practitioner combining medicine with witchcraft) from the pawang (wizard), noting that the latter term was rarely used locally [5, p. 29]. Gimlette’s most significant contribution was his documentation of the pupoh kampong (village quarantine, lasting thirty days) and pupoh rumah (house quarantine, lasting three days, extended to five by the bomors) observed during the 1910 cholera epidemic [5, pp. 29–30]. The quarantine was enforced by a tali pupoh (string with leaf twists) stretched across the main path, with a bamboo clapper that entrants had to strike; breach of quarantine attracted an adat (customary fine) comprising two dollars cash, 1½ lbs. of nasi kunyit (saffron rice), 2½ yards of white cloth, ten cents in pitis, and three skeins of white thread [5, p. 30]. Gimlette argued that many ostensibly magical prescriptions possessed a rational epidemiological or pharmacological logic that colonial medicine had yet to fully appreciate [5, p. 29].

The pharmacological dimension of Malay traditional medicine is illustrated by H. N. Ridley’s 1900 note on the use of the slow loris (Nycticebus tardigradus), which reproduces a Malay manuscript comprising eleven numbered prescriptions for the animal’s tears, blood, gut, eyes, heart, backbone, leg bone, lung, and liver in contexts ranging from love charms to obstetric aid [6, pp. 32–34]. Gimlette similarly catalogued a yaws remedy combining tiger kneecap, dugong bones, wild goat horns, realgar, and red sandalwood, ground in boiling rice water [5, p. 30].

In Borneo, M. C. Clarke documented the kalatong, which he identified as the “greatest of all the Murut berubat ceremonies” and an “all-out attempt to regain health” for chronic conditions such as haemoptysis or generalised oedema [2, p. 69]. The ceremony, observed in the Keningau district, could involve as many as twenty babalian attending from neighbouring villages, with a total attendance of 100–150 people [2, p. 70]. Its climactic phase involved a blood-sacrifice in which a special hereditary dagger, about six inches long and used for no other purpose, was driven through a pig’s chest; the patient’s body was then painted with a mixture of blood, rice tapai (fermented rice), and seven types of leaves [2, pp. 71–72]. Clarke noted that the ceremony’s frequency was directly governed by harvest yields: with a good harvest, as many as two kalatong might be held in an area within a year; with less rice available, there might be only one in three years [2, p. 72].

The Indian medical tradition in Malaysia, surveyed by F. C. Colley in 1978, encompassed formal practitioner-based medicine (Siddha and Ayurvedic) alongside a rich corpus of household remedies [7, p. 77]. Colley emphasised the interweaving of the pharmacological and the metaphysical: the Margosa tree was associated with the goddess Sri Maha Mariamman and believed to check the spread of smallpox, while turmeric’s widespread medicinal use was explicitly linked to its ritual function as a protective pigment against evil spirits [7, pp. 102–103]. He noted that onions, garlic, and turmeric were used medicinally by Malays, Chinese, and Indians alike, while bitter aloes, asafoetida, and chiretta were specifically imported from India [7, pp. 100].

Colonial Medical Infrastructure and Public Health

The development of Western medical infrastructure in the region was marked by chronic underfunding and institutional dependency. Y. K. Lee’s 1973 study traced the failure of local apprenticeship schemes in the Straits Settlements from 1786 to 1871, demonstrating that the first formal scheme (1823–1829) produced only two qualified men from four candidates, and that the entry salary of 50 Rupees per month was less than half the 105 Rupees paid to Indian-enlisted Medical Subordinates [8, pp. 104–105]. By 1860, Governor Cavenagh reported that the apprenticeship system had “proved an utter failure” [8, p. 113]. The decisive turning point came with the 1867 Transfer of the Settlements from the India Office to the Colonial Office, which severed the supply of Indian Apothecaries and forced the adoption of the Madras Medical College training model, with a starting salary of $45 per month and a three-year collegiate course, that persisted until the founding of the King Edward VII College of Medicine in 1905 [8, pp. 116–118].

The plantation economy generated its own medical infrastructure. By 1918, rubber estates in the Federated Malay States provided 7,057 hospital beds staffed by 45 doctors; by 1934, 223 hospitals across British Malaya served an estimated 162,290 estate workers [1, pp. 13]. Liew Kai Khiun argued that estate health was not merely a matter of medical provision but a site where planters actively negotiated the boundaries of private property, collective obligation, and state authority [1, p. 91]. The Health Board Enactment, described by the Legal Advisor as “a somewhat bold piece of experimental legislation,” was enacted around 1926 and dissolved in 1932, by which time the Central Health Board had incurred a deficit of $62,749.34 Straits dollars [1, pp. 16–18]. Liew reframed the planters’ role in malariology, arguing that by elevating malaria to the status of the colony’s most lethal obstacle to progress, planters simultaneously justified their own public health expenditures and entrenched their social position as pillars of colonial modernity [1, p. 114].

Naval medicine in the region was shaped by institutional dependency on the East India Company. Tham and Samsudin documented that between January 1787 and January 1798, 805 European seamen were admitted to the Penang General Hospital, of whom 127 died—a mortality rate of one in six, compared to a civilian rate of one in 27 [9, p. 7]. The hospital was situated on the beachfront, almost entirely encircled by stagnant swamps that bred malaria-bearing mosquitoes [9, p. 5]. HMS Wilhelmina, serving as a naval hospital ship at Penang from 1808 to 1813, received 355 patients between August 1809 and January 1811: 115 were discharged cured (32.4 per cent), 172 were invalidated (48.5 per cent), and 37 died (10.4 per cent) [9, p. 7].

Tropical Physiology and Nutrition

J. Argyll Campbell, a physician practising in Singapore, produced two studies that addressed the physiological effects of the tropical environment. His 1917 comparative study of diet, nutrition, and excretion in four medical students of different ethnic backgrounds (Chinese, Tamil, Malay, and Brahmin) demonstrated that European reference values for renal excretion were clinically useless when applied to Asiatic patients [10, p. 63]. The Chinese student’s average six-month diet supplied 1,577 kilocalories (60 g protein, 43 g fat, 227 g carbohydrate), while the Brahmin’s vegetarian diet supplied 2,493 kilocalories but only half the protein was metabolised [9, p. 58, Table II]. Total nitrogen excretion ranged from 6.64 g (Brahmin) to 9.25 g (Chinese) per diem, compared with 16 g for the European reference [9, p. 60, Table I]. Campbell attributed the lower caloric requirements of Singapore students to the city’s lack of seasonal temperature variation and its higher humidity, which reduced the body’s need to generate heat [10, pp. 61–62].

His 1919 study on body temperature and comfort, based on six years of self-experimentation across six climates, demonstrated that a rise in axillary temperature to 97.6°F, even in the absence of fever, produced significant discomfort [11, pp. 63–64]. The most instructive comparison was between two Singapore bungalows with nearly identical atmospheric conditions: the breezy hill-top bungalow yielded an average axillary temperature of 97.1° and the subject “very rarely felt uncomfortably hot,” while the still-air bungalow at near sea level produced an average of 97.6° and consistent discomfort [11, p. 64]. Campbell extended this to a public-health claim: in the thickly populated, still-air areas of Singapore, the combination of heat and moisture exerted its “greatest ill,” and the city’s high death rate was a consequence [11, p. 65].

Research and Documentation

The Society’s literature on medicine reveals a shifting set of priorities across more than a century. The earliest contributions (Blagden 1896, Skeat 1898, Ridley 1900) were ethnographic in character, produced by colonial administrators and naturalists who documented indigenous practice for metropolitan readership, often framing it through the interpretive lens of comparative religion or sympathetic magic [3, p. 1], [4, p. 4]. The interwar period saw a turn towards quantitative tropical physiology and public-health administration, exemplified by Campbell’s metabolic studies and the growing literature on plantation medicine and malaria control [10, p. 57], [1, p. 91]. Liew’s 2010 article represents a historiographical intervention that recasts planters as active political agents who shaped colonial health policy rather than passive recipients of it, and reframes their engagement with malariology as one of co-production rather than passive absorption of scientific knowledge [1, p. 114]. Colley’s 1978 survey of Indian medicine and Clarke’s 1954 account of the kalatong extend the ethnographic tradition into the post-war period, functioning as documentary records of practices observed in their respective communities during the 1950s and 1970s [7, p. 77], [2, p. 68]. The cumulative record demonstrates that medicine in this region has never been a single system but a contested and plural field in which therapeutic authority, economic interest, and cultural identity have been continuously negotiated.

MBRAS Sources

Traditional Medicine

Western Medicine

References

  1. Liew Kai Khiun (2010). Planters, estate health and malaria in British Malaya (1900‒1940 JMBRAS 83(1): 91–115.
  2. M.C. Clark (1954). Kalatong: the Murut treatment of chronic disease JMBRAS 27(1): 68–72. Read on JSTOR
  3. C.O. Blagden (1896). Notes on the folk-lore and popular religion of the Malays JSBRAS 29: 1–12.
  4. W.W. Skeat (1898). Some records of Malay magic by an eye-witness JSBRAS 31: 1–41. Read on JSTOR
  5. J.D. Gimlette (1913). Some superstitious beliefs occurring in theory and practice of Malay medicine JSBRAS 65: 29–35.
  6. H.N. Ridley (1900). On the use of the slow loris in Malay medicine JSBRAS 34: 31–34.
  7. F.C. Colley (1978). Traditional Indian medicine in Malaysia JMBRAS 51(1): 77–109.
  8. Y.K. Lee (1973). Medical education in the Straits, 1786–1871 JMBRAS 46(1): 101–122. Read on JSTOR
  9. Tham Junean and Mohd Bin Samsudin (2022). The Royal Navy and Disease in the Straits of Malacca, 1794–1815 JMBRAS 95(2): 22–38.
  10. J.A. Campbell (1917). Diet, nutrition and excretion of the Asiatic races in Singapore JSBRAS 76: 57–65. Read on JSTOR
  11. J.A. Campbell (1919). Body temperature and comfort JSBRAS 80: 63–66. Read on JSTOR