In several parts of North India, smallpox is usually identified with the goddess Sitala (literally ``the cool one''). Sitala was also referred to as mata (mother). There are several temples and shrines to Sitala all over North India. The main priests who attended to the worship of Sitala were women and a class of people called mali, who were mainly of the laborer and gardener classes. The annual festival for the goddess, Sitala is held in the month of march (chitra). The onset of smallpox is considered to be a manifestation of the goddess and not an essential characteristic. The disease was her khel (sport or play), and hence had to be tolerated giving due respect and honor. The patient is the abode of Sitala when the disease occurs. The patient and the goddess are fed cooling foods such as cold rice, plantains, and yoghurt. During festivities for Sitala, heating foods are banned, sexual activity is minimized, and all other heating activities are abstained from. Cooling drinks are offered to the patient, and his body is rubbed with neem pattha (leaf of the cooling neem tree). If the disease progressed, a Mali is called. The skin of the patient is rubbed with neem leaves, and a cooling mixture of tumeric and flour. Finally, when the boils of smallpox ripen, a small thorn is used to prick them and give relief to the patient. When the fever had subsided, prayers were offered to the Goddess, along with cooling offerings of coconut, rice, and flowers.
Thus smallpox was treated as a case of being possessed by Sitala. The The best a physician could do was to prescribe cooling drafts, use purgatives to relieve the body of its poisons, and to proscribe items that could prolong the pittam imbalance in the body. The rest was under the control of the Sitala. The one other practice that a special vaidya (who later came to be called tikadars (men who apply a mark)) could use was varolation, a procedure where a small amount of smallpox pistule matter was injected into the person's body such that the disease could be attained in a controlled and attenuated way. The practice of varolation was largely taken over by vaccination. In an analysis of the practice of varolation, [Arnold] argues how the practice was locally understood as a way of invoking the protective power of the Goddess Situla's rights over the body of the patient/possessed, instead of violating it. This allowed the practice to be be viewed as a celebration of the Goddess compared to vaccination, which was initially viewed as a violation.
Moreno and Marriott [Moreno] use the same theoretical framework to analyze the humoral transactions in the worship of the Tamil diety Mariamman (also the Goddess of Smallpox (and also mata or amma). In particular, they analyze the mutability of the humors of both devotee and Goddess, and show how Mariamman is seen as humorally variable and responsive to devotees.