Piramal Pharma’s QuikKool and the Biopolitics of Relief

Posted on 22nd November, 2025 (GMT 07:48 hrs)

ABSTRACT

This essay is a hybrid inquiry into pain, pharmacology, and structural violence, using Piramal Pharma’s QuikKool oral gel as both a clinical artefact and a political metaphor. Grounded in the lived experience of the author as a DHFL victim—one of the statistically erased bodies in India’s ongoing financial governance crisis—the text follows how stress-induced oral ulcers become sites of embodied vulnerability. These wounds, though clinically minor, reveal a deeper narrative: that the body becomes an archive where systemic injustice is recorded in mucosal scar tissue, where governance is felt not only in courts and bureaucracies but also in nerves, blood vessels, and salivary chemistry. A rupture in the narrative—a pharmacological table—interrupts the personal account, echoing what D. S. Kothari identifies as the reductionist violence of modern medicine. Clinical data intrudes into lived reality, forcing suffering to format itself into measurable toxicities, biochemical pathways, and treatable symptoms. The essay draws on Foucault, Sontag, Illich, Nandy, and Kothari to frame the ulcer as a biopolitical wound, the gel as an instrument of structural anesthesia, and the body as a ledger of financial erasure. Relief appears not as a neutral good but as a technique of governance: a way of rendering pain clinically legible while erasing its political origins. By interweaving pharmacology, political economy, narrative testimony, and philosophical critique, the essay argues that modern medicine—especially in its commercial OTC form—participates in a wider regime of numbing. Piramal’s non-pharmacological OTC products, when examined alongside QuikKool, reveal how toxic capitalism operates even through substances marketed as harmless. The essay ends by proposing a radical ethical stance: that healing must be understood as a political act, and relief must be interrogated as a form of governance.

I. The Wound: Body as a Ledger of Violence

There are years in a life when one becomes a statistic. Years when the self is converted into numbers, spreadsheets, “resolution percentages,” and actuarial abstractions. In the DHFL crisis, I became one such number—a wounded integer swallowed into an incoherently posed bankruptcy code that prides itself on crony efficiency rather than distributive justice, on timelines rather than truth, on pre-fixed outcomes rather than transparent fairness. Mr. Piramal gained, the BJP gained, but lakhs of Indian citizens lost something more than money: their right to dignity and dignified living.

When a system erases you, the body begins to remember in its own idiom.

I found myself turning into a strange, self-contained pharmacy of survival. The DHFL crisis colonized not only my finances but my physiology — every institutional failure had a somatic consequence. The judiciary’s delays, the RBI-approved write-offs, the bureaucratic cruelty of “process” over “person” carved stress into my nervous system until I became a chain-smoker. Nixit, Piramal’s anti-nicotine lozenge, tried to discipline a habit that the crisis itself had engineered — a habit born not of pleasure but of panic. Saridon numbed headaches manufactured not by biology but by the fused machinery of insolvency courts, ratings agencies, and state-corporate decrees masquerading as neutral law. Tri-Activ disinfected surfaces as if hygiene could bleach the rot of collusion and corruption that seeped invisibly into every day of my life. None of these products cured me, or the place I inhabit; they merely managed symptoms of a violence whose true source was institutional — a toxicity that no Piramal Pharma’s over-the-counter (OTC) label acknowledges, yet one that continues to course through the bodies of every DHFL victim.

Stress carved tiny ulcers into my mouth, and the stress made me smoke more; the smoking dried the mucosa, slowed healing, and deepened the lesions — aetiology and coping collapsing into one cycle.

These ulcers were clinically insignificant but phenomenologically vast. Their burning edges held the residue of every email unanswered, every petition dismissed, every notice issued in legalese, every arithmetic of erasure that financial capitalism performs on dispossessed, disenfranchised, expropriated citizens.

Pain is a form of data.
Pain is also a form of witnessing.

Reaching for Piramal Pharma’s QuikKool—the tiny OTC tube promising “fast relief”—felt like reaching for a miniature form of justice. If pain was political, perhaps relief carried its own politics. Perhaps numbing could be resistance. Or complicity.

But QuikKool numbed without healing.
Still, I could not eat or even talk properly.

Somewhere between the dulling pulses of pain, a question surfaced—one regarding biomedical modernity:

What if pathology is mislocated in the patient precisely because the universe of medicine is engineered to treat symptoms, thereby concealing aetiologies embedded in the performative machinery of political economy?

What if the ulcer is not the pathology—but the testimony?

II. The Gel: Chemistry, Ghosted Regulations, and the Aesthetics of Numbing

To understand my own suffering, I entered a peculiar investigative mode. I scoured Indian pharmacy websites, searching not for comfort but for information—package inserts, marketing authorizations, regulatory filings, clinical testing data. All I found were retail pages and a repeated formula:

• Choline salicylate (8.7%)
• Lidocaine (2%)
• Benzalkonium chloride (0.01%)

A gel sold nationwide with a ghost-like regulatory footprint.

A product widely consumed yet strangely absent from regulatory discourse.

This absence felt significant. In D. S. Kothari’s words, modern medicine often cloaks its violence under an aura of neutrality and inevitability. Its epistemic authority is so complete that the absence of oversight is not perceived as failure but as efficiency.

I realized that the gel in my hand was not simply a chemical mediator.
It was becoming a symbol of the structures that govern us:

• they soothe without solving
• they intervene without understanding
• they regulate without caring
• they numb the symptom while intensifying the system

As the gel dissolved on my tongue, theory—always lurking beneath sensation—returned. The ulcer was not merely biological damage. It was a biopolitical expression, a point where governance, injustice, and embodiment meet.

But to avoid drowning in abstraction, I decided on a deliberate narrative rupture.

QuikKool’s Ingredients and Toxicities: A Narrative Rupture

This table represents the violence of clinical rationality, where lived experience must submit itself to measurable categories. Where suffering is only valid once translated into pH levels, toxicity thresholds, and pharmacokinetic risks.

Ingredient	Pharmacological Role	Toxicity / Side-Effects	Commentary
Choline salicylate (8.7%)	Salicylate-class NSAID; inhibits COX pathways; reduces inflammation	Local stinging, allergic reactions; systemic toxicity if swallowed or overused: GI irritation, tinnitus, confusion, metabolic acidosis; particularly risky for children (Reye-like syndrome)	A chemical double agent: soothing while capable of systemic disturbance. Relief in one domain, risk in another.
Lidocaine (2%)	Local anesthetic; blocks sodium channels; temporarily halts nerve conduction	Numbness, accidental biting; systemic overdose includes tremors, seizures, arrhythmias, hypotension	Relief here is inseparable from risk. Numbing is both mercy and danger.
Benzalkonium chloride (0.01%)	Cationic surfactant; antiseptic; preservative	Mucosal irritation; cytotoxic at higher levels; disrupts cell membranes; cumulative toxicity possible	Institutional hygiene distilled into a molecule—protective yet inherently abrasive.
Gel base	Vehicle for mucosal application	Irritation, altered taste; modulates absorption	The invisible conductor of toxicity and relief.

Choline salicylate (8.7%) functions as a salicylate-group NSAID, engineered to inhibit COX-1 and COX-2 and thereby reduce prostaglandin-mediated inflammation and pain. While this mechanism provides rapid relief on the mucosal surface, it simultaneously suppresses protective prostaglandins that support healing. The result is an inherent tension: the compound soothes inflammation even as it can irritate the tissue it touches. Absorption across the richly vascular oral mucosa is far more efficient than across skin, meaning that repeated or excessive application can unexpectedly elevate serum salicylate levels. Systemic effects—such as nausea, dizziness, tinnitus, or metabolic acidosis—remain clinically plausible, especially if the gel is swallowed, and the risk is amplified in children due to salicylate association with Reye-like complications during viral illness. Sustained salicylate exposure dampens platelet aggregation at the application site, increasing micro-bleeding and prolonging the lifespan of ulcers—exactly what a patient seeks to reduce.

Lidocaine (2%) serves as an amide-type local anesthetic, blocking voltage-gated sodium channels to temporarily interrupt nociceptive transmission. Its numbing effect offers short-term functional relief, yet the absence of sensation introduces behavioural risk: a desensitized tongue or cheek is vulnerable to inadvertent biting and worsening trauma. Where tissue is already ulcerated, lidocaine crosses the membrane more readily and enters systemic circulation, raising the possibility of central nervous system excitation—tremors, seizures, and visual disturbances—and, at higher levels, cardiovascular depression leading to hypotension or arrhythmias. Compounding this risk is the pharmacodynamic competition between lidocaine and salicylate; salicylate-induced vasodilation can accelerate the entry of lidocaine into systemic circulation, reducing the buffer of safety usually built into topical dosing. Thus, a dose designed for safety can become problematic when the mucosa is damaged, inflamed, or overexposed.

Benzalkonium chloride (0.01%) operates as a quaternary ammonium antiseptic, formulated to disrupt microbial cell membranes and inhibit bacterial growth. Yet its mode of action is inherently cytotoxic; the same membrane-disruptive property applies to epithelial cells. At low concentrations it is tolerated, but on compromised mucosa it produces stinging, burning, and measurable inhibition of tissue repair. The paradox is biological and predictable: the compound protects the ulcer against infection while simultaneously delaying the regeneration of the very membrane it is meant to safeguard.

Finally, the gel base acts as a solvent and delivery matrix capable of stabilising active ingredients and retaining them against the mucosal surface. However, the vehicle often contains humectants and solvent derivatives that can induce dryness, altered taste, or local irritation. More importantly, the base modulates permeability. Its chemical properties—designed for rapid mucosal penetration—can accelerate absorption of both choline salicylate and lidocaine, thereby amplifying the very toxicities that are otherwise prevented by controlled dosing. Many gels also include mild surfactants to improve spreadability; when combined with benzalkonium chloride, the result is a synergistic stripping of the mucosal barrier, effectively “priming” the tissue for deeper uptake of the actives.

Taken together, the formulation represents a dense pharmacological compromise: pain relief requires tissue penetration, yet tissue penetration increases systemic load; antisepsis protects the lesion while slowing healing; numbness prevents pain while raising the risk of physical self-injury. The danger does not arise from any one ingredient in isolation but from the cumulative effect of each compound acting efficiently in a physiologically vulnerable site. The deeper risk lies not in the toxicity of any molecule individually but in the way each amplifies the other—salicylate increasing vascular uptake, benzalkonium suppressing the lipid barrier, the gel vehicle accelerating diffusion, and lidocaine masking the behavioural signals that would otherwise limit overuse. The result is an experience familiar to many users or consumers: immediate relief followed by a lingering fragility, a temporary silencing of pain accompanied by the subtle extension of harm.

The table ends.
But the wound continues its narrative.

III. The System: Toxicity as a Social and Political Network

As I studied the toxicities, I noticed how similar they were to the emotional and political toxicities of financial injustice.

Salicylate overdose begins with nausea, tinnitus, hyperventilation—the body rebelling against intrusion.
Lidocaine toxicity begins subtly—metallic taste, dizziness—then escalates catastrophically.

So too do systemic violences begin quietly:
A notice here, a delay there, a policy change, an opaque committee of creditors’ decision in the DHFL CIRP.
Then collapse.

The boundary between relief and systemic risk—chemical or political—is razor-thin.

In this interstitial space, theory sharpened its edges:

Foucault

In Birth of the Clinic, illness marks the point where power learns to see — and govern — the body. The ulcer is not merely a medical event but the place where governance touches flesh, where surveillance, diagnosis, and normalization penetrate the intimate interior. It becomes a site of biopolitical leakage: a reminder that the state does not rule only through laws and institutions but through the organization of pain, vulnerability, and cure.

Sontag

In Illness as Metaphor, disease is never just disease; it becomes the battlefield where meaning is imposed or expunged. The gel promises relief, but its comfort erases context, dissolving history and politics into surface sensation. It offers therapy instead of explanation, soothing the symptom to make the structure disappear — a politics of forgetting disguised as care.

Illich

In Medical Nemesis, medicine is not simply a healing profession but an institution that anesthetizes society into dependency. By pathologizing the self, it protects the very structures that generate illness — creating a cycle where the system produces harm and then monopolizes the cure. The clinic becomes a factory for conformity, converting existential distress into a managed “disorder,” all in service of social control.

Ashis Nandy

From Science, Hegemony and Violence to Traditions, Tyranny and Utopia, Nandy shows how therapeutic culture becomes a mode of postcolonial rule. The clinical promise of neutrality carries a hidden pedagogy: disciplining both body and psyche into obedience, replacing cultural memory with the logic of expertise. What appears humane becomes an instrument of governance — a gentle colonization of imagination, pain, and possibility.

D. S. Kothari

Here the integration deepens:
Kothari argues that modern medicine wields violence not primarily through errors or toxicities but through its epistemic arrogance, its reductive gaze, and its industrial collusion. According to Kothari:

• Medicine reduces complex suffering to treatable fragments.
• It medicalizes structural injustice as individual pathology.
• It creates dependence by pathologizing normal responses to abnormal society.
• It collaborates with corporate capitalism to proliferate products that numb but do not heal.

QuikKool becomes a perfect microcosm of this:
A product that numbs the wound but reproduces the system that caused it.

Latour

As Latour reminds us in Reassembling the Social, no entity ever acts alone; what we casually call “a situation” is in fact a network of heterogeneous actants—human and nonhuman—co-producing outcomes. The ulcer, the gel, the pharmaceutical brand, the regulatory vacuum, the anxious consumer, and the financial crisis do not sit in separate analytical boxes; they gather, translate, and relay forces into one another. The vulnerability is not inside the body alone but distributed across this network of agents.

In this Latourian topology, the chemical and the political no longer occupy different ontologies. Choline salicylate responds not only to inflamed tissue but to the inflamed life-world that necessitated its use; benzalkonium chloride exerts cytotoxic friction not only on epithelial cells but on the economic precarity that brought the consumer to the pharmacy in the first place. The gel is not merely applied to the wound; it becomes part of the wound’s ecosystem of relations—stabilising, numbing, irritating, and prolonging, all at once. And the wound, in turn, is inseparable from the mesh of institutional decisions, policy failures, and legal-financial violences that produced the stress behaviours enabling it.

The gel is part of the wound.
The wound is part of the system.
And the system—through a chain of actants—returns to the body as pain.

IV. The Witness: Ulcer as Testimony and Resistance

I return to the body—the first witness.

When a wound refuses to heal, it becomes narrative.
It becomes archive.
It becomes resistance.

My ulcers were tiny, yet each contained the biography of a financial betrayal. Each application of gel was a micro-ritual of endurance, a temporary treaty between my nervous system and a world that refused to acknowledge me.

Pain receded; injustice remained.
Relief arrived; meaning disappeared.
The wound persisted.

Tracing my tongue across the ulcer felt like reading topography:

• the ridges of bureaucratic apathy
• the valleys of regulatory silence
• the jagged edges of corporate greed
• the quiet insistence of survival

Narrative became the only space where pain, knowledge, and resistance could coexist.
The gel numbed.
The ulcer narrated.
The body insisted.

In its insistence there was a politics:
a refusal to let systemic violence become merely chemical pain.

IV-A. The Violence of Relief

Toxicology case reports often end with the phrase, “patient stabilized.”
But stabilization is not healing.
Numbing is not justice.

By the time the gel’s mild anesthesia wore off, my ulcer was still burning with memory—personal, political, biochemical.

The violence of relief is subtle.
It is the violence of forgetting.

QuikKool glints on my counter like a small monument to the contradictions of care in late capitalism: relief promised, risk embedded, truth bracketed.

The wound refuses disappearance.
It becomes a small protest against a world that would prefer silence.

V. The Governance of Pain, the Ulcer as Counter-Archive, and the Ethics of Healing

There is a point where political economy crosses the epithelium. A point where injustice, long abstracted into directives, orders, resolutions, insolvency percentages and sealed courtrooms, becomes vascular. The DHFL verdict did not stop at paper; it continued in blood flow, saliva viscosity, gastric pH. The porosity of the oral mucosa turned out to be more faithful than the porosity of law. Where the judiciary routed pain into procedure, the body absorbed it into nerve endings. One could say that in India, debt resolution is not merely a financial process — it is a redistribution of pain.

IBC does not erase liability; it reallocates it.
Corporate governance does not resolve injury; it monetises it.
Justice does not restore; it anesthetises.

The state too has learned the pharmacology of numbing. Each official notification works like lidocaine on democratic nerves — a temporary quieting without cure. Committee reports become benzalkonium chloride — antiseptic language that sterilizes moral responsibility while slowing collective healing. Philanthrocapitalism, in its glossy brochures, functions like choline salicylate — a fast-acting anti-inflammatory designed to reduce discomfort around corporate plunder without addressing the injury that produced it.

This is why governance depends on a very particular semiotics of relief.
If citizens are sufficiently numbed, justice need not arrive.

And yet, the body betrays the design.

Every time my tongue returned to the ulcer, it returned to memory. The wound became a counter-archive — a place where history preserved what the state attempted to redact. Courts may erase petitioners from their orders; audit firms may erase fraud from their ledgers; corporations may erase culpability through acquisition. But the body declines erasure. Each reopening of the ulcer was a declassification event. The body kept minutes of the meeting that democracy chose not to record.

If paper archives are written to forget, biological archives are written to insist.

This insistence is not metaphorical; it is biochemical. Sensory neurons refuse historical amnesia. Scar tissue will not ratify injustice. Pain routes around censorship the way water routes around stone — quietly, repeatedly, ungovernably. In an era where truth commissions are denied, the wound becomes its own commission.

But witness alone is not enough.
Pain demands an ethics.

And this is where the politics of medicine exposes itself most nakedly. Contemporary therapeutics does not ask what the wound says; it asks only how quickly it can be silenced. Medicine has mastered relief but abandoned meaning. It treats suffering as deviation rather than testimony, as malfunction rather than message. The clinic asks: How do we stop the pain?
The wound asks: Why was the pain necessary for the world to function?

What would a radical ethics of healing look like?

• It would reject the violence of relief that demands silence.
• It would refuse anesthesia as a substitute for justice.
• It would affirm that pain is not a failure of the organism but a critique of the environment.
• It would understand that healing is not the cessation of sensation but the restoration of dignity.
• It would hold that the body is not an enemy to be subdued but a witness to be heard.

In that ethic, QuikKool is not villainous — only symptomatic. It participates in a wider regime of pacification masquerading as care. It teaches us that capitalism does not simply extract labour or money; it extracts pain and then sells numbness back to the wounded as a commodity. It teaches us that the industrial apparatus of “comfort” is both a consequence of injury and an engine for its continuation.

And so the essay does not end in despair, nor in cure, but in clarity:

• A society is just not when its citizens are anesthetised into compliance.
• A medical system is ethical not when it removes pain but when it interrogates its origins.
• A democracy is functional not when it pacifies the wounded but when it refuses to create them.

If the wound speaks, the task of a civilization worthy of its name is not to silence it, not to numb it, not to pathologize it —
but to listen.
To change the world that produced it.
To ensure its recurrence becomes unnecessary.

Healing is not analgesia.
Relief is not justice.
Safety is not neutrality.

The ulcer has known this all along.

APPENDIX

Action Manifesto: The Body Is Not a Marketplace

Ban Harmful OTCs. Regulate Piramal Pharma. Protect Consumers.

The investigation into QuikKool was never about a single ulcer gel. It was an X-ray of Piramal Pharma’s entire OTC pharmacology — a portfolio in which safety is satisfied on paper, risk is externalized onto consumers, and pain becomes a predictable business asset. The danger is not the tube in a pharmacy aisle; the danger is the portfolio logic that treats human vulnerability as a revenue stream.

Harm here is not episodic. It is systemic.
It is not contained in one formulation. It is scaled across daily consumer behaviour.
QuikKool is not the exception — it is the blueprint.

The Two-Tiered Toxicity Model

Model of Toxicity	Exposed by QuikKool	Extended Across Piramal OTC Portfolio
Acute Chemical Toxicity	High mucosal permeability → rapid systemic exposure to salicylates + lidocaine	High-dose synthetic hormone shock (i-Pill), high-concentration biocide exposure (Tetmosol), additive analgesic load (Saridon, Sloan’s)
Chronic Regulatory Toxicity	Invisible risks, BAC-linked delayed healing, missing / inaccessible safety inserts	No regulator models cross-product exposure across weeks for consumers using Saridon + Polycrol + QuikKool + Lactocalamine

Across Saridon, Sloan’s, i-Pill, Polycrol, Caladryl, Tetmosol, Lactocalamine, Supradyn, Little’s baby products, and QuikKool, the constant is unmistakable:

Relief is not healing — it is the controlled continuation of vulnerability.
Suffering is not eliminated — it is monetized in instalments.

This is not collateral damage.
This is the design

The Pattern (Across The Piramal OTC Line)

Human Vulnerability	Piramal Solution	Mechanism of Dependence / Harm
Ulcers & mucosal pain	QuikKool	BAC delays healing → repeat use
Stress & headache	Saridon	Temporary numbing → source of stress untouched
Muscle / nerve pain	Sloan’s	Counter-irritation loop → reliance
Unprotected sex / fear	i-Pill	High-dose hormonal shock without medical supervision
Acidity & dyspepsia	Polycrol	Chemical suppression → digestive vulnerability persists
Skin infection / irritation	Tetmosol	Biocide dependence + microbiome disruption
Fatigue & burnout	Supradyn	Metabolic stimulant packaged as “wellness”, not recovery
Pregnancy anxiety / fertility fear	i-Know	Stress–anxiety cycle around fertility → recurring purchases
Chronic acidity from stress	Digeplex	Enzyme reinforcement → digestive laziness + dependency
Itching / skin discomfort	Caladryl / Caladryl Diaper Cream	Allergen masking → recurring irritation loop
Oily / acne-prone skin	Lacto Calamine	Clay drying → rebound oil secretion → repeated use
Infant care anxiety	Little’s (wipes, creams)	High-vulnerability stress → chemical exposure during neonatal months

Different pain, same mechanism:
Not cure — controlled relief.
Not healing — profitable vulnerability.

Policy Demands for Systemic Safety

The toxicity is chemical (in the body), cognitive (in consumer perception), and regulatory (through concealment). Real corrective action is not “reform” — it is the enforcement of safety already mandated by science and law.

1. Regulatory Enforcement (CDSCO)

• Public Repository of Documents — MAH files, package inserts, toxicology rationales
• Safety Signal Transparency — mandatory public summaries of PSURs & ADR-triggered alerts

If a product is safe enough to sell, it is safe enough to disclose.

2. Enhanced Labeling & Warnings (CDSCO + Industry)

Front-panel boxed warnings for:

• Maximum daily & cumulative dose limits
• Pediatric contraindications & Reye’s syndrome risk
• Anticoagulant interactions
• Explicit BAC-related delayed-healing warning

Cross-Product Load Warning:

“Do not use if concurrently taking other salicylate- or anesthetic-containing OTC products.”

Transparency is not optional — it is consent.

3. Industry Accountability

BAC Justification Dossier
The manufacturer must prove that:

• a wound-relief gel requires a wound-healing inhibitor
• consumers are not harmed by the concealment

If justification fails → mandatory reformulation with no litigation shield.

4. Civil Society & Public Health Activation

• RTI offensive — FDC approvals, PSUR compliance logs, ADR datasets
• Public-health literacy campaigns — safe oral gel use, topical anesthetics, hormonal contraception, infant skin products

Resistance here is not activism — it is harm-reduction.

The Irreducible Truth

QuikKool was the doorway.
The ulcer was the symptom.
The portfolio is the system.
And the system profits when pain continues — safely, slowly, and silently.

The gel is part of the wound.
The pill is part of the pain.
The portfolio is part of the vulnerability.

There can be no public health without public truth.
There can be no safety without enforced transparency.
There can be no healing until vulnerability stops being profitable.

The body is not a marketplace — and no company should be allowed to treat it as one.