This article explores missionary medical discourses in three Telugu journals published in the early twentieth century, to analyse how caste pivoted denunciations of alcohol, especially toddy and arrack, in the Madras Presidency and the Hyderabad state. It argues that one women’s missionary journal, Vivekavathi, deployed medical knowledge to formulate subtle and occasionally explicit condemnations of toddy and arrack as unclean and unhealthy substances. The journal relied on universal medical and missionary, British and American knowledge frameworks to mark out Dalits and other marginalised castes as consumers of these local beverages. This stigma was conjured through medical narratives of marginalised castes as lacking in the knowledge of alcohol’s relation to digestion, toddy’s role in ruining maternal and child nutrition, the unhygienic environment of arrack shops and their propensity to ‘alcoholism’. However, this article also traces counter-caste voices who too invoked ‘the power of the universal’ to dispel caste stigma against marginalised castes. While both sets of voices deployed medical ‘enslavement’ to alcohol as an interpretive move, they differed in their social imperatives and political imaginaries, defined in caste terms. This article explores a third set of implications of the term ‘universal’ by analysing global medico-missionary narratives of alcohol in two other Telugu journals. On a methodological plane, this article also pushes for a hybrid reading of what counts for ‘scientific instruction’, where hymns, catechisms, parables and allegories are considered alongside conventional scientific experiments. In that sense, it upholds vernacular missionary publications as an invaluable resource for the social history of medicine.