On Saturday, thousands of asthma patients from across Andhra Pradesh and other states lined up for fish 'prasadam', believed to cure the disease.
The Bathini Goud family started distributing the medicine to people at the sprawling Exhibition Grounds here at 32 counters.
The Goud family started distributing the medicine after a ritual at noon, the time of 'Mirgasira Karthi', which heralds the onset of monsoon. The distribution will continue till Sunday noon.
The "medicine" is a "secret" yellow herbal paste to be swallowed with a live 'murrel' fingerling.
Vegetarian patients are given the paste with jaggery. However, the Goud family says the medicine is effective only if swallowed with the fish. It is believed that if taken for three consecutive years, it cures asthma.
Sheer belief attracts thousands to the event, despite the controversies surrounding it.
"I have come here for the second time. It has given some relief and I hope it will cure the problem," said Ramakrishna Reddy, a patient from Kurnool town of Andhra Pradesh.
Rationalists and some rights groups had challenged the family's claims, terming the practice unscientific and superstition. After the substance was tested in laboratories, the high court had observed that while its efficacy was not proved, it is not harmful either.
Fisheries department officials said they had made arrangements to supply 50,000 fingerlings for the annual event.
Clearing the hurdles for the event, the Andhra Pradesh High Court Friday suspended the orders of Lokayukta regarding the arrangements.
A trust run by the Goud family had submitted to the court that they had been distributing the fish medicine for over 160 years. In 1997, the state government had asked the family to shift the venue from their ancestral house in the congested bylanes of Doodhbowli in the old city.
Last year, the event was shifted to a ground at katedan on the city outskirts. The authorities had failed to control the crowd, leading to stampede, which killed one and injured several others.
The Goud family claims that the secret formula for the herbal medicine was given to their ancestor in 1845 by a saint after taking an oath from him that it should be administered free of cost.