178 chapter
being treated, requires 45 days of inpatient treatment and dietary restrictions)
with the quick treatment of allopathy. Yet another patient explained that
ayurvedic therapy was diffi cult because it was hard to drink ghee (referring to
the snehapana treatment which was described as akin to the discomfort of eat-
ing too much heavy food) and he did not like having to give up smoking and
eating meat while in treatment. However, he added that after a while he began
to feel good on this more austere, vegetarian regimen. Allopathy, by contrast,
may be seen as creating at times sharp, heating unpleasant eff ects, a diff er-
ent kind of abrasiveness. Perhaps the diff erence is that allopathy’s eff ects are
unintended, “side eff ects” as many in Kerala point out, and it may be that the
sense of inappropriate or unexpected eff ects—as opposed to the expectation of
discomfort and inconvenience in some ayurvedic panchakarma procedures—
causes a more adverse reaction, exacerbating the somatic-aesthetic experience
in allopathic treatment.
Th e most signifi cant diff erence, however, is that while both allopathic and
ayurvedic procedures feature unpleasant or challenging eff ects, only ayurvedic
treatment included therapies that were reported as actually pleasant or “cool-
ing” to undergo. No allopathic therapy inspired positive aesthetic appraisals.
No patient explained that they enjoyed undergoing injections or ECT, even
though some said they benefi ted from these therapies.
Th ere are certainly contexts in India and other parts of the world where
there is a sense of “pleasure” in pain or redemptive eff ects of suff ering, but
there was little indication of such an orientation among people suff ering
psycho pathology in Kerala. Th e “diffi culty” in undergoing the lengthy and—
especially for those who normally smoke, drink alcohol or eat meat—austere
regimen was recounted with a sense of bravado, a certain sense of pleasure or
pride in overcoming a challenge, but there was no articulation among patients
of a sense that pain or discomfort was necessary for healing, or at least for heal-
ing problems of manas and bōdham.
Displeasure or pain is an important part of the process in other contexts
in South India, for example, in particular rituals and pilgrimages. On a road
near the Medical College campus in Trivandrum as I was on my way to meet
an allopathic psychiatrist, I observed a taipooja ritual wherein devotees pierce
their lower lips with long skewers and parade down the street in a demon-
stration of devotion to the divine marked, in part, by overcoming or enduring
the discomfort of the piercing. Daniel (1984) famously depicted his own
experience among Tamil pilgrims who were undertaking a 40 kilometer trek
to the Sabarimala shrine in the mountains of Kerala. Walking barefoot on
rocky, blazing hot trails, Daniel describes the experience of increasing pain
which devotees struggle to defy in order to enhance their devotion to the