three therapies of south india 47
of the ideology of curing, suggest the return-to-balance metaphor may involve
importing biomedical assumptions about curing as ridding of symptoms and
restoring functionality. Another way to look at the goals of healing in ayurveda
is to think of balance as an ideal state of health that one should strive for. As
Alter suggests, people are not seen in ayurveda as normally in balance before
illness and as having returned to a state of balance after treatment. Rather,
each individual in her normal state, absent of any illness has a dominant dosa,
or dosas, a certain body type or disposition. Th at is, people are usually not
balanced, and in states of illness their dosas are even more greatly misaligned.
Treatment, whether for a pathology or for health improvement, aims to correct
the problematic dosa(s) and move the patient closer to a state of dosic balance.
Th is continuum of experiences of incremental improvement toward an ideal
state can be seen among patients in Kerala who talk of achieving states of heal-
ing that range from simple “change” (māttam) to positive transformation.
Th ese conceptual features of ayurveda are described in texts and taught
in colleges and to some degree inform the practices of ayurvedic physicians.
However, it is diffi cult to explicitly see the theory of the dosas and other princi-
ples in everyday practice. Instead one often observes doctors simply prescribing
medications to treat a particular patient’s illness. If asked, some practitioners
say they are unable to explain the dosaic principles involved in a therapy while
others do off er connections to these principles.
Th e connection between practice and basic principles is more pronounced
among physicians who practice a method of treatment that involves tailor-
ing medications to individual patients’ problems. Today ayurvedic medicines
are processed in laboratories, packaged, and sold in pharmacies that are hard
to distinguish from allopathic pharmacies. Both ayurvedic and allopathic
pharmacies sell factory-made packages of pills, capsules and liquids, but some
ayurvedic pharmacies also sell raw medicinal plant materials. Th is standard-
ized, factory-based method of production diff ers from what is considered a
“traditional” method of ayurvedic practice involving the mixing of ingredients
to create medications that are specifi c to each patient’s unique condition. Using
the latter method, doctors combine their knowledge of ayurvedic conceptual
principles and pharmacology to either mix together a medicine designed
to treat a particular patient’s constellation of symptoms or write a prescrip-
tion tailored to a particular patient’s problem in the form of a recipe that the
patient’s family prepares at home using raw plant materials obtained from an
ayurvedic pharmacy.^8 Th is method continues to be used by some practitioners
in Kerala, but appears to be changing in relation to changes in the ayurvedic
drug industry, which has begun to standardize the production of pills and other
medications, possibly to increase production and profi tability or to conform to