three therapies of south india 51
to kaphotmadam except that vishadam can involve problems with anger, which
are not characteristic of kaphotmadam.
Th e dosa-genic disorders can result from excessive desire, trauma, shock,
dietary problems and other factors, and treatment involves taking medications,
undergoing snehapana (drinking ghee to oleate the body and facilitate the
removal of impurities), taking an oil bath, sweating, panchakarma (a two-week
course of purifi cation/detoxifi cation therapy consisting of fi ve steps: emesis,
purgation, medicated enemas, non-medicated enemas and medicines taken
through the nose) and talk therapy. Many ayurvedic psychiatric medications
and therapeutic procedures, according to Dr. Sundaran, work on the sringart-
aga, an area of the head about halfway between the forehead and the apex of
the head. Th is is the point of convergence of four senses (taste, hearing, smell
and sight) and is the center of mental activity in ayurveda.
Cooling the Mind at the Government Ayurveda Mental Hospital
Kerala’s Government Ayurveda Mental Hospital is located in northern Kerala
in Kottakkal, a town that is home to several other ayurvedic institutions includ-
ing the Arya Vaidya Sala, an organization founded in 1902 by the vaidyan
Vaidyarathnam P.S. Varier. Th e Arya Vaidya Sala currently operates a drug-
manufacturing center, hospital, nursing home, botanical research garden and
ayurveda college in Kottakkal. Th e Government Ayurveda Mental Hospital,
founded in 1984 and funded by the Government of Kerala, is one of the few
ayurvedic institutions in Kottakkal that does not operate under the auspices of
the Arya Vaidya Sala organization.
Th e mental hospital is staff ed by a director, two psychiatrist-physicians,
four nurses and several other attendants. Just over twenty outpatients are seen
every day, and at any time approximately eighteen inpatients (about 13 male,
5 female) are staying at the hospital. When I visited in 1999, the GAMH had
moved from the old Malabar-style mansion in which it had been located to
a larger, modern facility that holds fi fty patients, and the size of the staff had
increased.^10 Most of the following description is based on observations of the
hospital at the old facility in 1994 and 1997. Treatment at the hospital is free
for patients who earn less than Rs. 1,500 per year ($45 U.S., the average annual
income in Kerala being close to $200 U.S. at the time). Patients earning more
than this amount are required to make some contribution to their treatment
on a sliding scale. Most of the patient contributions go toward the cost of
medicines, which are becoming increasingly expensive.^11
Patients are admitted to the hospital after an outpatient consultation or
a period of outpatient treatment. Th ese consultations involve ascertaining