52 chapter
the patient’s symptoms, assessing the patient’s overall state of health, giving
memory tests and trying to evaluate the patient’s normal personality to deter-
mine to what degree the patient’s behavior deviates from her normal state.
According to staff physician Dr. Abdu, the inpatient treatment process at
the hospital lasts 45 days, and patients may repeat the course of treatment up
to three times, depending on the severity of the problem. Upon arriving at the
hospital, patients are given medicines for one week to relieve their symptoms
after which they do snehapana, which involves drinking medicated ghee (clari-
fi ed butter) every day for a week in amounts that increase by 60 ml per day.
Th e purpose of snehapana is to lubricate the body, and during this time the
patient is restricted to a diet of kanji, a mildly fl avored rice soup. After resting
for a day following snehapana, the patient is given oil baths and steam baths
to induce sweating. Th e baths are administered over two days, after which
patients begin the therapeutic procedure known as panchakarma. Panchakarma
is described in the classic ayurvedic texts, although it is not often used today
outside of Kerala.^12
Panchakarma begins with a day of vamana, where a drug is given to induce
vomiting, followed by virechana, in which a purgative is taken to empty the
bowels. Th ese steps plus the preliminary snehapana and sweating and later
steps in panchakarma, remove “impure substances,” from the body. Dr. Abdu
explained: “Th e purpose of snehapana is lubrication of the body.... impure
substances are lubricated by this treatment. Th en by way of fomentation
[sweating], these impure particles go to the alimentary canal. While in the
alimentary canal, some will come to the nose and others to the stomach and
intestines. Th e substances reaching the stomach are expelled by way of vomit-
ing. For other substances, which leave through the intestine, we give purgative
medicines.”^13
After the purgative treatment, virechana, and a day of rest, patients are once
again given medicines for specifi c symptomatic relief through the remainder of
their stay at the hospital. Th e next step in inpatient treatment at the GAMH is
the application of enemas or vasti. Snehavasti, an unmedicated enema with oil,
and kashayavasti, a medicated enema, are given alternating with days of rest for
a total of four snehavastis and three kashayavastis over the course of seven days.
Panchakarma therapy ends after a week of nasya, which involves steaming the
head and administering medicine through the nose.
During the remaining two weeks in the hospital, patients undergo picchu
and talapodichil. Picchu involves pouring medicated oil into two cloths that are
tied around the top of a patient’s head. Th e cloth is then left on the head for a
period of time while the oil is absorbed through the skin. Talapodichil consists
of applying a medicated gooseberry “mudpack”—a combination of gooseberry,