three therapies of south india 53
buttermilk and other ingredients that looks like mud or wet clay—to the
patient’s head and tying it in place with a banana leaf. After 45 minutes, a
marma halfway between the forehead and the top of the head is said to warm
to a temperature of 40° C. Marmas are physiologically signifi cant points on the
body that are engaged in understanding the functioning of the body and the
administration of some treatments, and this marma is considered an important
locus of mental activity. At this time, the mud from the area around the marma
is removed and replaced with fresh, cooler mud.
In observing administrations of talapodichil, I was struck that patients
who were undergoing this therapy were in a good humor. Th ey reported that
the procedure provided a pleasant, cooling eff ect, and they joked about how
the banana leaf looked. I thought it signifi cant that the mood and atmos-
phere among patients undergoing talapodichil and other ayurvedic therapies
described here contrasted with the seriousness and occasional trepidation I
observed among patients undergoing allopathic inpatient procedures such as
the administration of psychiatric medications and electroconvulsive therapy.
Patients did not dread, and often appeared to enjoy, treatment at the GAMH
although not all embraced the lengthy, austere regimen one had to undergo
while in therapy—for example, not being able to eat meat or fi sh or smoke
was a struggle for several male inpatients (many in Kerala say they cannot get
through the day without their fi sh curry and I began to feel the same way after
extended stays).
My understanding of the purpose of these procedures is that they calm and
“cool” the patient, which has connotations of mental balance and a positive
sensory eff ect, and remove impurities (it might be helpful to think of this as a
removal of toxins) thereby making medicines and talk therapy more eff ective.
Th e calming and cooling eff ect patients report is also therapeutic in and of
itself, while the implications of the pleasantness of undergoing these proced-
ures will be a topic of further scrutiny a little later.
Before continuing with further details about ayurvedic treatments, I should
emphasize that many in India are concerned about biopiracy of local medical
knowledge, the misappropriation of ayurvedic medical knowledge by research-
ers and producers who intend to develop commercial products based on this
knowledge. Botanical researchers and drug producers are required to consult India’s
Traditional Knowledge Digital Library (www.tkdl.res.in) to obtain offi cial access
to medical information and information on profi t- sharing requirements for products
that are produced based on ayurvedic knowledge.
Th e medications given to patients at the GAMH are designed to treat their
specifi c pathologies. Dr. Sundaran treats many of his outpatients with a powder
made of the medicinal plant sankapushpi (Sanskritic name for Clitoria ternata),