Ayurveda in Kerala: How a Panchakarma Stay Works

Ayurveda is the traditional medical system of India. Its classical texts are ancient, and it is practised across the country, but nowhere as visibly as in Kerala. The state has Ayurvedic hospitals and colleges, families of hereditary physicians, factories that prepare the oils and decoctions, and a large number of resorts that receive visitors for residential treatment. For a traveller interested in the wellness traditions of Asia, a stay here is the equivalent of an onsen town in Japan or a temple massage school in Bangkok: the practice seen where it belongs.

This guide describes how such a stay is organised. It does not assess the treatments as medicine. Ayurveda is a traditional system, and its methods are not accepted by evidence-based medicine in the way its practitioners describe them. Anyone with a health condition should take the advice of their own doctor before booking a programme.

Two kinds of programme

Kerala Tourism, the state tourist board, distinguishes two broad kinds of stay. The first is rasayana chikitsa, or rejuvenation therapy, a gentler course of oil massage, steam and diet intended for people who are well. The second is panchakarma, the classical course of cleansing, which is longer and stricter. Most resorts offer both, and many guests begin with the first.

The three stages of panchakarma

The word means “five actions”, after the five cleansing procedures described in the classical texts. In practice the physician selects among them for each person, and the whole course is carried out in three stages.

Purvakarma, the preparation. For several days the body is treated with oil, outside and in, and made to sweat. This is the part of Ayurveda most visitors picture: two therapists working in unison with warm medicated oil on a wooden table, followed by a steam box or a herbal bath. Kerala has its own versions, among them a continuous pouring of oil over the body and a massage with small cloth bundles of cooked rice or herbs.

Pradhanakarma, the main procedures. These are the cleansing actions themselves, chosen and supervised by the physician. They are medical in character and are not pleasant in the way a massage is. Kerala Tourism also lists specialised treatments for the eyes, ears and head, and the use of leeches.

Paschatkarma, the aftercare. The course ends with a period of rest, a carefully graduated diet and advice on daily routine. Practitioners treat this stage as part of the course and ask guests to allow time for it before travelling on.

The day

Life during a programme is deliberately uneventful. A typical day begins early with yoga or a walk. Treatments are scheduled through the day. Meals are vegetarian, lightly spiced and prescribed individually. Herbal preparations are taken at set times. Centres commonly ask guests to avoid alcohol and strenuous activity, and many discourage excursions until the course is over; the rules vary, so ask before booking. Those who expect a holiday with treatments attached are often surprised by the discipline; those who accept it tend to value the quiet most.

How long, and when

Panchakarma is a course of weeks rather than days, and centres will tell you the length they recommend; a rejuvenation programme is shorter. Centres work throughout the year. By tradition the best time is the monsoon, and especially Karkidakam, the last month of the Malayalam calendar, which falls in July and August and which Kerala Tourism presents as the season of rejuvenation. It is the wettest, quietest part of the year, and there is little else to do. Travellers who want to combine treatment with the backwaters or the hills usually prefer December to February.

Choosing where to go

There are three kinds of place. A hospital is for patients, plain in its comforts and serious in its regime. The best known is the Arya Vaidya Sala at Kottakkal, founded as a small clinic in 1902 by P. S. Varier, which now runs five hospitals, its own medicine factories and herb gardens of some 220 acres. A dedicated Ayurveda resort gives the same treatments in a setting of gardens, cottages and a beach or a lake, and takes only guests who are following a programme. A general hotel with an Ayurveda centre is the least demanding and the least complete.

Kerala Tourism lists centres that it has approved and classified, which is the first check to make; confirm a centre’s current approval with the board. The second is to ask who the physicians are, how long the consultation lasts, and whether treatments are prescribed individually. A centre that sells panchakarma by the day is selling something else.

For travellers

Kochi and Thiruvananthapuram are the gateways. Plan the programme as the centre of the journey, and add sightseeing before it, not after. Our Experience page Follow an Ayurvedic programme in Kerala sets out the practical points, and our page on Kerala covers the rest of the state.

The same tradition is followed across the water in Sri Lanka, and in the Himalayan foothills at Ananda. For how these compare with retreats elsewhere, see Serious Wellness in Asia.