This paper examines the twin German institutions of the Kur (spa), and the 'lay' licensed healing practitioner or Heilpraktiker. Through an ethnography of a Heilpraktiker and his Ayurvedic spa in a small catholic village in Germany, where patients arrive in person or as body parts by post, it examines the poly-therapeutics of the practitioner, who seems to combine in his being a dizzy array of diagnostic and therapeutic possibilities. It argues that the while the Ayurvedic spa can be seen as a kind of variation of the traditional German Kur, the Heilpraktiker's poly-therapy has to draw upon the special nature of the practice of medicine in Germany, symbolised in part by the very figure of the Heilpraktiker. It attempts to show that the practitioner's panoply of therapies is partly a symptom of an epistemic impasse at the heart of biomedicine, leading patients on an itinerant quest toward different therapeutic locales, such as the Kur, or to different therapeutic possibilities, such as the ones offered by the Heilpraktiker. But while the Kur and the Heilpraktiker would be either fringe or alternative in the Anglo-American world, in Germany the Kur is part of orthodox medicine, and the Heilpraktiker is a legal entity; and the two together re-draw and make fuzzy what elsewhere seem to be clearly drawn boundaries between medicine and the spa, between pleasure and therapy, and medicine and alternative medicine.

Anthropol Med. 2011 Apr;18(1):67-86. Naraindas H. Centre for the Study of Social Systems, School of Social Sciences, Jawaharlal Nehru University, New Delhi 11067, India.