During nonemergency appointments at traditional sites of āyurvedic healthcare in Kerala, South India, classically trained Brāhmaṇa physicians and their patients seldom exchange anything of substance (whether medicinal or monetary). The physician-patient interface instead routinely involves an exchange of knowledge. Interactions between physicians and patients in these meetings evoke the highly theorized notion of the “Indian gift” and the question of prestation in South Indian societies. This article explores the nature of exchange in the supply and reception of healthcare among physicians and patients at traditional sites of āyurvedic treatment (that is, sites not affiliated with governmental or private hospitals or clinics) in contemporary Kerala. Drawing on classical treatises about the dharma of gifts (dānadharma) and the Sanskrit medical classics of Āyurveda, it examines reciprocity, ideal preconditions of givers and receivers of gifts, and the possibility of a “pure gift” in the appraisal and production of wellbeing.