This chapter discusses the syncretism of Ayurveda and cosmopolitan medicine. It shows how large-scale historical changes frame the interpretations of illnesses employed by Ayurvedic physicians, and at the same time help define the character in this century of Indian civilization. Its narrative of Dr. Lenora, Pandit Shiv Sharma, Dr. Dwarkanath, Sri Bapalal Vaidya, and Pandit Ganapathy moves from political controversy about how Ayurveda should be taught to an analysis of the conceptual structure of modern Ayurvedic thought in textbooks, in clinical teaching, and in private practice. It illustrates related styles of professional Ayurvedic medicine in the practices of Shiv Sharma, physicians at an Ayurvedic college, and of an educated village healer. It indicates that in the public eye, professional Ayurvedic institutions cannot compete with biomedical institutions in creating striking new diagnostic and therapeutic technology. The physicians described in this chapter are sometimes painfully aware that cosmopolitan medicine dominates the Indian medical system, yet a substantial market exists for commercial Ayurvedic products and for consultations with practitioners.