The Invisible Architecture of Care: Spontaneous Order, Dignity Goods, and the Speech-Swallow-Soul Triad at an Indian Hospice

This paper presents ethnographic fieldwork at Manipal Hospice and Research Centre (MHRC), India, conducted over 6 weeks (Summer 2026) as part of the Stories That Matter Community Impact Internship at MISHA, MAHE Manipal. It applies F.A. Hayek's spontaneous order theory, Carl Menger's subjective welfare economics, Kirzner's entrepreneurial alertness, Polanyi's tacit knowledge framework, and Everly's Psychological First Aid triage model alongside the Ayurvedic caregiver pharmacopoeia to document 30+ informal care practices invisible to formal clinical protocols. Original contributions include: (1) the Speech-Swallow-Soul (Vak) Triad — the mouth's three simultaneous functions (Swallowing, Speech-Vak, Soul-Prana) treated as separate clinical domains in Western medicine but unified in Indian cultural-spiritual practice; (2) the Dual Pharmacopoeia framework — the parallel operation of biomedical and Ayurvedic informal remedy systems at MHRC; (3) an original IDDSI–Ayurvedic food continuum mapping (Manda → Level 1, Peya → Level 2, Vilepi → Level 4); (4) a detailed analysis of the Kanji-Ghee-Gut-Brain biochemical axis (butyrate, HDAC inhibition, neuroprotection via Sneha principle); and (5) seven original research gaps for future study. Submitted to F1000Research (June 2026).