TRADITIONAL TIBETAN MEDICINE

The BudhaTraditional Tibetan medicine, also known as Sowa-Rigpa medicine, is a centuries-old traditional medical system that employs a complex approach to diagnosis, incorporating techniques such as pulse analysis and urinalysis, and utilizes behavior and dietary modification, medicines composed of natural materials (e.g., herbs and minerals) and physical therapies (e.g. Tibetan acupuncture, moxabustion, etc.) to treat illness. It embraces the traditional Buddhist belief that all illness ultimately results from the three poisons: ignorance, attachment and aversion. Tibetan medicine follows the Buddha's Four Noble Truths which apply medical diagnostic logic to suffering.

Traditional Tibetan Medicine is a unique and holistic medical system. Treatment includes the prescription of herbal pills prepared according to traditional medical texts, and modifications to the patient's diet and behaviour. The effectiveness of Tibetan Medicine has been demonstrated in its simple treatment of complex long-term conditions such as epilepsy, diabetes, jaundice, and certain forms of cancer. Traditional Tibetan Medicine has absorbed two great Asian systems of medicine, namely those of India and China, as well as elements of Mongolian, Persian and other medical systems. It is a vast and highly evolved medical science which can not be summed up in a few pages than can modern Western medicine, so we have tried to give a general outline here. It is based on the religious and medical traditions of Bon and Tibetan Buddhism but also incorporated medical ideas from Greece, Persia, India and China. In the 18th century it was formalised in four great medical texts, the Four Tantras (the rGyud-bzhi - pronounced 'gyu-zhee'). These comprise 156 chapters and 5,900 verses on concepts and causes of disease, diagnosis and treatment and are still used for medical teaching today.

Tibetan medicine is over 2,000 years old and said to originate from medical teaching given by the Buddha around 500 BC. By synthesizing knowledge from various medical systems, Tibetans created an approach to medical science drawn from thousands of years of accumulated empirical knowledge and intuition about the nature of health and illness. Centuries ago, before Buddhism entered Tibet, Tibetans like all ancient people had a significant degree of medical knowledge. According to traditional sources, in the beginning of the 4th century many new ideas regarding medicine began to enter the country. At first influences came from India in the form of what is now called Ayurvedic medicine, as well as more spiritual and psychologically based systems from Buddhist and other sources. Around the 7th-8th centuries the Tibetan government began sponsoring conferences where doctors skilled in the medical systems of China, Persia, India and Greece presented and debated their ideas regarding health and the treatment of illness. Those with superior abilities in the diagnosis, treatment and understanding of illness were invited to stay and contribute to the country's medical knowledge base. In the 11th century, this knowledge was codified into a unique system containing a synthesis of the principals of physical and psychological medicine imbued with a Buddhist spiritual understanding. This understanding formed a foundation for Tibetan medicine and benefited patients and doctors alike. It acknowledged how health and illness resulted both from the relationship between the mind and the body and people's connectedness to the natural world and sense of spirituality.

Traditional Tibetan MedicineAs Indian culture flooded Tibet in the eleventh and twelfth centuries, a number of Indian medical texts were also transmitted. For example, the Ayurvedic Astangahrdayasamhita (Heart of Medicine Compendium attributed to Vagbhata) was translated into Tibetan by Rinchen Zangpo (9571055). Tibet also absorbed the early Indian Abhidharma literature, for example the fifth century Abhidharmakosasabhasyam by Vasubandhu, which expounds upon medical topics, such as fetal development.A wide range of Indian Vajrayana tantras, containing practices based on medical anatomy, were subsequently absorbed into Tibet. Some scholars believe that rgyud bzhi (the Four Tantras) was told by the Lord Buddha, while some believe it is the primary work of Yuthok Yontan Gonpo (708 AD). The former opinion is often refuted by saying "If it was told by the Lord Buddha, rgyud bzhi should have a Sanskrit version". However, there is no such version and also no Indian practitioners who have received unbroken lineage of rgyud bzhi. Thus, the later thought should be scholarly considered authentic and practical. The provenance is uncertain. Youthog Yontag Gonopo adapted and synthesized the Four Tantras in the 12th Century. The Four Tantras are scholarly debated as having Indian origins or, as Remedy Master Buddha Bhaisajyaguru's word or, as authentically Tibetan with Chinese origins. It was not formally taught in schools at first but, intertwined with Tibetan Buddhism. The 5th Dalai Lama supported Desi Sangye Gyatso to found the pioneering Chagpori College of Medicine in 1696. Chagpori taught Gyamtso's Blue Beryl as well as the Four Tantras in a model that spread throughout Tibet along with the oral tradition.

The guardian deity of Tibetan medicine is the Medicine Buddha who is often symbolically depicted with a bowl of long-life elixir and a myrobalam fruit - a potent medicinal plant said to cure all diseases. Three 'humours' are said to make up the physical body and regulate physical and mental processes. Each has particular qualities and functions:

  • Loong (vital energy or 'wind') is light, moving, and dry and influences respiration, thinking, digestion, reproduction, physical movement and vitality.
  • Tripa (body heat or 'bile') is hot, oily and odorous and influences appetite, thirst, digestive function, skin quality, joint lubrication, vision and tempestuousness.
  • Peken (moisture and fluids or 'phlegm') is cold, heavy and sticky in nature and regulates sleep, joint mobility, digestion, excretion and mental alertness.

Written HerbalsWhen the humours are balanced there is good health. However imbalance can be caused by lifestyle factors, unhealthy diet, negative thoughts, environmental factors and spirit influences, leading to disease. At the root of all diseases are three mental 'poisons': desire, hatred and confusion. Desire (characterised by attachment, greed, pride and cravings) disturbs 'wind'. Hatred (including anger, aggression and aversion) disturbs 'bile'. Confusion (characterised by indecision, mental lethargy and listlessness) affects 'phlegm'.

The Four Tantras (Gyushi, rGyu-bzhi) are native Tibetan texts incorporating Indian, Chinese and Greco-Arab medical systems. The Four Tantras is believed to have been created in the twelfth century and still today is considered the basis of Tibetan medical practise. The Four Tantras is the common name for the text of the Secret Tantra Instruction on the Eight Branches, the Immortality Elixir essence. It considers a single medical doctrine from four perspectives. Sage Vidyajnana expounded their manifestation. The basis of the Four Tantras is to keep the three bodily humors in balance; (wind rlung, bile mkhris pa, phlegm bad kan.)

  • Root Tantra - A general outline of the principles of Tibetan Medicine, it discusses the humors in the body and their imbalances and their link to illness. The Four Tantra uses visual observation to diagnose predominantly the analysis of the pulse, tongue and analysis of the urine (in modern terms known as urinalysis )
  • Exegetical Tantra - This section discusses in greater detail the theory behind the Four Tantras and gives general theory on subjects such as anatomy, physiology, psychopathology, embryology and treatment.
  • Instructional Tantra -The longest of the Tantras is mainly a practical application of treatment, it explains in detail illnesses and which humoral imbalance which causes the illness. This section also describes their specific treatments.
  • Subsequent Tantra - Diagnosis and therapies, including the preparation of Tibetan medicine and cleansing of the body internally and externally with the use of techniques such as moxibustion, massage and minor surgeries.

Some believe the Four Tantra to be the authentic teachings of the Buddha 'Master of remedies' which was translated from sanskrit, others believe it to be solely Tibetan in creation by Yuthog the Elder or Yuthog the Younger. Noting these two theories there remain others sceptical as to its original author. Believers in the Buddhist origin of the Four Tantras and how it came to be in Tibet believe it was first taught in India by the buddha when he manifested as the 'Master of Remedies'. The Four Tantra was then in the eighth century translated and offered to Padmasambhava by Vairocana and concealed in a monastery called samye. In the second half of the eleventh century it was rediscovered and in the following century it was in the hands of Yuthog the Younger who completed the Four Tantras and included elements of Tibetan medicine, which would explain why there is Indian elements to the Four Tantras. Although there is clear written instruction in the Four Tantra, the oral transmission of medical knowledge still remained a strong element in Tibetan Medicine, for example oral instruction may have been needed to know how to perform a moxibustion technique. Tibetan Medicine classifies 84,000 types of diseases divided into four main types: due to early life, present lifestyle, past life (karma) and spirit influence.

Traditional Tibetan MedicineDiagnosis is based on pulse taking, urine analysis, observation (of tongue, skin, eyes, ears, gait etc) and questioning. The best Tibetan doctors are said to be able to diagnose using pulse alone. Pulses for each internal organ are taken on the radial arteries of the wrists and there are also seven 'wondrous' pulses for determining pregnancy and spirit influences. Astrological charts may also be used to determine predisposition to disease and underlying cause. The aim is to restore the balance of the humours. This is achieved through dietary modification, behavioural change, medicines, external treatments, religious rituals and purification techniques.

Diet and lifestyle changes are always recommended and are based on the effects of different types of food and behaviour on each humour. Medicines are herbal, made from the roots, leaves, flowers, bark and fruits of different plants, minerals and occasionally animal products. The remedies are given as pills, powders, decoctions and ointments. External therapies include moxibustion (a form of heat treatment), massage and bone-setting. Spiritual healing involves prayers and rituals by the physician and/or the patient and often the healing power of the Medicine Buddha is invoked.

Like other systems of traditional Asian medicine, and in contrast to biomedicine, Tibetan medicine first puts forth a specific definition of health in its theoretical texts. To have good health, Tibetan medical theory states that it is necessary to maintain balance in the body's three principles of function [often translated as humors]: rLung (pron. Loong), mKhris-pa (pron. Tree-pa) [often translated as bile], and Bad-kan (pron. Pay-gen) [often translated as phlegm]

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