Tibetan Art -  ( Image compiled by Dr. Blog )

Tibetan medicine, a shining pearl among the jewels of traditional Chinese medicine, comes from an accumulation of experience that the Tibetans gained during the prolonged course of fighting nature and disease. Many accomplished Tibetan medicine practitioners are responsible for forming the medical system that is unique to Tibet. For historical and social reasons, however, the system developed at a slow pace until the late 20th century.

Tibetan medicine has a history of over 2,000 years. Around 200 BC, when Tubo King Nyitri Tsampo raised six questions concerning Tibetan medicine, a man named Zila Garma Yade answered one of these by saying: "Poison could be used as an antidote to poison.'' In accordance with this theory, Gyaipo Chixi developed a kind of medicinal ball, which was called Tujoinwangrab.

During the 4th century, Lhato Torab summed up his experience in the theory of “treating illness caused by cold factors with medicine of a heat nature, and illness caused by heat factors with medicine of a cold nature.’’ Tonge Tojogyain enriched the theory of Tibetan medicine with his knowledge of Indian medicine learned from his father Gachi Bichi. Tojogyain was so effective that he was able to perform surgery on the eyes of Molung Gunbazha. When Zhonnyi Dewo contracted leprosy, he lived in an underground cell to keep from infecting his relatives. All these examples illustrate a high level of medical knowledge and treatment.

Tibetan medicine gained new ground in the 7th century when Tibetan King Songtsan Gambo unified the Tibetan Plateau and became friendly with the Tang Dynasty through his marriage to Tang Princess Wen Cheng. The princess brought the Outline on Traditional Chinese Medicine to Tibet. It was turned into Tibetan by Mahatiwa, a Han monk, and Dharmokorka, a Tibetan sutra translator. Though the Tibetan version of this classic text is now lost, the fundamental principles have been incorporated into the Four-Volume Medical Code, a famous classic. Songtsan Gambo encouraged medical studies, which led to the further development of Tibetan medicine.

In the early 8th century, Tibetan King Tsampo Tride Zudain married another Tang Dynasty Princess, Jin Cheng. Princess Jin Cheng brought many medical classics to Tibet. Mahayana, a Han monk, and Vairocana, a Tibetan master translator, translated the Medicine Kong on Medical Treatment, the earliest Tibetan medical work available today.

Yutog Nyingma Yundain Goinbo was the most accomplished and famous Tibetan medical practitioner during the time of Trisong Detsan. He gathered folk medical prescriptions from among the common people. He studied medicine in Nepal and India, and invited medical practitioners from China’s hinterland, Nepal and India to work and lecture in Tibet. Based on his research and experience, he wrote the Four-Volume Medical Code, which marks the formation of a unique Tibetan medicinal system. In the early 13th century, Yutog Sama Yundain Goinbo, an offspring of Yutog Nyingma Yundain Goinbo, studied the Medicine King on Medical Treatment and Indian medical works, and, on this basis, revised the Four-Volume Medical Code.

The 14th century saw the rise of the Qamba and Soika medical factions with treatment aimed at coping with the diverse climates of south and north Tibet. Tibetan medical masters created many medical works and wrote copies of annotations to the Four-Volume Medical Code.

During the 17th century, the 5th Dalai Lama, who set great store by Tibetan medicine, created such Tibetan medical schools as the Soirabzhobianling in the Zhaibung Monastery, the Soirab Changsun Duibaling in Xigaze, and Lhawangjor and Sangpo Nyimatang in the Potala Palace. Sanggyi Gyamco, a Degsi official under the 5th Dalai Lama, made an historical contribution to Tibetan medicine by completing the Blue Glaze, an annotation to the Four-Volume Medical Code in 1689. He also created the Outline of Medical Theory and the Feast for the Immortals in 1703. These became the major works for Tibetan medicine practitioners of later generations. Sanggyi Gyamco also created 79 of Tibet’s first colored medical charts, based on the Medicine King on Medical Treatment, his own works including Blue Graze and Outline of Medical Theory, and medical theory of the Qamba school. He also contributed to the training of Tibetan medical workers by establishing the Rachizhobianling Medical School at Yaowangshan Mountain in 1696.

Basic Principles of Tibetan Medicine

Like the phenomena of conditioned existence, diseases are also the product of causes and conditions. There are two main causes of the disease: a long term cause and short cause. Ignorance or unawareness is the ultimate cause of all diseases. Because of ignorance or delusion, one cannot see the reality of the phenomena and thereby clings to personal self or ego which in turn give rise to the three mental poisons: desire. hatred and stupidity. So ignorance and three mental poisons constitute the long term cause of disease. Secondly the short term causes of disease are the three humours: wind energy (Tib. rlung), bile energy (Tib. mkhris pa) and phlegm (Tib. bad kan). They are in fact produced by the three mental poisons: desire gives rise to wind, hatred to bile and stupidity to phlegm. These three humours constitute the basic energy system in the body. They are interrelated to all vital functions of the body, organs, seven constituents and three excretions. Seven constituents of the body are: food (nutrition), blood, flesh, fat, bone, marrow, semen. The three excrements are: sweat, urine and faeces.

When the three humours, seven body constituents and the three excrements are balanced one is healthy, when they are unbalanced one becomes sick. There are four factors responsible for the imbalance, they are: improper climate, influence of demons, improper diet and improper behaviour. Since everything is interrelated, imbalance in one organ or one of the humours effects the rest of the organism. Because of the interdependence of humours and body constituents etc., their imbalance can be diagnosed by the methods specially used by Tibetan doctors.

Diagnosis Procedure

Interrogation
Considering the patient’s history is very important as a Tibetan diagnostic method.

Visual Examination
Visual examination consists of examining the patient’s physical structure, eyes, tongue and urine, etc.

Tactile examination
This method of diagnosis is concerned with such things as temperature of the body, inflammations, etc. Most important here is diagnosis by pulse.

Methods of Treatment

There are four methods of treatment:

Through diet
Through behaviour modification
Through medicine
Through physical therapy

The most important therapeutic technique is to restore the balance of the three “NYES-PA” (humours) and to ensure that the seven constituents of the body are always in a healthy state. These seven constituents are:

Essential nutriment (Dangsma)
Blood (Khark)
Fat (Tsil)
Muscle tissues (Sha)
Bone (Rus)
Marrow (rKang)
Regenerative fluid (Khuwa)

Diet
The first treatment involves the prescribing of a proper diet. For example, if the patient is suffering from a bile disorder he should not take alcohol and should drink cool boiled water.

Behaviour Modification
Treatment through behaviour modification: for instance, a patient with a bile disorder should not do heavy physical activities. He should rest in the shade and not sleep during the day. If these two factors fail to bring about: a positive result, further treatment should be carried out.

Medicine
Prescription of natural drugs. Here again the physician starts with less potent concoctions and turns to stronger forms, if necessary. The drugs can be classified in 10 forms: decoction, pills, powder, gruels, medicinal butter, medicinal calxes, concentrated extractions, medicinal wine, gem medicine and herbal medicine.

Physical Therapy Apart from the prescribing of natural drugs, the physician may also have to depend on other therapeutic techniques. They are again to be classified in gentle and rough techniques. Massage, hot and cold compresses, mineral spring bath therapy and medicinal bath are the gentle techniques. Blood letting, cauterisation, moxibustion, cupping, golden needle therapy are considered as rough techniques. There is also some minor surgery such as the draining of abscesses. Surgery is no longer practised by Amchis.

Tibetan medical philosophy is a holistic philosophy involving the harmonious operation and balance of all the energies that constitute the human psycho-physical being. These energies are the psychologically originating three “NYES-PA”, or humours, which correspond to the three mental poisons, and the five cosmo-physical energies that are at the basis of all phenomena. If all the factors that influence these energies (seasonal factors, diet and nutrition, life style and mental attitudes) are positively disposed, then these energies remain in balanced operation and health is experienced. It is the objective of Tibetan medicine that the balance in these energies should be maintained.

References

China Tibet Informational Center ( source, Tibetan Medicine brief history )
A Brief Introduction to Traditional Tibetan Medicine in Ladakh by Amchi Tsewang Smanla