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THE

Vol. XXX & Vol.XXXI, No.4 & No.1, Winter 2005

& Spring 2006

TIBET

JOURNAL

a publication for the study of Tibet

The Tibet Journal

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The Tibet Journal

A publication for the study of Tibet

Contributions to the study of Tibetan medicine

Alessandro Boesi & Francesca Cardi
GUEST EDITORS
Geshe Lhakdor

Dhondup Tsering

EDITOR-IN-CHIEF

MANAGING EDITOR

WINTER & SPRING

VOL.XXX, NO.4 & VOL.XXXI,
NO.1
2005 & 2006

ARTICLES
sMan and Glud: Standard Tibetan Medicine and Ritual
Medicine in a Bon Medical School and Clinic in Nepal
Colin Millard
Tibetan Medicine in Gyalthang
Denise M. Glover
Hybrid Methodologies in the Lhasa Mentsikhang: A
Summary of Resources for Teaching about Tibetan
Medicine
Frances Garrett
Plant categories and types in Tibetan materia medica
Alessandro Boesi
Principles and methods of assembling Tibetan medicaments
Francesca Cardi
Nyes pa: A brief review of its English translation
Yonten Gyatso
An excellent measure: the battle against smallpox
in Tibet, 1904-47
Alex McKay

3
31

55
65
91
109

119

Zurkharwa Lodro Gyalpo (1509-1579) on the

Controversy of the Indian Origin of the rGyud bzhi
Olaf Czaja
A Hitherto Unknown Medical History of mTsho
smad mkhan chen (b.16th cent.)
Olaf Czaja

131

153

BOOK REVIEWS
Mahayanasutralamkara, The Universal Vehicle
Discourse Literature edited by Prof. Robert Thurman
Prof. Parmananda Sharma
Britain and Tibet 1765-1947: A select annotated bibliography
of British relations with Tibet and the Himalayan states
including Nepal, Sikkim and Bhutan by Julie G. Marshall
Alex Mckay
Exile as Challenge: The Tibetan Diaspora, Bernstorff, Dagmar
and Hubertus von Welck (eds.)
Feminism, Nationalism and Exiled Tibetan Women
by Alex Butler
Geoff Childs
The Autobiography of Jamgn Kongtrul: A Gem of Many
Colors translated by Richard Barron
Martin A. Mills
The Practice of Dzogchen by Longchen Rabjam
translated by Tulku Thondup
Georgios Halkias
The Life of Buddhism, Frank E. Reynolds and
Jason A. Carbine (eds.)
The Power of DenialBuddhism, Purity and
Gender by Bernard Faure
D.R. Chaudhry

173

174

174

179

181

182
184

OBITUARIES
Heinrich Harrer (1912 - 2006)
Henry George Baker (1918 - 2006)
Roger Croston

189
193

CONTRIBUTORS

197

sMan and Glud: Standard Tibetan Medicine and Ritual

Medicine in a Bon Medical School and Clinic in Nepal
Colin Millard
For anybody who has ever visited a Tibetan doctor, the immediate image that the
term Tibetan medicine provokes in the mind is that of diagnosis through reading
the pulse and therapy in the form of small brown medicinal pills. In September 1996
I set off for the valley of Dhorpatan in the Baglung district of West Nepal with the
intention of carrying out research in the Tibetan medical school situated there on
how the medical students learned medicine. After almost two years of studying the
kinds of medical activities that the students were involved in, I ended up with quite a
different conception of Tibetan medicine than that confined to pulse reading and
small brown pills. There is now a relatively large body of literature (Aschoff 1996)
on Tibetan medicine, much of which gives the impression of Tibetan medicine as a
medical system based on humoural theories of health and disease, which has much in
common with Ayurvedic and Chinese medicine. This body of knowledge and practice
is documented in the main medical text the rGyud bzhi and its numerous commentaries,
perhaps the most famous of which is the Blue Beryl of Sangs rgyas rgya mtsho. As we
will see the Bonpo have an equivalent text to the rGyud bzhi known as the Bum
bzhi, where the same medical system is presented.
Based on these texts Tibetan medicine is a science1 that can be practised, and
indeed often is, without making any reference to Tibetan religion2. In what follows I
will refer to this aspect of Tibetan medicine as standard Tibetan medicine; this is
what is conveyed by the Tibetan word sman. However it is clear from reading the
main medical text that Tibetan medicine in its theories and practices is intimately
related to Tibetan religion and this was evident in the medical practices that I observed
in Dhorpatan, so much so that there was a clear division of labour between the Tibetan
doctor who dealt with all the patients who required standard Tibetan medical therapy
and the head lama of Dhorpatan who dealt with all sicknesses that required a ritual
intervention.
Although the use of ritual in healing clearly takes healing into the domain of Tibetan
religion, in Dhorpatan it was still thought to be an aspect of Tibetan medicine. The
body of knowledge and practice concerned with disease and healing in Tibetan culture
is known in Tibetan as gso ba rig pa. This translates as the art (or science) of healing.
The semantic scope of the Tibetan term is not coterminous with the English word
medicine. Broadly speaking gso ba rig pa is the art of maintaining and restoring
balance in the human constitution, community and environment, and many of the
activities which relate to it lie within the domain of Tibetan religion. The main ritual
techniques that were used in healing in Dhorpatan are known in Tibetan as glud. This
paper will discuss the distinction between standard Tibetan medicine and ritual
medicine, and then outline the ritual aspect of gso ba rig pa, as I observed it in the
Tibetan community in Dhorpatan.

4 TIBET JOURNAL
NORDZINLING SETTLEMENT AND TASHI GEGE THARTENLING BONPO MEDICAL SCHOOL
The Nordzinling Tibetan settlement consists of five camps situated at various
locations along the valley of Dhorpatan. It takes approximately one hour to walk
from the first to the last. During the period of my stay in the valley there were
around 250 Tibetans in residence. There was a clear distinction between the two
camps to the east of the valley where the Tibetans originated from the Tewa region
of Tibet and followed the Tibetan Bon religion, and the three camps to the west of
the valley where the residents mostly came from the Kham region of east Tibet and
followed the Karma Kagyu Buddhist sect. The first camp that one comes to as one
approaches the valley from the east, because it is the location of the only functioning
Tibetan temple, is known as Gompa. This is also the location of the medical school
and clinic. Although only a third of the Tibetans were Bonpo this was the most
significant religion in the valley in terms of community religious activity, as the
one lama and several monks who stayed in the Gompa compound and served the
communities religious needs, were all Bonpo. In the summer months the valley
was also host to around 1000 Nepalese from six ethnic groups; for this reason most
of the patients who came to the clinic during this period were Nepalese.
There are a number of reasons why I chose this location to carry out research on
Tibetan medical education. I first heard about the school on a visit to Triten Norbutse
Bon monastery in Kathmandu where I was told that the school in Dhorpatan taught
Bon medicine and the main text in the school was not the Buddhist rGyud bzhi but
an equivalent Bon medical text called the Bum bzhi. Intrigued by this I wanted to
discover the nature of Bon medicine and how it compared to Tibetan Buddhist
medicine. Another point of interest was that there were 10 medical students in the
school, all at different stages in the course curriculum. Furthermore the school had
an attached clinic that served the medical needs of both the Tibetan and Nepalese
communities, and a pharmacy where locally gathered plants and raw medicinal
substances brought from Kathmandu, and occasionally Tibet, were processed into
medicinal compounds. The learning occurred in three arenas: in the classroom, by
engaging in medical practice in the clinic or in the community, and in pharmaceutical
contexts.
The medical school is known as Tashi Gyegay Thartenling. It was established in
1990 by Tsultrim Sangye, a Bon monk and Tibetan medical doctor who is commonly
referred to as Amchi Gege. He was born in 1938 and comes from a family of
medical lineage. All the medical teaching in the school was done by him. Of almost
equal importance to Amchi Gege in the arena of health care was the young head
lama of Dhorpatan, Geshe Tenzin Dargye. He had studied in the dialectics school
at Menri Bon monastery at Dolanji. After successfully completing his final
examination and achieving the title of Geshe, he had been sent to serve as the head
lama at Dhorpatan by the abbot of Menri, Sangye Tenzin. He was born in 1967 and
as such Amchi Gege was considerably senior to him in terms of age, though he
always deferred to his superiority in terms of religious knowledge. As we will see,
these are the two key figures who administered to the communities health care
needs. Amchi Gege would attend to all the sicknesses that could be treated by
standard Tibetan medicine. When a sickness required a ritual intervention, Amchi
Gege would pass on this kind of work to Geshe Tenzin Dargye who would then be
assisted in carrying out the rituals by the medical students; this then was another
area of medical knowledge into which the students were inducted.

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ... 5

Whilst I was in Dhorpatan there were four female and six male medical students
aged between 16 to 28 years. Three of the male medical students were monks and
the eldest medical student came from a sngags pa3 lineage in Mustang and as such
had some considerable experience of Tibetan religion and ritual techniques.
Although there was no rule that students at the school should be monks, there was
no doubt that this was Amchi Geges preference due to the large area of overlap
between the Tibetan medical and religious domains. The two other male students,
though not ordained as monks, were expected to don the monks habit at times of
important rituals. Through serving as assistants in the ceremonies in the temple
they had also acquired a good practical knowledge of Tibetan ritual.
THE BON AND BUDDHIST SOURCES OF TIBETAN MEDICINE
I have said that the Tibetan religious activities in Dhorpatan were primarily of the
Bon religion, and that Amchi Gege teaches Bon medicine using a text called the
Bum bzhi. Before proceeding to discuss the types of healing rituals used in
Dhorpatan, in this section I will present relevant background information about the
Bon and Buddhist religions of Tibet, and a summary of the relationship between
the two main medical texts, the Buddhist rGyud bzhi, and the Bon Bum bzhi. In
addition I will consider where the rituals that I observed in Dhorpatan fit in the
Bon canon.
We have seen that in Dhorpatan the Tibetans are divided into two religious groups
and following common usage I have referred to these two religious groups as
followers of Buddhism and Bon. However this contrast is in certain ways misleading.
Using the more appropriate Tibetan designations, the distinction is between the
Tibetans who are chos pa, followers of the religion of chos, and those who are bon
po, followers of the religion of Bon. Both Snellgrove (1967:1) and later Kvaerne
(1972:23) have pointed out that there is no word for Buddhism in the Tibetan
language. The closest approximation is the word nang pa, which means insider,
but as Kvaerne as indicated this word designates both the chos pa and the bon po.
There is a long tradition of chos pa polemical writings on the Bon religion going
back to the 13th Century AD (Martin 1991) where the Bon religion is presented as
little more than a plagiarised version of chos. Bonpo scholars have made the same
counter claim. Whatever the case in terms of doctrine and practice both religions
have much in common: both are based on the doctrine that life is marked by
impermanence and suffering, and that through the force of karma, beings are bound
into a constant cycle of death and rebirth into one of the six realms of existence
until through religious practise and virtuous actions they achieve liberation.
Furthermore, both religions use the same word sangs rgyas4 to refer to the one who
has accomplished this state of emancipation, and both religions are based on the
teachings of such an individual: for the followers of chos it is the Buddha Sakyamuni;
and for the followers of bon it is the Buddha Tonpa Shenrab (sTon pa gshen rab).
According to the chronology of the Bon lama, Nyi ma bstan dzin (b. 1813),
Tonpa Shenrab was born in 16016 BC (Kvaerne 1972) in a royal family in the land
of Ol mo lung ring5. The exact location of this land is not specified in the Bon
texts, but it is said to be a part of a land called sTag gzig, which is located somewhere
to the west of Tibet6. Tonpa Shenrab taught the doctrines of Bon primarily in Ol
mo lung ring. He visited Tibet briefly, in quest of his seven prized horses that had
been stolen by the demon Khyap pa lag ring; at this time he taught only the lower

6 TIBET JOURNAL
ways of Bon, finding the people not ready for the higher teachings. He entrusted to
each of his sons certain aspects of the Bon doctrine7. The most important in this
context is his second son dPyad bu khri shis, to whom Tonpa Shenrab passed on all
his medical knowledge.
According to Bon history there were six great translators8 who were responsible
for translating and spreading the doctrines of Bon in the surrounding countries.
The disciples of Mu cho ldem drug of sTag gzig translated the teachings into the
language of Zhang zhung, and it was from here that the teachings were brought to
Tibet during the reign of the legendary first King of Tibet, gNya khri btsan po9.
Zhang zhung plays the same role for the Bon religion as India does for Tibetan
Buddhists. According to Bon sources, Zhang zhung was a large kingdom stretching
from Gilgit in the west and encompassing all of western Tibet. Its capital was
Khyung lung dngul mkhar in the region of Mt Ti se (Kailash). Tradition maintains
that the second king of Tibet Mu khri btsan po, invited 108 Bon scholars from
Zhang zhung to Tibet, and 37 religious centres were established during his reign
(Cech 1987). The Bonpo claim that most of their texts were originally written in
the language of Zhang zhung. This is why the title has been left in this language on
the first page of many of their Tibetan texts akin to the way Tibetan Buddhist texts
have retained their original Sanskrit title.
Traditionally, the doctrines and practices of Bon have been classified according
to two main systems: the four doors and the five treasures (sgo bzhi mdzod lnga)10,
and the nine ways (theg pa dgu). There are three versions of the nine ways: the
northern treasure (byang gter), the southern treasure (lho gter), and the central
treasure (dbus gter). The nine ways are explained in the Ziji, The Glorious, the
long biography of Tonpa Shenrab; the relevant sections have been studied by
Snellgrove (1967)11. In brief the nine ways are12:
1. The Way of the Shen of Cha (phywa gshen theg pa): covers the four
activities of divination (mo), astrological calculation (rtsis), ritual (gto) and
medicine (sman)
2. The Way of the Shen of Phenomenal Universe (snang gshen theg pa):
deals with classes of malevolent spirits and local deities, and rituals associated
with them, rites of exorcism, and ransom rites.
3. The Way of the Shen of Magic Power (phrul gshen theg pa): explains
how to carry out rituals of destruction against harmful beings.
4. The Way of the Shen of Existence (srid gshen theg pa): comprises of
funerary rites.
5. The Way of the Virtuous Ones (dge bsnyen theg pa): covers the rules of
behaviour for the lay practitioner.
6. The Way of Ascetics (drang srong theg pa): deals with the rules of monastic
discipline.
7. The Way of White A (a dkar theg pa): covers tantric theory and practice.
8. The Way of Primordial Shen (ye gshen theg pa): gives further details on
Tantric practice.
9. The Supreme Way (yang rtse bla med theg pa): the teachings of the great
perfection (rdzogs chen).
The nine ways are divided into two groups. The first four are collectively referred
to as the Bon of Cause (rgyui bon) and involve knowledge and practices that are

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ... 7

of practical benefit for worldly ends. These were the practices that were used in the
context of healing in Dhorpatan, although as we will see elements of the higher
ways were also used. This group of practices is sometimes further subdivided into
12 lores of Bon, which according to Tibetan historical sources were prevalent
during the reign of the first king of Tibet, gNya khri btsan po, who reigned around
126BC (Norbu 1995:xv). The higher five ways are referred to as the Bon of Fruit
(bras bui bon); they include the teachings found in the Bon tantras and dzogchen
texts, which deal with the methods of liberation from this world.
As Snellgrove (1967:12) points out, this classification covers almost the whole
range of Tibetan religious culture. The only thing that is missing is the pattern of
learning that occurs in Buddhist and Bon dialectic schools; this is because this
form of study developed after the compiling of the nine-fold classification. The
rNying ma pa sect also classifies its knowledge into nine vehicles, though in a
different way from the Bon classification (Samuel 1993:231, Rinbochay 1982).
The first three vehicles refer to non-tantric practices, the next five on different
aspects of tantric practice, and the ninth classification, like the ninth way of Bon
deals with their highest level teachings, the theories and practices of Dzogchen.
When I arrived in Dhorpatan I found that Amchi Gege was indeed using the
Bum bzhi in the medical school, but after some time I came to realise that the
Bum bzhi was almost identical to the rGyud bzhi. Amchi Gege had no problem
explaining this. In his opinion Tibetan medicine was first taught by the founder of
the Bon religion, Tonpa Shenrab, and the rGyud bzhi is a Buddhist reworking of
the Bum bzhi. For this reason he is quite happy to use both texts in the school. The
standard Buddhist history of the rGyud bzhi is that it was first taught by an emanation
of the Medicine Buddha, Rig pai ye shes in Oddiyana, eventually to be written
down in Sanskrit and passed on to the Kashmir pandit Candranandana who
transmitted it to Vairocana. Vairocana translated it and passed it on to
Padmasambhava, who, so the account goes, thought that the people of Tibet were
not ready for it at that time and consequently hid it in a pillar in Samye monastery.
It was taken from Samye monastery in 1098 by the gter ston Grwa pa mngon shes.
Eventually the text passed into the hands of g.Yu thog Yon tan mgon po the younger
in the 12th century, from whom the present edition stems.
The Bonpo have a different account of the origin of the rGyud bzhi. For them it
is based on the Bon medical text the Bum bzhi, which was first taught by Tonpa
Shenrab to his son dPyad bu khri shis. Amchi Gege explained to me that from
dPyad bu khri shis the text was passed on through the medical lineage in sTag gzig
and Zhang zhung, eventually to be translated into Tibetan by sDon rgyung mthu
chen, Gyim tsha rma chung, lCe tsha mkhar ba, and Sha ri dbu chen, at the time of
the second king of Tibet Mu khri btsan po. Later, when the Bon religion was
persecuted, the Bum bzhi, along with many other Bon texts was hidden. There are
three different accounts of the way the text was discovered. One account states that
the text was found by the Bonpo gter ston Khu tsha zla od13 in Bhutan. A second
account holds that it was one of the texts rediscovered at Samye monastery in 913
AD by three Nepalese monks; the gter ston is named as a tsa ra. The third account
is given in the history of the Bon religion of Shar rdza bKra shis rgyal mtshan
(Karmay 1972:170). He writes that in 1037 AD, Bu mtsho Srid pai rgyal po found
several medical texts in western Tibet, amongst which was the Bum bzhi. In the
catalogue (kar chag) of Bon texts of Nyi ma bstandzin, nine medical texts are

8 TIBET JOURNAL
listed in the Bon bKa gyur (Kvaerne 1974:101); these he states were all discovered
by Bu mtsho Srid pai rgyal po. The first of these texts is the Bum bzhi. Nyi ma
bstandzin adds to his entry that the four parts of the Bum bzhi were transformed
(bsgyur pa) by Vairocana into the four parts of the rGyud bzhi. He gives as evidence
of this that the mantras in the text have been left in the language of Zhang zhung,
and the Bon word for a fully ordained monk, drang srong14 has also been left
unchanged. Other Bon accounts claim that it was g.Yu thog Yon tan mgon po the
younger who transformed the Bum bzhi into the rGyud bzhi.
With the exception of a few minor differences in detail, the two texts are essentially
the same. Where they diverge substantially is in the material that deals with the
history of the medical teachings and the medical lineage. The Bum bzhi originates
in Ol mo lung ring where Tonpa Shenrab first taught it to his son dPyad bu khri
shis. The whole of the text is structured as a dialogue between them; each section
begins with dPyad bu khri shis requesting the teachings from his father. The rGyud
bzhi, on the other hand, was taught by the Medicine Buddha, Bhaisajyaguru, in his
palace, in the city of Tanaduk beautiful to behold. Here, from his body he magically
emanates two sages. The sage Yid las skyes as the embodiment of his speech requests
the teachings, which are given by the emanation of his mind, the sage Rig pai ye
shes. The rGyud bzhi is structured as a dialogue between these two sages. Both
texts consist of four volumes, which deal with different aspects of the medical lore.
The Bum bzhi has one hundred and sixty-six chapters, and the rGyud bzhi has one
hundred and fifty-six. This disparity arises from the few occasions when material
that is covered in one chapter in the rGyud bzhi is divided into separate chapters in
the Bum bzhi.
In terms of medical theory and practice, the rGyud bzhi and the Bum bzhi are
identical. There is a parallel here with the considerable overlap in the theory and
practice of the Tibetan religions of chos and bon. As Kvaerne has suggested where
there is divergence this relates not to metaphysical doctrine or religious practice,
but to different notions of history, legitimation and religious authority. Certainly
the followers of chos and bon in Dhorpatan, in matters of religious practice, behaved
to a large extent as one unified religious community.
THE RELATIONSHIP BETWEEN TIBETAN COSMOLOGICAL NOTIONS AND TIBETAN MEDICINE
The distinction between sickness that can be treated by standard therapies and that
which requires a ritual intervention can be understood by looking at the causal
mechanism of such disorders according to Tibetan medicine. This will be discussed
fully in the next section. First, as the cause of disease in Tibetan medicine is
intimately related to Tibetan religious and cosmological notions, a brief discussion
will be made of this relationship here.
Tibetans have three main overlapping schemes which describe the nature of the
natural environment, and the types of beings which inhabit it. For Tibetan Buddhists
this information is contained in the Buddhist Hinayana, Mahayana and Vajrayana
texts which were brought to Tibet from India. As we saw in the previous section
the Bonpo have equivalent texts which they claim were translated from the language
of the Central Asian kingdom of Zhang zhung.
The first cosmological scheme is found in the fourth century Abhidharmakosa
texts of Vasubandhu where the universe is described as one of an infinite number
of world systems (Brauen, M. 1997, The Mandala: Sacred Circle in Tibetan

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ... 9

Buddhism. London: Serindia. Sadakata, A. 1997. Buddhist Cosmology: Philosophy

and Origins. Tokyo: Koosei Publishing) that arose through the karma of early living
beings. At the centre of the world system is the four-sided Mount Meru encircled
by seven mountain ranges. These mountain ranges are divided by an inner sea.
Beyond them is an outer sea in which twelve continents are located: one large
continent in each of the cardinal points with one small continent on its either side.
Humans live on the southern continent known in Tibetan as Dzam bu gling (skt.
Jambudvipa). It is said that our sky is blue because Dzam bu gling faces the southern
side of Mount Meru which is made of lapis lazuli. Beings are distributed through
the world system according to a hierarchy of purity. It is said that the top of Mount
Meru is the Abode of 33 Gods. Above Mount Meru there are 25 heavens ascending
in escalating degrees of purity. Below Dzam bu gling there are eight hot and eight
cold hell realms.
Whereas the Mount Meru world system focuses on the spatial distribution of
realms and beings, the second main Tibetan cosmological scheme follows the
Buddhist and Bon notion of impermanence and emphasises the transmigratory nature
of life. This relates directly to Bon and Buddhist conceptions about why beings are
caught in the endless cycle of death and rebirth. Beings are born into transmigratory
existence through a fundamental ignorance of their own nature. This deep ignorance
(ma rig pa) leads to the three mental poisons (dug gsum) of ignorance (gti mug),
desire (dod chags) and aggression (zhe sdang). It is these afflictive emotions which
generate the karma which leads beings to be born into one of the six realms of the
wheel of existence (srid pai khor lo): the three higher realms of humans, gods
and asuras; and the three lower realms of animals, hungry ghosts and hell beings.
According to Tibetan medical theory the three mental poisons generate the three
humours in the body which underlie all psychological and physiological processes:
desire generates wind; aggression generates bile; and ignorance generates phlegm.
Traditional paintings of the wheel of life include 12 sections equally spaced
around the circumference where the twelve symbols of the chain of interdependent
origination are depicted. At the centre of the wheel the three mental poisons are
represented by a pig for ignorance, a snake for aggression, and a cock for desire.
At the centre of the Bon version of the wheel the three mental poisons are represented
by a monstrous beast with the body of a cow, the tail of a snake, and having three
heads, a pigs head, a cocks head, and a serpents head (Kvaerne 1995:143).
These schemes serve only to provide a summary of the classification of beings
in Tibetan religion but in fact Tibetan tradition recognises a huge variety of divinities
and spirits many of them classed under the Tibetan generic term lha. NebeskyWojkowitz (1956) classic study of the Tibetan protective deities gives an idea of
the extensive scope of the subject and also demonstrates that the Tibetan pantheon
includes Buddhist, Bon and folk elements. In fact as we shall see it is through the
action of Tibetan lamas that mountain deities or deities associated with a given
territory are bound to serve the Buddhist or Bon traditions.
Nebesky-Wojkowitz notes that in the Tibetan tradition there is a clear distinction
between protective deities that have passed beyond samsaric existence (jig rten
las das pai srung ma) and those that still reside within it (jig rten pai srung
ma). These two classes appear in Samuels (1993:166) fourfold classification of
Tibetan deities and spirits. The four classes that Samuel gives are: deities of the
Bon and Buddhist heavens (jig rten las das pai lha); deities of this world (jig

10 TIBET JOURNAL
rten pai lha); malevolent spirits (dre or gdon); and the tantric meditational deities
(yi dam).
Deities of the Bon and Buddhist heavens are the enlightened beings that live in
the various heaven realms that exist above Mt. Meru. Some of them serve as high
religious protectors. The group includes divine Bodhisattvas such as the Buddhist
Avalokitesvara, and Majusri and the corresponding Kun bzang rgyal ba rgya mtsho
and sMra bai seng ge of the Bon tradition.
The group of divinities that remain within samsaric existence includes a wide
range of types of deities and spirits usually associated with locations in the natural
environment such as: mountains, rivers, caves, trees, rocks, lakes, mountain passes,
and so on. Certain powerful deities within this class have a retinue of helpers which
in the texts is likened to a court with the main deity at the apex of a hierarchical
structure including generals and ministers and host of lesser attendants (NebeskyWojkowitz 1956:21). One classification of these divinities divides them into three
groups according to the specific locations where they reside. The deities that reside
in the sky are the white lha, those that reside in the intermediate realm are the red
btsan and the yellow gnyan, and those that dwell under the earth are the blue klu.
(Tucci 1980:167, Stein 1972:204). A well known rNying ma pa classification is
the eight classes of gods and demons lha srin sde gyed. Cornu (1990) gives ten
gods and demons that often appear in various renditions of this grouping: klu,
gnyan, sa bdag, btsan, rgyal po, bdud, ma mo, gza, gnod sbyin, and lha. Another
rNying ma text cited by Nebesky-Wojkowitz (1956) lists thirty classes of gods and
demons.
The third group of divinities are the yi dam, the tantric meditational deities.
Typically, a tantric deity has a cycle of texts associated with it where the attributes
of the principal deity, the subsidiary deities connected with it, its mandala and
rituals are explained. The principal tantric deity is referred to as the yi dam. The
ontological basis of the yi dam relates to the level of consciousness beyond samsaric
existence. The yi dam has two aspects, it expresses both the potential within the
practitioner to achieve enlightenment, and the enlightened state itself. Trungpa
explains that the name yi dam is a shortened form of yid kyi dam tshig, which
means the mental committment (1982:228). It is the commitment made by the
practitioner which aims to transform the dam tshig sems dpa (commitment mind)
into the ye shes sems dpa (wisdom mind). This occurs through two stages: in the
generation stage the practitioner generates his or herself as the commitment being;
transformation into the wisdom being occurs during the completion stage practices
which involves knowledge and experience of the subtle anatomy explained in the
tantric texts, particularly the yoga practice of the channels and winds (rtsa rlung).
By generating oneself as the yi dam the tantric practitioner is not merely
performing an exercise in imagination, he or she is actualising a latent potential to
achieve enlightenment. In respect to healing, through the visualisations and mantras
used in the tantric ritual, the practitioner acquires the power to heal, empower
medicines, and control harmful spirits. This is why the yi dam are often referred to
as tutelary deities. It is common for Tibetans to have a special relationship with
one particular yi dam. This may be through personal choice, or through the advice
of a lama. Some families also have a special relationship with a specific yi dam.
Geshe Tenzin Dargyes family has a special relationship with the Bon yi dam, dBal

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ...

11

chen ge khod, and it was this deity that he most often resorted to in healing rituals
in Dhorpatan.
The fourth general classification is the group of harmful spirits known collectively
as dre or gdon. This group incorporates a wide range of malevolent spirits which
are inherently disposed to cause harm. In certain instances the dre relates to human
activity (Tucci 1980: 187). If, when a person dies, they remain attached to a given
place through and unfilled task or an existing vendetta, they may linger in this
location causing harm as a shi dre. There is also the gson dre. This is a person,
usually a woman, who has the power to cause harm that has been passed on through
the family line.
Stories about spirits abounded in Dhorpatan. Many of the Tibetans claimed to
have seen them or experienced them in one way or another. On numerous occasions
I heard people talking about a kind of spirit known as dre me, which were frequently
encountered in the valley. The name means spirit fire and derives from the spirits
appearance as a ball of light hovering or moving above the ground. Geshe Tenzin
Dargye explained that a number of different kinds of spirits can appear in this way.
One of Amchi Geges medical students encountered such a spirit on his way home
from the medical school. The ball of light moved in front of him and away across
a nearby river. Shortly after this he was confined to bed with a fever during which
time a boil15 appeared in his neck. He recovered after appropriate rituals were
conducted.
From this brief description we can see that Tibetans in Dhorpatan share their
world with a host of gods and spirits, the presence of whom is felt in the surrounding
environment. The tantric deities and protectors are experienced through their images
and the rituals associated with them. Local spirits are associated with locations in
the natural environment such as specific mountains, mountain passes, rivers, lakes,
springs, caves, trees, and so on. When such a location has a known association
with local gods or spirits it will be ritually marked in some way, such as setting up
prayer flags on the location, or cairns (lha tho) on mountain tops in honour of the
mountain deities. Abundant mantras carved into rocks and mchod rten16 here and
there in the valley convey the message of the liberating power of the Buddhist and
Bon teachings. The Tibetans in Dhorpatan take care to live in harmony with the
natural environment, an environment which is replete with symbolic meaning.
Geshe Tenzin Dhargye explained to me that when the Tibetans first arrived in
the 1960s, the region of the valley where they now live was densely forested and
there were many harmful spirits present. These unruly spirits were controlled by a
number of lamas but one Bon lama, Tsultrim Nyima is still spoken about today for
his achievements in this area. Samuel (1993:167) has noted that the taming of the
environment by the power of religion is a common motif in Tibetan history. The
role that Tsultrim Nyima played in Dhorpatan parallels that of the tantric adept
Padmasambhava in Tibet. In the eighth century whilst establishing the Vajrayana
form of Buddhism in Tibet he spent considerable time subduing local spirits and
binding them by oath to uphold the Buddhist doctrine.
The harmony that exists between the Tibetans and the natural environment in
Dhorpatan is something that has to be constantly re-established through ritual. As
we will see there are specific rituals that are carried out periodically by the monks
and the local people for this purpose. Before moving on to discuss the types of
rituals that are used in Dhorpatan, in the following section we will consider the

12 TIBET JOURNAL
mechanisms by which a spirit can cause sickness. In order to understand this we
need to consider the subtle anatomy as it is described in the highest yoga tantras
and in the medical teaching.
THE SUBTLE ANATOMY IN THE TANTRAS AND TIBETAN MEDICINE
In the above discussion on the tantric deities I mentioned that the success of tantric
practice is founded on a practical knowledge of the subtle anatomy as it is described
in the tantric texts. It is this subtle anatomy which provides a link between the
microcosm of the human constitution and the macrocosmic environment. This body
of knowledge is associated primarily with the highest yoga (annuttarayayoga) tantric
texts such as the Kalachakra Tantra (Dus khor rgyud) and the Bons Mother Tantra
(Ma rgyud). As we will see in the following section on aetiology it is by entering
the body through specific channels that harmful spirits are able to cause illness by
disturbing the flows of winds in the channels of the subtle anatomy.
Tibetan medical theory about anatomy is covered in chapter four of the second
volume of the rGyud bzhi and the Bum bzhi, and it is here that the influence of
tantric cosmology on Tibetan medicine is most clearly evident. The chapter begins
by outlining the parts of the physical body in terms of quantities and proportions to
the size of the body17. The main components of the body are listed as the three
humours of wind (rlung), bile (mkhris pa) and phlegm (bad kan), the seven bodily
constituents18 the excreta, the five solid organs19 (don lnga) and the six hollow
organs20 (snod drug). It then moves on to describe the various channels (rtsa)21 in
the body.
According to the anuttarayayoga tantric texts, underlying the physical anatomy
there is a subtle anatomy comprised of a huge network of channels through which
flows a vital force referred to as wind. There are three main channels which run
down the centre of the body. At various points along the central channel are certain
centres (Tib. khor lo, Skt. cakra) where many channels converge. These centres
are co-ordinating points that relate to various psychological and physiological
processes. Traditionally the number of channels in the subtle anatomy is listed as
72,000, but different figures appear in various texts (Wangyal 2002:81).
From this vast network of channels, chapter four focuses on four classifications
of channels which have particular relevance to the medical teaching. The first group
of channels is the channels of formation (chags pai rtsa). These are the three
channels that run down the centre of the body that are mentioned above. They are
the first to be formed in the human embryo. The power of the afflictive emotions
and karma, which carries the consciousness into rebirth, is carried through into the
embryo, and has a causal affect on how the body subsequently develops. As we
saw earlier, each one of the three mental poisons has a direct causal relationship
with one of the three humours: desire is the cause of wind (rlung), aggression
brings about bile (mkhris pa), and ignorance generates phlegm (bad kan). In a
similar manner, the three mental poisons are related to the three channels of
formation. The first channel (Tib. rkyang ma, Skt. ida) has the nature of the water
element. It rises from the umbilical region moving up the left side of the body,
passing the heart and the throat and finally forming the brain and the white
channels22, and thereby mental confusion and dullness; it is related to phlegm and
as such this humour is associated with the upper body. The second channel (Tib. ro
ma, Skt. piogala) of formation is related to the fire element and the blood. Between

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13

the heart and lungs it is known as the life channel (srog rtsa). It passes through
the middle of the body carrying the essential nutriment of the digested food to the
liver, from there it heads to the 10th vertebra and forms the black life channel
(srog rtsa nag po); this channel is the source of anger, which is situated in the
black life channel and the blood. As we have seen, anger is the cause of the bile
humour and consequently this humour is associated with the middle of the body.
The third channel (Tib. dbu ma, Skt. surumna) of formation is associated with air.
It is the intermingling of blood and wind in this channel at the heart that leads to
the blood circulation. From the umbilical region it goes downwards and forms the
genital organs, which are the seat of desire, and thus the humour of wind is associated
with the lower body.
The second classification of channels is called the channels of existence (srid
pai rtsa). These channels are related to our psychological functions, to our
emotions, to sensory perception and cognition. There are four principal channels
of existence. The first is situated in the brain and is surrounded by 500 small
channels; these provide sensory experience. The second channel of existence is
situated in the heart centre, and is said to be the width of a hair in a horses tail. It
is surrounded by 500 small channels; these provide various mental functions such
as the sense of self, memory and intellectual processes. It is here where the various
components that are spoken of in Buddhist psychology interface with the
psychophysical continuum of the human constitution.
Radiating out from each of the cardinal points around the heart centre are four
channels: at the front (east) is the channel which relates to the consciousness of the
five senses; behind (west) is the consciousness of the conflicting emotions; at the
left is the channel which relates to cognition and intellectual processes; and at the
right is the channel which relates to the store consciousness (alaya vijana). These
series of channels are referred to as the good mind (yid bzang ba). At the centre
of the heart centre is the life channel (srog rtsa) which is the location of one of the
five main types of wind, the life holding wind (srog dzin rlung). This wind is of
particular importance to the harmonious functioning of psychological processes. A
subtle element of this wind in the life channel supports the subtle consciousness
which transmigrates from life to life. As we will see in what follows, ritual
intervention is required when disease arises as a result of disturbances in this wind
through the action of harmful spirits. The third channel of existence is situated at
the navel. It is surrounded by 500 small channels; it functions to develop and
maintain the body. The fourth channel of existence, which is also surrounded by
500 small channels is situated at the genitals and is responsible for procreation.
The third classification of channels are the connecting channels (brel bai
rtsa). These refer to the blood vessels and the nervous system. We have seen that
there are three channels that run down the centre of the body. The right channel
gives rise to the black channels of the blood vessels, and the left channel gives
rise to white channels of the nervous system.
The fourth classification of channels is the lifespan channels (tshe yi rtsa). The
text describes three lifespan channels, though what is being described is not so
much a channel, rather it is the movement of the life force, or what is sometimes
translated as soul, through the body. The first life force (bla) is described as the
one which penetrates the whole of the body23. This circulates around the body
according to the lunar cycle. The Tibetan doctor must verify the position of the life

14 TIBET JOURNAL
force (bla gnas) before carrying out moxibustion or blood letting. The second life
force is known as the one that accompanies the breath and refers to a vital energy
that is drawn into the body through the breath.
The third life force, which is also referred to as bla, is of direct relevance to
certain forms of illness and the use of ritual in healing. The text says of this that it
is like the soul and roams about. We have seen that the seat of the consciousness
(rnam shes) is in the heart centre. Amchi Gege explained to me that the bla originates
from the consciousness. It is a vital principal which provides support to the body.
It was also described to me as the most refined nutrient of the metabolic process
(dangs mai dangs ma), along with the vitality fluid (mdangs). Geshe Tenzin
Dargye explained to me that the bla is often considered as part of the threefold
group, bla yid sems gsum which relates to the mind in the Bon tradition. Sems is
the ordinary mind, yid is a deeper layer of the mind in which thoughts circulate,
and the bla is the vital energy which sets things in motion. Lopon Tenzin Namdak
referred to the bla in this context as the karmic traces (bag chags) which cause
thoughts to arise in the mind. For a variety of reasons the bla may leave. As this is
potentially fatal for the individual, appropriate rituals must be done to bring it
back.
As we can see from this description, in Tibetan medicine there is no separation
between the body and the mind; they form part of a single psychophysical continuum.
It is also worth noting that according to Tibetan medical theory, the human
constitution responds to rhythms in the natural environment. We have already seen
that the bla rotates around the body according to the lunar cycle. Tibetan medical
therapies are based on the notion that there is a direct relationship between the five
elements of fire, air, water, earth, and space, in the inner world of body and these
same elements in the outer world. Cures are affected by finding medicines in the
environment that have an elemental nature which counteracts the elemental
disequilibrium in the body. This interrelationship between the outer and inner worlds
can be seen in the way that each of the elements and the humours rise and decline
according to the prevailing season. This is discussed in some detail in the pulse
chapter of both the Bum bzhi and the rGyud bzhi, where a series of interrelationships
are given. Each season consists of three months: two months of thirty-six days and
a transitional month of eighteen days. Each of these months corresponds to an
astrological sign, one of the five elements, one solid and hollow organ, a natural
event in the environment, a constellation, and a certain type of pulse. The Tibetan
doctor must be aware of this when he or she is taking the pulse in order not to
confuse the naturally changing pulse throughout the year with a pathological pulse.
AETIOLOGY IN TIBETAN MEDICINE
The distinction between sickness that can be treated by standard therapies and
those that require a ritual intervention can be understood by considering the subject
of disease causation in Tibetan medicine. Dunn (1976:134) lists four causative
factors that lead to health or disease: exogenous, endogenous, behaviour, and human
population. He specifies the endogenous factors as genetic, and he subdivides the
exogenous factors into biotic and non-biotic. This accords well with a biomedical
perspective, but the scheme also provides a useful template for understanding other
medical traditions, where there will be some cultural divergence as to the
explanations that appear under these headings.

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15

As the main medical text of the Bon tradition, the Bum bzhi, and the main medical
text of the Buddhist tradition, the rGyud bzhi, are virtually identical, both texts are
used interchangeably in the school in Dhorpatan. The first volume24 gives a summary
of the medical teaching using the metaphor of a tree with three roots. Each root has
stems, branches, and leaves which enumerate and summarise the various elements
of the medical teaching. The first root summarises the condition of the healthy and
pathological body. The second root summarises methods of diagnosis, and the third
root summarises forms of therapy. The second volume covers a range of topics
including anatomy, physiology, pathology, diet, behaviour, the characteristics of
medicines, and diagnosis. The third volume which is by far the largest, covers
Tibetan nosology. The fourth volume deals with pulse and urine diagnosis, and
various forms of therapy.
The cause of disease is explained in several locations in the main medical text. It
is first summarised in the first volume by the second stem of the first root of the
medical tree. The first stem of this root explains the condition of the healthy body.
It has three branches which signify the humours, the seven bodily constituents and
the excreta. These are explained in more detail by the 25 leaves depicted on the
branches. As long as these elements are functioning harmoniously and are in their
correct locations and proportions then one experiences the two flowers of longevity
and good health, and three fruits of spirituality, happiness, and wealth, which are
displayed at the top of the stem.
The second stem has nine branches which explain the causes and conditions
which lead to disease. The nine braches are: the primary (rgyu) causes of disease;
the contributory (rkyen) causes; the entrances of disease; the locations of disease;
the pathways of disease; the time of predominance; the conditions having fatal
outcome; humoural reactions; and a summary on types of disease. These nine broad
subdivisions are explained by the sixty-three leaves attached to the branches. For
our purpose here in understanding the various causes of disease, it is the first two
branches where we find the primary and contributory causes of disease which are
of most interest and clearly indicate the connection between Tibetan medicine and
Tibetan religious and cosmological notions. The three leaves of the first branch
gives the primary causes of disease as the three humours of wind (rlung), bile
(mkhris pa) and phlegm (bad kan). As we have seen earlier the three humours are
generated by the three mental poisons which according to Bon and Buddhist
philosophy arise out of the fundamental ignorance which causes beings to be born
in samsaric existence. The second branch of the stem lists the four contributory
causes of disease as: seasons, harmful spirits, diet and behaviour.
The humours are referred to in Tibetan by names which have specific physical
referents, but the term refers to much more than this. According to Tibetan medical
theory there are five forms of each of the humours, which govern specific functions
in the body and the mind. In this way the three humours taken together are
responsible for the entire range of psychophysical functions. For instance, wind is
responsible for: breathing, movement, circulation in the body, the passage of bodily
wastes, making the senses sharp, and sustaining the body. Bile is responsible for:
hunger and thirst, digestion, body heat, the clearness of the complexion, and courage
and intelligence. Phlegm is responsible for the firmness of the body and stability of
mind. It enables sleep, allows the bodys articulations, gives patience, and makes
the body soft and lubricated.

16 TIBET JOURNAL
The three humours have a paradoxical double nature. If they are in their correct
proportions and locations they are the cause of health, hence they are listed on the
first branch of the stem of the body in a condition of health. At the same time as all
disease involves some kind of dysfunction in the humours they are also listed on
the first branch of the stem of the body in a pathological condition. Ayurvedic
medicine, which has many similarities to Tibetan medicine, has two different terms
for the humours. If they are in a healthy state they are referred to as dhatu,
constituents, and if they are in a disturbed state they are referred to as dosa,
defects (Meyer 1995:128). In Tibetan medicine they are referred to by only one
name, nyes pa, which means fault or wrong doing. This follows the Bon and
Buddhist philosophy that suffering is inherent to all forms of samsaric life. The
main text graphically describes the innate disposition of the humours to generate
sickness to an insect poisoned as a consequence of feeding on a poisoned tree.
The short summary of the cause of disease in the first volume of the main medical
text is elaborated on in considerably more detail in chapters eight to ten of the
second volume. Chapter eight provides a general discussion of the primary and
contributory causes of disease which it frames as distant and close. Chapter nine
provides a detailed discussion of the contributory causes of disease. Here the
aetiology appears more complex as it is explained that each of the humours has
several properties and may be disturbed when opposite conditions are present25.
Later in the same chapter a list of six general causes of disease are given: season or
climatic conditions, harmful spirits, incorrect treatment, poison, diet, and negative
karma. The subject of primary and contributory causes of disease is repeated at the
beginning of each of the ninety-two26 chapters of the third volume dealing with
Tibetan nosology, where specific causes are given for each class of disease.
The topic of the cause of disease is also presented in the twelfth chapter of the
second volume which gives various classifications of disease in Tibetan medicine.
The chapter commences by listing three broad classifications: by cause, by host,
and by type of disorder. The classification by cause gives three subdivisions:
disorders that arise when contributory causes disturb the three humours in the present
life of the individual, disorders which arise from negative karma accumulated in
previous lives, and disorders which involve a combination of the two. In an
interesting parallel to the scheme proposed above by Dunn, the text then proceeds
to divide disorders that arise due to causes in this life into two sorts: endogenous
(rang bzhin nad), which involve an internal disturbance of the three humours; and
exogenous (phyi rkyen), for which the text gives, poisons, weapons, and harmful
spirits. Disorders arising from negative karma, which spans across Dunns
behavioural and endogenous categories, are placed by the text in a class of their
own in that they cannot be treated solely by the therapies of standard medicine27
but also require religious intervention.
On several occasions now we have seen harmful spirits listed as a pathogenic
agent. Amchi Gege explained to me that in Tibetan medicine there are whole classes
of disease that derive from the action of harmful spirits, such as the gnyan nad28
class of infectious disease originating from the gnyan spirits, and the rims29 class
of infectious disease, which also originates from the action of harmful spirits. Amchi
Gege was of the opinion that none of the types of disease that come under the
gnyan nad classification existed in the past. In his view they appear in the Bum
bzhi because Tonpa Shenrab had the spiritual insight (mngon shes) to know that

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17

this group of disease would exist in the future. He explained that even during his
grandfathers time gnyan nad was seldom found in Tibet; this situation changed
after the First World War.
We saw in the previous section that according to Tibetan medicine, psychological
processes are related to the channels of existence located in the brain and at the
heart centre. If a spirit is able to disrupt the normal functioning of these channels
and the winds which traverse them, then this will lead to some form of psychological
disorder. Chapters 77-81 of the third volume of the rGyud bzhi and the corresponding
chapters 83-87 of the third volume of the Bum bzhi form what has been referred to
as the psychiatric section. These chapters cover illnesses arising from spirits of the
elements (byung poi gdon), spirits that cause madness (smyo byed kyi gdon),
spirits that disrupt memory (brjed byed kyi gdon), spirits that cause strokes and
epilepsy (gzai gdon), and disorders arising from the klu (skt. naga) class of spirits
(klui gdon). A common form of psychological disorder recognised by Tibetan
medicine is that of srog rlung. It is known by the name of the life bearing wind
because the disorder arises when this wind is disturbed in its location in the heart
centre. Commonly this disturbance is caused by a harmful spirit. The symptoms of
srog rlung range from mild anxiety and depression to full blown psychosis30.
The name that was generally used in Dhorpatan to refer to sickness caused by
spirits was gnod pa. Often this was thought to be a consequence of some kind of
human activity which was damaging to the environment, such as, polluting a stream,
food spilling out of the pot onto the hearth, quarrying work, or cutting down trees.
On this topic Amchi Gege recounted a story about when he was you in the Khyungpo
region of Kham in eastern Tibet. He had heard of a nearby village where there
were several cases of gnod pa. A lama was sent to ascertain the cause. It turned out
that the people had been burying their dead in an area of land without consulting
the sa bdag, the spirit governing this area of land. The outbreak of gnod pa stopped
when the appropriate rituals were carried out.
Another notion which I came across frequently in Dhorpatan was that of sgrib.
This is a form of pollution deriving from certain impure activities, such as working
with dead bodies, breaking social taboos, eating garlic when one has a connection
with certain yi dam, carrying out sinful (sdig pa) activity, using dead peoples
possessions, and so on. It is thought that the accumulation of sgrib can lead to
illness. Furthermore, all the above polluting activities connected with the spirits in
the local environment can also bring about sgrib. Samuel (1993:161) has noted
that much of the ritual activity that Tibetans perform to preserve a harmonious
relationship with the natural environment is a means to prevent sgrib.
We can now see that when a disorder arises from the action of a spirit then the
therapies of standard Tibetan medicine will not be sufficient and the appropriate
ritual must be performed. Usually standard Tibetan medical therapies are used
alongside ritual. As I mentioned earlier this led to a strict division of labour between
Amchi Gege administering all the standard Tibetan medicine and Geshe Tenzin
Dargye who performed the rituals. In what follows I will describe the kind of rituals
Tibetans in Dhorpatan performed to maintain balance and harmony in their lives
and in their relationship with the natural environment. Following this I will describe
some of the rituals that were performed when disease occurred which was thought
to be caused by harmful spirits.

18 TIBET JOURNAL
RITUALS OF PROSPERITY AND PROTECTION
The most popular route to Dhorpatan is to follow the footpath along the Myangdi
River from Beni to the village of Lumsum. At Lumsum one climbs a steep path
cutting its way through dense forest to the top of the Jaljala pass. At the top there is
a small stone cairn (lha tho) mostly painted white and heavily adorned with offerings
and Tibetan prayer flags. In the forest nearby there is a large pool which is also
surrounded by prayer flags. Every time I arrived there, the Tibetans I was travelling
with would throw a stone onto the cairn or fasten a new prayer flag to it. At the
same time, they would shout out ki ki so so lha rgyal lho, the gods are victorious.
Already some four hours before arriving at the Tibetan settlement one encounters
the first visible signs of ritual activity carried out to maintain harmony with the
local spirits.
The clusters of Tibetan houses in the valley can be easily discerned from the
Nepalese homesteads by the abundance of Tibetan prayer flags. Prayer flags also
adorn a point at the western extremity of the settlement where a stream emerges
from under a rock which is considered to be the abode of a klu spirit. The Gompa
camp is the first group of buildings that one arrives at when approaching the
settlement from Jaljala. As this is the location of the Bon temple and the medical
school, it is the centre of the communitys medical and religious activity. Surrounding
the Gompa compound are many ma ni stones inscribed with the Bon mantra Om
Matri Muye Sale Du. In the Buddhist areas of the settlement the stones display the
usual Om Mani Padme Hum. Within the Gompa compound there is a building
containing a large prayer wheel (ma ni khor lo) used for accumulating karmic
merit.
Already within the first few months of my stay in Dhorpatan I witnessed a range
of ritual activity that related to the local deities and spirits in the valley. Some of
these rituals were concerned with maintaining balance and harmony and cultivating
prosperity, others specifically related to sicknesses that were thought to have been
caused by spirits. When I asked Geshe Tenzin Dargye about these rituals he couched
his explanation in terms of the traditional nine fold classification of Bon knowledge
which we saw earlier. He said that what I had witnessed him doing was rituals that
are part of the first classification, the way of the shen of cha, this includes
divination, astrology, ransom rituals, and medicine.
Tenpa Yungdrung, the Abbot of Triten Norbutse monastery in Kathmandu, told
me that the reason why the four lower ways are known as the Bon of Cause is
because they deal with the methods of how to find out the causes of problems in
this life, and the techniques that are used to overcome these problems. He said the
knowledge and practices found in the Bon of Cause are based on the notion that
everything is interconnected, that everything in the external world is reflected in
the microcosm of the human body. This follows on from what was discussed above
in the section on the subtle anatomy and tantric cosmology, namely that the five
elements in the outer world have a symbiotic relationship with five elements that
make up the human constitution. In Tantric cosmology this appears as a series of
fivefold correspondences where the five elements are related to the five mental
poisons, the five skandhas, the five solid organs, the five orifices, the five seasons,
the five transcendental wisdoms, the five cosmic Buddhas, and so on. This subject
is dealt with in detail in the higher ways of the Bon of Fruit. Tenpa Yungdrung
explained that based on the notion that the internal and the external worlds are

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19

related, it follows naturally that the actions people engage in the external world are
inextricably related to their physical and psychological well being.
The key Tibetan word in connection with rituals of prosperity and protection is
phywa. According to Tucci (1980:172) popular ritual practice has a number of
aims: to bring about health (nad med), prosperity and auspiciousness (bkra shis,
bde legs), long life (tshe ring), and wealth (longs spyod). The Tibetan word that is
commonly employed to convey auspiciousness is bkra shis, though phywa which
conveys the same meaning is most often used in a ritual context. In Geshe Tenzin
Dargyes view phywa is the potential for health and prosperity that can be generated
through ritual to bring about actual prosperity, g.yang. He said that though g.yang
and phywa are similar in nature to accumulated karmic merit (bsod nams) they are
not the same. He explained that the main Bon ritual that is used to invoke phywa
and g.yang, is the phywa khugs g.yang khugs which is connected with the wealth
deity dZam bha la. This ritual is often carried out at the time of marriage though it
can be carried out at about anytime.
In the texts of the Bon of Cause, phywa is associated with two other related
concepts dbang thang and rlung rta. dBang thang relates to a persons charisma
and personal power. It is connected to the persons ability to be able to perform at
a high level in some capacity; for this reason Norbu (1995:62) translates the term
ascendency capacity. The capacity to accumulate wealth may also be associated
with some valuable possession that an individual owns. For instance, one Tibetan
man in Dhorpatan owned many horses, one of which was particular striking for its
strength and beauty. A nomad in Tibet had offered him 20 yak for the horse, but he
refused because in his view the horse was his wealth god (nor lha) and to get rid of
it would amount to giving up his capacity to accumulate wealth.
rLung rta31 is the name given to the Tibetan prayer flag that is found in abundance
at any Tibetan settlement. The flag shows a picture in the centre of which is a horse
surrounded by four animals, one in each corner, a tiger, a lion, a dragon, and an
eagle. The symbolism concerns the continuous and speedy transformation of the
elements into auspicious conditions. As the flags blow in the wind, health and
prosperity are invoked. rLung rta also come in the form of small squares of thin
paper with the symbols printed on them. The ritual of the rlung rta, involves reciting
a prayer and casting a large quantity of rlung rta papers into the wind. The aim of
the ritual is to increase ones good fortune. It can be done at anytime but it is most
often done at the beginning of a new venture. The Tibetan New Year is traditionally
the time when all the old rlung rta flags are replaced by new ones. On one occasion
during my stay in Dhorpatan I went up in the hills with Geshe Tenzin Dargye and
one of the medical students looking for medicinal plants. At the top of the highest
hill, Geshe Tenzin Dargye fastened a rlung rta flag to a pole and securely fixed the
pole into the ground. Following this he recited prayers to the local deities and we
each threw a handful of barley up in the air in a gesture of offering. The purpose of
this ritual can be understood in the light of Tenpa Yundrungs comments above.
For him, throwing the rlung rta papers into the wind, or barley, or setting up a
rlung rta flag, is an action that by affecting the outer elements brings about a
corresponding change in the inner elements.
There are two types of ritual activity that are carried out to invoke phywa in
Dhorpatan: rituals carried out intermittently by monks and lay people for individual
benefit, and annual rituals that are carried out for the benefit of the community.

20 TIBET JOURNAL
Individual rituals include: the rlung rta ritual, the decorating of mchod rten,
repainting sacred buildings or images, carving or sponsoring the carving of mani
stones, reciting or sponsoring the recital of sacred texts, and making offerings at
the household altar. Another practise that was carried out by many of the Tibetans
is the bsangs offering, which is usually done early in the morning. It involves burning
juniper and reciting an offering prayer to the local deities as the large aromatic
cloud of smoke disperses into the air.
Every year three large rituals are carried out by the monks and lamas for the
benefit of the whole community. As the year unfolds the first ritual to be performed
is the ritual connected with the three classes of beings, the klu, sa bdag and the
gnyan32. The ritual take place at the beginning of June and lasts for a week. It was
explained to me that the best time to perform the ritual is in the spring as this is the
time when these beings awake.
Before the ritual began there were several days of preparations, which involved
making the butter lamps, drawing the mandala33 with coloured sand, and making
the appropriate gtor ma34. During the ritual, different types of objects were placed
as offerings on specific locations of the mandala, these included: sweet smelling
herbs, branches of juniper, various types of gtor ma, rgyang bu35, pho sdong and
mo sdong36, and nam mkha37. During the ritual, the klu, sa bdag, and gnyan are
called to the mandala to receive the offerings. At the close of the ritual, the mandala
is dismantled and the offerings are gathered together in four big metal dishes and
placed some distance from the temple in each of the cardinal directions next to an
object representing the element of that direction, such as next to a stream for water,
or a stone for earth. In this way the spirits are appeased and a positive bond is
struck between them and the human community.
The next ritual occurs around the middle of August and again lasts for a week.
Whenever I asked Geshe Tenzin Dargye about this ritual, he always referred to it
as the gompa puja. The generic Tibetan term for ritual is zhabs brtan, but most
often he used the Sanskrit term puja. This ritual is the annual ritual of the Bon
temple (lha khang) that is situated next to the medical school. It focuses on the
Bon protectors, Nyi pang sad, Mi bdud, rGyal po shel khab, sDon rgyung mthu
chen, and the class of btsan.
The third ritual, which Geshe Tenzin Dhargye referred to as the peoples puja,
commenced a few days after the end of the ritual of the Bon protectors. The ritual
involved the reading of two sets of texts: the bum, the 16 volumes of the Bon
prajnaparamita sutras, and the gZi brjid, the long biography of Tonpa Shenrab.
After the monks had done this they performed a long ritual dedicated to the Bon
goddess Shes rab byams ma. The merit that is accumulated from the reading of the
texts is dedicated to the benefit of the community for the coming year. Shes rab
byams ma is invoked as a guardian deity to bring prosperity and eliminate obstacles.
The four principal peaceful deities of the Bon religion are the Four Transcendent
Lords (Der she tso bzhi) which includes a mother goddess, and three male deities:
the god (lha), the procreator (srid pa) and the teacher (ston pa). In the present age
these are respectively: Sa trig er sang, gShen lha od dkar, Sangs po bum khri, and
gShen rab mi bo. Shes rab byams ma is a form of the great goddess Sa trig er sang.
Her name means the Loving Lady of Wisdom (Kvaerne 1995:24-28). Though she

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ...

21

is primarily a peaceful deity, the Bonpo consider her to be extremely powerful.

The principal wrathful protector of the Bon religion, Srid pai rgyal mo, is considered
to be her emanation.
The ritual culminated in her gtor ma being carried beyond the monastic compound
and cast into a fire of burning juniper branches. Most of the Tibetan people of the
settlement came to witness this, along with many Nepalese. There was a strong
contrast between the solemnity of the ritual and the party atmosphere amongst the
people who were watching it. Though most of the valley of Dhorpatan lies above
3000m it is still engulfed by the monsoon rains before the clouds dissipate in face
of the indomitable Dhaulagiri mountain range situated a short distance to the north.
At this time of the year the monsoon rains are beginning to thin out, yet it was still
unusual to have a day without rain. Geshe Tenzin Dargye said that after he had
finished the same ritual on the previous year, the rain had stopped, which he
attributed to the power of the ritual. The same thing happened after the ritual I
observed. Within a few hours of the culmination of the ritual, the skies cleared and
the rain stopped. However they did ensue again incessantly on the following day.
RANSOM RITUALS AND RITES OF EXORCISM AND DESTRUCTION
Geshe Tenzin Dargye informed me shortly after I arrived in Dhorpatan that even
though considerable effort is put into maintaining balance and harmony with the
local deities and spirits, this state is frequently disrupted. Dhorpatan has a reputation
amongst Tibetans as a place where gnod pa frequently occurs. Both Nepalese and
Tibetans living in the valley would frequently visit Geshe Tenzin Dargye and ask
him for a blessing or some kind of amulet to protect themselves. Most often the
blessing involved wafting the individual with incense whilst he recited prayers and
mantras. Sometimes he would give them protection cords (srung mdud) which the
person could tie around their neck, or amulets (srung khor) made of pieces of
paper with mantras inscribed on them, folded into small squares and wrapped with
different coloured thin threads.
Tenpa Yungrung informed me that when a sickness is diagnosed as caused by a
harmful spirit, then ritual must be used to resolve the problem. In the four lower
ways of Bon, the Bon of Cause, we can see that the severity of the ritual increases
as one moves up the scheme. This approach parallels the established protocol in
Tibetan medicine that treatment should begin with milder therapies and move on
to more intense therapies only if required. He explained that one should begin by
using the less severe rituals of the first way of Bon. If this does not solve the
problem then one moves on to the more severe forms of ritual, the rites of ransom
and exorcism that are documented in the second way of Bon. These rituals are
aimed at remedying the situation by appeasing the offending spirit through various
kinds of offerings. If the techniques of the first two ways are unsuccessful then one
moves on to the powerful methods of the third way, the way of the shen of magic
power, where the yi dam and protectors are invoked to capture the offending spirit
and potentially destroy it. Tenpa Yungdrung explained that for this reason it is
misleading to think of the lower and higher ways of Bon to be separate. Many of
the rituals of the lower ways require a familiarity with the yi dam practices
documented in the higher ways.
The ritual response to gnod pa found in the first two ways of Bon usually takes
the form of ransom rituals, where an effigy of the person (or animal) afflicted is

22 TIBET JOURNAL
offered to the spirit causing the harm as a substitute for the real person. There are
numerous forms of ransom rituals which are collectively referred to by the Tibetan
word glud.38 The same word glud is also used for the effigy which is used in the
ransom ritual. In this context the word means substitute or representative and is
applied to the effigy that is offered as a representation of the afflicted person or
animal. In Dhorpatan the everyday Tibetan word for representative, tshab, was
often used in this context, but this word does not have the same ritual connotations
as glud. Ransom rituals are used to cure sickness caused by harmful spirits in both
humans and animals. There are also specialised ransom rituals that are used to
prevent death (chi bslu), to bring back a persons soul, (bla glud) and the life
force (srog glud).
Ransom rites are one of the four classifications of practice found in the first way
of Bon, where they are referred to collectively as gto. Usually these rites involve
the construction of a small replica of the afflicted person or animal made from
barley dough (tsam pa). This is surrounded by other offerings to add to the
authenticity such as clippings of the persons hair and small pieces of the persons
clothes. The figure is then surrounded by other pleasing items such as pho sdong,
mo sdong, rgyang bu, and nam mkha. All these items are then offered together as
a ransom to the offending spirit. Shortly we will see a ransom ritual that I witnessed
in Dhorpatan that occurred exactly in this way. During the first few months of my
stay in Dhorpatan I came across several ageing nam mkha strewn around the
periphery of the monasterys compound, and at certain crossroads nearby. As I was
to learn, in a simplified version of the gto ritual nam mkha are offered on their
own.
When Amchi Gege suspected any of his patients to be suffering from gnod pa,
before any course of treatment could be prescribed, first it was necessary to make
the verification of the diagnosis. Both the urine and pulse diagnosis sections of the
Bum bzhi and the rGyud bzhi contain lengthy subsections on the characteristic
signs of spirit-caused sickness. This subsection of the pulse chapter (Bum bzhi
1999:44) begins by stating the characteristics of this type of pulse: it is irregular in
the sense that the rhythm is not constant but fluctuates. It may also be taut (then)
and sometimes it feels like two pulses are occurring at the same time (lcam dral).
The section then moves on to say that if these qualities are found in any of the
pulses39 of the five solid organs this indicates the action of specific classes of spirits;
two or three are listed for each organ40. Following this the text lists five types of
sickness that are caused by harmful spirits and identifies the spirits involved. These
sicknesses are: wind disorders (rlung nad); a specific kind of fever affecting the
lungs (btsan bdud); a fever affecting the gall bladder (rims dang mkhris nad);
oedema (dmu chu), and certain kinds of tumours (skran) in the form of small hard
lumps (bras)41 which according to Amchi Gege are very difficult to cure. The
Bum bzhi concludes this section by saying whatever is the case one must use the
relevant offering ritual (gto) and exorcism (bskrad)42. The corresponding line in
the rGyud bzhi strikes the same note, one must recognise what is the case and call
for a ritual specialist43 to carry out the relevant offering ritual (mdos) and exorcism.44
Section thirteen of the pulse chapter is also of relevance to the use of ritual in
healing as it explains the pulse of the bla. Amchi Gege explained that as the bla is
the support (rten) of the body, it is present in all of the twelve pulses taken on the
radial artery. However in order to ascertain the condition of the bla itself, the doctor

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ...

23

must palpate the ulnar artery at the wrist. If the bla has been captured by a spirit,
the pulse will be erratic, moving quickly from fast to slow, from prominent to
sunken, and so on. If this is the case then the ritual that should be performed is the
bla bslu. This ritual was performed three times whilst I was in Dhorpatan. One of
these occasions will be discussed below.
Urine is dealt with in the chapter immediately following the pulse chapter. The
urine chapter is divided into eight sections of which the last section is the one
which discusses the characteristic features of the urine which signify sickness caused
by a harmful spirit. Most of the relevant detail is not provided in the Bum bzhi or
the rGyud bzhi, but is found in commentaries. Amchi Geges teachings on the subject
were based on Khyungtrul Rinpoches commentary45. The procedure involves the
patient urinating into a flat bottomed round bowl. If the patient is male, the urinating
must be done in the east direction; if female, in the west direction. The container is
then turned around 180 degrees and placed on the ground. Four thin sticks are
placed over the container dividing the surface of the urine into nine sections. Each
section is associated with a category identified as the source of the harmful spirits46.
The Tibetan doctor must observe the shape and location of any material suspended
in the urine (ku ya), and the shape and location of the surface film (spris ma). If
either of these two items is located in one of the nine sections then this indicates
the source of the affliction. The Tibetan doctor may also use the power of his or her
own yi dam to identify the relevant section. Amchi Gege explained that after
invoking the yi dam the doctor spits in the direction of the urine and whichever
section is struck directly is the source of the affliction. Another method is for the
doctor to use nine grains, only one of which is black. The doctor drops one grain
into each section without knowing the colours of the grains. The section where the
black grain falls is the cause of the affliction.
The shape of the suspended material and the surface film can also give direct
information about the class of spirits causing the harm. The Khyung sprul sman
dpe relates eight specific designs for the suspended material and 23 for the surface
film to classes of spirits. For example the shape of a scorpion in the surface film
signifies the cause to be the klu or bdud, or if the shape is a deer antler then this
indicates the class of the rgyal po or yam shud.
We can see here that some of the techniques used in examining the urine to
identify the class of spirits causing the affliction are rather acts of divination than
diagnosis. Amchi Gege stressed that if gnod pa is the cause of the disease then one
must ascertain exactly which class of spirit is causing the problem in order that the
appropriate ritual response can be made. In this area, Amchi Gege usually deferred
to the divinatory skills of Geshe Tenzin Dargye.
Divination is another one of the four topics of the first way of Bon. Within Tibetan
culture there are numerous divination techniques, such as: scapulomancy (sog dmar),
interpreting knots made in ropes (ju thig), dice divination (sho mo), and oracular
pronouncements made by spirits possessing men (lha pa) or woman (lha mo)46.
The two most common types of divination used by Tibetan lamas are dice divination
(sho mo) and rosary divination (phreng mo). Whenever Geshe Tenzin Dhargye
was asked to perform a divination in Dhorpatan he used one of two techniques:
divination using rosary beads (phreng mo), or divination using the astrology text
(rtsis). Phreng mo was the method that he most often used to verify cases of gnod
pa. He explained to me that there are three forms of this type of divination in the

24 TIBET JOURNAL
Bon religion: the first governed by the main protector of Bon, Srid pai rgyal mo,
the second connected with the Bon deity sMra bai seng ge47, and the third system
connected with the Bon protector rGyal chen grags pa seng ge, which is the one
that he personally preferred. After reciting a prayer to the protector he counted the
beads on his rosary in a way that randomly generated a number. He then referred to
the entry under this number in the divinatory text under the relevant heading, such
as travel, business, child illness, theft, and so on.
Frequently people from the Tibetan and the Nepalese community would come
and seek advice from Geshe Tenzin Dargye, suspecting that they had some sickness
caused by harmful spirits. On one occasion a Tibetan woman approached him saying
that her young son could not sleep and kept complaining of seeing a black figure
during the night. He did a divination which stated that his life force (srog) was
being attacked by the spirit of a dead woman coming from the north-east. This
stopped after he carried out the relevant ritual, changed the boys name (ming
gyur), and his family set free one of their goats (tshe thar) from being slaughtered.
On another occasion he cured the baby of a Nepalese family who was thought to be
suffering from gnod pa. News of this passed quickly through the local Nepalese
community, and consequently over the ensuing months a steady stream of Nepalese
babies were brought for his blessing.
On several occasions divination showed that amongst the Tibetans certain cases
of gnod pa were caused by spirits associated with the familys ancestral home. For
example, on one occasion one of the female medical students asked Amchi Gege to
do a mo concerning the health of her brother who had been suffering from recurring
bouts of fever and insomnia. The result of the mo was that a particular type of
demoness (srin mo) with a pigs head was causing the problem. When her father
heard about this he identified it with the same kind of spirit that had caused much
gnod pa in his village in Tibet. The following account of gnod pa that I witnessed
in Dhorpatan is of particular interest because it shows the way that standard Tibetan
medicine and ritual medicine work together. It also provides an example of the use
of gto, and the bla bslu ritual.
Sometime around mid-morning I saw Geshe Tenzin Dargye consulting a Tibetan
text for an old Tibetan man from the nearby Tibetan camp. When he had gone,
Geshe Tenzin Dargye told me that the man was very concerned about his daughter
who had started the day well, but had suddenly become very ill. Suspecting gnod
pa he had come immediately to get advice. Geshe Tenzin Dhargye had performed
a divination using the rtsis48 text which had confirmed the mans suspicions, saying
that the cause was either a widow or the spirit of a dead person.
Meanwhile Amchi Gege had sent one of his students, Yundrung, to examine the
woman. When he came back, without knowing the result of the rstis reading, he
recounted the following details to Geshe Tenzin Dargye. He said that the woman
was lying in the corner of the room with a fever and a great deal of pain in her
throat. He said that her pulse was slow like a bad kan pulse. In the morning she
had begun the day well, cooking and eating breakfast with her family. After this
she had taken all the dirty pots to wash in a nearby stream. While she was washing
the pots, an old Nepali woman came angrily shouting at her as all the dirty water
had gone down stream to where she was collecting drinking water. The Tibetan
woman had become sick shortly after this. The fact that the Nepali woman was a

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25

widow verified the rtsis reading. It seems that the anger of the widow had provoked
the spirit attack.
Geshe Tenzin Dargye went to visit the woman early in the afternoon and I
accompanied him. After giving her a protective amulet he decided to carry out the
glud ritual later in the afternoon, as the best time to make the offering is at dusk. In
preparation for the ritual he mixed several medicines, snippets of the womans
hair, and small pieces of her clothing into some barley flour. He then made the
flour into dough (tsam pa) and made a small female figure from it in the likeness of
the sick woman. Yungdrung, who was assisting him, made several gtor ma, and a
butter lamp from the tsam pa. The figure was placed on a plate with the tsam pa
butter lamp in front of it. Different kinds of food were spread around the figure and
all the offerings were wrapped with a white ceremonial scarf (kha btags) and a red
scarf belonging to the sick woman. The glud text was then recited which took
about two hours. The ritual was punctuated by moments when rice was scattered
around the room in a gesture of offering, and moments when the sick woman was
enveloped in clouds of incense.
The ritual culminated with Geshe Tenzin Dargye leaning over the sick woman,
reciting a long mantra, and gently tapping her on the head several times with the
ritual text. After this the glud was left at a bridge crossing the stream at a point
close to where it was thought the whole incident had begun in the morning. Back at
the house the sick woman managed with great difficulty to eat a little Tibetan stew
and to take some Tibetan medicine that Amchi Gege had sent. Yungdrung took her
pulse which he said had changed to a fever pulse. A few hours after the completion
of the ritual, Geshe Tenzin Dargye, Yungdrung, and myself returned to the gompa
compound. When we reached the bridge where the glud had been placed, all that
remained of the offering was the womans red scarf. There was no doubt in their
minds that the widow had taken everything.
On the following day the womans condition had improved slightly but she was
still very sick. In the evening, Amchi Gege made another glud offering for her at
the medical school. On the third day he diagnosed that the spirit causing the sickness
had captured the womans bla. The bla bslu ritual was carried out that afternoon by
two monks and the senior medical student according to the instructions found in
the text Swastika of Life (Tshe yi g.yung drung). On this occasion I was not
present at the ritual but I was told the ritual was exactly the same as I had seen
performed for another person a couple months before, which I have described
elsewhere (Millard, C. 2002. Learning Processes in a Tibetan Medical School.
PhD: University of Edinburgh)49. The ritual involves making a small human figure
in a boat from tsam pa dough; this figure is called the figure of the soul (bla
gzugs). The figure holds its arms out straight in front of it. In its left hand it holds
a small turquoise stone representing the bla, and in its right hand a small arrow
representing the sick persons life force. A liquid is prepared consisting of water,
milk and medicines in a large bowl. The boat is set floating on the surface of this
liquid.
In the first part of the ritual various gtor ma and a small figure resembling the
person made of tsam pa dough are offered to the spirit causing the affliction. The
aim of the ritual is to call the bla into the turquoise stone held in the hand of the
figure of the soul and thus return it back to the individual. At the end of the ritual
various divinations are carried out to verify that the bla has returned. One method

26 TIBET JOURNAL
involves stirring the water so that the boat and figure are set spinning, when the
figure comes to rest, if the arms are pointing to the right of the sick person; this
indicates the bla has returned. Another technique involves placing a black and
white stone in the liquid and again setting it in motion. At a certain point one of the
people conducting the ritual, randomly dips into the liquid and fishes out one of
the stones; the white one indicates the ritual has been successful. All the signs had
indicated that the ritual had been successful for the woman and she was well within
a few weeks.
We have seen that the art of medicine (gso ba rig pa) in Tibetan culture includes
a range of activities that are outside the usual scope of the English word medicine.
The Tibetan healing activities in Dhorpatan demonstrate this range of meanings.
Tibetan medicine can be practiced as a medical science without making any
reference to Tibetan religion. As Tibetan medicine is increasingly affected by
globalisation and modernising influences, a process of transformation has been
identified whereby the categories of Tibetan medicine are reformulated according
to the hegemonic theories and principles of biomedicine (Janes 1995, 2002). The
potential culmination of this process is that Tibetan medicine will be truncated and
exclusively identified with the aspect which has been described above as standard
Tibetan medicine.
If we consider the kind of healing activities that occur in Dhorpatan, gso ba rig
pa taken at its broadest meaning would include standard Tibetan medicine and
rituals associated with maintaining and preserving harmony with the environment,
generating prosperity, and healing. In the examples given above we have seen that
each of the four groups of practices that constitute the first way of Bon: astrology,
divination, medicine, and ransom rituals were all used in the healing activities in
Dhorpatan. The claim that these activities should be considered as aspects of gso
ba rig pa is substantiated by the frequent reference to these activities in the rGyud
bzhi and the Bum bzhi. These texts do not describe healing rituals in detail but
they do identify the types of sickness where such rituals should be performed, for
example, as we saw above in the pulse chapter of the Bum bzhi, the Tibetan doctor
must first verify if a patient is suffering from harm caused by a malicious spirit,
and if this is the case, one must use the relevant offering ritual and exorcism.
Notes
1.

2.

3.
4.
5.

Leslies comments on Ayurvedic, Chinese and Persian medicine are equally applicable
to Tibetan medicine. He points out that they are scientific in the sense that they
involve the rational use of naturalistic theories to organize and interpret systematic
empirical observation (1976:7). On the same subject see Needham (1963, 1969).
Janes (1995) identified this modernising transformation of Tibetan medicine in his
study of Tibetan medicine in Lhasa where he noted the downplaying of elements of
Tibetan religion and an emphasis on disease entities similar to the approach taken in
biomedicine.
A sngags pa is a class of non-celibate religious practitioner who has taken vows
associated with a certain lineage of practice.
The Tibetan word means Buddha, but a more literal translation would be one who
has been completely purified.
The layout of Ol mo lung ring is described in detail in Bon texts, see Martin (1995)
Karmay (1975) and Reynolds (1991).

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ...

6.
7.
8.

9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.

22.
23.
24.

25.

26.
27.

28.
29.
30.

27

The land of Ol mo lung ring can be approached by following the arrow path and
thus parallels Buddhist mythical land of Shambala.
For a detailed discussion of the history and doctrines of Bon, see Karmay (1998)
These translators are dMu tsha Tra he of sTag gZig, Khri thog sPa tsha of Zhang
zhung, Hu lu sPa legs of Sum pa, lHa bdag sNgags dro of India, Legs tang rMang po
of China, and gSer thog lCe byams of Phrom (Karmay 1972:16)
See Haarh (1969) for an account of the early kings of the Yarlung dynasty.
On this classification see Karmay (1975 1998:11) and Norbu (1995: 37).
His study represents only the southern treasure; the other two versions have not yet
been studied by western scholars.
I have followed the English translation of the titles of the nine ways given in Norbu
(1995)
Khu tsha zla od is identified by the Bonpo with g.Yu thog Yon tan mgon po the
younger.
The corresponding Tibetan Buddhist term is dge long.
The Tibetan name for boil is gnyen bur which identifies the causal agent as the gnyen
class of spirits.
The mchod rten is a reliquary monument, the structure of which symbolically represents
the attributes of Buddhahood.
For instance the amount of bile in the body should fill the scrotum.
Chyle (dangs ma), blood, flesh, fat, bone, marrow, and regenerative fluid (khu ba)
Heart, liver, lungs, spleen, and kidneys.
Intestine, stomach, seminal vesicle/ovaries, colon, gall bladder, and bladder.
The Tibetan word rtsa has a range of meanings, including channel, vein, artery,
nerve, and pulse. Here the term is used for the channels (Skt. nadi) that convey
wind (Skt. prana).
The white channels (rtsa dkar po) is the Tibetan name for nerves.
The three descriptions of the life channels provided here are those given by Meyer
(1988:125)
The rGyud bzhi, as the name denotes, consist of four tantras: the Root Tantra (rtsa
rgyud), the Explanatory Tantra (bshad rgyud), the Instruction Tantra (man ngag rgyud),
and the Final Tantra (phyi ma rgyud). The titles of the corresponding parts of the
Bum bzhi do not include the word tantra. These are respectively: the Root OneHundred Thousand Essence of the Blue Sky (rTsa ba thugs bum mkha sngon), the
One-Hundred Thousand Multi-Coloured Examinations (dPyad bum khra bo), the
Black One-Hundred-Thousand Remedies for Disease (gSo byed nad bum nag po),
and the White One-hundred-thousand Victorious Medicines (rNam rgyal sman bum
dkar po). As the four parts form a coherent whole, covering different aspects of the
medical teaching, I have referred to them as volumes.
The qualities of wind are: rough, light, cool, subtle, firm and mobile. The qualities of
bile are: oily, sharp, hot, light, strong-smelling, purgative and moist. The qualities of
phlegm are: cool, oily, heavy, smooth, dull, firm and adhesive.
The third volume of the rGyud bzhi has ninety-two chapters and the third volume of
the Bum bzhi has ninety-six.
Various types of medicinal compounds, and the external therapies of moxibustion,
blood letting, hot and cold compresses, medicinal massages, steam baths, and minor
surgery.
Das (1995) gives the names and a short description of fifteen types of gnyan nad.
The rims class includes flu (cham rims) and typhoid (rims mi zad pa)
For further information on the types of sicknesses caused by disturbances in this wind
and on the classification and treatment of psychiatric disorders in Tibetan medicine
see Millard (forthcoming)

28 TIBET JOURNAL
31. Karmay (1993) spells the word rlung rta and translates it as wind horse. Norbu
(1995:62) prefers the spelling klong rta, as the word klung which now means river,
in the past used to mean space, which is now conveyed by the world klong. However,
both authors agree on the symbolic meaning.
32. A short description of a similar Bon ritual connected with these three classes of spirits
can be found in Norbu (1995:131).
33. The mandala is a concentric diagram representing the palace or environment of a
deity, and the deitys emanations and attributes.
34. An offering cake made from barley. gTor ma come in many different shapes and colours,
corresponding to types of ritual and deity.
35. A wooden stick with three strings tied on it; I was told the strings represent, life
(srog), body (lus) and ascendancy-capacity (dbang thang).
36. Wooden sticks with pictures of men (pho) or women (mo) on them, some rgyang bu
also show pictures of animals; they are offered to the local deities and spirits as
representatives of the real thing.
37. Sticks, with coloured threads wrapped around them in intricate patterns. There are
many different types of nam mkha. The types used here symbolise the five elements:
red thread, fire; white thread, air; green thread, water; yellow thread, earth; and blue
thread, sky.
38. For further information on these rituals see Tucci (1980), Snellgrove (1967), NebeskyWojkowitz (1956), Norbu (1995), Beyer (1973), and Karmay (1998).
39. Tibetan pulse diagnosis involves each of the first second and third fingers take two
pulse, one at the top of the tip of the finger, the other at the bottom. Pulses are taken
on both wrists, hence a total of twelve pulses are taken: the five solid organs all at the
top of the tips of the finger (two kidneys gives a total of six pulses); and the six hollow
organs at the bottom of the tips of the fingers (Meyer 1990, Donden 1986).
40. Heart (lha and rgyal po), lungs (klu, bdud, and klu btsan), liver (sa bdag, dam sri, and
gri mo), spleen (gri bo, gnyan, and sa bdag), right kidney (klu and gnyan), left kidney
(mtsho sman and klu srin).
41. The Tibetan word used in the text, bras, means rice; it is used in this context
because the lumps resemble rice.
41. De la rang rang gang mthun gto dang bskrad par bya (Bum bzhi 1999:45)
42. Interestingly the word which I have translated here as ritual specialist is bon, which
may be a reflection of the chos pa pejorative use of the term, identifying the Bonpo
with the practices only of the lower ways.
43. dos zin bon dang mdos dang bskrad pa dang (rGyud bzhi 1992: 566)
44. Khyung sprul Jigs med nam mkhai rdo rje, Bon lama and scholar born in 1897 and
passed away in 1956. His four medical works collectively referred to as Khyung sprul
sman dpe, were published by the Tibetan Bonpo Monastic Centre at Dolanji in 1972.
45. The nine categories that are given as possible sources of harmful spirits are: gods,
humans, spirits, paternal/maternal ancestors, oneself, children and grand children,
cemeteries, home, and land.
46. For a discussion of Tibetan divinatory techniques see Nebesky-Wojkowitz (1956:454)
and Norbu (1995) On the subject of oracles in Tibetan culture see Day (1989) NebeskyWojkowitz (1956:398-443), Prince Peter (1978) and Berglie (1976).
47. The deity that corresponds to the Buddhist Majusri.
48. rtsis is usually used for finding out the auspicious time to embark on a new venture,
such as, marriage, a new business, building a new house, going on a journey, and so
on.
49. For further information on this ritual see Lessing (1951), Bawden (1962), Mumford
(1989), Karmay (1998) and Norbu (1995).

SMAN AND GLUD: STANDARD TIBETAN MEDICINE ...

29

Bibliography
Aschoff, J.C. 1996. Annotated bibliography of Tibetan medicine, 1789- 1995: Garuda Verlag.
Bawden, C.R. 1962. Calling the Soul: A Mongolian Litany. Bulletin of the School of Oriental
and African Studies 25, 81-103.
Berglie, P.-A. 1976. Preliminary Remarks on Some Tibetan Spirit Mediums in Nepal.
Kailash 4, 87-108.
Cech, K. 1987. The Social and Religious Identity of the Tibetan Bonpos with Special
Reference to a North-west Himalayan Refugee Settlement. Ph.D: Oxford University.
Cornu, P. 1990. Lastrologie Tibtaine: Collection Prsences.
Das, S.C. 1995 (1902). A Tibetan English Dictionary. Delhi: Book Faith India.
Day, S. 1989. Embodying Spirits: Village Oracles and Possession Ritual in Ladakh, North
India. Ph.D: London School of Economics and Political Science.
Peter, HRH Prince, of Greece and Denmark. 1978. Tibetan Oracles. In Himalayan
Anthropology: The Indo-Tibetan Interface (ed.) J.F. Fisher.
Donden, Y. 1986. Health Through Balance: An Introduction to Tibetan Medicine. Ithaca,
New York: Snow Lion Publications.
Dunn, F.L. 1976. Traditional Asian Medicine and Cosmopolitan Medicine as Adaptive
Systems. In Asian Medical Systems (ed.) C. Leslie. Berkley: University of California
Press.
Haarh, E. 1969. The Yarlung Dynasty. Copenhagen.
Janes, C. 1995. The Transformations of Tibetan Medicine. Medical Anthropology Quarterly
9, 6-39.
. 2002. Buddhism, Science and the Market: The Globalisation of Tibetan Medicine.
Anthropology and Medicine 9, 267-289.
Karmay, S.G. 1972. The Treasury of Good Sayings: A Tibetan History of Bon. London:
Oxford University Press.
. 1975. A General Introduction to the History and Doctrines of Bon. Memoirs of the
Toyo Bunko 33, 171-218.
. 1993. The Wind-horse and the Well-being of Man. In International Seminar on the
Anthropology of Tibet and the Himalaya (eds.) C. Ramble & M. Brauen. 1990 :
Ethnographic Museum of the University of Zurich.
. 1998. The Arrow and the Spindle: Studies in History, Myths and Beliefs in Tibet.
Kathmandu: Mandala Book Point.
Rinbochay, K S 1982. Tantric Practice in Nying-ma. London: Rider.
Kvaerne, P. 1972. Aspects of the Origin of the Buddhist Tradition in Tibet. Numen 19, 2240.
. 1974. The Canon of the Tibetan Bonpo. Indo-Iranian Journal xvi.
. 1995. The Bon Religion: The Iconography of a Living Tradition. London: Serindia.
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of California Press.
Lessing, F.D. 1951. Calling the Soul: a Lamaist Ritual. Semitic and Oriental Studies XI,
263-84.
Martin, D. 1991. The Emergence of Bon and Tibetan Polemical Tradition. Phd: Indiana
University.
Meyer, F. 1988. Gso-Ba Rig-pa: Le System Medical Tibetain. Paris: C.N.R.S.
. 1995. Theory and Practice of Tibetan Medicine. In Oriental Medicine (eds.) J.V.
Alphen & A. Aris. London: Serindia Publications.
Millard, C. forthcoming. Tibetan Medicine and the Classification and Treatment of
Psychiatric Disorders. In Soundings in Tibetan Medicine, Proceedings of the Tenth

30 TIBET JOURNAL
Seminar of the International Association of Tibetan Studies, Oxford 2003 (ed.) M.
Schrempf. Leiden: Brill.
Mumford, S.R. 1989. Himalayan Dialogue : Tibetan Lamas and Gurung Shamans in Nepal.
Madison, Wisconsin; London: University of Wisconsin Press.
Nebesky-Wojkowitz, R.d. 1956. Oracles and Demons of Tibet: The Cult and Iconography
of the Tibetan Protective Deities. The Hague: Mouton.
Needham, J. 1963. Poverties and Triumphs of the Chinese Scientific Tradition. In Scientific
Change (ed.) A.C. Combie. New York: Basic Books.
. 1969. The Grand Titration: Science and Society in East and West. London: George
Allen and Unwin.
Norbu, N. 1995. Drung, Deu and Bn: Narrations, Symbolic Languages and the Bn
Tradition in Ancient Tibet. Dharamsala: Library of Tibetan Works and Archives.
Peter, H.P. 1978. Tibetan Oracles. In Himalayan Anthropology: The Indo-Tibetan Interface
(ed.) J.F. Fisher. The Hague: Mouton.
Reynolds, J.M. 1991. Yungdrung Bon - The Eternal Tradition, The Ancient Pre-Buddhist
Religion of Central Asia and Tibet: Its History, Teachings, and Literature: Bonpo
Translation Project.
Samuel, G. 1993. Civilized Shamans: Buddhism in Tibetan Societies. Washington; London:
Smithsonian Institution Press.
Snellgrove, D.L. 1967. The Nine Ways of Bon (London Oriental Series, Vol. 18 . London:
Oxford University Press.
Stein, R.A. 1972. Tibetan Civilization. London: Faber and Faber.
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Kegan Paul.
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Bum bzhi 1999. gSo rig bdud rtsii bang mdzod bum bzhi bzhugs Delhi: Paljor Publications.
rGyud bzhi 1992. bDud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud ces
bya ba bzhugs so: Bod ljong mi dmangs dpe skrun khang. (Lhasa edition)

Tibetan Medicine in Gyalthang

Denise M. Glover
This article is an overview of Tibetan medicine in Gyalthang (rGyal thang), focusing
mainly on the significance of ethnicity in the practice and use of Tibetan medicine in
the area. I begin the article by discussing how the discourse on traditional and
ethnic medicine is effectively linked to ethnic discourse in the contemporary PRC.
Next, in order to provide ethnographic detail of the current practice of Tibetan
medicine in Gyalthang, I move on to give brief profiles of the doctors with whom I
studied in the area and to discuss the basic training and certification of a Tibetan
doctor. Lastly I offer a brief introduction to the natural environment of Gyalthang,
which allows for abundance of medicinal plants; because of this natural wealth, the
area has much significance in terms of material resources, the access to which has
become an area of increasing contestation. Much of this contestation takes the form
of ethnic identity politics and provides another example of the link between ethnicity
and medicine in Gyalthang.
ETHNOGRAPHIC SETTING

Gyalthang is located in the southernmost reaches of Khams. Of the six sgang (T)
(plateaus/highlands) in Khams, Gyalthang is located in sPo bor sgang and roughly
corresponds to present-day Shangrila County in Diqing Tibetan Autonomous
Prefecture (C, Diqing Zangzu Zizhizhou), northwest Yunnan Province.1 Essentially
there are two Gyalthang: Gyalthang1, which refers to the greater cultural (and
previously administrative) area, and Gyalthang2, which refers to the core town of the
greater cultural area. The research presented in this paper was conducted in 1999,
2001 and 2002 (for a total of 11 months) in central/navel Gyalthang (Gyalthang2), in
the town known in Chinese as Zhongdian, and in surrounding villages.2 As explained
below, most of my time was spent with doctors of Tibetan medicine at two of the
three public hospitals in Zhongdian town. The main focus of my research was on the
classification of medicinal plants by Gyalthang doctors, which I discuss at length in
my doctoral dissertation (Glover 2005). The research presented here, however, is
important for understanding the current status of Tibetan medicine in southern Khams,
and in some instances more generally throughout the entire PRC, and is therefore
presented in this forum for such benefit.
MEDICINE AND ETHNIC IDENTITY

Tibetan medicine, throughout China, is ethnically marked in Mandarin: zang yi or

zang yao,3 where zang is short for Zangzu, or the Tibetan ethnic group.4 Chinese
medicine is, instead, the unmarked, non-ethnicized category of zhong yi or zhong
yao, medicine of the middle country, or, more contemporarily, the nation. The linkage
between Chinese medicine and the Han ethnic group is not linguistically explicit
(that is, Chinese medicine is seldom called Han yi/yao), although it is implicit and
often quite overt in medical publications, particularly those that deal with ethnic
medicines. There is even a slippage in terminology, so that sometimes Chinese
medicine is referred to as zhongyi/yao (Chinese medicine) and sometimes it is
Zhongguo yi/yao (medicine of China) (see below). Western biomedicine, although

32 TIBET JOURNAL
utilized quite extensively in some areas of medical treatment throughout China for
close to 50 years, carries the name of the (imagined) area of its origin: the West (xi).5
In the past decade or more, traditional, institutional Tibetan medicine, as practiced
at the Tibetan Hospital in Zhongdian, has been touted as one of Chinas great medical
treasures, although its status in relation to Chinese medicine is somewhat ambiguous.
Often Tibetan medicine gets lumped in with other medical systems of Chinas ethnic
minorities in contrast to Chinese medicine and sometimes it is presented as an example
of Chinas ethnic medicines along with Chinese medicine.6 The crux of understanding
how Tibetan medicine fits into the larger discourse of medicine in China depends in
large part on understanding what Chinese medicine symbolizes in China. Here I
examine two instances in which Tibetan medicine comes in contact with the larger
discourse of medicine in China and Chinese medicine. The first is a highly publicized
horticultural exposition that I attended in Yunnan and the second is a recent publication
on minority medicines in China.
At the 1999 World Horticultural Exposition in Kunming, a small exhibit titled
Ethnic Medicine and Pharmacology (Minzu yiyao),7 contained within the larger
exhibit of Herbal Medicine Gardens (Yaocao yuan), presented a variety of medical
traditions in the PRC. Non-Chinese medical traditions8 (Tibetan, Mongolian, Uighur,
Yi, Dai, etc.) were exhibited in one hall while Chinese medicine was exhibited in
several connecting and adjacent halls. Although the entire exhibit was titled Ethnic
Medicine and Pharmacology, the use of this phrase was mostly limited to cases of
ethnic minority medicine. For example, signs in the hall with non-Chinese medical
traditions that read Ethnic Drugs with Unique Curative Effects (Liaoxiao dute de
minzu yao) and Rich and Varied Ethnic Drugs in Yunnan Province (Fengfu duoshi
de Yunnan minzu yao) actually cite examples of texts and drugs from non-Chinese
medical traditions only. Signs in the halls for Chinese medicine did not use the term
ethnic medicine to describe Chinese medicinethe tradition was referred to either
as zhong yi/yao, Zhongguo yi/yao (significance of these terms discussed below) or
traditional medicine (chuantong yiyao). And yet at the same time, in the hall where
displays of minority medical traditions were housed, the Han ethnic group is briefly
mentioned as an important ethnic component of the nation and as the holders of the
Chinese medical tradition:
China is a multi-ethnic country. Not only does the Han ethnic group have Chinese
medicine and pharmacology (Hanzu you zhong yiyaoxue) [emphasis mine] but also
each of the other fifty-five minority groups has its own ethnic medicine and pharmacology
[with] long-standing histories and rich contents; they are an important component of
Chinas medical and pharmacological sciences (shi Zhongguo yiyaoxue zhongyao zucheng
bufen).

So Chinese medicine is a type of ethnic medicine as well, since it is the medical

tradition of the Han ethnic group, yet it is seldom directly referred to as such. The
use of ethnic medicine is generally reserved for non-Han Chinese traditions. In this
sense, the term ethnic (minzu) is used in very much the same way that it is in the
United States: ethnic music generally means music of non-Anglo origin; the ethnic
food aisle at a large chain grocery store usually contains Mexican, Chinese, Thai,
and Japanese foods, for example.9 Ethnic in the United States generally means nonAnglo; in China it means non-Han.

TIBETAN MEDICINE IN GYALTHANG 33

There is often a slippage in terminology between Chinese medicine (zhong yi/yao)

and medicine of China (Zhongguo yiyao). In another sign at the same exhibit the
term Zhongguo yiyao (medicine and pharmacology of China) is clearly used to mean
Chinese medicine. This sign lists important medical canons in the Chinese tradition
and outlines a brief history of the same. Throughout the text of the sign, Zhongguo
yao (medicine of China) is used interchangeably with zhong yao (Chinese medicine).
Not surprisingly, the slippage between Zhongguo yi/yao and zhong yi/yao parallels
that in other ethnic discourses in the PRC, where the traditions of the Han-Chinese
majority are made to symbolize those of the nation. Thus Chinese medicine is the
hallmark traditional medicine of China. All other types of medical traditions are
ethnic, non-Hanmarked, and not mainstream.
These marked medical traditions were presented at the Expo as examples of the
wondrous resources of the nation, particularly in natural materials. A sign titled
Brilliant Future for Pharmaceutics of Ethnic Drugs (Qianjing guangguo de minzu
yao zhiji), at the exhibit reads:
China has devoted much attention to the work for exploration, management, development
and investigation of ethnic drugs (minzu yao). In recent years, large numbers of
pharmaceutics from ethnic drugs with significant curative effects have been investigated
and manufactured. [It then lists examples of drugs that have been manufactured, giving
their Chinese and Latin names and uses] Development and research of ethnic
pharmaceutics will bring enormous contributions to humanity.

Although no particular mention is made in this sign of which medical traditions

these drugs have come from, certainly non-Chinese traditions are among them (I
recognize one example as coming from the Tibetan tradition). Later in this article I
discuss how some of the exploration and development of Tibetan pharmaceutics in
Gyalthang has played out, from production factories of Tibetan medicine to plant
prospecting in remote villages.
Lastly, at the Expo, viewers were briefly introduced to the theoretical foundations
of non-Chinese medical systems through the interpretive lens of Chinese medicine
and dominant Han Chinese culture. Tibetan medicine, for example, was discussed in
terms of yin/yang theory; such a theory is particular to Chinese medicine, but not at
all to Tibetan medicine. All plant names given for mounted specimens were Chinese
(and Latin), not those from the language of the respective medical tradition, or even
Chinese phonetic approximations of these names.10 Books displayed in cases were
all written in Chinese, although in the case of Tibetan medicine, for example, there
are countless medical publications within the PRC in Tibetan. Clearly the World
Horticultural Exposition was aimed in large part at the Han Chinese middle to uppermiddle class (and some international travelers, since most signage was translated
into English); in this cohort are citizens with some knowledge of Chinese medicine,
a budding curiosity about the diverse nature of the nation (and the world),11 and
enough money to pay the entrance fee of 100 yuan (approximately US$12) per person
per day. Ethnic medicines, as with other things ethnic in the PRC, were presented as
objects of wonder and potential consumption by the greater Chinese, un-marked yet
implicitly Han-centric, public.12
A related discourse about the relation between Chinese medicine, the nation, and
medical traditions of Chinas minority nationalities appears in a 2000 publication
titled Collection of Traditional Minority Medicines of China (Zhongguo Shaoshu

34 TIBET JOURNAL
Minzu Chuantong Yiyao Daxi). First, while the volume profiles medical systems of
thirty-five ethnic minority groups in China, comparisons to the Chinese medical system
are made throughout. In the opening paragraphs of the Tibetan medicine section
(which is 189 pages long, divided into 25 chapters), the authors state,
On the Tibetan Plateau, the Tibetan ethnic group created Tibetan medical science (zang
yixue), which has a long history, substantial content, and a unique system and theory
that are second only to the integrated medical system of the Han (Hanzu yixue). (Qi and
Luo: 3)

The text goes on to state that the history of Tibetan medicine is generally considered
not as extensive as that of Chinese medicine due to the fact that written Tibetan
language was not established as early as written Chinese:
In terms of the history of Tibetan medical science, generally speaking it is not as long as
that of Han Chinese medicine (buru Hanzu zhongyi name youjiu). This is because the
history of Tibetan written language standardization did not start until the time of the
ruler that united the country [Tufan wangchao tongyi xueyupresumably this means
Songsten Gampo (Srong btsan sgam po), mid 7th Century]. However, if we start
calculating from the time of human habitation in Tibet (ruguo cong xueyu kaishi you
renlei juzhu shenghuo suanqi), then Tibetan medical science could also be said to have
a lengthy history. (Qi and Luo: 3)

Here two versions of Tibetan medical history (one text based, the other orally
based) are offered up, with clear preference of accuracy given to the first. If the
second version were truly plausible, that could mean that the Tibetan medical tradition
might rival the Chinese in antiquity.13 The important point here is not which version
of Tibetan medical tradition is correct, but that Tibetan medicine (and other traditions
discussed through the text) is always placed in contrast with Chinese medicine. And
usually Tibetan medicine falls short of the standard set by Chinese medicine in one
way or another.
Secondly, in this volume the authors make explicit that the Tibetan medical system,
as a minority medical tradition, is one of several great traditions of the Chinese nation
that, consequently, should bolster the strength of the nation.14 Citing the Constitution
of the Peoples Republic of China, which stipulates that the traditional medicines of
the nation (literally our nation, woguo) should be developed (fazhan), the authors
explain that minority medical traditions, taken together as a whole, are one of the
great treasures (weida de baoku) of the nation (the other great treasure is Chinese
medicine, of course). Because of this important status, all minority medical traditions
should work to discard the false and retain the true [as well as] discard the crude
and retain the refined (qu wei cun zhen, qu cu cun jing). Furthermore, they should
be practical and realistic in picking and choosing (shishi qiushi de qushe yangqi)
what to discard and what to retain (Qi and Luo: i-ii). The authors further urge party
and government officials, as well as health care workers, to take ethnic medical
traditions seriously because doing so advances ethnic culture (hongyang minzu
wenhua), implements ethnic policy (guanche minzu zhengce), and generally helps
medical sciences of the motherland (zuguo) prosper. The authors warn that while
important technological changes must be implemented in minority medical systems,
substantial leaps (tiaoyue) should not be taken hastily. In particular, Western medicine
is cited as an area for caution:

TIBETAN MEDICINE IN GYALTHANG 35

Some people think that changing to Western medicine, or medical westernization, (xiyao
hua) is a shortcut. But after making such a change [to use of Western medicine], ethnic
medical traditions are unable to find themselves again (minzu yiyao ye jiu zhaobudao
ziji le). This is something that all ethnic medicine workers must consider. (Qi and Luo:
ii)

In other words, these medical traditions are part of a nexus of national treasures
and as such have obligations to the motherland: to adapt to changing conditions but
also to maintain integrity. The nationalist rhetoric in this volume (much of it quite
reminiscent of like rhetoric during the Maoist era) is not surprising because the
discourse on ethnic medicines in China is linked to ethnic minority discourse, which
is effectively linked to nationalist discourse.
In both the 1999 World Horticultural Exposition and Collection of Traditional
Minority Medicines of China, Tibetan medicine and other non-Han Chinese medical
systems are presented to the inquiring public in the shadow of Chinese medicine and
Han Chinese culture at large. In this context, Tibetan medicine is always a medical
tradition of a minority group (shaoshu minzu yiyao), a tradition on the fringe of the
mainstream. While Tibetan doctors may not consider themselves terribly on the fringe
during the midst of their practiceindeed they are very much at the center of medical
care for most Tibetans in Gyalthangthey do seem acutely aware of the position of
Tibetan medicine in the larger context of the entire nation, especially given that the
doctors with whom I studied are presently or have been doctors at state-sponsored
institutions. They commented that Tibetan medicine, although finally recognized as
the important tradition that it is after many years of persecution in the PRC (see
Janes 1995: 15-22), still struggles in some areas to achieve the equality granted to
Chinese medicine (below I discuss certification of pharmacologists as one example).
TIBETAN MEDICAL DOCTORS

Traditionally, there have been two main types of doctors in the Tibetan cultural
complex: monastically-trained and family-trained. Since monasteries were the
storehouses of and foci for Tibetan intellectual life for centuries, it was also in these
institutions that medicine was taught and practiced. Part of a monks15 basic educational
curriculum consisted of courses in medicine (along with logic, debate, astrology,
grammar, calligraphy, and others). If a monk found that he was particularly interested
in medicine, he could continue to study beyond the basic curriculum, provided there
was someone to teach him, and/or he could attend a specialized medical college.
Even without a teacher present, however, a monk could learn a fair amount from
studying medical texts, since literacy was one of the hallmarks of monastic life. Patients
would seek out qualified doctors at nearby monasteries. The second type of medical
lineage consisted of those doctors trained within the family. Before 1949 most of the
families with which we are familiar in the literature were aristocratic and often traced
their ancestry back to important historical figures (many Indian) in the development
of Tibetan medicine. Doctors of this genre were connected to landed estates, were
literate, and varied in the degree to which they practiced medicine as a profession.
Although most of these doctors were men, it was possible for women in a medical
family to be trained as well.
Such are the two ideal historical types of Tibetan doctors. Certainly there must
have been quite a few doctors that did not match the descriptions given here: doctors
who may have had some basic monastic training in medicine but then returned home

36 TIBET JOURNAL
to village life to become the local village doctor; doctors who were somehow selftaught, possibly traveling to other locations to find willing teachers; or other familytrained lineages. What this typology of Tibetan doctors leaves out are those doctors
trained outside the world of literacy. Certainly I encountered a few such doctors
during the course of my fieldwork, although I was not able to study with them
extensively (explained below). Sometimes called village or country doctors in Chinese
(nongcun yisheng),16 these doctors were usually trained within a family by a parent,
grandparent, aunt or uncle and are undoubtedly part of a long tradition of oral medical
training. Such doctors tended to be men as well, although not exclusively so, and
they treated patients within the local context of a village or group of villages. These
lineages were (and are) most often found in more remote areas, away from cultural
centers and large monasteries.
Since the founding of the PRC and the Communist Revolution, the specialized
study of Tibetan medicine in institutions has been moved from the monasteries to
state-sponsored colleges and hospitals;17 medicine of this lineage is no longer yoked
exclusively to religious study.18 The Gyalthang doctors with whom I studied were all
products of institutions, hence I use the term institutional doctors to describe them.19
Yet the types of institutions in which they studied vary depending on age. Those born
before 1940 (Pema Tenzin, Tsedrup Gnpo, and Shiang Rinpoche) had all begun
their study of Tibetan medicine as young monks in monastic institutions. In contrast,
younger doctors, born after 1960, (Ma Liming and Kelsang Chden) had started by
apprenticing with one or more senior doctors and then had gone on to study at formal
medical institutions. One of the underlying commonalities for all of these institutional
Gyalthang doctors is literacy in Tibetan language. One cannot study Tibetan medicine
without fluency in the language. Although there is nothing stopping a non-Tibetan
from learning to read and write Tibetan (and therefore studying Tibetan medicine) it
is thus far unheard of in Gyalthang.20
GYALTHANG INSTITUTIONAL DOCTORS OF TIBETAN MEDICINE

Institutional doctors in Gyalthang for the most part practice in hospitals.21 There are
three main public hospitals in the town of Zhongdian.22 The Diqing Prefectural
Peoples Hospital (C, Diqing Zangzu Zizhizhou Renmin Yiyuan) was established in
1978 and utilizes both Western and Chinese medicines. In 1979, the Prefectural
Hospital established a clinic of Tibetan medicine that was disbanded after the
establishment of the Tibetan Hospital (see below) in 1987. Since there were no doctors
of Tibetan medicine at the Prefectural Hospital during the time of my research I did
not spend any time there. The County Peoples Hospital (C, Zhongdian Xian Renmin
Yiyuan) was founded in 195223 and utilizes mostly Western and Chinese medicines
but also has a small clinic of Tibetan Medicine. I interviewed the doctor of Tibetan
medicine, Tsedrup Gnpo, at the County Hospital several times. The third public
hospital in Gyalthang is the Tibetan Hospital (C, Diqing Zhou Zang Yiyuan; T, bDe
chen khul bod lugs sman khang), established in 1987. At the Tibetan Hospital, Tibetan
medicine is practiced almost exclusively; of the twenty-seven doctors on staff, twentythree of them are doctors of Tibetan medicine, two are doctors of Chinese medicine,
and two are doctors of Western medicine. (All doctors of Tibetan medicine at the
Tibetan Hospital have had minimal training in both Western and Chinese medicines.)
Most of my time was spent at the Tibetan Hospital. My main consultant was Ma

TIBETAN MEDICINE IN GYALTHANG 37

Liming. In addition, I interviewed Pema Tenzin while he was still a doctor at the
Tibetan Hospital in 1999 and then again later in 2001 and 2002 at his private clinic.
These three hospitals are within an approximately two-mile radius of each other.
The Prefectural and County Hospitals are toward the center of town and within blocks
of various government buildings (prefectural and county), the bus station, and the
central food market. The Tibetan Hospital is located on the north end of town, past
the Minorities Middle School (Zhou Minzu Zhongxue) and the statue of a man
(visually marked as Tibetan) riding on horseback. The location of these facilities is
symbolically significant and mirrors the status of the respective medicines in the
eyes of the state; locating the Tibetan Hospital on the edge of town signals the
peripheral status of Tibetan medicine within the larger discourse of medicine in China.
PROFILES OF DOCTORS

Pema Tenzin (Pad ma bstan dzin)

Pema Tenzin is a native of Dongwang (literary name: gTer ma rong),24 a township in
the northern part of Zhongdian County. He began his study of Tibetan medicine in
Dongwang with teachers Ani Lhatsa and Tsering Gyatso at age eight or nine; he was
a monk until age 27. Pema Tenzin explained that he had traveled to many places (the
TAR, Gansu, Qinghai, Sichuan and Yunnan) throughout the years, studying medicine
with a variety of teachers. He himself has been a doctor since 1966 and has been
practicing in Zhongdian since 1984. First he worked in the Tibetan Medicine Clinic
of the Prefectural Hospital but then moved to the Tibetan Hospital after it was
constructed in 1987.25 He explained to me once that he only instructs about four
students at a time, for four to six years. In 2000 he retired from the Tibetan Hospital
and opened his own private clinic in his home. He was quite humble about the
importance of his clinic but every time I was there a line of patients (between 8-25
people long) was formed in the courtyard to see him. He often treated people and
dispensed medicines free of charge. I was told by Ma Liming that people will come
from far away, especially from his home area of Dongwang (about an eight-hour trip
by bus), to see him.
When I first arrived in Gyalthang in 1999 I went directly to the Tibetan Hospital.
I was accompanied by a graduate student from the Kunming Institute of Botany;
although she had never been to the area herself and was from neighboring Lijiang
Naxi Autonomous County, she was assigned to be my peitong (accompanying
companiontheoretically required for all researchers in the PRC). We had names of
doctors to contact that were given to us by one of her fellow graduate students who
had done research in the area. At that time Pema Tenzin was one of the leading
doctors at the Tibetan Hospital and Ma Liming was a new doctor there who had been
studying under Pema Tenzin for many years. One of the distinct memories I have of
that first visit is of Pema Tenzins demeanor. I remember that his voice was quite
soft, his Mandarin was heavily accented, and his face had a warm glow. His skin was
not weathered like that of many in the area, presumably from having spent most of
his adult life indoors studying. His smile was sweet and his eyes seemed kind. In
many ways he was guarded: he had asked that I not record our interviews (I asked if
I could since I had difficulty understanding his Mandarin at times) and he seemed
especially careful about my questions concerning the connection between medicine
and religion. I realize now that most of the questions I asked at that time were too
direct for these beginning conversations. Although cautious, Pema Tenzin nonetheless

38 TIBET JOURNAL
was encouraging and extremely helpful; I remember that a particularly bright smile
came across his face when he learned that I could read Tibetan (although haltingly).
In 2002 I spent time at his private clinic, observing doctor-patient interaction,
interviewing him, and receiving treatment myself.
Once when I was at his clinic in 2002, and after all patients had left for the afternoon,
Pema Tenzin took me into the upstairs part of his home to show me where he stores
all of his plants. He explained how he used to collect most of the plants himself, but
now he mostly buys them from a few people he trusts to collect. Baskets of plants
were drying in the sun on the rooftop while others were drying in the shade.26 He had
built shelves on which to stores bags of dried plant parts; the upstairs rooms and
hallway were filled with the aroma of these. Next he showed me his shrine room,
where thangkas lined the walls and a central shrine was at the west end of the room.
Some plants were even stored in the shrine room, and he explained that to aid in
efficacy all plants should be properly blessed. We did not talk much about the contents
of the shrine room, since his main purpose in bringing me upstairs seemed to be to
show me his storehouse, but I was able to recognize many of the figures in the thangkas,
some of which were the Medicine Buddha. I felt honored that he would share all of
this with me. I also felt that perhaps in some way he was trying to communicate to me
that the questions I had asked him three years previously about the connection between
medicine and religion were important ones, even though he had not chosen to discuss
them with me then. In many ways I began to feel like Pema Tenzin and I were finally
establishing a meaningful relationshipjust as my fieldwork was coming to a close.
I am sorry that this did not happen in large part before mid-2002.
Ma Liming
Ma Liming is from a farming family in Yangthang village (C, Xiao Zhongdian),
about 25 km south of Zhongdian town. His Tibetan name is Chos phel but he hardly
ever uses this name, he told me. He explained that he did well in school from an early
age and therefore was encouraged to continue on to study medicine. He was an
apprentice for six years with Pema Tenzin before attending the School of Health (C,
Weisheng Xuexiao) in Zhongdian where he studied for four years. The same age as
myself (34 in 2002), Ma Liming has been the head pharmacologist at the Tibetan
Hospital since Pema Tenzin retired in 2000; now he even occupies the office that
previously belonged to Pema Tenzin. He is in charge of acquiring all medicinal
ingredients (either through organizing collecting parties or purchasing) and is overseer
for all production of medicines at the hospital. There are four doctors who work
under him that actually mix the medicines, and help with collecting materials.
The majority of my time interviewing was spent with Ma Liming, hence I consider
him my main consultant. He often had afternoons free and these were the best times
for me to visit the hospital to interview. He was instrumental in my learning, never
seeming to tire of my rudimentary questions. He explained an enormous amount of
Tibetan medical theory to me and showed me how to read recipes in medical texts.
He helped me decipher audiotapes I had made in Dechen and in surrounding villages
of doctors and common householders reciting names of plants. We drove around
several times in his small minibus identifying plants in the field and taking small
collections. One time we even drove out to Tsoli village for the day; Ma Liming said
he would be happy to help me interview some random villagers and a few men he
knew there that had working knowledge of local medicinal plants. We of course

TIBETAN MEDICINE IN GYALTHANG 39

spent a good amount of our time discussing plant classifications and he helped me
identify and locate important texts for my research. He has even responded recently
to a letter I wrote him about my findings on the variations in plant classifications in
medical texts and has provided his interpretation of some of these. Overall I feel
incredibly indebted to him and could not have undertaken this research without his
help.
It is worth noting here that while in general I felt quite at ease with Ma Liming, and
I believe he did with me as well, he seemed quite cautious about our spending too
much time together alone. The few times he offered to take me plant hunting were
when my son was along (the decision was usually spontaneous, as was bringing my
son along to interviews). He tended to wax more conversational when there were
other people in the room during our interviews. Even when we drove to Tsoli village
(we did drive there alone and had some very interesting conversations along the
way), he asked a friend in Tsoli to accompany us for the day. I have no way of
knowing for sure whether Ma Liming would have behaved differently in these regards
if I were a man, but I suspect so. Although I do not feel that I was slighted in any way,
that somehow information was withheld from me because of my gender, by any of
the Tibetan doctors, I was and am conscientious about my role not only as a foreign
anthropologist, but as a woman as well.27
Tsedrup Gnpo (Tshi sgrub mgon po)
Tsedrup Gnpo was born in Geze village, about 30 km north of Zhongdian town. He
went to Lingshi Ridr (Gling bzhi ri khrod) Monastery in Bathang (in present-day
Sichuan Province) when he was eight years old. By age thirteen he was ordained as
a monk and had begun his study of Tibetan medicine. When the Communist Revolution
arrived in China in 1949, Tsedrup Gnpo (aged twenty-four) removed his robes and
gave up his monks vows. He practiced medicine for ten years in his home village of
Geza (C) before coming to work at the Tibetan Hospital when it was first established
(1987). In 1996 he moved to the Tibetan medicine clinic of the County Hospital,
where he is the only Tibetan doctor on staff. In 1999 he told me that he had seventeen
students, which seemed like a large number. He also told me once that only Pema
Tenzin, Shiang Rinpoche, and himself know anything about Tibetan medicine in the
Gyalthang area: All the other doctors [he did not mention names] are book doctors
they dont know enough about actual practice, he said.
I interviewed Tsedrup Gnpo several times at the County Hospital. He was fairly
gruff and sometimes seemed bothered by my requests to speak with him. I was told
by many people, Pema Tenzin and Ma Liming included, that Tsedrup Gnpo is simply
that way, that I should not worry too much about his behavior and attitude. But I
found it challenging to be around him. He constantly chided me for misspelling Tibetan
plant names (even after I told him that I specifically needed help with the spellings)
and he spoke very sternly to me quite often. In general I was quite put off by his interpersonal style and could tell early on that he was not someone with whom I would be
able to work extensively. Nonetheless, he was clearly a knowledgeable doctor with
decades of experience and I tried to make the most of our encounters.
OTHER TIBETAN MEDICAL SCHOLARS IN GYALTHANG

In addition to the doctors at the Tibetan and County Hospitals, there are other
practitioners and medical scholars in the area. Shiang Rinpoche (Byang28 Rinpoche)

40 TIBET JOURNAL
is one of the areas most well respected authorities on Tibetan Buddhism and Tibetan
medicine. At an age of 80 and having just undergone gall-bladder surgery, Rinpoche
was kind to agree to an interview with me in 1999. At that time he said he was not
sure if we would meet again when I returned to Gyalthang, alluding to concern that
his present life was soon to end. Fortunately he was still alive when I returned in
2001 and 2002 and I was able to interview him several times. However, his failing
memory seemed a point of embarrassment to him and he continually mentioned how
he had not practiced medicine in a very long time. In particular, Rinpoche helped fill
me in on some of the history of Tibetan medicine in terms of specializations within
particular Buddhist sects.
Kelsang Chden (sKal bzang chos ldan) is a native of Lhasa and did his medical
training both there and in India, where he lived for many years. In Gyalthang, Kelsang
is actually a tour guide in the summer months, since he can make a fair amount of
money doing this.29 He then returns to Chamdo (Chab mdo) in the winter months to
work at the Tibetan medicine factory there, where he helps mix medicines. When I
first met Kelsang (we were introduced by a mutual friend) he explained to me that it
was quite difficult for him to find work. Since he had left Lhasa when he was fairly
young (age thirteen I believe) and spent so much time in India, his Chinese language
skills, especially written Chinese, were quite poor. He said it was impossible to get a
job anywhere in this part of cultural Tibet without being able to read and write Chinese.
He had come to Gyalthang hoping to work in medicine but had then settled on tourism
when no other jobs were available for him (and he grew to appreciate the income
from tourism, he said). Kelsang was not only a consultant but also a good friend. We
shared many meals together with other friends and he was a fun person to be around,
with a bright face and gentle demeanor.
NON-HOSPITAL PRACTITIONERS

I was also able to interview several village doctors in Zhongdian. Ngdrup (dNgos
sgrub) lives at Sumtsenling (Sum rtsen gling) Monastery. His son is a monk at the
monastery, so he is able to live in a small room there. He sees patients occasionally
and specializes in healing stomach ailments. He is from a line of village doctors that
goes back at least eight generations. His father, who died when Ngdrup was ten
years old, is still famous in the area for being able to diagnose illnesses from gazing
at corpses (a type of visual autopsy); I interviewed at least half a dozen villagers in
the area who mentioned this. Ngdrup told me that because his father died when
Ngdrup was so young he was not able to learn as much as he would have liked to
from him. Although I expressed what I believe is sincere interest in learning from
Ngdrup, in many ways he seemed very suspicious of me. He told me only a few
names of plants that he uses, saying that he did not know the names of most of the
plants. For a while I thought that possibly because he is not literate in Tibetan, he felt
uncomfortable with the fact that I am. Thinking this, I explained that he could just
tell me whatever names he knows for plants, that he need not be concerned with
whether they are standard names or not; he just responded, several times, that he
does not know any names for the plants he uses (below I explain why).
Another fellow in town with a very similar name, Yudrup (g.Yu grub), also claimed
that he did not know the names of the ten plants he uses to treat muscle strains and
broken bones (his specialty) although he very agreeably answered other questions I
had. By the time I had interviewed Yudrup, I already had been pondering this

TIBETAN MEDICINE IN GYALTHANG 41

phenomenon of un-named plants: I speculated that possibly there are names that
are used just within the family and that since I was not a family member I should not
be privy to them. I asked Yudrup if this was the case; I said that he did not need to tell
me what the names are if he did not want to. He again said that they do not use names
for the plants but that they can easily recognize them in the field. I was puzzled: can
such covertness exist for these useful plants? In a later conversation with Ma Liming,
I was told that the names of these plants are secretivethey are passed on from one
generation to the next and not shared outside the family. This I had suspected. But
apparently even the fact that the names are secretive is also secret.
While I was extremely interested in learning more from these men I was not able
to. I am not sure which was the biggest obstacle: being a woman, an outsider, too
forward in my approach, not persistent enough, or a possible liability in terms of
keeping family secrets/traditions. It is not that I learned nothing from them, as the
above account of secretive names indicates. Whatever the case, the way in which
knowledge is imparted to and shared among institutionally trained doctors is much
more congruent with the type of research I was conducting and the way in which I
conducted it. After all, I also come from a world of educational institutions.
STREET VENDORS, MEDICINAL MARKETS

On the streets in Zhongdian there are also street vendors selling various medicines.
When I first got to Zhongdian in 1999 I interviewed several of these vendors, mostly
Tibetan women over 50. One of the most interesting exchanges I remember was one
womans response to my inquiry as to whether the goods she sold were Tibetan or
Chinese medicine: Its a little bit of bothand not exactly Chinese or Tibetan.
Here was folk medicine in the making, I thought: eclecticism at its best. Unfortunately,
the number of street vendors diminished by 2001 and 2002, and none of the women
I had interviewed in 1999 were selling on the streets any longer. I realized that these
vendors were more itinerant merchants than healers, which is not to say that they did
not know about the medicines they sold. Nonetheless, I could not track down the
original interviewees and other vendors seemed too intermittent for a sustained
research project. Additionally, a variety of markets and stores exist throughout
Zhongdian town that sell medicinal plants; I did not extensively interview any of the
proprietors although I did take note that the stores in particular seemed to expand
between my first and last stays (1999 to 2002) in Gyalthang.
CURRENT MEDICAL TRAINING, PRACTICE, AND CERTIFICATION

The most obvious difference in training between older, monastically trained doctors
and younger institutional doctors is the context within which Tibetan medicine is
studied and practiced. Monastically trained doctors learn that they often need to treat
not just the body but also the mind/spirit of a patient. So, in addition to prescribing
medicines to take, a monastically trained doctor might suggest certain prayers to say
or might offer a ritual blessing to a patient. They are taught that ultimately health
refers not just to the proper physiological functioning of the body but also to the
balanced functioning of the mind/spirit/psyche. They also learn that karmic actions
often play an important role in the health of an individual. Institutionally trained
doctors in the PRC (that is, non-monastically trained), on the other hand, spend the
majority of their time learning and conceptualizing about the primarily material nature
of the body and the ramifications thereof in terms of treatment. They prescribe

42 TIBET JOURNAL
medicines but not prayers. And yet, I found that there was definite conviction among
young doctors that there is more to health than just the material body. The difference
is not so much that younger doctors are strict materialists, not believing in the
concerns of metaphysical contemplation or the law of karma, but that they readily
admit that they are not trained to treat disorders connected to such matters. Ma Liming
explained to me once that if he suspects that a patient needs treatment having to deal
with the spirit/psyche (C, shen) or with karmic action (T, las), he will send him/her to
the monastery to speak with and/or receive blessings from a high monk.30
Medical training for those that attend the program in Tibetan medicine at the School
of Health in Zhongdian includes study of two topics that the older generation of
Tibetan doctors never received trained in: Western and Chinese medicines. Although
Chinese medicine is studied for only one semester (four months) during the fouryear curriculum, Western medicine is studied for a full year. I found that when I
spoke with younger doctors they would sometimes draw parallels between certain
aspects of Tibetan medicine and Western medicine or point out the ways in which the
two systems are different. Importantly, while instruction in Tibetan medicine is
completely in Tibetan, instruction in Chinese and Western medicine is in Mandarin,
which points to the linguistic divide between Tibetan and non-Tibetan medicines in
China.
A significant change in medical practice between the two generations has to do
with specializations. Pema Tenzin explained to me that during his training, he learned
all aspects of medicine (diagnosis, treatment and preparation of medicines) because
a doctor could expect to utilize skills in all of these areas throughout his career.31 He
explained that beginning in 1990 at the Tibetan Hospital a division of labor was
formed wherein doctors either diagnose (C, kanbing) or work in the mixing of
medicines (C, peifang).32 While students at the School of Health do learn all aspects
of Tibetan medicine during the course of their study, they are encouraged to pick a
specialization (either diagnosis or medicine-mixing) toward the end of the program,
in large part because this will help determine placement in a facility after graduation.
Now that facilities such as the Tibetan Hospital have administrative units that reinforce
this division of labor, doctors by default become specialists once they begin
employment in such institutions (see Table 4.1).
Table 4.1. Relationship between areas of specialization, administrative units and
number of employees per unit at the Tibetan Hospital, Gyalthang.
Specialization
diagnosis
(C, kanbing)
diagnosis
(C, kanbing)
medicine-mixing
(C, peifang)
(administrative)

Tibetan Hospital Unit

In-patient
(C, zhuyuan bu)
Out-patient
(C, menzhen bu)
Manufacturing/preparation
(C, zhiji shi)
Administration
(C, bangong shi)

Number of
employees per unit
14
4
5
10

TIBETAN MEDICINE IN GYALTHANG 43

The state system of medical certification, as Ma Liming described it to me, is a series

of progressive advances toward Directing Physician. After graduating from a certified
medical facility, such as the local School of Health, one is awarded the title of Medical
Practitioner (C, yishi). After eight years of practice and successful passing of a
standardized exam, one can then become a Qualified Doctor (C, yishi).33 After seven
more years of practice and passing another exam, one can move on to Attending
Physician (C, zhuzhi yishi). Finally, one can advance to the position of Directing
Physician (C, zhuren yishi) if one so desires.34 Ma Liming explained that the Tibetan
medical text the rGyud bzhi recognizes three levels of qualification for medical
doctors: Kachupa (dka bcu pa), Men rampa (sman rams pa), and Bum rampa (bum
rams pa), which roughly correspond to levels 1 & 2, level 3, and level 4, respectively,
in the state certification program (see table 4.2).
Table 4.2 State and canonical levels of certification/qualification for doctors of Tibetan
medicine.
State certification
(titles in Chinese)
Yishi(4)35
Yishi(1)
Zhuzhi yishi(1)
Zhuren yishi(1)

Level of qualification
in rGyud bzhi (in Tibetan)
dka bcu pa
dka bcu pa
sman rams pa
bum rams pa

Approximate English
translation
Medical Practitioner
Qualified Doctor
Attending Physician
Directing Physician

Interestingly, the division of specialization discussed above (diagnosis vs. medicinemixing) is reflected in the state system of medical certification for Chinese medicine
but not yet for Tibetan medicine, although Ma Liming explained in 2002 that such a
structure was soon to be established for Tibetan medicine as well. Thus if one has
specialized not in diagnosis but in the mixing of medicines, one can become a Qualified
Pharmacist (C, yaoshi) instead of a Qualified Physician (C, yishi). Likewise, rather
than an Attending Physician (C, zhuzhi yishi) the parallel for those specialists in
medicine-mixing is Lead Pharmacist (C, zhuguan yao). Finally, Directing Physician
(C, zhuren yishi) is replaced by the title Directing Pharmacist (C, zhuren yaoshi) in
this system of certification. I have not been able to determine if there is a causal
relationship between the bureaucratic structuring of specialization (encouraged in
medical schools and obligatory in employment) and the state system of medical
certification or if these two structures arose simultaneously. Whatever the case,
specialization does appear to be a new development in the ongoing careers of Tibetan
doctors in the PRC; it will be interesting to see how this plays out in generations to
come. Below I mention some areas in which this could have potentially volatile
ramifications.
CONSUMPTION OF TIBETAN MEDICINE BY TIBETAN HOUSEHOLDERS IN GYALTHANG

Part of my time in Gyalthang was spent interviewing common householders about

their knowledge (or perceived lack thereof) of medicinal plants (Glover, forthcoming).
I interviewed both within the town of Zhongdian and in five surrounding villages.
During these interviews, besides asking about the use of medicinal plants, I also
inquired about the utilization of prepared medicines and medical services, querying
where common Gyalthang-ers seek medical care and asking what types of medicines

44 TIBET JOURNAL
they consume. People explained to me that twenty to thirty years ago medicine was
difficult to obtain, even Tibetan medicine, which mostly came from Lhasa. Now,
people commented, prepared medicines are easy to get. You can buy them at hospitals,
pharmacies, and apothecaries in Zhongdian. Some of these medicines are locally
produced, some are from Lhasa, some from India, and some (particularly Chinese
and Western medicines) come from Kunming or other parts of China. Most
interviewees said that although medicines are more available now, they are also more
expensive. As one forty-one year old woman from Bongchating village commented,
When I was younger medicine was hard to get but cheap. Now its easy to get but
expensive.36 Additionally, interviewees commented that doctors are more prevalent
now, especially in Zhongdian. While the County Hospital was founded in the early
1950s and state-run health clinics proliferated in the 1960s, it is difficult to know
how much these institutions were accessed by local Tibetans at the time. According
to my interviews they were fairly underutilized, at least for common ailments.37 As
stated above, Tibetan medicine was not institutionalized in the area until 1979, when
the Tibetan medicine clinic was established at the Prefectural Peoples Hospital and
again later, in 1987, when the Tibetan Medicine Hospitalwhere Tibetan doctors
practice Tibetan medicinewas built.38 Some villages in the area may have had
resident village doctors, but in only one of the villages in which I interviewed had
there been such a practitioner in the past forty years. One woman noted the increased
pervasiveness of doctors and the convenience this brings: Oh its much easier to go
see a doctor now than having to treat yourself [with medicinal plants]. Furthermore,
the combination of greater availability of both medicines and doctors has generally
created improved health-care conditions, people noted. One woman from Bongchating
village stated, When I was younger, we could only get medicine from Lhasa. Now
we can go to the hospital in Zhongdian if we get very sick. Previously if you got
really sick you would just die!39
While many Gyalthang-ers said they sometimes utilize non-Tibetan medicines
(Western or Chinese), they all commented that Tibetan medicine was constant in
their choice of medicines. They also voiced a preference for Tibetan medical services.
Id rather go to the Tibetan Hospital because the doctors are really great there, one
woman commented. She added, They know what our lives are like; they are Tibetan
too. For some older women, language is an issue; many do not speak fluent Mandarin
and are concerned whether they will be able to effectively communicate with doctors.
Tibetan doctors all speak Tibetan, of course, so this is another reason to seek out a
practitioner of Tibetan medicinewhether at the Tibetan Hospital or elsewhere. Being
a Tibetan patient in Gyalthang means foremost using Tibetan medicine.40
NATURAL ENVIRONMENT & MEDICINAL TRADE IN GYALTHANG

With an average elevation of 3,000 meters (9,840 feet) enormous vertical undulations,
and a location of 27 N latitude,41 the environment in Gyalthang and the surrounding
area is an interesting mix of temperate to alpine (boreal) vegetation. Valley floors
(2,000-2,500m) are often dotted with cacti, palm trees, and eucalyptus while alpine
areas (3,500+ m) host rhododendrons, gentians, and the prized snow lotus (Saussurea
medusa), which looks a bit like a pelt when dried. Deqin County, just northwest of
Gyalthang, boasts the worlds lowest-latitudinal glacier (Minyong), a key tourist
destination in the area. Three major rivers of China and Southeast Asia (the Yangtze,
Mekong, and Salween) all pass through Gyalthang and the area directly west of

TIBETAN MEDICINE IN GYALTHANG 45

Gyalthang, separated by only a few valleys in some places. In summer the area is
greatly affected by the southwestern monsoon from the Indian Ocean; this weather
system brings warm moist air to the region and causes heavy summer rains.
Unpublished climatic data from 1958-2001 for Zhongdian42 indicate an average annual
precipitation of 635mm, nearly 75% of which (467mm) falls from June-September.43
The Tibetan Plateau protects the area from Siberian cold current in the winter and
consequently temperatures are relatively mild in winters, particularly given the
elevations (Chang 1983). In Zhongdian, the mean temperature in January is3.31C
(26F), with highs reaching an average of 6.28C (43F) and lows averaging10.7C
(13F). These conditions make ideal growing environments for a wide range of
vegetation types, thus the area is touted as one of immense biological diversity.44
Many of the medicinal herbs used for both Chinese and Tibetan medicines come
from this part of Yunnan; this is undoubtedly a result of the wide range in biodiversity.
It is estimated that approximately 6,000 plant species exist in the northwestern corner
of Yunnan and that 40% of plants used in Chinese medicine and close to 75% of
plants used in Tibetan medicine come from this area. Gyalthang and Dechen are well
known for the existence of the intriguing caterpillar fungus (Cordyceps sinensis) so
prized in Chinese medicine, although used only occasionally in traditional Tibetan
medicine.45 In addition, important plants (for both systems of medicine) such as
Aconitum, Gentian, Saussurea and some Meconopsis are available only in this area.
From a medical point of view, the variety of growing conditions produces a variety
of healing potencies in plants. The Menri (sMan ri: Medicine Mountain) Range,
which borders the prefecture and the Tibetan Autonomous Region (TAR), as well as
Pema (Pad ma: Lotus) Mountain are cherished areas for the collection of medicinal
plants by Tibetan doctors; the plants gathered in these areas of high altitude have
great potency (nus pa), particularly for disorders with hot characteristics. Even in
the popular imagination plants from this area have great potential. In 2001, I
interviewed a young Chinese man from Kunming who says that he comes to Zhongdian
specifically to buy herbs for his ailing grandparents. Although many of these same
plants can be purchased in Kunming, this man expressed his belief that the ones
purchased in Zhongdian are more potent and fresh. There are many small herb shops
in Zhongdian, many of which specialize in caterpillar fungus; additionally, there are
street vendors that sell a mix of medicinal plants and animal parts. Recently there
appears to be substantial over-harvesting of some plants, a majority of which end up
in the Chinese market, and this has become an increasing area of concern for
conservation efforts.46
While it is difficult to obtain reliable information on the extent of the historical
plant trade in this area, we can speculate that it was quite pervasive. We do know that
at least one branch of the ancient tea trade route went through Gyalthang: tea (along
with silk, cotton goods, and brocades) from China was traded for wool, hides, musk
and deer horn from inner Tibet. Given that a fair amount (my rough estimate is onequarter to one-third) of plants used in Tibetan medicine grow in tropical regions and
possibly up to three-quarters of Tibetan medical plants grow in the Gyalthang and
Dechen areas, there had to have been a substantial commerce in plants between this
area and those to the north and south. Trade still exists, of course, although I did not
ask extensively about this when I was in the field and have not been able to find any
published literature on the topic. I do know that the Tibetan Hospital does purchase
medicinal plants from India and southern Yunnan; I am just not sure how much. In

46 TIBET JOURNAL
fact, in the medicinal plant storerooms at the Tibetan Hospital in Gyalthang, dried
plant materials are organized according to their place of origin: one room is for local
plants (collected in the Gyalthang and Dechen areas) while the other is for plants that
come from elsewhere (mainly India and Yunnan).47 To the best of my recollection,
the storeroom with plants from elsewhere seemed at least three-quarters as full as the
room with local plants, although this is certainly not a reliable way to measure annual
imports. I have even less information about medicinal plant exports, either in raw or
prepared form, since my research was not focused on this. Given that Yunnans plans
for economic development include bolstering environmental tourism and the medicinal
plant trade (Time International 2000), we can expect that the flow of medicinal plants
to and from this region will only increase in the years to come.
MEDICINES IN PRODUCTION

There was an interesting transformation in the local medicine factory during the
course of my research in Gyalthang that highlights in many ways the complexities of
power and identity politics in the local production of medicinals. When I first arrived
in 1999, the Tibetan medicine factory was administered under the auspices of the
Tibetan Hospital. I was given a tour of the medicine factory (the hygienic nature of
the venue and the shiny new equipment were especially highlighted) as well as of the
storage rooms where plant materials were kept until processing. Physically located
on the hospital premises, the medicine factory was an integral part of the hospital.
When I had returned to Zhongdian in 2001 much had changed: all of the stores of
medicinals that were at the Tibetan Hospital had been bought by a businessman from
Kunming who now owned a separate medicine factory (to be renamed the Diqing
Shangrila Tibetan Medicine Company in 2002). Doctors at the Tibetan Hospital
explained to me that they had no choice but to sell to this businessman. As I understand
it, the man who was head of the medicine factory while it was under the Tibetan
Hospital remained head under the new ownership and persuaded the doctors to sell
their stock.48 There seemed to exist a certain amount of animosity between the Tibetan
Hospital, at least as represented by the doctors, and the new medicine factory/company.
As one doctor stated, We care about treating patients; they [the owners of the factory]
only care about making money. Theyre businessmen.
By the time of my return in early spring 2002, the Tibetan Hospital had replenished
its stock of medicinals and was again making medicines. Most of the medicines
prescribed by doctors at the hospital can be purchased at the hospital dispensary,
located on the first floor of the main building in the hospital complex. By late summer
2002 the hospital had also established its own pharmacy adjacent to the hospital that
was open to the public. The doctors seemed to express a small amount of pride at this
new, modest pharmacy, which stands in great contrast to the opulence of the Tibetan
Medicine Company only 300 yards or so down the road. Medicines from the hospital
pharmacy appear to be aimed only at local consumption, while those at the Medicine
Company are accompanied by slick brochures in Chinese and reportedly have a wider
circulation than the Gyalthang area. To the best of my knowledge, plant resources
from both the Company and the hospital come from similar areas (Gyalthang, Dechen,
Chamdo, southern Yunnan, India). During 2002 the Hospital installed a new statue
of Yuthog Yonten Gonpo (g.Yu thog Yon tan mgon po), an important historical figure
in the development of Tibetan Medicine, in its small courtyarda symbolic
representation of the connection to a long lineage of medicine.

TIBETAN MEDICINE IN GYALTHANG 47

During the course of my fieldwork I did not interview anyone at the Tibetan
Medicine Company (although I did interview Wang Yongshen, who would become
one of the head administrators of the Medicine Company, in 1999 at the Tibetan
Hospital). In part the Company became off-limits for me due to my indirect
involvement with The Nature Conservancy. In 2001 I was invited by Dr. Jan Salick
of the Missouri Botanical Garden to participate in a research trip to the Khawakarpo
Mountain area, northeast of Gyalthang. Dr. Salicks research is on sustainable
harvesting practices in the sMan ri (Medicine Mountain) area and is contract work
for The Nature Conservancy. We made arrangements to meet in Dechen; I was to
drive from Zhongdian to Dechen with one of the doctors from the Tibetan Hospital,
who had also been invited along. When the doctor appeared at my hotel on the morning
of our departure, he was accompanied by three other menfrom the medicine
company. Although I suspected that there could be a potential conflict of interest
(explained below) I did not feel that it was my place to resolve these issues and so we
proceeded to Dechen. After our arrival in Dechen we participated in a very
uncomfortable dinner where the company employees and the doctor were told that
they could not come with us to the village. Since the doctor had actually been the
only one invited initially, he explained that he was told by his boss that he had to
bring these fellows along. He did not explain why his boss made such a demand but
it became clear that The Nature Conservancys interest in conservation and the
presumed commercial interest of the medicine company in finding new hunting
grounds for plant collection were at odds. I asked that we please allow the doctor to
come along, since we invited him and he made the long journey there; I also had little
suspicion in my mind about the doctors general interest and was hoping he could
help me identify plants. We did invite him, but he declined and said that he should
stay with the other men, since they were in part his responsibility given by his
higher-up. I understood his position, but I was terribly worried that a major faux pas
had been committed. I was not so much concerned about the company workers, but
I was concerned about the doctor and worried that an important relationship had
been destroyed before it had barely begun. In the end, the doctor ended up being an
important consultant and a good friend while the company refused to let me and
another researcher from the Missouri Botanical Garden into their factory on several
occasions. The people in the village to which we traveled thanked us for not bringing
the men from the medicine company along; the villagers were equally suspicious of
the intentions of this company.49
The production of medicines in Gyalthang points to two important phenomena.
First, this is not an obvious case of ethnic identity politics at work in criticizing the
production of medicinals since many of the workers at the company, and indeed the
head of production, are Tibetan. The criticism levied at the company by the doctors
does not appear to be ethnic in natureit is more a discourse about ethics and
motivations (doctors help people, businessmen make money). In many ways, it appears
to be a commentary on the emerging market economy. And yet, no one (doctors and
lay people alike) ever seems to forget the fact that the owner of the medicine company
is non-local, and therefore non-Tibetan; this point was continually reiterated to me.
What local could afford to undertake such a venture, some wondered. Given that few
of Chinas emerging nouveaux riches, or those capable of such capital investment,
are Tibetans, the apparently non-ethnic, and possibly class-based, nature of this
discourse could easily become ethnic in focus. Indeed, many of the commentaries

48 TIBET JOURNAL
about ethics (doctors as altruistic, businessmen as selfish) seem to parallel ethnic
stereotypes (Tibetans as willing to help others, Chinese as out for themselves).50
Secondly, this points to the significance of the changes brought on by the new
institutionalized division of labor in Tibetan medicine. There are new possibilities as
to how this division will play out with the opening of a market economy not only
dependent upon an increasingly product-oriented consumer body such as the Chinese
public51 but also upon capital investment. While this division of labor does not appear
to be the foremost concern of doctors criticizing the company (indeed, one of the
most vocal critics was a doctor that himself specializes in knowledge of medicine
manufacturing) the fact that one can own the means of production of medicine, much
more easily at present than one can own the production of medical services, could
create new issues in this division of labor, particularly with the added variability of
ethnicity.52
CONCLUSION

Insomuch as a Tibetan ethnic revival continues in Gyalthang, Tibetan medicine will

undoubtedly become even more of a symbol of Tibetan ethnicity, both for practitioners
and consumers and in the larger context of ethnic medicines in China. Yet the
nationalistic rhetoric of Tibetan medicine as a great treasure of the motherland may
always outweigh any symbolic strength otherwise gained. The specialization of training
in Tibetan medicine may take on new meaning in terms of career choice and
collegiality. It will be interesting to see if more non-native Tibetan speakers in the
PRC will begin training in Tibetan medicine in the near future and, if so, what sorts
of changes their involvement might bring to the profession. Ownership of the
production of Tibetan medicines will undoubtedly continue to be an area in which
contending views will be voiced and identity politics enacted. Intellectual property
rights may become increasingly drawn upon in the struggle for contestation over
knowledge appropriation, particularly in the commercialization of prepared Tibetan
medicines.53 And the struggle over natural resource extraction will no doubt escalate
as continued harvesting increases and population density builds. The doctors of
Tibetan medicine in Gyalthang with whom I studied will hopefully continue to practice
medicine as long as is feasibly possible for each of them and will continue to train
new students of Tibetan medicine in the years to come. There is no doubt that they
will continue to make an important difference in the lives of many Gyalthang Tibetans
and at least one foreign anthropologist.
Acknowledgements
I would like to thank the Kunming Institute of Botany in Yunnan for being my official host
and ally in making necessary arrangements during the course of my research in Gyalthang.
Research funding was provided in large part by the Fulbright Program; additional funding
was made possible by the Department of Anthropology and the Jackson School of International
Studies at the University of Washington. Thanks to Stevan Harrell for comments on portions
of this paper and to Larry Epstein for his endless encyclopedic knowledge. I extent an enormous
heartfelt thanks to the doctors mentioned herein for their patience with me and to the people
in Gyalthang who kindly agreed to interviews. Alas, any errors are my own.

A Note on Language Usage

Throughout this article I use both Tibetan and Chinese names and words, relying on the
Wylie system of transliteration (minus the periods in between syllables) for Tibetan and

TIBETAN MEDICINE IN GYALTHANG 49

pinyin romanization (minus tone marks) for Chinese. I purposefully use Chinese names for
political units (county, prefecture, province, nation) to highlight their creation under the
modern Chinese state. I use Tibetan names for cultural and historic areas as well as local
place names used by Tibetan inhabitants. Thus Zhongdian is used to refer to the county and/
or the county seat (although see footnote #1 about the recent county name change) while
Gyalthang is used to refer to the cultural area of this study. (Similarly, I use Deqin (C) to refer
to the county next to Zhongdian but Dechen (T) to refer to the cultural area.) Place names
and proper names are not italicized in either case, although all other terms are. When not
clear from context, I indicate C or T for Chinese or Tibetan, respectively, directly before or
after a given name or word. When available I indicate full Tibetan spellings; it should be
noted that I could not obtain reliable spellings for several villages in which I interviewed
(most of the population in the Gyalthang area is not literate in Tibetan) and have therefore
relied on approximate transliterations of local pronunciations.

Notes
1. Zhongdian County (Zhongdian Xian) was officially renamed Shangrila County
(Xianggelila Xian) in May 2002.
2. The scholar/abbot in exile Geshe Tenpa Gyaltsen (full name: Lha mkhar Yongs dzin
Geshe bsTan pa rgyal mtshan) wrote in 1985 that Gyalthang consists of five rdzong (an
administrative unit where the district magistrate was headquartered; a county, Chinese
xian, can correspond roughly to a former rdzong): Gyalthang yul lte ba (central, literally
navel Gyalthang), gTer ma rong (present-day Dongwang), Yangthang (Chinese Xiao
Zhongdian), Jang (the area north of Shigu, near the first major bend in the Yangtze), and
Rong pa (present-day Nyi shar area). Geshe Tenpa Gyaltsens explanation of a greater
Gyalthang area centered on a core, navel town of Gyalthang (what I refer to as Zhongdian)
is one that is corroborated by many Tibetans in the area today. I thank Wang Xiaosong of
the Diqing Institute of Tibetan Studies in Zhongdian for helping me make sense of the
relation between textual place names and those on current Chinese maps.
3. The distinction between Chinese yi and yao is essentially that yi generally refers to the
practice of medicine while yao refers to the material of medicine education,
pharmaceuticals, medicinals). Often the two terms are combined.
4. Throughout this article, I have chosen to translate Chinese minzu as ethnic group rather
than the more legalistic term of nationality. This is because ethnic group (along with
correlatives ethnic and ethnicity) is much more effective in conveying the connotative
meanings of minzu.
5. It is significant that even when speaking Tibetan many Gyalthang Tibetans use Mandarin
zhong yi/yao (Chinese medicine) and xi yi/yao (Western medicine) rather than the Tibetan
rgya sman and nub phyogs pai sman (or sometimes phyi gling pai sman), respectively.
In contrast, the Tibetan bod sman (Tibetan medicine)is more often used than Mandarin
zang yi/yao.
6. The term traditional medicine (chuantong yiyao) is often used inter-changeably with
ethnic medicine (minzu yiyao), especially for medical systems other than Chinese
medicine.
7. The more complete translation for yiyao is medicine and pharmacology although
throughout I often shorten this to the all-inclusive English lay term of medicine for the
sake of simplicity. See footnote 3.
8. In using the term non-Chinese medical traditions I simply mean traditions other than
Chinese medicine, usually referred to in the West as Traditional Chinese Medicine (TCM).
9. A local market nearby my house that I like to frequent and which caters mostly to the
immigrant population of the city in which I live has enacted a creative reversal of this
trend: the ethnic foods at this market (located in a separate part of the store and labeled
ethnic foods) are cheeses, sausages, steaks, hot dogs, potato chips, etc. The foods that
would be classified as ethnic in a large chain super-market, along with fruit and vegetables,

50 TIBET JOURNAL
constitute the bulk of the merchandise in this market. The hegemony of using ethnic to
mean non-Anglo may indeed be gradually changing in the US and certainly varies from
community to community.
10. We cannot expect, of course, that the average exhibition viewer could have read Tibetan
script, for example. Some of the medical traditions do not actually have their own script
(although I do not recall if any of these were displayed in the exhibit). But the fact that no
phonetic approximations were offered again signals the filtering through the Chinese
medical system (and Han Chinese culture at large), which utilizes many of these same
plants.
11. Other exhibits in the Expo included those of the nation (an exhibit for each of Chinas
provinces and autonomous regions) and of the world (exhibits for a variety of nations,
from Switzerland to Sudan).
12. See Janes (1995) for a brief discussion of classifying Tibetan medicine under the rubric
of Chinese traditional medicines in documents issued by the central government.
13. The Chinese medical classic The Yellow Emperors Book of Internal Medicine (Huangdi
Neijing) is sometimes cited as dating back as far as 2500 BC (the supposed time in which
the Yellow Emperor lived); this is about one thousand years before written Chinese
language (in the form of oracle bone writing) began. Most scholars agree that the more
likely date for this text is sometime during the Han Dynasty (206 BC-220 AD).
14. See Adams (2001) for a discussion of how practices considered scientific (read: apolitical)
in Tibetan medicine in the TAR are acceptable while those considered religious (i.e.,
political) are not. Although religious and political expression in Yunnan does not seem as
aggressively repressed as in the TAR, Adams point is worth considering for any national
discourse on Tibetan medicine.
15. Throughout I use the normative male title of monk even though there have always been
a small percentage of clerics in Tibetan culture who were female.
16. Not all village doctors are non-literate, but many are.
17. A move in this direction was begun during the reign of the 13th Dalai Lama, in the early
20th Century, with the establishment in 1916 of the Mentsikhang (Medical and Astrological
Institute) in Lhasa and the Dalai Lamas interest in increasing secularization of the medical
profession.
18. To the best of my knowledge, however, most basic monastic education still does have a
component of medical study.
19. Below I present two other doctors in the Gyalthang area that were of the family-trained,
non-literate ilk of doctors but with whom I did not study (I discuss why). Although my
research was with institutional doctors, this does not imply that these are the only doctors
present in Gyalthang. At the same time, based on interviews I conducted among common
householders in 2001 and 2002, I would argue that institutional doctors occupy a dominant
position in providing health care to Tibetans in Gyalthang.
20. This is not the case elsewhere (the US, Europe, India) where Tibetan medicine is being
taught to non-Tibetans.
21. Exceptions include Pema Tenzin, who opened his own private clinic in his home in 2000
but who previously worked for both the Prefectural and Tibetan Hospitals, and Shiang
Rinpoche, who used to see patients at his home in addition to the Prefectural and Tibetan
Hospitals (although he was never an employee of either hospital as far as I could ascertain).
22. There were two other hospitals in town during the tenure of my field work, the Army
Hospital and the privately owned Shangrila Liver, Gallbladder, and Urology Hospital (C,
Xianggelila Gandan Miniao Zhuanke Yiyuan). Neither of these hospitals employed
practitioners of Tibetan medicine, however.
23. The County School of Health Hospital (Zhongdian Xian Weisheng Yuan) officially became
the County Peoples Hospital (Zhongdian Xian Renmin Yiyuan) in 1956.
24. Although Dongwang may appear to be strictly a Chinese name for the area, linguist Ellen
Bartee (who has conducted extensive linguistic research in Dongwang) explained to me

TIBETAN MEDICINE IN GYALTHANG 51

that the pronunciation of gTer ma in the local Dongwang dialect sounds phonetically like
dong wang. She explained that Tibetan ma as a second syllable in this dialect is often
pronounced wang or wong and the e vowel (as in gter) is often pronounced as a backrounded vowel. So most likely Chinese Dongwang is actually derived from the local
pronunciation of gTer ma.
25. While interviewing in Ninong village in the Dechen area in 2001, I met a doctor (Ngawang
Chpel) who knew Pema Tenzin from the time when the Tibetan Hospital first opened;
the two were doctors on staff together. He explained that the hospital was overrun with
patients at first and that they could not make enough medicine to keep up with the demand;
they would have to close the hospital for a week at a time to mix enough medicines for
patients and then reopen.
26. It is important that plants are properly prepared. Plants that are cooling should never be
dried in the sun but always in the shade, while those with heating characteristics should
be dried only in the sun.
27. All of the doctors who I interviewed were male. Although there were several female
doctors at the Tibetan Hospital during the time I was in Zhongdian, none of them were
specialists in plants and/or pharmacology. I do hope that further research in the Gyalthang
area will allow me to come into contact with some of these female Tibetan doctors since
it would be interesting to know more about their training and areas of specialization and
to examine their interactions with me as a comparison.
28. The combination of the Tibetan letter ba with subscript ya in Gyalthang dialect is
approximately pronounced as . Throughout I simply write sh for .
29. In particular, Kelsang is fluent in English and has an international savvy (undoubtedly
from living in India) that is valuable in the booming tourist industry of northern Yunnan.
30. One of the signs of having an illness at least partially caused by karma is not responding
effectively to medicines, Ma Liming explained. It is somewhat easier to spot a problem
with mind/spirit/psyche, Ma Liming said, because usually the person will act erratically
and is often clearly psychologically unstable.
31. Additionally, according to the classic medical text the rGyud bzhi, the training of a doctor
involves all of these aspects of medicine. In Part I of the rGyud bzhi, medicine is described
in terms of the analogy of a tree; two of the three roots of this tree are diagnosis (ngos
dzin rtags) and treatment (gso byed thabs). The preparation of medicine is described as
one of the eleven principles to be learned by the student of Tibetan medicine.
32. The amount of doctors working in diagnosis is much greater than that of those making
medicines at the Tibetan Hospital. During my tenure in Gyalthang, there were five doctors
that worked in medicine preparation while there were eighteen doctors total working in
diagnosis (see figure 4.1).
33. Although the romanized spellings for medical practitioner (yishi) and qualified doctor
(yishi) are identical, the characters (and tones) for shi are different. The character shi in
medical practitioner translates roughly as scholar while that of qualified doctor means
master. Yi in both cases refers to the practice of medicine.
34. Unfortunately, I am unable to recall (and it is not clear in my notes) if there is also a time
factor (practicing for a certain number of years) and an exam to pass before qualifying for
Directing Physician. I suspect that there is not (since I did not note that there is) but
cannot say so for certain.
35. I have indicated tones of Chinese shi with numbers in parentheses after each title. See
footnote 19 for an explanation.
36. Only one interviewee mentioned that medicines are actually cheaper now than they were
before. However, this man had an above-average income as a private driver; his remarks
undoubtedly reflect his economic standing and are not representative of the sentiment of
most Gyalthang farmers.

52 TIBET JOURNAL
37. It should be noted that the local monastery in Zhongdian, Sumtsenling, does not appear
to have a significant history of providing medicines or medical services to the local
community.
38. My conjecture is that Gyalthang Tibetans first became exposed to professional doctors
through the Tibetan clinic at the Prefectural Hospital and later the Tibetan Hospital. More
than several times people told me how incredibly busy the doctors were the first few
years after the Tibetan clinic openedpatients would wait in line for hours to see a Tibetan
doctor. One of the two doctors involved with establishing the clinic in fact told me that
they could not make enough medicine to keep up with the demand for the first two years
and were often overwhelmed, having to turn patients away. I suspect that local Tibetans
were interested in the Tibetan medicine clinic in part because the doctors were Tibetan
themselves.
39. And yet this health care is becoming increasingly more difficult to access for those without
money. Although doctors visits at local hospitals are free, patients have to pay out of
pocket for most medicines. There are a number of independent practitioners in Zhongdian
who charge rather reasonable ratesin many cases they even treat patients for free. Most
of these independent practices operate less as commodity-based businesses and more as
charities, accepting whatever bit of money or other offerings (usually food) patients
give, rather than having set rates for treatment.
40. I discovered another interesting link to ethnic identity during these interviews: householder
self-perception of knowledge of medicinal plants was quantified in relation to other ethnic
groups. One man in Yangthang village highlighted what he saw as an important difference
in ethnic knowledge bases: Han, Yi, and Naxi know how to use plants and harvest them
in the high mountains. Most local Tibetans dont know much. There was one Tibetan guy
about sixteen years ago who knew about plants but he didnt teach anyone and now hes
dead. Two other interviewees mentioned that village remedies came from non-Tibetan
families: one Naxi, one Lisu. Thus on the level of assessing their own knowledge base of
medicinal plants, Gyalthang Tibetans often compare themselves with other ethnic groups
and find their own knowledge lacking. See Glover, forthcoming (2005).
41. As a reference, Houston and Cairo are at about the same latitude.
42. This data was graciously supplied to me by the Yunnan Meteorology Center via Xu Jianchu.
43. For comparison, the greater Seattle area, with a reputation as being one of the rainiest
parts of the United States, receives an approximate 1000mm, although the majority of
this rain is during the winter months. I have often joked about not seeing the sun in years
while doing fieldwork: living in Seattle during the rainy season (winter) and Gyalthang
during the rainy season (summer).
44. The high density of biodiversity has made the area of particular interest to both domestic
and international researchers. While The Nature Conservancy has been conducting research
within the past several years on biodiversity and conservation in the area (mostly in Deqin
County), local biological/biodiversity research in northwest Yunnan, conducted by The
Center for Biodiversity and Indigenous Knowledge (an NGO established in 1995) as well
as the Kunming Institute of Botany, has been continuous for over the past decade.
45. The collection of caterpillar fungus has become a recent side business for many locals
who can sell the fungus for a high price. As of summer 2004, the going rate for one
caterpillar fungus in the Gyalthang area was 8-10 yuan (US$.90-1.20) per piece (Daniel
Winkler, personal communication). See Boesi (2003) for an important discussion of
caterpillar fungus. Even more lucrative, of course, is the matsutake (songrong) mushroom
market, where mushrooms are harvested in Gyalthang and hurriedly shipped to Japan and
Korea where they fetch a high price.
46. In many cases, local Tibetans themselves participate in the depletion of resourcesdue
undoubtedly to the market incentives involved. In an interview in Nyi shar (C, Nixi)
village in May 2002, an old monk told me that there are a number of medicinal plants that
villagers harvest to sell, many of which they themselves do not know how to use, and that

TIBETAN MEDICINE IN GYALTHANG 53

this harvesting is depleting some local plant populations. The monk insisted that local
villagers are selling them to the Chinese market, although I could not get confirmation of
this. At the same time, non-locals (Chinese, Tibetans, possibly Naxi) are supposedly
participating in similar resource depletion. During an interview in the Khawakarpo (Kha
ba dkar po) Mountain area with a local village doctor in July 2001, I was told that
outsidersmostly non-Tibetanshave tried to come to the area to harvest gentians for
non-local use.
47. It is interesting to consider the classification that is being enacted in the storerooms.
Yonten Gyatso, a Tibetan doctor in the States (trained in India) with whom I have had a
correspondence for several years once said that one can classify plants according to those
that are native (yul sman) and those that come to Tibet from across the mountains
places like India and China (la sman). Yonten was careful to say that although la sman
would appear to mean medicine from the mountains, this is not actually the case. When I
asked Ma Liming about this kind of classification, he said that la sman means medicine
that grows in the mountains while yul sman means those that grow very locally, in and
around villages (he said that yul in this case corresponds to Chinese cun or village).
But it was not a common way of classifying, Dr. Ma stated. It is interesting that these two
doctors should have such different interpretations of the same terms, especially la sman.
I attribute such differences to each doctors geographic orientation and location of training.
However, Yonten Gyatsos explanation of these terms seems to describe quite effectively
the actual layout of the medicinal plant storerooms at the Tibetan Hospital in Gyalthang.
48. I am not clear exactly who had the last say in all of this. Undoubtedly this is the product
of administrative negotiations and the doctors themselves could have had very little say
over the fate of these materials.
49. The villagers told us during this trip how on a number of occasions there had been outsiders
(Chinese from Kunming and also Tibetans from Chamdo) coming into their village trying
to collect medicinal plants. This village is in the sMan ri (Medicine Mountain) rangea
range that has plants of exceptional potency from the perspective of Tibetan medicine, as
stated above.
50. One doctor told me his opinion about the difference between Tibetans and Chinese: a
Tibetan will give money to a beggar in the street, while a Chinese will not only not give
money but will kick the beggar and tell him he is in the way!
51. Tibetan medicine is apparently being marketed in China in recent years as having successful
miracle cures for heart conditions, impotence, hair loss, cancer, etc. Even the SARS
outbreak in 2002 spurred on increased advertising for a prepared Tibetan medicine (ril bu
dgu nag) which supposedly was effective in preventing SARS (WTN May 7, 2003).
52. It would be interesting to do a comparative study of the privatization of hospitals. The
recently opened Shangrila Liver, Gallbladder, and Urology Hospital (Xianggelila Gandan
Miniao Zhuanke Yiyuan) is reportedly financed by a Hong Kong businessman.
53. Although intellectual property rights do not appear to figure much in the current discourse
of medicine (Tibetan or other) in China, I suspect that especially with the increasing
presence of various NGOs in the country, particularly in the Southwest, there may be an
augmented currency in their usage.

References cited
Adams, Vincanne. 2001. The sacred in the scientific: ambiguous practices of science in
Tibetan medicine. Cultural Anthropology 16(4), 542-75.
Boesi, Alessandro. 2003. dByar rtswa dgun bu (Cordyceps sinesis Berk): An important
trade item for the Tibetan population of Li thang County, Sichuan Province, China. Tibet
Journal 28(3): 29-39.
Chang, David H.S. 1983. The Tibetan Plateau in relation to the vegetation of China. Annals
of the Missouri Botanical Garden 70:564-570.

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Glover, Denise M. 2005. Up From the Roots: Contextualizing Medicinal Plant
Classifications of Tibetan Doctors in Rgyal thang, PRC. PhD Dissertation, University of
Washington.
Glover, Denise M. Forthcoming (2005). The Land of Milk and Barley: Medicinal Plants,
Staple Foods, and Discourses of Subjectivity in Rgyalthang. In Schrempf, Mona (ed.)
Soundings in Tibetan Medicine: Historical and Anthropological Perspectives. Proceedings
of the 10th Seminar of the International Association of Tibetan Studies (PIATS), Oxford Sept
6-12, 2003. Leiden: Brill Publishers.
Janes, Craig R. 1995. The transformations of Tibetan medicine. Medical Anthropology
Quarterly 9(1), 6-39.
Lha mkhar Yongs dzin Geshe bsTan pa rgyal mtshan. 1985. rGyal thang yul lung dgon
gnas dang bcas pai byung ba mdo tsam brjod pa blo gsal mgul pa mdzes pai rgyan (A
History of the rGyalthang dGon pa Monastic Complex and Its Environs) Dharamsala: Tibetan
Library.
Qi, Ling and Luo Dashang (eds.) 2000. Zhongguo shaoshu minzu chuantong yiyao daxi
(Collection of Traditional Minority Medicines of China). Chifeng: Science and Technology
Publishing House of Inner Mongolia.
Time International, August 21, 2000. Natures Remedy: A backward province steers its
economy from drugs to a clean, green source of income. 156 (7/8):70.
World Tibet Network News. <www.tibet.ca/en/wtnarchive/2003/5/7_2.html> Tibetan
medicines in demand to keep SARS at bay.

Hybrid Methodologies in the Lhasa Mentsikhang: A

Summary of Resources for Teaching about Tibetan
Medicine
Frances Garrett
A number of studies have been published in the last decade documenting the
practice of Tibetan medicine in Tibetan regions of the Peoples Republic of
China. Many of these articles have focused on the effects of modernization
on the practice of medicine in the Mentsikhang in Lhasa. The present article
announces the presence of new multimedia resources for the study of Tibetan
medicine, based on a series of videos shot in the Lhasa Mentsikhang. These
resources, freely available online, used along with the growing list of scholarly
publications by ethnographers who have worked in Lhasa, greatly enhance
the richness of materials available for teaching about Tibetan medicine in the
university classroom.
TIBETAN MEDICINE IN THE TIBETAN AND HIMALAYAN DIGITAL LIBRARY

The Tibetan and Himalayan Digital Library (THDL) was founded in 2000
under the auspices of the University of Virginia Library and the University of
Virginias Institute for Advanced Technology in the Humanities. It is an
integrated environment for the digital publication of projects developed by
scholars and institutions around the world. Although supported and published
by THDL, individual projects are run by independent administrations that
are decentralized and autonomous. THDL holdings are organized under five
domains: community, reference, collections, tools and education.
Current resources on Tibetan medicine are devoted to three main themes:
Clinical Practice, Therapeutics and Pharmacy, and History and Culture.
Developed in collaboration with the Tibetan Academy of Social Sciences,
the Lhasa Hospital of Tibetan Medicine (Mentsikhang) and the University of
Virginias NIH-funded Center for the Study of Complementary and Alternative
Therapies, this project was begun by Frances Garrett in Lhasa during the
summer of 2001 with the collection of over 25 hours of video (see Table 1)
and several hundred photographs and other forms of documentation on the
contemporary practice of Tibetan medicine. These videos are now being
transcribed and translated by Mentsikhang doctors and medical students in
Lhasa; draft transcriptions and translations are made available online at THDL
as they are processed. The THDL collections on Tibetan medicine currently
contain only materials on Tibetan medicine as practiced in Lhasa. The Library
hopes to expand these resources to encompass medical theories and practices
of the entire Himalayan region as individual or institutional collaborators
willing to develop these resources are identified. Development priorities
presently fall under the following rubrics: clinical practice observations,
traditional pharmacology, history of medicine, and the relationship between
medicine and culture. The development of Tibetan language digital text

56 TIBET JOURNAL
collections and lexical and bibliographic resources over the next several years
is also anticipated.
DISCUSSIONS OF THE TREATMENT OF GASTROINTESTINAL DISORDERS AT THE LHASA
MENTSIKHANG

The official attitude toward Tibetan medicine in the PRC has fluctuated greatly
since the 1950s, and many of these changes are seen reflected in the microcosm
of Tibetan medicine in the Lhasa Mentsikhang. Tibetan medicine was officially
admitted into the PRC public health system in 1962, was declared illegitimate in
1978, and was again accepted by the health bureaucracy in the mid-1980s.1 Craig
Janes 1995 article, The Transformations of Tibetan Medicine, outlines the
ways in which shifts in government policy resulted in significant theoretical,
institutional, and clinical transformations in Tibetan medicine within the PRC.1
The administrative organization of the Lhasa Mentsikhang was one of these
changes. Janes notes, for example, that the hospital was organized into specialized
departments, such as the Department of Liver Disorders, the Department of
Gastro-intestinal Disorders, and so on, and that doctors began wearing white
coats to appear more modern and scientific.2 Janes explains that from the 1970s
onwards, the director of the Mentsikhang was charged with the task of
transforming Lhasas Tibetan medical institution according to three principles:
First, to create an institution that paralleled, symbolically and in terms of the
organization of care, the biomedical institutions then present in Lhasa; second, to
increase utilization rates in order to demonstrate the popular demand for services;
and third, to de-emphasize those elements of Tibetan medicine that the government
found objectionable, particularly the use of religious concepts and the problematizing
of the mind or self in diagnosis and treatment.3

In his research, Janes demonstrates the process by which interaction with the
PRC health bureaucracy altered the face of Tibetan medicine in the 20th century,
but he notes also that post-1980 reforms to social policy in the TAR led to a
revitalization of Tibetan medicine, allowing it a somewhat more conceptual and
epistemological autonomy than other Asian medical systems.4
Much of what Janes outlines is seen reflected in the THDL videos with
Mentsikhang doctors, making these videos a vivid classroom complement to the
study of Janes research. In the three-part THDL video series on Gastrointestinal
Disorders,5 Dr. Lobsang Norbu introduces the Mentsikhangs Department of GI
Disorders. In 1984, he explains, the department was affiliated with the Department
of Clinical Research and was responsible for conducting various clinical trials
on GI disorders, for which it received an award from the Ministry of Health. In
1987 it joined the Department of Internal Medicine (khog nad sde khag) and
fourteen doctors supported the inpatient treatment of over ninety patients a year.
In 1996, the Gastrointestinal Disorders Department (pho rgyu sde khag) was
formed as one of four specialization units, with twenty doctors and over forty
hospital beds. Of these twenty doctors, one possesses the Bumrampa (bum ram
pa) degree, four the Rabjampa (rab byams pa) degree, seven the Duraba (bsdus
ra ba) degree, and eight serve as professors of medicine. Lobsang Norbu says
that these doctors now treat nearly 400 patients a year. Disorders treated include

HYBRID METHODOLOGIES IN THE LHASA

57

atrophic gastritis (pho rub), chronic gastric ulcers (pho ba smug po) and others,
and Lobsang Norbu reports a 96% recovery rate.
In this video series, Dr. Lobsang Norbu explains that the Four Tantras and
other ancient Tibetan medical texts divide atrophic gastritis (pho rub) into three
progressive stages: the stage in which the disease is generated from ordinary
phlegm (bad kan), a more serious stage in which the disease is generated from
phlegm from the digestive system (bad kan lcags dregs), and a very serious third
stage in which tumors (skran) may develop.6 These tumors, he comments, develop
as a result of untreated open wounds in the stomach or intestines, but Tibetan
treatments can successfully prevent the progression of the disease to its more
serious stages. The three stages of gastritis have three different treatment
protocols. For a patient in the first stage of the disease, Tibetan doctors prescribe
medicinal compounds such as gtsho bkru zla shel,7 grub thob ril dkar,8 smug po
gyul rgyal,9 and others. Additional compounds aimed at stopping hemorrhage
are added in later stages of the disease, and in the early stages of gastric tumor
development, medicines such as rin chen grang sbyor 10 and se bru 25 11 are
recommended. Combinations of medicinal treatments are customized according
to a patients particular set of symptoms. Lobsang Norbu explains that a very
advanced case of gastrointestinal tumor resulting from untreated gastritis (pho
rub) may be incurable and is likely to be fatal. Early detection and successful
treatment of the early stages of the disease is therefore essential.
The occurrence and treatment of GI disorders in Tibetan regions has been
studied by numerous medical researchers from around the world, and Tibetan
Mentsikhang researchers, some of whom were educated in medical institutions
in the Peoples Republic of China located outside the Tibetan Autonomous Region,
and are active participants in the lively scientific community of the PRC.12 Janes
situates this emphasis on the importance of scientific research as part of the
generalized acceptance of the cultural authority of science in urban Tibetan
medical communities today.13 Vincanne Adams research also highlights the selfconscious effort by medical practitioners to modernize Tibetan medicine,
defining modernization as establishing the scientific legitimacy of the traditional
system.14 Although Janes states that in 1993 Mentsikhang research activity was
low or nonexistent, in the Department of GI Disorders THDL video series
Lobsang Norbu asserts that physicians in the GI Disorders Department today are
involved in various research projects. He cites a research study on atrophic
gastritis (pho rub) in which researchers have ascertained the success of a
traditional Tibetan remedy, and a promising study on gastric bacteria that was
presented at the International Conference on Tibetan Medicine held in Lhasa in
2000. Lobsang Norbu notes that research by doctors in the Department of GI
Disorders reports particular success with Tibetan treatments of chronic gastric
ulcers (pho ba smug po).
Doctors in these videos describe the usage of a variety of diagnostic and
therapeutic methodologies, as Adams has also noted to be the case in the
Mentsikhang womens ward.15 Modern medical instruments such as gastroscopes
are used to track the progress of gastric ulcers, although in general physicians do
claim to interpret disease states in a manner consistent with the teachings of the
ancient Tibetan medical text, the Four Tantras. Biomedical instruments are used
to photograph ulcerous conditions, to examine tissue samples, and to remove

58 TIBET JOURNAL
excess gastrointestinal tissue, and Lobsang Norbu speaks favorably of the benefits
of combining use of these tools with use of traditional Tibetan diagnostic
techniques and medicines. He asserts that evidence collected by means of modern
instruments reinforces, and does not contradict, the understanding of
gastrointestinal diseases founds in Tibetan medical texts, and he emphasizes the
view that the combined use of modern and ancient methods of diagnosis and
treatment can only be beneficial. Adams analysis of a recently published Tibetan
text on womens health, authored by a Mentsikhang doctor, points similarly to
the texts insistence that biomedicine validates, rather than rejects, traditional
medicine.16
DISCUSSIONS OF THE TREATMENT OF LIVER DISORDERS

In a six-part series filmed in the Lhasa Mentsikhang Department of Liver Disorders

(mchin nad sde khag), 17 Doctors Samten and Yangchen Drolkar discuss the
departments history and organization and introduce some common diseases
encountered in the department and the methods by which they are typically treated.
The specialized Department of Liver Disorders was established in 1997. In 2001
it supported fifteen health care providers, including nine doctors and six nurses,
and twenty-five hospital beds. Most patients are treated for liver diseases such as
hepatitis (ldem bu) and mchin dug, as well as hepatic ulcers (mchin khrag smug
po), for which, the doctors report, recovery rate is high with the application of
Tibetan medicines. Doctors Samten and Yangchen Drolkar also note that many
Chinese patients, in addition to Tibetan patients, come for Tibetan medical
treatment of liver disease, and that Tibetan medicines for liver disease are very
popular throughout the PRC. The Chinese scientific community has also shown
an interest, and a number of research studies have been conducted on Tibetan
liver disorders and their treatment in China and elsewhere.18
In this video series, Doctors Samten and Yangchen Drolkar discuss the
prevalence of icterohepatitis (grang mkhris) and the efficacy of Tibetan remedies
for this disease, although they do note that occasionally some types of
biomedicines are prescribed in addition to the Tibetan preparations. The fourth
part of the series focuses on the various types of hepatitis (ldem bu), as understood
by traditional Tibetan medicine, and on the specific treatments that are used.
Although the Four Tantras describes nearly fifty types of medicinal compounds
to be used for liver diseases, these Mentsikhang doctors say they now primarily
use a specialized set of seven medicinal compounds: zla bdud, dwangs gtso,
autpal nyer lnga, gur mchog, mun sel, ghi dgu kha tshar, and ghi dgu khyung
nag kha tshar.
THE LHASA FACTORY OF TIBETAN MEDICINE

The THDL collections on medicine also contain nearly forty short videos recorded
in 2001 at the Factory of Tibetan Medicine on Nyangral Road in Lhasa. This
includes an eleven-part series illustrating the process of making medicinal
compounds in the factory, as well as a number of videos on related topics such as
factory operations, gathering medicinal substances, and the changing techniques
of pharmacy.
This Factory of Tibetan Medicine in Lhasa produces medicines that are sold at
cost to clinics and in some cases to individuals in Tibet and internationally. Janes

HYBRID METHODOLOGIES IN THE LHASA

59

notes that in 1992 the factory produced over 60,000 kg of 400 different medicinal
compounds, netting an estimated one million Yuan (US $ 200,000).19 In the THDL
video Medicine Factory Operations (THDL ID #672), a factory administrator
explains that the Nyangral Road factory supplies Tibetan medicines to all areas
of Tibet, Xinjiang Province, Mongolia, and Inner Mongolia. The Factory offers
heavily discounted prices on medicines supplied to rural doctors and hospitals,
he explains, and it supplies medicines directly to individual buyers as well, often
at prices significantly discounted from rates available at hospital or clinic
pharmacies. (Janes 1992 study, by contrast, comments that at that time rural
clinics were rarely able to afford medicine produced in large urban centers. 20)
Despite these practices, the video reports that the sale of some medicines brings
in a good profit, although because the Factory supplies medicines to such a large
area and at such reduced rates, it does not operate on a high profit margin.
TIBETAN MEDICINE LEARNING RESOURCES

Based on these videos shot in Lhasa, THDL is now developing a set of multimedia
instructional materials for the study and teaching of Tibetan medicine. The project
is not completed and is expected to continue production through 2005. These
materials are aimed at those interested in alternative medical traditions and in
ethnographic and clinical research on these traditions, as it provides a view of
Tibetan medical professionals in practice, as well as translations of discussions
about medical and pharmacological theory and practice by Tibetan professionals,
and accompanying reference materials. This resource will also be valuable to
language students who are beginning to learn about Tibetan medicine in Tibetan,
as no such resource for these students exists to date. Together with the excellent
scholarly articles by ethnographers such as Craig Janes and Vincanne Adams,
there is now a rich grouping of resources for higher education classroom
instruction and the in-depth study of Tibetan medicine as practiced today in Lhasa.
The Tibetan Medicine Learning Resources (TMLR) project is focusing on
development of two instructional units for the study of Tibetan medicine using
either English or Tibetan language. The first unit, Clinical Practice, includes
video examples of doctors in Lhasas Hospital of Tibetan Medicine examining
patients and commenting in detail on their disorders. It also includes interviews
on types of disease, on the prevalence of those diseases in the hospital, and on
the general operations of the hospital. Using these videos as basic instructional
sources, supporting materials are being developed, such as vocabulary lists,
explanatory essays, self-study tests, and additional recommended readings. The
second unit, Tibetan Pharmacy, is based on the series of videos filmed at Lhasas
Factory of Tibetan Medicines. These videos outline the Factorys process of
making medicines, and will also be accompanied by a database of Tibetan
medicinal substances and compounds, as well as vocabulary lists, explanatory
essays, self-study tests, and additional recommended readings.
LINKS TO KEY PAGES IN THE TIBETAN AND HIMALAYAN DIGITAL LIBRARY

Videos discussed in this survey, plus their transcripts and translations as these are
produced by the THDL transcription staff in Lhasa, are now available as works-inprogress online.

60 TIBET JOURNAL
http://www.thdl.org THDL home page
http://iris.lib.virginia.edu/tibet/intro/index.html Orientation to THDL
http://iris.lib.virginia.edu/tibet/collections/medicine/ THDL collections on
Tibetan medicine home page
http://iris.lib.virginia.edu/tibet/collections/medicine/TMLR.html Tibetan
Medicine Learning Resources home page
http://forums.itc.virginia.edu/tibet/ndrp/mediaflowcat/home.cfm Audio/Video
Collections search page
Notes
1.
2.
3.
4.
5.

Janes, 1995: 7.
Janes, 1995: 18.
Janes, 1995: 18.
Janes, 1999a: 1816.
Information in this section is derived from the following video titles: Department of GI
Disorders: Introduction 1 (THDL ID #345), Department of GI Disorders: Introduction
2 (THDL ID #346), and Department of GI Disorders: Introduction 3 (THDL ID #347).
Please see the THDL video cataloging details for these videos for a record of participating
physicians, transcribers, translators and other individuals who contributed to the
publishing of these titles.
6. Tumors of various types are discussed in the Four Tantras third book, the Oral Secret
Tantra (man ngag rgyud), chapter seven. This chapter has been translated into Sanskrit
and English by Bhagwan Dash, in his Encyclopedia of Tibetan Medicine, Volume 7
(Delhi: Sri Satguru Publications, 1999). Other gastrointestinal disorders are discussed
in that books tenth and thirty-ninth chapters. The disorder bad kan smug po, which
sometimes manifests symptoms in gastrointestinal regions, is discussed in the Oral
Secret Tantras fifth chapter as an example of a disorder caused by an imbalance in all
three humors. That chapter has been translated into Sanskrit and English by Bhagwan
Dash, in his Encyclopedia of Tibetan Medicine, Volume 6 (Delhi: Sri Satguru
Publications, 1999).
7. Contents unknown at this time.
8. For the traditional ingredients of this compound, see T.J. Tsarong, Handbook of
Traditional Tibetan Drugs (Kalimpong: Tibetan Medical Publications, 1986), 40. On
the herb Picrorhiza kurroa (hong len), see Picrorhiza kurroa: Monograph in Alternative
Medicine Review: A Journal of Clinical Therapeutics 6:3 (Jun 2001), 319-321.
9. For the traditional ingredients of this compound, see T.J. Tsarong, 1986.
10. Contents unknown at this time.
11. For the traditional ingredients of this compound, see T.J. Tsarong, 1986.
12. Research publications on gastrointestinal diseases and their treatment in Tibetan
communities include the following articles. A literature search on Chinese scientific
research on atrophic gastritis in its various stages reveals this to be a highly active area
of interest among Chinese physicians, as it is among Tibetan physicians.
Basnyat, B.; Cumbo, T.A.; Edelman, R. Infections at high altitude. Clinical infectious
diseases : an official publication of the Infectious Diseases Society of America. 2001
Dec 1; 33 (11): 1887-1891.
Katelaris P, Tippett G, Zoli G, Lowe D, Norbu P, Farthing M. An evaluation of factors
affecting Helicobacter pylori prevalence in Tibetans exiled in India. Trans R Soc
Trop Med Hyg. 1993 Jul Aug;87(4): 400-3.
Katelaris PH, Tippett GH, Norbu P, Lowe DG, Brennan R, Farthing MJ. Dyspepsia,
Helicobacter pylori, and peptic ulcer in a randomly selected population in India.
Gut. 1992 Nov;33(11): 1462-6.

HYBRID METHODOLOGIES IN THE LHASA

61

Shrestha, S.M.; Takeda, N.; Tsuda, F.; Okamoto, H.; Shrestha, S.; Shrestha, V.M. High
prevalence of hepatitis B virus infection amongst Tibetans in Nepal. Tropical
gastroenterolog y : official journal of the Digestive Diseases Foundation. 2002 AprJun; 23 (2): 63-65.
Wang JC. Pathologic analysis of mucosal biopsies from 548 cases of chronic gastritis
in the Tibet plateau. Zhonghua Bing Li Xue Za Zhi. 1988 Dec; 17 (4): 295-7. (Chinese.)
Zhao GB, Li L. Impairment of the digestive system in high altitude erythrocythemia.
Zhonghua Nei Ke Za Zhi. 1991 Aug;30(8): 492-4, 521-2. (Chinese.)
13. Janes, 1999a: 1815 and Janes, 2001: 207.
14. Adams, 2001: 225.
15. Adams, 2001: 232.
16. Adams, 2001: 234.
17. Information in this section is derived from the following video titles: Department of
Liver Disorders: Introduction 1 (THDL ID #349), Department of Liver Disorders:
Introduction 2 (THDL ID #350), Department of Liver Disorders: Introduction 3 (THDL
ID #351), Department of Liver Disorders: Introduction 4 (THDL ID #352), Department
of Liver Disorders: Introduction 5 (THDL ID #353), and Department of Liver Disorders:
Introduction 6 (THDL ID #354). Please see the THDL video cataloging details for
these videos for a record of participating physicians, transcribers, translators and other
individuals who contributed to the publishing of these titles.
18. Research publications on liver disease and its treatment in Tibet include the following
articles:
Bai Y, Cheng N, Jiang C, Wang Q, Cao D. Survey on cystic echinococcosis in Tibetans,
West China. Acta Trop. 2002 Jun; 82(3):381-5.
Bai Y, Cheng N, Wang Q, Cao D. An epidemiological survey of cystic echinococcosis
among Tibetan school pupils in West China. Ann Trop Paediatr. 2001 Sep; 21(3):2358.
Cao M, Liu F, Jiang S, Shao X, Lan K, Li X, Zhang Z, Wang W, Zhao W, Huang R.
Seroepidemiologic survey of hepatitis G virus in selected population of Shanxi,
Qinghai and Xinjiang Provinces (region) of China. Zhonghua Shi Yan He Lin Chuang
Bing Du Xue Za Zhi. 2002 Dec; 16(4):345-7. (Chinese.)
Cui C, Shi J, Hui L, Xi H, Zhuoma, Quni, Tsedan, Hu G. The dominant hepatitis B
virus genotype identified in Tibet is a C/D hybrid. J Gen Virol 2002 Nov; 83 (Pt 11):
2773-7.
Harris NS, Crawford PB, Yangzom Y, Pinzo L, Gyaltsen P, Hudes M. Nutritional and
health status of Tibetan children living at high altitudes. N Engl J Med. 2001 Feb
1;344(5):341-7.
Jiang J, Yang C, Fu K. Clinical characters and CT findings of steatohepatitis in highland
area. Zhonghua Gan Zang Bing Za Zhi. 2003 Feb; 11(2):84-5. (Chinese.)
Litch JA, Shackleton JR, Bishop RA. Prevalence of hepatitis B infection among Tibetan
refugees in northern India. Trop Doct. 1998 Oct; 28(4):229-30.
Luo K. Seroepidemiological investigations on hepatitis B virus infection in the
populations of Han, Tibetan, Dai, Yao, Uighur, Mongol and Li nationalities. Zhonghua
Liu Xing Bing Xue Za Zhi. 1993 Oct; 14(5):266-70. (Chinese.)
Mai K. Study on hepatitis delta virus infection in China. Zhonghua Liu Xing Bing
Xue Za Zhi. 1989 Feb; 10(1):21-3. (Chinese.)
Nikolaev SM, Sambueva ZG, Chekhirova GV, Tsyrenzhalov AV. Effect of hepatophyt
on the choleretic function of the liver damaged by tetracycline. Antibiot Khimioter.
2003; 48(4):24-6. (Russian.)
Peng B, Feng W, Wang L, Li L, Zhang Y. Effect of Tibetan drug Arenavia kansuensis
Maxim. var. ovatipetala Tsui on inflammation and immunological function. Zhongguo
Zhong Yao Za Zhi. 1991 Jun; 16(6):363-6, 383. (Chinese.)

62 TIBET JOURNAL
Qi Z, Cui D, Pan W, Yu C, Song Y, Cui H, Arima T. Synthesis and application of
hepatitis E virus peptides to diagnosis. J Virol Methods. 1995 Sep; 55(1):55-66.
Shang XY, Shi JG, Yang YC, Liu X, Li C, Zhang CZ. Alkaloids from a Tibetan medicine
Meconopsis quintuplinervia Regel. Yao Xue Xue Bao. 2003 Apr; 38(4):276-8.
(Chinese. )
Shrestha SM, Takeda N, Tsuda F, Okamoto H, Shrestha S, Shrestha VM. High
prevalence of hepatitis B virus infection amongst Tibetans in Nepal. Trop
Gastroenterol. 2002 Apr-Jun; 23(2):63-5.
Zhao SM, Li HC, Lou H, Lu XX, Yu XF, Gao DH, Hu J, Chiba H, Takezaki T, Takeshita
H, Yashiki S, Fujiyoshi T, Sonoda S, Tajima K. High Prevalence of HBV in Tibet,
China. Asian Pac J Cancer Prev. 2001; 2(4): 299-304.
Zhao GB, Li L. Analysis of the etiology and clinical characteristics of Tibetan cirrhosis
in Tibet. Zhonghua Nei Ke Za Zhi. 1989 Sep; 28(9): 529-31, 571-2. (Chinese.)
19. Janes, 1999a: 1814.
20. Janes, 1999a: 1814.

Bibliography
For online bibliographies of Tibetan medicine, see
Jurgen Aschoffs Tibetan Medicine Annotated Bibliography,
http://www.uni-ulm.de/%7Ejaschoff/bibli2.htm,
THDLs Recent Publications on Tibetan Medicine,
http://iris.lib.virginia.edu/tibet/collections/medicine/biblio_medicine.html
Adams, Vincanne. 1998. Suffering the winds of Lhasa: Politicized bodies, human rights,
cultural difference, and humanism in Tibet, Medical Anthropology Quarterly 12 (1): 74102.
Adams, Vincanne. 2001. Particularizing Modernity: Tibetan Medical Theorizing of
Womens health in Lhasa, Tibet, in L. Connor and G. Samuel (eds.), Healing Powers and
Modernity. Traditional Medicine, Shamanism, and Science in Asian Societies, London,
Bergin and Garvey, pp. 222-246.
Adams, Vincanne. 2001. The Sacred in the Scientific: Ambiguous Practices of Science
in Tibetan Medicine, Cultural Anthropology 16 (4): 542-575.
Adams, Vincanne 2002 Establishing Proof: Translating Science and the State in Tibetan
Medicine In Mark Nichter and Margaret Lock (eds.), New Horizons in Medical
Anthropology New York: Routledge pp.200-220.
Adams, Vincanne and Fei Fei Li. (forthcoming) Integration or Erasure? Modernizing
Medicine at Lhasas Mentsikhang, in in L. Pordie (ed.), Exploring Tibetan Medicine in the
Contemporary Context, New Delhi, Sage Publications.
Janes, Craig R. 1995. The Transformations of Tibetan Medicine, Medical Anthropology
Quarterly 9 (1): 639.
Janes, Craig R. 1999a. The Health Transition and the Crisis of Traditional Medicine:
The Case of Tibet, Social Science and Medicine 48: 1803 1820.
Janes, Craig R. 1999b. Imagined Lives, Suffering, and the Work of Culture: The Embodied
Discourses of Conflict in Modern Tibet, Medical Anthropology Quarterly 13 (4): 391-412.
Janes, Craig R. 2001. Tibetan Medicine at the Crossroads: Radical Modernity and the
Social Organisation of Traditional Medicine in the Tibet Autonomous Region, in L. Connor
and G. Samuel (eds.), Healing Powers and Modernity. Traditional Medicine, Shamanism,
and Science in Asian Societies, London, Bergin and Garvey, pp. 197-221.
Leslie, Charles and Alan Young (eds). 1992. Paths to Asian Medical Knowledge. Berkeley:
University of California Press.
Loizzo, Joseph J. and Leslie J. Blackhall. 1998. Traditional Alternatives as
Complementary Sciences: The Case of Indo-Tibetan Medicine. The Journal of Alternative
and Complementary Medicine 4, no. 3: 311-319.

HYBRID METHODOLOGIES IN THE LHASA

63

McKay, Alexander. (Forthcoming) Himalayan Medical Encounters: the Establishment

of Biomedicine in Tibet, in Mona Schrempf (ed.), Soundings in Tibetan Medicine. Historical
and Anthropological Perspectives. Proceedings of the 10th Seminar of the International
Association for Tibetan Studies (PIATS), Oxford Sept. 06-12 2003, Leiden, Brill Publishers.
McKay, Alexander. (Forthcoming). The Birth of a Clinic: the IMS dispensary in Gyantse
(Tibet), 1905-1910, in Medical History.
Pordie, Laurent. 2002. Pharmacopeia as an Expression of Society. An Himalayan Study,
in Fleurentin et al. (eds.), From the Roots of Knowledge to Future Medicines, French Society
for Ethnopharmacology.
Samuel, Geoffrey. 1999. Religion, Health and Suffering among contemporary Tibetans,
in John R. Hinnells and Roz Porter (eds.), Religion, Health and Suffering, London, Kegan
Paul International, pp. 85-110.
Samuel, Geoffrey. 2001. Tibetan medicine in contemporary India: theory and practice,
in L. Connor and G. Samuel (eds.), Healing Powers and Modernity. Traditional Medicine,
Shamanism, and Science in Asian Societies, London, Bergin and Garvey, pp. 247-274.

1: A SUMMARY OF THDL VIDEO TITLES ON MEDICINE

Introductory lectures on aspects of Tibetan medical theory, practice and education by various
doctors from the Lhasa Mentsikhang, and documentation of doctor-patient and patientpatient interactions:
TABLE

An explanation of Tibetan embryology, by Dr. Palden Tenzin (approx.1 hour)

An explanation of Tibetan methods of treating bone disorders and broken bones, by
Dr. Lobsang Dorje (approx. 50 minutes)
Detailed commentary on four pages about medicine from the Shes bya kun khyab,
by Dr. Palden Tenzin (approx.1 hour, 20 minutes)
An interaction between a man suffering serious joint and muscle pain and a woman
who treats him using certain types of massage. (approx. 45 minutes)
Interactions between patients and doctors at the in-patient Mentsikhang (approx.4
hours total)
An interview with a doctor about maintaining a private clinic in Lhasa, with Dr.
Tsegyal (approx. 45 minutes)
Comments from several doctors about treating terminally ill patients (approx. 45
minutes)
A re-enactment of the entire process of going to see a doctor at the out-patient
hospital, with Dr. Lobsang, actors from the Tibetan Drama Group, and other
Mentsikhang staff (approx. 1 hour)
A discussion between several older people about various medical conditions theyve
experienced in the past (approx. 30 minutes)

Additional short video topics:

a woman consults her friend about trouble conceiving a child

a woman announces to her friend that she is pregnant and asks questions about
morning sickness and birth practices
a woman about to give birth asks about diapers and taking care of an infant
two people discuss remedies for altitude sickness
two people talk about having diarrhea
a couple worries about the safety of the blood supply
two people talk about allergies
two men discuss male health problems
two people talk about wounds and scars

64 TIBET JOURNAL

discussion of dentistry practices in Lhasa

discussion of various physical disabilities and what arrangements are made for
persons with disabilities in Lhasa
comments on various dermatological problems, particularly on the face

Topics in the history of medicine:

A history of Tibetan medicine (from Yuthok Yonten Gonpo the Elder to Desi Sangye
Gyatso, roughly), by Dr. Jampa Trinley (approx.1 hour)
A history of the Tibetan Medical Hospital (Mentsikhang), by Dr. Dramdul, the
Mentsikhang president (approx.1 hour)

Plant categories and types in Tibetan materia medica

Alessandro Boesi

INTRODUCTION
Nowadays as in the past medicinal substances represent an important resource
for Tibetan people both for health and wealth. Tibetan medical institutes and
independent practitioners carry out activities related to drug identification,
collection, and the compounding and administration of remedies. Tibetan
communities have been always relying as a source of income on the bartering
and selling of several products taken from the natural environment such as
rhubarbs, Fritillaria bulbs, caterpillar fungus and musk deer pods, sought after
by practitioners of Tibetan, ayurvedic and Chinese medicine and at present also
by pharmaceutical and phyto-pharmaceutical companies.
The materia medica of Tibetan medicine, significantly influenced by
Ayurveda1 (as other aspects of the Tibetan medical science) after the translation
into Tibetan language of medical and tantric treatises of Indian origin, has been
enriched and modified during the centuries according to the needs of the
population and has been adapted to the environmental conditions of Tibetan
regions. Even at the present time Tibetan traditional doctors try to find new
drugs. In addition, owing to the great extension of the area over which Tibetan
medicine is practised, the many substances of mineral, animal, and plant origin
of Tibetan pharmacopoeia may vary according to the region, climate and
vegetation, medical schools, local traditions, and foreign influences.
Fundamental medical treatises, their commentaries, and several texts of
materia medica are devoted to describing features, qualities and therapeutic
properties, time and methods of collection, and processing of medicinal
substances. Yet when I decided to research into Tibetan medicinal plants and in
particular on their classification I realised that it was not possible to accomplish
this study only through the reading of the written sources because the information
on the different categories is for the most part too concise for grasping the criteria
upon which they have been devised. The explanation of the master is absolutely
crucial to completely understand plant actual features, classifications, properties,
and ways of exploitation. Therefore I decided to ask directly to Tibetan traditional
doctors about these categorisations. The research fieldwork has been conducted
with practitioners from different Tibetan regions focusing on those who collect
and process medicinal substances and know fundamental medical texts and
pharmacopoeias. Participant observation and open-ended conversations have
been mostly used as methods of investigation. Semi-structured interviews have
also been conducted with other Tibetan doctors who do not perform the above
activities2.
Some systems of medicinal substance categorisation are described in classical
literary sources. The classification may be devised on the basis of medicinal
substance morphological, biological and ecological features (particularly for
plants), taste (ro)3, potency (nus pa)4, and on the basis of the disease (nad) cured.
For example, medicinal substances may be separated into two groups: the former

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includes drugs that cure hot diseases (tsha nad) whereas the latter consists of drugs
that cure cold diseases (grang nad). Some classifications are mainly practical such
as the one proposed by some practitioners from Baragaon (central Nepal) who
distinguish two types of medicinal plants: the ones growing at high altitude, named
mtho sa sman, medicines of high altitude areas, and the ones growing at low
altitude, named dma sa sman, medicines of low altitude areas.
The principal aim of this article is to examine that traditional classification which
separates Tibetan medicinal plants into categories, sub-categories and types5 and
in particular to try to explain the criteria upon which they have been worked out.
The analysis does not concern the categories including the medicines of mineral and
animal origin. The first part of the article is devoted to introducing the categories of
medicinal substances, in the following part the different categories of medicinal
plants are thoroughly examined. The last section is devoted to analysing the
classification of medicinal plants in types. Each category has been examined initially
on the basis of the information available on written sources. After I have tried to
explain this information according to the elucidations given by the informants, the
data concerning the botanical identification of the plant specimens gathered during
my fieldwork and the identification proposed in modern pharmacopoeias.
The classification of Tibetan materia medica in its entirety has been dealt with
by Francesca Cardi6 in her dissertation work on Tibetan pharmacopoeia and
preparation of the remedies. Meyer7 in his book devoted to Tibetan medicine has
briefly dealt with the categories of medicines.
CATEGORIES OF MEDICINES
In Tibetan medicine medicinal substances (sman)8, natural and non-natural, are
classified in several categories and sub-categories.
Although the classical classification described in fundamental treatises is accepted
by all practitioners, I emphasise the discrepancy in the conception of certain
categories, and in particular of the categories of thang sman, medicines of the
plains, and sngo sman, herbaceous medicines. The cause of this disparity depends
on the practitioners level of education, and on the influence of the modern treatises
of Tibetan medicine, which introduce new concepts and systems of classifying
medicinal substances. This recent phenomenon is enhanced also because the
traditional classification of medicinal plants in categories, according to fieldwork
observations and to the opinion of the informants, has little practical relevance and
in this way it may be easily substituted by a simpler one.
As far as the level of knowledge of Tibetan materia medica is concerned, the
recent standardisation and industrialisation of the process of medicament production
in the biggest medical institutes, the specialisation of practitioners and the capillary
distribution of the medicines to the dispensaries (for example to the ones which
depend on the Tibetan Medical & Astro Institute of Dharamsala, Himachal Pradesh,
India) in many regions, imply that only a portion of practitioners has an in-depth
knowledge of medicinal substances. In spite of that other traditional doctors in all
Tibetan regions have been carrying on practising Tibetan medicine in a traditional
way and know very well its pharmacopoeia.
The types of substances included in each category may be heterogeneous. As it
will be shown in the next sections, some categories consist of medicines coming
exclusively from minerals, others include only medicines coming from plants, one

PLANT CATEGORIES AND TYPES ... 67

category includes medicines from living beings, one category consists of different
types of substances, another includes only mineral substances except for one that is
a plant.
The following categories (rigs) of medicines are described in The Four Tantras
(rGyud bzhi) and in its commentary The Blue Beryl (Vaidurya sngon po): rin po
chei sman (precious medicines), rdoi sman (stone medicines), sai sman (earth
medicines), rtsi sman9 (essence medicines), shing sman (medicines coming from
woody plants), thang sman (medicines of the plains), sngo sman (herbaceous
medicines), srog chags sman (medicines coming from living beings), and lo thog gi
sman (crop medicines). The expressions properly designating each category are not
commonly employed by the practitioners in their practical activities, but only during
theoretical discussions on the materia medica.
Differently some other categories of medicines are described in the Crystal Rosary
(Shel phreng): tshwa sman (salt medicines), chui sman (water medicines), mei
sman (fire medicines), and gdus pai sman (concentrated medicines).
I point out that in The Four Tantras and consequently in The Blue Beryl the
different groups of medicinal substances are described in a chapter whose aim is to
describe their potencies10.
Plants are included in five among the eight categories above mentioned: rdoi
sman (or sa sman according to the text), rtsi sman, shing sman, thang sman, sngo
sman, and lo thog gi sman. The three categories that include the majority of medicinal
plants (shing sman, thang sman, sngo sman) may be separated into some subgroupings worked out on the basis of the plant organs that are gathered and\or
employed as medicines such as leaves, flowers, and stems. According to the The
Four Tantras11 and The Blue Beryl12 shing sman and thang sman are divided into
sub-groupings whereas the category sngo sman is not. I emphasise that in these texts
the drugs that belong to rtsi sman, shing sman, and thang sman are listed together
without setting any limit between the categories and between their sub-groupings
and, as far as the categories shing sman and thang sman are concerned, their
constituents are listed together without any order. Thus it is very difficult to distinguish
them. This might suggest that it is not very important to know to which of the above
categories a drug belongs probably because this does not have significant implications
on its potency. Yet the drugs that belong to the category rtsi sman can be distinguished
more easily since they are listed together and because of the indications given in The
Blue Beryl, as it will be explained in the section devoted to this category.
Differently from the two texts above, the author of The Crystal Rosary describes
several sub-groupings also in the category sngo sman and he clearly differentiates
the shing sman category by enumerating the constituents according to their subgroupings13. The thang sman medicines are listed without distinguishing their
sub-groupings 14 as in The Four Tantras and The Blue Beryl.
According to the authors of the two texts above on one side and to Deu
dmar dge bshes on the other one, the categories shing sman, thang sman, and
sngo sman exhibit a significant disparity in their content. In The Four Tantras
and The Blue Beryl many plants included amongst the sngo sman such as thang
phrom 15, dres ma (Iris spp.) 16, dwa ba (Arisaema spp.), and mtshe ldum
(Ephedra spp.), are considered in the Shel phreng as thang sman. Moreover,
according to The Four Tantras and The Blue Beryl, woody plants such as shug
pa tsher can (Juniperus spp.), mdzo mo (Caragana spp.), skyi ba (Sophora

68 TIBET JOURNAL
moorcroftiana) 17 , dbyi mong, (Clematis spp.), and ba lu (Rhododendron
anthopogon)18 are included in the category sngo sman, herbaceous medicines.
These drugs are consideredprobably more correctly considering their
biological and morphological featuresas shing sman in the Shel phreng.
Curiously in The Four Tantras, se rgod (Rosa spp.) and skyer pa (Berberis
spp.) are mentioned twice: firstly when the shing sman, rtsi sman, and thang
sman medicines are listed and secondly among the sngo sman medicines in
the same chapter19. Medicinal salts (tshwa sman), which are placed in a category
of its own in the Shel phreng20, in The Four Tantras and The Blue Beryl are
listed amongst the shing sman and the thang sman medicines.
The author of The Four Tantras describes only a part of the actual plants
that belong to each category of medicines probably with the intention of giving
some examples. As a matter of fact many other plants (and other medicinal
substances of mineral and animal origin) are mentioned in the other parts of
The Four Tantras. sDe srid Sangs rgyas rgya mtsho has systematized these
medicines in The Blue Beryl 21 and in the Tibetan Thankas 22 he has
commissioned, where they are described as supplementary materia medica
(kha skong gras, supplementary class).
Medicinal substances have been organized more properly in relation to
their features in the Shel phreng where the categories and sub-categories (except
for the thang sman) are neatly separated and the number of medicinal substances
described is exhaustive. I have chosen this text as the main classical reference
also because of its frequent use by the informants and the relatively detailed
plant descriptions (concerning both morphological and ecological plant
features) given by the author and since it constitutes the main reference source
for the recently published modern texts of Tibetan materia medica.
An interesting aspect of the classification of medicinal plants (and in general
of all kinds of medicinal substances) in Tibetan medicine is the disparity in
the criteria employed to group the plant together in the different categories.
The constituents of the category rtsi sman are assembled on the basis of their
peculiar therapeutic properties and fragrance, the category shing sman is
worked out on the basis of the plant features from which its components come
and the categories thang sman and sngo sman are devised on the basis of plant
morphological, biological features, and environment of growth.
I note that in The Four Tantras23 the term rtswa is employed to indicate
thang and sngo medicinal plants at the same time. Actually several traditional
doctors from the regions of Litang, Baragaon, and Ladakh include in a single
group called sman rtswa, medicinal herbaceous plants, and rtswa sman,
herbaceous medicines, all medicinal herbaceous plants. This classification
is probably used for convenience.
In all Tibetan cultural regions the new designations and categorisation
systems introduced in the modern Tibetan pharmacopoeias certainly under
Chinese influence are seldom used although they are known by the new
generations of practitioners and also by some traditional doctors from isolated
regions because of the rapid diffusion of the above texts. Karma chos phel
(1993) presents three new categories of medicinal substances: gter dngos kyi
sman rdzas, mineral medicinal substances; skye dngos kyi sman rdzas,
medicinal substances which grow, that includes medicinal plants; srog chags

PLANT CATEGORIES AND TYPES ... 69

kyi sman rdzas, medicinal substances of living beings. The authors intention
is probably to work out a classification that reflects the one of modern science
in three kingdoms: mineral, plant, and animal. Yet it is not possible to adapt
the drug traditional classification to the classification system of modern science
because the criteria upon which they are based are different. For example, it is
doubtful whether the traditional category of the essence medicines (rtsi sman)
can be included in the so-called skye dngos kyi sman rdzas group, medicinal
substances which grow, as proposed by Karma chos phel, because besides a
few medicinal plants some substances of animal and mineral origin such as
gla rtsi (musk) and brag zhun (bitumen)24 are also listed in this category.
Categories of medicines that include plants
STONE MEDICINES AND EARTH MEDICINES
The medicine called rdo dreg (Parmelia tinctorum25) is included in the category
of stone medicines (rdoi sman)26 according to the pharmacopoeia Shel phreng27
whereas according to The Four Tantras (bShad rgyud 28) it is included in the
category of earth medicines (sa sman)29. The expression rdo dreg may be
translated as stone incrustation. Although considered as a plant by all
informants, it has probably been included among the medicines coming from
the stones because it appears to be growing directly from the rocks, as some
practitioners from Litang and Baragaon assert.
In the modern treatises of Tibetan materia medica, rdo dreg has been
included either in a new-devised category including stone medicines and earth
medicines, called sa rdoi sman30, or amongst the herbaceous medicines (sngo
sman)31 reflecting a recent adjustment of the classification according to the
one of modern botany certainly under Chinese influence.
ESSENCE MEDICINES
The essence medicines (rtsi sman)32 represent a peculiar category that consists
of heterogeneous components. According to written sources, these medicinal
substances may come from sentient beings as in the case of gla rtsi (musk)33
and dom mkhris (bear bile)34, from stones as brag zhun (bitumen)35, and from
plants (see below).
Here follows the description of this category according to The Four
Tantras36 (the same is given in the Blue Beryl): the rtsi sman originate from
herbaceous plants (rtswa), woody plants (shing), and sentient beings (srog
chags). Differently, according to the Shel phreng37, the rtsi sman originate
from woody plants (shing), from the plants of ldum type, from the plants of
sngo type38, from sentient beings (srog chags), and from stones (rdo) Here
the essence medicines also include a substance (brag zhun) that comes from
the stones and the two distinct expressions ldum and sngo are employed in the
place of the term rtswa to indicate herbaceous plants.
The author of the rGyud bzhi does not give any indication about which
substances belong to the essence medicines: all the substances included in the
shing sman, rtsi sman, and thang sman are listed without setting any limit
between them. Nonetheless in the Vaidurya sngon po39, when commenting this

70 TIBET JOURNAL
category, it is stated that some practitioners affirm that all the medicines listed
between gi wang (liver and gall-bladder bezoars) and utpala (Meconopsis spp.)
belong to the rtsi sman. The above medicines are gi wang, cu gang, gur gum,
sug smel, dzwa ti, li shi, ka ko la40, gla rtsi, dom mkhris, and utpala. Thus in
this text, essence medicines consist of ten substances.
Differently in the Shel phreng Deu dmar dge bshes41 lists 12 different rtsi
medicines: ga bur42, dzwa ti, li shi, sug smel, cu gang, gur kum, gi wang, gla
rtsi, dom mkhris, dbang po ril bu (intestinal bezoars), and brag zhun. In this
text, among the rtsi sman of plant origin, in the place of utpala, which here is
included in the category sngo sman43, there is ga bur, which is assigned to the
category shing sman in The Four Tantras. The medicine of animal origin dbang
po ril bu and the one of mineral origin brag zhun have been added. In the
rGyud bzhi brag zhun is placed in the category of earth medicines (sa sman).
As far as utpala44 is concerned, it might be speculated that in ancient times
it corresponded to the imported Indian blue lotus (Nymphaea nouchali)45 and
therefore was included in the rtsi sman category as described in the Four
Tantras owing probably to its fragrant perfume and the lotus being a symbol of
purity, perfection, and compassion. Later on, when some species of Himalayan
poppy (Meconopsis spp.) were selected as local substitutes, the drug was
reallocated in the category of the herbaceous medicines sngo sman, as shown
in more recent classical pharmacopoeias as the Shel phreng46 and the materia
medica of Jam dpal rdo rje47.
A few modern Tibetan pharmacopoeias, most probably under Chinese
influence, introduce new elements among the essence medicines. In the materia
medica of dGa bai rdo rje dbyar rtswa dgun bu (Cordyceps sinensis), a
parasite mushroom traditionally considered as a herbaceous plant by Tibetan
people48, is included among the rtsi sman and designated with the recentlydevised name rtswa da byid49. Yet another modern pharmacopoeia 50 published
at Lhasa regards the same medicine as belonging to the category ldum bu thang
sman that mainly includes herbaceous plants. The dbyar rtswa dgun bu is not
mentioned in the fundamental treatises of Tibetan medicine as rGyud bzhi and
Vaidurya sngon po and in the classical pharmacopoeia Shel gong and in its
commentary Shel phreng, but it is described in the illustrated materia medica
written in the XIX century by Jam dpal rdo rje51, a practitioner from Mongolia,
where it is included in the category of herbaceous medicine (sngo sman)52.
The analysis of the expression rtsi is significant to assess the features of
the essence medicines. The Tibetan-English dictionary of Chandra Das 53
proposes the following definitions: varnish, paint, all fluids of a certain
consistency, such the juice of some fruits, certain secretions, etc.. These
definitions cannot be employed for the term rtsi according to its use in Tibetan
medicine. Also Meyer54 has stated that the expression rtsi ne peut pas tre
traduit par comme cela a t fait dans la table des matires de An Illustrated
Tibeto-Mongolian Materia Medica of Ayurveda55, car ce groupe de drogues
comprend des produits aussi divers que la bile dours, le camphre et les clous
de girofle.
In order to understand the nature of the essence medicines, I have asked
the informants the following questions: what is the reason for assembling
together these drugs that apparently seem to be so different? Which are the

PLANT CATEGORIES AND TYPES ... 71

parameters that justify this classification? The first answer given by many
practitioners from different regions has been that the attribution of the term
rtsi to certain substances indicates that they have strong therapeutic properties.
In particular the fact that even a small amount (sman nyung nyung) of any rtsi
medicine has strong potency (nus pa chen po) has often been emphasized as
the fundamental feature. Hence, according to the informants, a little amount
of them is enough to prepare medicaments.
A traditional doctor from Baragaon states that the presence of fragrance is
an important feature of the essence medicines as well: when fragrance (dri
ma) is absenthe saysthere is no potency, even if the taste of the plant
corresponds to the one described in medical texts. Actually the majority of
informants agree that the drugs included in the category of essence medicines
have good fragrance (dri bzang) and that this scent denotes their curative
properties 56. Almost all the drugs of this category actually have a strong
fragrance and also in the Shel phreng57 the good fragrance dri bzang (and dri
zhim) is attributed to the majority of them. A practitioner from Litang assigns
to essence medicines the property of being good medicines (sman bzang
po). He affirms that these drugs possess outstanding and long-lasting therapeutic
properties.
It may therefore be assumed that the expression rtsi mainly refers to the
following conception: good fragrancestrong and concentrated medicine. In
this way the definition of rtsi proposed by the Dharma Dictionary58, essence,
elixir, nectar, seems more appropriate in Tibetan medicine.
The modern pharmacopoeia of dGa bai rdo rje59 mentions a treatise named
g.Yu thog dgongs rgyan where this category of medicines is defined as follows:
name of a class of medicines that are endowed with the essence (rtsi bcud)
that provides sustenance to the bodily constituents and defeats the diseases.
After that60 it is also explained that the substances included in the category of
rtsi sman have, among the others, the property of increasing strength (zungs
skyed). Therefore the introduction of the dbyar rtswa dgun bu in this group
may be ascribed to its properties as a tonic and aphrodisiac and to its great
importance in Chinese medicine. Another drug recently introduced among the
essence medicines is the horn of rhino (bse ru)61 which, like dbyar rtswa dgun
bu, is a well-known product in China. Traditionally bSe ru is placed in the
medicines of animal origin as reported in the Shel phreng62 and in the rGyud
bzhi63.
THE MEDICINES COMING FROM WOODY PLANTS
The medicines named shing sman consist of drugs which come from woody
plants (shing sdong). According to the rGyud bzhi64 the divisions of the shing
sman are ten. Each of them is devised by assembling the plants of which the
same organs are employed in medicine: fruits and seeds (bras bu), flowers
(me tog), leaves (lo ma), trunks (sdong po), branches (yal ga), skins (shun
pa), resins (tshi ba), roots (rtsa ba), shoots (ldum bu) and marrow (rkang). I
emphasise that several practitioners from Litang and Baragaon have stated
that the meaning of the term ldum bu, usually employed to designate a category
of medicines65 or generally herbaceous plants by common people, corresponds
here to the expression gsar skyes66: fresh shoots and leaves.

72 TIBET JOURNAL
Differently in the Shel phreng67 the divisions of the shing sman are eight68,
the two divisions shoots (ldum bu) and marrow (rkang) are lacking.
Although in the Shel gong69 the division of roots (rtsa ba) is mentioned at
the beginning of the section devoted to shing sman, it is omitted in the following
pages where the plants that belong to each division are described. The author
gives the reason for the omission in the Shel phreng70 where he explains that,
even if a group of shing sman designated rtsa ba exists, this division has not
been dealt with independently owing to the fact that only the root of bra ma
(Caragana spp.) is evocated during practical activities. Bra ma has been placed
here in the sub-group of branches71.
The same woody plant may be included in more than one division at the
same time according to the plant organ used as medicine. For example,
according to the Shel phreng, se ba72 (Rosa spp.) belongs to three divisions: 1)
fruits and seeds (bras bu), with the name of se rgod bras bu73; 2) flowers (me
tog) as se bai me tog74; 3) skins (pags pa) as se rgod75. Similarly skyer pa
(Berberis spp.) is included in the division of flowers as skyer pai me tog76 as
well as in the division of skins as skyer pa77.
In The Blue Beryl 78 it is stated that some practitioners affirm that all the
medicines listed in this text between ga bur and a ga ru are shing sman,
particularly ga bur, tsandan dmar po (Santalum album), tsandan dkar po
(Pterocarpus santalinus), and a ga ru (Aquilaria sinensis)79. Yet the author
also states that there are doubts on the above order because in the category of
shing sman there are ten sub-groupings and, according to the above statement,
only four examples are given. Actually many plants commonly categorized as
shing sman as a ru ra (Terminalia chebula), ba ru ra (Terminalia bellirica),
and skyu ru ra (Phyllanthus emblica)80 are listed in the following pages.
According to the Shel phreng81, it seems that the sub-groups of shing sman
and sngo sman (herbaceous medicines) are not seen by Deu dmar dge bshes
exactly in the same way, because in the description of the sub-groups of shing
sman he omits the term btu ba, to gather, which is employed in reference to
sngo sman. The omission might suggest that the medicines coming from woody
plants are not gathered locally. This may be explained considering that several
of these medicines do not thrive on the Tibetan plateau and are bought on
local markets already cut in parts. Nonetheless several medicinal woody plants
thrive in the region of origin of the author of this famous treatise (east Tibet)
as I could also verify in the Litang County and adjacent regions. Deu dmar
dge bshes lists as example of shing sman some plants coming from the tropical
and sub-tropical regions of India and China as tsan dan dkar po, tsan dan
dmar po, and a ru ra (Terminalia chebula), but he also indicates se ba (Rosa
spp.), a woody plant thriving in many Tibetan regions, as several other medicines
coming from woody plants that I have gathered for example in the Litang
County82.
According to the descriptions of each medicine given in The Crystal Rosary,
the majority of the plants included in the category shing sman come from the
low altitude regions of India, China and Nepal (nearly 40%) and from the
deep forested valleys at relatively low altitude (nearly 27 %) located in east,
south Tibet, and at the fringe of the Tibetan plateau, which are called rong by
Tibetan people. The woody medicines gathered over the high areas of the

PLANT CATEGORIES AND TYPES ... 73

Tibetan plateau are fewer (nearly 33%). Although the above percentages are
not very indicative since in the Shel phreng the descriptions of the growing
areas of each plant are not always precise and sometimes not even existing,
they are similar to the data that can be obtained by analysing the plant botanical
identifications proposed by Karma chos phel: 34.35% of the woody medicines
come from tropical and sub-tropical regions, 33.3% from the relatively lower
Tibetan regions, and 32.35 % from the proper Tibetan plateau.
I note that sometimes in modern pharmacopoeias a medicine included in
this category may present some types which are herbaceous plants. For example,
although the standard drug that corresponds to khyung sder 83 is a woody plant
(Uncaria scandens), there are some types which are herbaceous plants as
suggested by the determinant sngo placed at the beginning of their names84: a
white type (sngo khyung sder dkar po, Saussurea katochaetoides)85 and a
purple-brown type (sngo khyung sder smug po, S. stella)86.
THE MEDICINES OF THE PLAINS AND THE HERBACEOUS MEDICINES
These two categories of medicines have been dealt with in the same section
since their distinction is not clear according to both informants and written
sources, and because many practitioners tend to see them as a single group.
The category thang sman is commonly designated by employing a few
slightly different expressions according to the text considered and the informant.
The rGyud bzhi87 mentions the term thang sman, medicines of the plains,
whereas in the Shel gong88 this category is designated as ldum bu thang sman,
medicines of the plains and of ldum type. In the Shel phreng89 three similar
expressions are mentioned: thang sman, ldum sman, ldum medicines, and
ldum buam thang sman, medicines of the plains or of ldum type.90 Deu
dmar dge bshes, in a chapter devoted to introducing the different categories of
medicines, explains that the expressions thang and ldum are equivalent 91 in
the sense that they indicate the same category. Practitioners from all the regions
where the fieldwork has been carried out employ the designations thang sman
and ldum bu thang sman indifferently. The expression ldum sman has been
seldom evoked.
The rGyud bzhi 92 and the Shel phreng93 describe some sub-groupings of
this category. They are worked out on the basis of the plant part which has to
be gathered and therefore that is employed in medicine. In the former text five
sub-groupings are described (rtsa ba, underground organs; ngar pa, stalk; lo
ma, leaves; me tog, flowers; bras bu, fruits and seeds) whilst in the latter only
four, the sub-group ngar pa not being mentioned.
Curiously Deu dmar dge bshes does not list the medicines included in this
category according to their sub-groupings, as he does with the other main
categories of medicinal plants (shing sman et sngo sman), but all the medicines
of the plains are presented together as it happens in the Four Tantras. As we
have already explained in the section devoted to essence medicines, in the
Four Tantras and in The Blue Beryl it is not possible to discern the drugs
included in the category thang sman clearly, since all the shing sman, rtsi
sman, and thang sman medicines are listed without setting any limit between
them.

74 TIBET JOURNAL
As concerns the category sngo sman, herbaceous medicines, it is also
categorised in several sub-groupings devised on the basis of the plant part
which has to be collected, as it is explained in the Shel phreng 94 where six subgroupings are described: the one whose underground organs (rtsa ba) are
collected, the one whose leaves (lo ma) are gathered, the one whose flowers
(me tog) are collected, the one whose fruits and seeds (bras bu) are collected,
the one whose aerial portion of the plant along with fruits (lo sdong me bras)
are gathered, and the one whose the entire plant without the stalk (rtsa lo me
bras) is collected. This distinction is not mentioned in The Four Tantras and
in The Blue Beryl.
Most informants from different regions do not have precise ideas of what
the real nature of the medicines that belong to the thang sman and sngo sman
categories is and even learned practitioners do not clearly elucidate the
differences between them. This phenomenon might be explained considering
that the classification of medicinal plants in thang sman and sngo sman does
not seem to have any practical utility according to informants. Actually a
practitioner from Dhorpatan and some practitioners from Litang have affirmed
that the plants included in these two categories share the same characteristics
(mtshan nyid), the same particular qualities (khyad chos) and the same mode
of use (lag len). Traditional classification may therefore be substituted, as we
have shown in the above sections, with other usually simpler classification
systems. This phenomenon is very common and many traditional doctors in
different regions adopt a classification which does not differentiate thang sman
and sngo sman, but they consider a category seen as including medicinal
herbaceous plants. Other than using the term rtswa sman (herbaceous
medicines), the tendency towards employing the expression sngo ldum sman
(sngo and ldum medicines), as proposed by the authors of some modern treatises
of Tibetan materia medica95 that have been recently spreading over all Tibetan
regions, is not so common. This expression connotes medicinal herbaceous
plants. Other practitioners employ the term sngo sman to indicate all medicinal
herbaceous plants.
In order to explain the real nature of the plants included in the category
thang sman, the term thang will be analysed below. The common sense of this
word is plain, flatlands 96. However in Tibetan medicine it may also
designate a type of medicinal preparation, notably decoctions. Actually many
informants from different regions have wrongly affirmed that the term thang 97
sman exclusively indicates decoctions and not also a category of medicinal
substances. A few other informants have also incorrectly asserted that the thang
sman include drugs of plant origin, which are used to prepare decoctions.
Meyer98 has given similar explanations in his book devoted to Tibetan medicine.
A small number of practitioners from different regions have suggested more
interesting definitions of the thang sman. They affirm that the medicines of
the plains grow on flatlands (thang) in opposition to the herbaceous medicines
(sngo sman) which thrive on the mountains (ri la). However it is important to
point out what is here the meaning of the expression thang according to the
informants: it does not generally specify the flatlands located at low altitudes
as the ones of India and China, but it also designates the localities of Tibetan
regions that are endowed with bde mo and snyoms po99 qualities. The attribute

PLANT CATEGORIES AND TYPES ... 75

bde mo is assigned to comfortable and pleasant areas and the attribute snyoms
po to the localities that are uniform and evenly balanced as far as altitude,
climate, and conformation of the ground are concerned. These features may
certainly be ascribed to some Tibetan localities. In particular the informants
have mentioned flatlands and valleys which are not situated at high altitudes.
Tibetan people see high altitude areas as uninhabited high mountains, and as
plateaus where, owing to the harsh climate, there are no villages and only
nomads can live.
A few traditional doctors from Baragaon, Litang, and Dharamsala have
suggested a definition of the category thang sman, which is also mentioned in
the medical dictionary gSo ba rig pai tshig mdzod g.yu thog dgongs rgyan 100,
that describes the ecological setting of the plants belonging to this category:
Category of medicines that thrive in the flatlands and not in the elevated
areas as stony mountains, slate mountains101 and snowy mountains.
The same source also mentions a commentary to the rGyud bzhi written by
dPal spungs dbon Karma bstan dzin phrin las rab rgyas where it is stated that
As with the thang sman, they are medicines that do not grow in high areas
and grow in flatlands like tig ta and ba sha ka. Tig ta (Swertia chirayita)102
mostly grows on the southern slopes of the Himalayan Range between 1,000
and 2,500 metres and ba sha ka (Adhatoda vasica)103 thrives until 1,500 metres
for example in India and in the Chinese province of Yunnan. The term thang is
here employed with a sense that is opposite to the one of the term mtho sar
and indicates relatively low and low altitude mountains areas.
The two above definitions are similar to the ones given by our informants:
the thang sman category consists of medicinal plants that do not thrive over
high mountains and plateaus, but in low flatlands and in low and relatively
low mountain areas. Therefore the translation plateau medicines of the
expression thang sman given by some authors104 does not seem to be very
accurate because the term plateau may connote either the entire Tibetan plateau
or the high-cold flatlands of Tibet. According to practitioners and written
sources, the herbaceous medicines (sngo sman) and not the medicines of the
plains (thang sman) thrive in these areas.
Deu dmar dge bshes105 has described the medicines of the plains according
to their morphological and biological features: Thang sman represent the
plants whose underground organs are developed and whose aerial organs grow
each year as the ones of woody plants, but which, except for the underground
organs, perish in winter as the plants of the sngo type, and therefore are replaced
each year. For example ma nu (Inula racemosa)106, lcum (Rheum palmatum)107,
and according to The Four Tantras, the main thang sman are: tig ta (Swertia
chirayita) and ba sha ka (Adhatoda vasica). Their underground organs have
the essential nature of woody plants (shing), their stalks the one of the ldum
type, their leaves and flowers the green and tender (sngo) one of herbaceous
plants.108
According to my fieldwork data and the botanical identifications of modern
Tibetan materia medica109, the underground organs of the majority of thang
sman are stout and thick, just as stated in the definition and in line with the
examples proposed by Deu dmar dge bshes.

76 TIBET JOURNAL
In the definition above, the three expressions shing, ldum and sngo are
employed to describe the essential nature (rang bzhin) of the three different
organs of plants belonging to the thang sman group and they clearly point out
to different morphological traits. The only difficulty consists in the
interpretation of the term ldum110 which indicates the features of stalks that are
neither like the ones of woody plants (shing) nor as the ones of green-tender
herbaceous plants (sngo). The examination of features and vegetative cycle of
the plants taken as example by Deu dmar dge bshes may help us to ascertain
to which kind of plant and plant traits the term ldum refers. Inula racemosa
and Rheum palmatum are herbaceous plants that have a stout herbaceous stalk.
The Indian tig ta 111 seems, according to Deu dmar dge bshes 112, a small woody
plant (shing phran). Actually it is a robust herbaceous plant. Interestingly some
practitioners from Litang designate ldum the stalk of some types of rhubarbs
as lcum (Rheum palmatum) and chu skyur (Rheum alexandrae) in the same
way as in the example proposed by the author of the Shel phreng. According
to the informants, these two plants have a hard-rigid (khregs pa) green stalk,
which is endowed neither with an essential nature of sngo type nor of shing
type. Ba sha ka (Adhatoda vasica) is a woody plant, according to the Shel
phreng113. It should therefore not be included in the thang sman category also
because its aerial organs survive in winter. Yet this plant, being imported from
the hot regions of India, Nepal, and China and sold on local markets, might
have not been observed directly on the field by Tibetan doctors who therefore
do not know its vegetative cycle and have only seen stems and branches. In
this reference some traditional doctors from Baragaon and Dharamsala have
stated that some medicines of the plains may have a woody stem, but that it
dries up at the beginning of the cold season.
I will now examine the meaning of the term ldum bu which, according to
the medical dictionary gSo ba rig pai tshig mdzod g.yu thog dgongs rgyan, is
the following: name of the herbaceous plants (sngo) that, as re ral114, dwa ba
(Arisaema spp), and snya lo (Polygonum polystachyum)115, are not cultivated
plants, naturally grown green grass (rtswa) and flowers planted in a garden,
but that grow together with these.116 The same source also mentions an almost
identical definition ascribed to Deu dmar dge bshes117: lDum bu are not
cultivated plants, green grass and garden flowers, but the name of the
herbaceous plants that grow together with these. The three plants taken as
examples in the above definitions are included in the category thang sman in
the Shel phreng118. They exhibit morphological and ecological features that
correspond to the ones described by Deu dmar dge bshes for the thang sman.
Re ral, a stout plant having robust underground organs, and dwa ba with
tuberous roots mostly grow in forests. sNya lo is a shrubby herbaceous plant
which thrives between 2,000 and 4,000 metres.
We may therefore put forward that the plants designated ldum mainly include
herbaceous plants having robust underground organs and\or stout herbaceous
stems. Only in some cases they are tiny shrubs. Thus thang medicines are also
named ldum medicines because they may exhibit the above morphological
features.
This assumption is supported by the data reported by informants and written
sources which attribute the category of herbaceous medicines (sngo sman) a

PLANT CATEGORIES AND TYPES ... 77

few distinctive morphological and ecological features opposite to the ones of

thang sman. Actually the majority of practitioners from different regions
associate the expression sngo sman to medicinal herbaceous plants that are
tiny, tender, that have small roots and grow mostly on the mountains (ri la).
Deu dmar dge bshes corroborates these statements when in the Shel phreng119
writes that the sngo [sman] are a type of herbaceous plants that have a type of
tiny underground organs. The analysis of the botanical identification of the
plants belonging to this category, for example in the materia medica of Karma
chos phel120, has shown that most botanical species consist of tiny herbaceous
plants with slender underground organs. In the same treatise121 it is affirmed
that sngo sman are plants which grow anew each year but the plants included
in the thang sman category also share this feature.
Thus the parameters of distinction between the categories thang sman and
sngo sman may be the following: as concerns the underground organs, the size
is tiny and slender in the ngo sman and big and robust in the thang sman; as
concerns the stem, it is thin and green-tender in the former, stout and hardrigid in the latter; as concerns the environment of growth, the sngo sman thrive
on high mountains and plateaus and the thang sman at lower altitude. According
to some traditional doctors from Baragaon all these parameters need not to be
present at the same time. After examining the plants included in the two
categories it seems that morphological features, in particular underground organ
size, are more important than the environmental ones in defining the medicines
of the thang sman category. For example, chu rtsa is a stout herbaceous plant
with a thick root, which grows at high altitude (4,100-5,200 m.).
According to the descriptions given in The Crystal Rosary most of the
sngo sman (nearly 90%) and the majority (roughly 75%) of thang sman come
from Tibetan regions. These data are corroborated by the modern materia
medica of Karma chos phel122 that presents the plant botanical identifications.
According to it, the 68.75% of the thang sman come directly from proper
Tibetan plateau areas while the 18.75% from the Tibetan regions called rong,
which are relatively low forested river valleys. The 12.5% come from abroad,
particularly from the sub-tropical and tropical regions of India, Nepal, and
China. As to the sngo sman medicines, 78.41% come from proper Tibetan
plateau regions, 15.41% from rong areas, and 6.18% from sub-tropical and
tropical regions.
THE CROP MEDICINES
Several Tibetan pharmacopoeias as the Shel phreng123 describe a category
including some vegetables and cereals and give it the name of lo tog gi sman,
crop medicines, among which we find bras (Oriza sativa), sre da (Avena
sativa), rgya sran (Vicia faba), yungs dkar (Brassica alba), la phug (Raphanus
sativus), and a sho pa tra (Zea mays)124.
This group is not described in The Four Tantras, where edible plants are
dealt with in the three chapters devoted to dietetics125. In a modern Tibetan
pharmacopoeia126 this category is designated brui sman, grain medicines.
Although the meaning of the term bru is a grain of anything127, vegetables
such as turnips (nyung ma, Brassica rapa) 128 and radish (la phug) are included
in it.

78 TIBET JOURNAL
THE TYPES
Each medicinal substance, notwithstanding the category to which it belongs,
may exhibit some types (rigs). Relatively detailed descriptions of them are
presented in the Vaidurya sngon po129 and, furnishing interesting information
as concerns plant morphological and ecological features, in the Shel phreng.
Modern Tibetan medical texts give in-depth descriptions of the different plant
types as well, most of which are based on the above classical treatises.
The plant classification in types as reported in written sources is probably
the most common categorisation, which however may not be accepted by all
practitioners. Since Tibetan medicine is practised over a huge area throughout
several countries130, its materia medica may show differences according to
local vegetation, traditions, and foreign influences. All these factors may affect
plant traditional identification and classification as our field data have shown.
Thus Tibetan materia medica, as Tibetan medicine in general, is not to be
considered as standard and static both in time and space, but as a tradition that
has been constantly evolving.
Plant types are usually differentiated and categorized on the basis of a small
number of features, whose recognition may be crucial because each plant type
may have peculiar therapeutic properties, a different time and method of
gathering, drying, and a dissimilar use. Some plant types may belong to different
plant forms 131 as in the case of khyung sder, a woody plant that has two
herbaceous types: sngo khyung sder dkar po, and sngo khyung sder smug po132.
Here follow the most frequent classification criteria.
Some plant may be categorised on the basis of their therapeutic properties
in three (or two) types. In this case the following determinants are added to
the name of the plant: mchog, superior, which indicates the type having the
best therapeutic properties; bring, intermediate, which specifies intermediate
therapeutic properties; dman, inferior, designating the types having weak
potency 133. Several types of well-known medicinal plants are categorized
according to the above criterion as below: hong len mchog (Picrorhiza
scrophulariiflora)134, hong len dman pa (Lagotis glauca)135; klu bdud rdo rje
mchog (Codonopsis mollis) 136 , klu bdud rdo rje dman pa (Adenophora
liliifolia)137; ug chos mchog (Incarvillea grandiflora)138, ug chos dman pa
(Incarvillea arguta)139; spra thog (Leontopodium dedekensii) and spra ga dman
pa (Gnaphalium strackeyi)140.
I met a traditional doctor from Litang that was used to distinguishing subtypes (or varieties) of a plant type on the basis of the same criterion, each subtype having different therapeutic properties determined by the features of its
environment of growth. This practical classification has been worked out by
the practitioner for the area where he carries out the plant gathering. This is
the case of the well-known medicinal plant bong nga that consists of four
types141: amongst these, the type named bong nga nag po (Aconitum spp.),
black bong nga, is a plant that has cold potency (nus pa bsil). Three subtypes of it are distinguished by the informant, each one having a different
potency in relation to altitude and aspect142: bong nag143 mchog, superior bong
nag, which thrives at high altitude on the shady side of the mountains and
whose cold potency is particularly strong; bong nag bring, intermediate bong

PLANT CATEGORIES AND TYPES ... 79

nag, which also grows on shady mountainsides, but at lower altitude, and
that is why its potency is less strong; bong nag dman, inferior bong nag,
which thrives on the sunny mountainsides. In this case the power of the sun
decreases the cold potency of the plant, which is gathered only in case of lack
in the other sub-types.
The flower colour is a parameter frequently employed to distinguish and
categorise the different types of a plant, for example, as concerns shang shang
dril bu, bell of shang shang 144, a plant that belongs to the herbaceous
medicines (sngo sman). Traditional doctors from different regions describe
several types (they all belong to the botanical genus Primula) of this medicinal
plant, which are distinguished from their flower colour. A practitioner from
Baragaon recognizes three types: shang dril ser po (yellow shang dril,
Primula sikkimensis), shang dril dkar po (white shang dril, P. atrodentata)
and shang dril smug po (purple-brown shang dril, P. atrodentata) 145.
Practitioners from Litang County distinguish the following types: shang dril
ser po (P. sikkimensis), shang dril smug po (Primula sp.) and shang dril dmar
po (red shang dril, P. secundiflora).
A Tibetan doctor from Khyungpo (east Tibet) has reported that there are
five types of this plant: shang dril dkar po, shang dril dmar po, shang dril ser
po (P. sikkimensis), shang dril smug po, and shang dril nag po (black shang
dril, P. atrodentata). The informant has affirmed that the designation shang
dril nag po, only used in Khyungpo and in few other Tibetan regions, is a
synonym for the more common shang dril sngon po, blue shang dril. The
name shang dril nag po is not mentioned in the classical and modern
pharmacopoeias examined. Similarly, traditional doctors from the region of
Dolpo use the expression shang dril sngon po as a synonym of shang dril nag
po (Primula macrophylla)146, thus corroborating the information reported by
the informant from Khyungpo.
Deu dmar dge bshes147 describes three different classifications: 1) in three
types: dmar po, dkar po, ser po; 2) in four types: dkar po, dmar po, sngon po,
ser po; 3) in four types: dkar po, dmar po, smug po148, ser po. In the last
classification model the author presents the classification parameters: the
principal is the flower colour, but it is also stated that the red and the yellow
types thrive on wet soils (chu las skye, to be born from water) whereas white
and purple-brown types grow on dry soils (skam sar skye).
The disparities between the classifications reported can be explained
referring to changing ecological conditions and local traditions in the different
Himalayan and Tibetan regions.
Some classifications are devised according to the size of the plant or of
some of its organs. In this case the determinant chen (big) may be added to the
big type and the determinant chung (small) to the small type. For example,
thar nu includes two types that exhibit similar morphological features and that
are classified on the basis of the size of some of their organs: thar chen, big
thar nu (Euphorbia wallichii), has larger and thicker leaves and a stouter
stalk than the type named thar chung, small thar nu (Euphorbia longifolia)149.
Three types of star bu (Hippophae spp.) are distinguished according to
their height: star bu gnam star, star bu bar star, star bu sa star. For each type
a determinant which points out to the height of the plant is employed: gnam,

80 TIBET JOURNAL
sky, bar intermediate space, and sa, ground. The first designates the
highest type, the last the lowest one150.
Feminine (mo), masculine (pho) and, if necessary, hermaphrodite (ma ning)
types of a plant may be distinguished in Tibetan medicine. The classification
is usually worked out on the basis of the following parameters: plant general
aspect, size of the entire plant or of one of its organs (usually flowers), other
minute morphological features. Plant size is the most frequent parameter of
classification: masculine types usually have a big size while feminine ones are
small. Hermaphrodite types may exhibit intermediate size between masculine
and feminine plants or simultaneous masculine and feminine features. This
classification may also imply some inferences on the modalities of
administration of each type. For example in the case of me tog glang sna151
masculine plants (pho glang, Pedicularis integrifolia) have to be administered
to feminine patients and feminine plants (mo glang, Pedicularis anas)152 to
male patients whereas hermaphrodite plants (ma ning glang) may be
administered to both.
Some plants are separated into types according to their environment of
growth. Medicinal plant types may thrive in the meadows (spang), between
rocks (brag), and in forests (nags). A traditional doctor from Baragaon
categorises three types of mtshe ldum: brag mtshe, spang mtshe, and chu (water)
mtshe, the last type thrives near streams and on wet grounds153.
A few plants are separated into two types: the former, designated g.yung
(domestic), usually grows in areas that are not located at high altitude as in
forested valleys (rong) and near villages and sometimes even in house gardens
(ldum ra); the latter, named rgod (wild), usually thrives on the mountains (ri
la) at high altitude (sa cha mtho po) where the climate is harsh154. For example,
Deu dmar dge bshes 155 describes two types of dwa ba: the type designated
dwa rgod grows on the mountains, the one named dwa g.yung thrives in the
cultivated fields.
The classification may depend on the medical traditions Byang and Zur. At
the end of the XV century two schools of Tibetan medicine were established
by two famous traditional doctors: Byang pa, descendant of the king of Minyak
(a region located in eastern Tibet), Seu rgyal po, and Zur mkhar ba mNyam
nyid rdo rje. The former established the Byang lugs medical tradition, the
latter the Zur lugs one. These traditions, which exhibit little differences 156,
formally survived until the reign of the Fifth Dalai Lama (1617-1682) in the
seventeenth century. Some practitioners have stated that they may follow one
of the two medical schools in the case of the classification and identification
of certain medicinal plants. For example according to two informants from
Khyungpo and Baragaon there is a type of dug mo nyung (Holarrhena
antidysenterica) designated sngo dug mo nyung (Cynanchum vincetoxicum)157
that has been categorized and identified by the Byang school. Similarly they
have affirmed that the identification of ut pal sngon po differs in relation to
Byang and Zur schools: the former recognises it as an aster (Aster
tricephalus)158, the latter as a blue poppy (Meconopsis spp.). The majority of
practitioners over Tibetan regions adhere to the identification of the Zur
tradition.

PLANT CATEGORIES AND TYPES ... 81

CONCLUSION
The classification of medicinal plants dealt with in this article is constant among
traditional doctors from different Tibetan regions and almost corresponds to
the one described on classical texts of Tibetan materia medica. Yet I emphasise
the existence of a significant disparity of knowledge owing to the recent modern
standardisation of Tibetan medicine. Many practitioners practising in
dispensaries and clinics which depend on important medical institutes and who
do not carry out any more the gathering of medicinal plants and do not make
the remedies have an imprecise knowledge of the materia medica, of its
classification and identification and of the criteria of attribution of curative
properties to substances. Only a moderate number of informants, particularly
independent practitioners, have a deep knowledge of medicinal plants and their
use, based on a detailed knowledge of medical texts, an education with a learned
master, and a great field experience.
The recent introduction under Chinese influence of a new terminology and
the attempt of devising a new classification reflecting the one of modern science
so far has had a slight impact on traditional classification.
Few medicinal substances have been shifted from one category to another
owing either to their importance in Chinese medicine or to the attempt of
reallocating them according to the classification of modern science.
The classification of medicinal plants in types, although based on the same
criteria such as plant morphological traits, place of growth, and quality, may
vary significantly according to climatic conditions, local traditions and medical
schools. That is why the same Tibetan plant designation may correspond to
different botanical species.
The peculiar botanical and medical knowledge of independent practitioners,
in particular of the ones of family lineage, might disappear in the near future
because of the standardisation and modernisation of Tibetan medicine.
Notes
1.
2.

And probably to a lesser extent also by the pharmacopoeia of Chinese medicine.

The data have been obtained during a research project on the ethnobotany of Tibetan
speaking populations, undertaken by the author from 1998 to 2002 in different regions
of the Tibetan cultural area: the Litang County (Sichuan, China), the region of
Baragaon (Mustang District, Central Nepal), Dhorpatan (Baglung District, Central
Nepal), and Ladakh (Jammu & Kashmir, India). Medicinal plant specimens gathered
on the field have been identified in collaboration with professor J. F. Dobremez
(Laboratoire dEcologie Alpine, Universit de Savoie, France) and have been deposited
at the Herbarium of the Musum National dHistoire Naturelle de Paris, France.
Classical texts of Tibetan medicine and some traditional and modern treatises of
Tibetan materia medica have been employed to analyse medicinal plant classification:
The Four Tantras (rGyud bzhi), the fundamental text of Tibetan medicine (g.Yu
thog Yon tan mgon po, 1992), probably composed between the VIII and the XII
century; its famous commentary The Blue Beryl (Vaidurya sngon po), written by
the Regent sDe srid Sangs rgyas rgya mtsho (1982) in the XVII century; The Crystal
Block (Shel gong) and the commentary to it The Crystal Rosary (Shel phreng)
(Deu dmar dge bshes bsTan dzin phun tshogs, 1994), two of the most important
classical texts of Tibetan materia medica, both written in the first half of the XVIII
century; two modern Tibetan pharmacopoeias published at Lhasa (Karma chos phel,

82 TIBET JOURNAL

3.
4.

5.

6.
7.
8.

9.
10.
11.
12.
13.
14.
15.

16.

17.
18.
19.
20.
21.
22.
23.

1993) and Chamdo (dGa bai rdo rje, 1998). I am grateful to the Museum of
Archaeology of the University of Cambridge (Frederick Williamson Memorial Fund)
and Padma A. G. (Switzerland) for supporting part of the fieldwork.
Proper Tibetan spellings are given according to the Wylie (1959) system of
transliteration (minus the hyphen in between syllables).
The term potency (nus pa) points out to the action that a substance may originate
by means of its features and qualities. In Tibetan medicine this expression designates
both particular qualities of medicinal substances, which constitute their therapeutic
properties (the eight nus pa), and their therapeutic effect (Boesi, 2004: 48-50).
From the ethnobiological perspective the so-called plant types (rigs) correspond
here to the taxa designated by Berlin (1992: 22) specific, and varietal. Although
the meaning of the term rigs may be type, class, category, and kind, it is
mainly used by Tibetan practitioners to indicate plant types and varieties. They usually
share their primary name (Ibidem: 27) (also designated basic name according to
Conklin, 1954) and are differentiated by adding a specific (or two in the case of
varieties) determinant.
Cardi, 2004.
Meyer, 1983: 71.
The commonly employed expression sman, medicine, designates all substances
that have therapeutic properties and includes both medicinal plants and the other
medicinal substances of mineral and animal origin. This term also indicates medicinal
preparations.
Also written rtsii sman.
sMan gyi nus pa bstan pa /, Explanation of the medicine potency. g.Yu thog Yon
tan mgon po, 1992, bShad pai rgyud (Explanatory Tantra), Chapter 20: 75.
Ibidem: 68, 70.
sDe srid Sangs rgyas rgya mtsho, 1982, Commentary to the Explanatory Tantra (bShad
pai rgyud kyi rnam bshad), Chapter 20: 262.
Deu dmar dge bshes, 1994: 180-255, 305-395.
Ibidem: 255-304.
Over the Tibetan cultural regions, thang phrom exhibits some types that correspond
to several species of the botanical family of Solanaceae. For example, according to
my field data from the Litang County the white type (thang phrom dkar po)
corresponds to Hyoscyamus niger whereas the black type (thang phrom nag po)
corresponds to Anisodus tanguticus.
The botanical identifications presented in this article are mainly the ones reported in
modern Tibetan materia medica and the ones related to the specimens gathered on
the field by the author. I would like to point out that, because the botanical identification
of Tibetan materia medica may vary according to several factors as explained in the
article, the identification presented may represent only one of the possible botanical
species to which a Tibetan designation corresponds.
Specimen gathered in the region of Baragaon.
Specimen gathered in the region of Dhorpatan. The same botanical identification is
mentioned in the two modern pharmacopoeias used as reference (see note 4).
g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20.
Deu dmar dge bshes, 1994: 396-409.
sDe srid Sangs rgyas rgya mtsho: 1982, Commentary to the Explanatory Tantra (bShad
pai rgyud kyi rnam bshad), Chapter 20: 322.
Parfionovich et al., 1992: 73.
g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 68.

PLANT CATEGORIES AND TYPES ... 83

24. See the section devoted to essence medicines for the identification of these medicinal
substances according to modern science.
25. dGa bai rdo rje, 1998: 66. Parmelia tinctorum is a lichen that grows in crust like
form on rocks and trees.
26. This category includes mineral substances such as hematite, calcite, and a few fossils.
27. Deu dmar dge bshes, 1994: 144.
28. g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 67.
29. This category consists of two groups of substances of mineral origin: natural (rang
byung pa, self originated) and non-natural (las kyi bcos bas gtsang par byas pa,
that have been purified with an artifical intervention).
30. dGa bai rdo rje, 1998: 66.
31. Karma chos phel, 1993: 303.
32. Another suitable translation of the expression rtsi sman may be nectarous medicines
as proposed by Parfionovich et al. (1992: 63).
33. The musk deer is well-known because of his musk pod, a small sac (6 cm. long)
situated in the inguinal region. The glands inside the pod produce the musk, a substance
with a very strong scent that is secreted by the males during the rut season. Several
species of musk deer exists over Tibetan regions: Moschus sifanicus lives in alpine
areas, Moschus berezovskii in subalpine regions (Schaller G., personal communication,
2001) whilst Moschus chrysogaster is common in Himalayan regions. In the region
of Khams (east Tibet) I have observed Tibetan people trying to sell the musk to
Tibetan medical institutes as the one in Dar rtse mdo, and to traders of medicinal
plants.
34. According to the recent pharmacopoeias edited at Lhasa and Chamdo, this substance
corresponds to the bile of Selenarctos thibetanus. Karma chos phel, 1992: 19; dGa
bai rdo rje, 1998: 104.
35. Some informants from Ladakh affirm that this drug is an animal substance coming
from the excreta of a bra (Ochotona spp.).
36. g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 68.
37. Deu dmar dge bshes, 1994: 154-155.
38. The meaning of the expressions thang and sngo will be examined in the section
devoted to thang sman and sngo sman.
39. sDe srid Sangs rgyas rgya mtsho, 1982, Commentary to the Explanatory Tantra (bShad
pai rgyud kyi rnam bshad), Chapter 20: 262.
40. According to dGa bai rdo rje (1998: 96-112), cu gang corresponds to silica secretion
from the stem of Schizostachyum chinense and Bambusa textilis; gur gum to Crocus
sativus; sug smel to Amomum compactum and to Elettaria cardamomum; dzwa ti to
Myristica fragrans; li shi to Eugenia aromatica; ka ko la to Amomum tsao and to A.
subulatum. According to Karma chos phel (1992: 5-16), cu gang corresponds to
silica secretion from the stem of Schizostachyum chinense; gur gum corresponds to
Crocus sativus (kha che gur gum); sug smel to Elettaria cardamomum; dzwa ti to
Myristica fragrans; li shi to Eugenia caryophyllata; ka ko la to Amomum tsao and to
A. subulatum.
41. Deu dmar dge bshes, 1994: 154-179.
42. According to dGa bai rdo rje (1998: 97-98) and Karma chos phel (1993: 3) it
corresponds to Dryobalanops aromatica, Blumea balsamifera, and Cinammomum
camphora.
43. Deu dmar dge bshes, 1994: 326.
44. The Tibetan expression utpala is the transliteration of the Sanskrit word utpala that
points out to the blue lotus. Some plants thriving in Tibetan regions are the substitutes

84 TIBET JOURNAL

45.
46.
47.
48.

49.
50.
51.
52.

53.
54.
55.
56.

57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.

73.
74.
75.
76.

for plants that once were imported from India. Some of them have maintained their
original Sanskrit designation as in this case.
See Sharma et al., 1993: 430-431; Nadkarni, 1999: 859-860.
Deu dmar dge bshes, 1994: 326.
Jam dpal rdo rje, 1971: folio 173.
All Tibetans believe that during winter the dbyar rtswa dgun bu, summer-grass
winter-worm, lives as a worm and that, after a metamorphosis occurring at the
beginning of spring, it changes into a kind of grass (rtswa). Boesi, 2003: 32.
dGa bai rdo rje, 1998: 109.
Karma chos phel, 1993: 177.
Jam dpal rdo rje, 1971: folio 168.
To my knowledge, the oldest treatise of Tibetan medicine where dbyar rtswa dgun
bu is mentioned is the Bye ba ring bsrel (Relics Empowered by Millions of Oral
Instructions), composed in the XV century by Zur mkhar mNyam nyid rdo rje (14391475) (Zur mkhar mNyam nyid rdo rje, 1985) (Acknowledgment to Olaf Czaja for
indicating me this).
Chandra Das, 1992: 1010.
Meyer, 1983: 171.
The translation of the term rtsi sman in this text is Exudates and secretions. Jam
dpal rdo rje, 1971: 6.
The potency (nus pa) of some drugs is determined by the presence and strength of
their fragrance. This property is designated drii nus pa the potency of fragrance.
The presence of scent is also a crucial parameter for the attribution of curative
properties in the case of some plants included in other categories. For example, tsan
dan dmar po (Pterocarpus santalinus) and tsan dan dkar po (Santalum album) that
belong to the medicines coming from woody plants (shing sman) and spang spos
(Nardostachys grandiflora) that is included in the category of herbaceous medicines
(sngo sman).
Deu dmar dge bshes, 1994: 154-179.
Kunsang, 1996.
dGa bai rdo rje, 1998: 96.
Ibidem.
Ibidem: 112.
Deu dmar dge bshes, 1994: 410.
g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 73.
Ibidem: 68.
See the next section: ldum bu thang sman, ldum sman.
Literally new born.
Deu dmar dge bshes, 1994: 180, 250. The author employs the term tshi ba as synonym
of thang chu.
In the Shel phreng (Ibidem) the group including plant skins is named pags pa, the
one including branches yal phran and the one of plant exudates tshi ba thang chu.
Ibidem: 10.
Ibidem: 180.
Ibidem: 245.
I point out that Deu dmar dge bshes (1994: 226, 248) describes two types of se ba:
a wild type, se rgod, and a domestic one se g.yung, which are mainly distinguished
according to morphological features.
Ibidem: 215.
Ibidem: 226.
Ibidem: 248.
Ibidem: 227.

PLANT CATEGORIES AND TYPES ... 85

77. Ibidem: 247.

78. sDe srid Sangs rgyas rgya mtsho, 1982, Commentary to the Explanatory Tantra (bShad
pai rgyud kyi rnam bshad), chapter 20: 262.
79. For the botanical identification of the three last plants see dGa bai rdo rje, 1988:
148, 149, 164.
80. For the botanical identification of the three last plants see Karma chos phel, 1993:
23-27.
81. Deu dmar dge bshes, 1994: 74-75.
82. For example, khyi shing (Lonicera thibetica); dzo mo shing (Caragana ericacea);
sur dkar (Rhododendron sp.), sur nag (Rhododendron sp.); skyer pa (Berberis sp.);
spen nag (Dasiphora fruticosa).
83. dGa bai rdo rje, 1988: 119.
84. Differently, according to the Shel phreng (Deu dmar dge bshes, 1994: 278), khyung
sder belongs to the category of thang sman (medicines of the plains), which, as it
will be shown in the next section, includes the herbaceous plants and a few tiny
woody plants.
85. dGa bai rdo rje, 1988: 119.
86. Ibidem.
87. g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 68.
88. Deu dmar dge bshes, 1994: 15.
89. Ibidem: 72-75, 255.
90. It is quite difficult to work out an appropriate translation in English of the Tibetan
term ldum according to its use in Tibetan medicine.
91. Thang zhes pa dang ldum bu ni don gcig /. Deu dmar dge bshes, 1994: 75.
92. g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapter
20: 68.
93. Deu dmar dge bshes, 1994: 255.
94. Ibidem: 75.
95. I point out to dGa bai rdo rje (1998).
96. Chandra Das, 1992: 568; Krang dbyi sun, 1998: 1140.
97. The term thang (soup) comes in this case from Chinese language and, in particular,
from the thang preparations of Chinese medicine.
98. As far as the category thang sman is concerned Meyer maintains: Il ne sagit pas de
mdecine prpare par dcoction partir de diffrentes parties de plantes comme
on le trouve dans la table des matires de An Illustrated Tibeto-Mongolian Materia
Medica of Ayurveda [Jam dpal rdo rje, 1971], mais du nom gnrique dun groupe
de drogues vgtales qui ne prjuge pas de leur technique de prparation. A lcole
de mdecine de Dharamsala, le terme thang sman est interprt comme mdecines
de plaine. En ralit ce groupe contient des plantes aux habitats trs divers et non
limits aux plaines (Meyer, 1983: 171). The same incorrect interpretation of the
expression thang sman occurring in the edition of the materia medica of Jam dpal
rdo rje has also been put forward by Dash (1994: XXIV).
99. Tibetan practitioners also employ the term snyoms po to designate the nature of a
medicinal plant when it is neither hot nor cold.
100. rDza ri g.ya ri gangs ri lta bu mtho sar skyes pa ma yin par bde thang du skye bai
sman gyi rigs ming ste /. Byangs pa Phrin las, 1983: 216. The same definition is
proposed in the dictionary Bod rgya tshig mdzod chen mo (Krang dbyi sun, 1998:
1142-1143).
101. Most educated and non-educated informants from different regions have affirmed
that the expression g.ya ri connotes the mountains whose ground consists of many
flat stones (rdo leb) and earth (sa) and where to slide is easy. The dictionary Bod rgya
tshig mdzod chen mo (Krang dbyi sun, 1998: 2617) proposes the following definition

86 TIBET JOURNAL
for the term g.ya ri: mountains that consists of small flat stones and of stones of
bluish colour.
102. Karma chos phel, 1993: 132.
103. Ibidem: 143. The latest Latin binomial of this plant is Justicia adhatoda (Hara and
Williams, 1979: 141). It is a woody plant imported from sub-tropical regions of India
and Nepal. Yet there is also a type of this plant directly gathered in Tibetan regions,
which is considered inferior (dman) as its quality is concerned. Three practitioners
from Khyungbo, Baragaon, and Litang designate this plant sngo ba sha ka,
herbaceous ba sha ka. Its botanical identification corresponds at Dhorpatan to
Corydalis longipes, a herbaceous plant. dGa bai rdo rje (1998: 142) mentions a
type named ldum ba sha ka, whose botanical identification correspond to Corydalis
impatiens.
104. See for example, Parfionovich et al., 1992: 63.
105. Deu dmar dge bshes, 1994: 75.
106. dGa bai rdo rje, 1998: 260; Karma chos phel, 1993: 145.
107. Botanical identification of the specimen gathered by the author in the Litang County.
According to dGa bai rdo rje (1998: 198) lcum corresponds to Rheum officinale.
108. rTsa ba rgyas shing lo sdong sogs lo rer shing ltar skye yang dgun nas rtsa ba ma
gtogs sngo ltar rgas nas lo re bzhin brje bas ma nu dang lcum lta bui rigs la / rgyud
las / thang gi gtso bo tig ta ba sha ka / gsungs pas rtsa ba shing la sdong po ldum lo
me sngoi rang bzhin can/. Deu dmar dge bshes, 1994: 75.
109. Karma chos phel, 1993; dGa bai rdo rje, 1998.
110. The term ldum may be generally employed in the common language with a sense
similar to the one of the term sngo. Le dictionary Tshig mdzod chen mo (Krang dbyi
sun, 1998 : 1454) proposes the following definition: general term equivalent to sngo.
111. In Tibetan materia medica several type of tig ta are described. The standard tig ta
also called rgya tig (rgya gar gyi tig ta, Indian tig ta) is the one which mainly
thrives to the south of the Himalayan chain. This plant has been identified as Swertia
chirayita (dGa bai rdo rje, 1998: 205; Karma chos phel, 1993: 132).
112. Deu dmar dge bshes, 1994: 255.
113. Ibidem: 258.
114. Some types of re ral (or ldum bu re ral) have been described by my informants and in
written sources. For example, Deu dmar dge bshes (1994: 276) states that it may be
classified in three types: 1) rgyal po (king) re ral, 2) blon po (minister) re ral, 3)
btsun mo (queen) re ral. He also quotes a text (khrung dpe) where three types of this
drug are distinguished according to their place of growth: ldum bu re ral, be ljang re
ral, and g.yu brug khyil ba. Most informants report the latter classification. In
modern Tibetan materia medica botanical identification of this plant may vary:
according to dGa bai rdo rje (1998: 223) rgyal po re ral corresponds to Drynaria
sinica, be ljang re ral to D. propinqua, and g.yu brug khyil ba to Polystichum
squarrosum. According to Karma chos phel (1993: 184-186) the above drugs
respectively correspond to Polistychum squarrosum, Drynaria baronii, and D.
propinqua. According to the same author (1993: 187-189), blon po re ral is a synonym
for brag spos (Lepisorus waltonii), btsun mo re ral corresponds to Aleuritopteris
argentea or it is a synonym for brag skya ha po (Corallodiscus kingianus).
115. I have collected this plant in the Litang County. Its botanical identification corresponds
to the one reported in the materia medica of dGa bai rdo rje (1988: 203) and Karma
chos phel (1993: 201).
116. Byangs pa phrin las, 1983: 277. So nam byas pai lo thog dang / rang bzhin skyes
pai rtswa ljang / ldum rar btsugs pai me tog bcas ma yin pa de dag dang mnyam du
skyes pai re ral dang / dwa ba / snya lo lta bu sngoi ming ste /.
117. Ibidem. lDum bu lo thog rtswa ljang dang / ldum rai me tog ma yin pai / de dag
mnyam skyes sngo yi ming /. The dictionary quotes as source of this definition a

PLANT CATEGORIES AND TYPES ... 87

medical text composed by Deu dmar dge bshes: gSo rig skor gyi ming tshig nyer
mkhoi don gsal.
118. Deu dmar dge bshes, 1994: 276, 283, 284.
119. Ibidem: 75. sNgo ni rtsa ba phra bai rigs kyi rtswai rigs so /.
120. Karma chos phel, 1993: 255-473. We have chosen this text because it is the only
modern pharmacopoeia that presents the drug botanical identification and maintains
the correct traditional classification in categories.
121. Ibidem: 1993: 255.
122. Karma chos phel, 1993.
123. Deu dmar dge bshes, 1994: 458. The complete name is zhing gi lo tog las byung bai
sman.
124. As far as the botanical identification of these plants is concerned, see Karma chos
phel, 1993: 474-491.
125. g.Yu thog Yon tan mgon po, 1992, Explanatory Tantra (bShad pai rgyud), Chapters
16, 17, 18.
126. dGa bai rdo rje, 1998: 323-331.
127. Chandra Das, 1992: 931.
128. dGa bai rdo rje, 1998: 325. According to Karma chos phel (1993: 487) this plant
corresponds to Raphanus sp.
129. sDe srid Sangs rgyas rgya mtsho, 1982, Commentary to the Explanatory Tantra (bShad
pai rgyud kyi rnam bshad), Chapter 20: 249-350.
130. Tibetan medicine is practised over a vast area which covers all the regions inhabited
by populations of Tibetan language and culture and other areas: the northern states of
India (Jammu & Kashmir, Himachal Pradesh, West Bengal, and Sikkim); Bhutan; a
large part of the northern regions of Nepal; the following Chinese Provinces: Tibetan
Autonomous Region, Qinghai, Gansu, Sichuan and Yunnan; Mongolia; Buryat
(Russia); and other many countries where Tibetans have settled.
131. As Berlin (1992: 166-167) reports ...such broadly inclusive classes [plant forms]
generally occur as the first major groupings within each ethnobiological classification
kingdom, forming a contrastive group of a small number of taxa of plants and
animals...While some groupings correspond rather closely to recognized scientific
higher-order taxa, most life-form taxa do not reflect biologically natural classes of
organisms....In the plant world, the focus of major differences based on stem habit,
probably one of the primary perceptual features leading to the recognition of the
most common major life-form taxa found in folk systems of ethnobiological
classification (e.g. tree, vine, herbaceous plant), leads to grouping that often
violate natural biological taxa at the family level. Tibetan people recognize five or
four plant forms, listed according to two different models. 1) The five plant forms are
mushrooms (sha mo), grasses (rtswa), flowers (me tog), woody plants (shing sdong),
and woody climbers (khri shing). 2) In the second model plant forms consist of four
taxa: mushrooms (sha mo), herbaceous plants (rtswa), woody plants (shing sdong),
and woody climbers (khri shing). In this model the categories rtswa (herbs) and me
tog (flowers) of the first model are included in a single taxon named rtswa (Boesi,
2005: 45-46).
132. See the section devoted to shing sman for the identification of these two drugs
according to modern botany.
133. Sometimes, in particular on written sources, the following determinants are also
employed: rab excellent, bzang good; dma inferior, ngan bad.
134. Karma chos phel, 1993: 255. The specimen gathered in the region of Baragaon
corresponds to the same botanical species.
135. Ibidem: 257.
136. Ibidem: 396.
137. Ibidem: 398.

88 TIBET JOURNAL
138. Specimen gathered in the Litang County.
139. Specimen gathered in the region of Baragaon.
140. The two last specimens have been gathered in the Litang County.
141. The four types are the following: black (bong nga nag po), white (bong nga dkar
po), red (bong nga dmar po), and yellow (bong nga ser po).
142. As it is described in the rGyud bzhi (g.Yu thog Yon tan mgon po, 1992, Explanatory
Tantra (bShad pai rgyud), Chapter 20: 65): the snowy mountain and the bigs byed
mountain, having [respectively] the power of the moon and of the sun, possess a
power which becomes increasingly cold or hot. In particular, the hot (tsha) power
(stobs) of the sun dominates on the sunny slopes (nyin), whilst the cold (bsil) power
of the moon prevails on the shady ones (srib).
143. Abbreviation of bong nga nag po.
144. Shang shang: a mythological bird similar to a Garuda.
145. Primula atrodentata has flowers whose colour may vary from purple to mauve-blue
or white. In this case, the two types white and purple-brown correspond to the
same botanical species.
146. Lama, Ghimire, Thomas, 2001: 106.
147. Deu dmar dge bshes, 1994: 338-339.
148. Deu dmar dge bshes also states that the expressions shang dril smug po and shang
dril sngon po are synonyms. Thus the two classifications that differentiate four types
are equivalent.
149. The botanical identification of the two types refers to the specimens that have been
gathered in the region of Dhorpatan.
150. As far as the three types of star bu are concerned, it is difficult to find the exact
correspondence between their Tibetan designations and the botanical species. The
data given by the informants are often inconsistent. The cause of these differences is
determined by the difference of height that this plants may attain in ecological settings
that are sometimes contrasting. In particular, several informants have pointed out to
Hippophae rhamnoides subsp. turkestanica both as star bu sa star and star bu bar
star in the Indian region of Ladakh. The same appellations might be valid with H.
salicifolia whose size may also vary in relation to climatic conditions. It might also
be suggested that the latter plant, attaining nearly the height of 5 metres in very
favourable ecological conditions, is also designated star bu gnam star, as it has been
shown with the Nepalese regions of Dolpo (Lama, Ghimire, Thomas, 2001: 79). The
type star bu gnam star is usually described by the informants as a woody plant of big
size thriving at relatively low altitude in the so-called rong forested deep valleys. In
a recent Tibetan pharmacopoeia (dGa bai rdo rje, 1998: 131) star bu gnam star is
identified as Hippophae rhamnoides and star bu bar star as Hippophae neurocarpa.
According to my fieldwork data, in the region of Baragaon the type named star bu sa
star corresponds to H. tibetana. The same identification is given in the two above
quoted texts.
151. Me tog glang sna includes several types belonging to the botanical genus Pedicularis.
152. I have gathered these two medicinal plants in the Litang County.
153. Brag mtshe (Ephedra gerardiana) is the type observed in the region of Baragaon.
dGa bai rdo rje (1998: 269) describes three types of this plant two of which
correspond to Ephedra: mtshe ldum (E. equisetina) and spang mtshe (meadow
mtshe) (E. gerardiana, E. minuta). Yet the third type, named chu mtshe (water
mtshe), corresponds to a species (Equisetum diffusum) that belongs to a different
botanical division and interestingly has different healing properties from the other
two.
154. The two determinants do not always imply this difference of growing area as in the
case of se rgod and se g.yung, as shown in the section devoted to describing medicines
coming from woody plants (shing sman).

PLANT CATEGORIES AND TYPES ... 89

155. Deu dmar dge bshes, 1994: 283-284. Dwa ba dag la rigs gnyis te / ri las skyes pa
dwa rgod yin / zhing las skyes pa dwa g.yung te /.
156. The difference concerns the localisation of some vital points, the identification of
some drugs and the preparation of some formulas. Meyer (1983: 81) affirms that
these differences also reflect dissimilar ecological and epidemiological conditions.
157. Holarrhena antidysenterica is a plant that thrives in the low regions of India, Nepal
and China. (dGa bai rdo rje, 1998: 219). In the same text (ibidem) the botanical
identification of sngo dug mo nyung corresponds to Cynanchum vincetoxicum. Also
the specimen sngo dug mo nyung collected in Litang County corresponds to the
genus Cynanchum and is the Tibetan substitute to H. antidysenterica.
158. Specimen gathered in the region of Dhorpatan.
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g.Yu thog Yon tan mgon po, 1992. bDud rtsi snying po yan lag brgyad pa gsang ba man
ngag gi rgyud. Bod ljongs mi dmangs dpe skrun khang, Lhasa (This text is commonly
known as rGyud bzhi, The Four Tantras).
Zur mkhar ba mNyam nyid rdo rje, 1985. Bye ba ring bsrel. Tibet House, Delhi.

Principles and methods of assembling Tibetan medicaments

Francesca Cardi
INTRODUCTION
According to the Tibetan science of healing (gso ba rig pa)1 medicaments, along with
diet and behaviour, play a relevant role in the cure of illnesses. Tibetan medicaments
are nowadays employed in all Tibetan cultural regions and in many other countries
where Tibetan medicine has spread. Notwithstanding the general interest of scholars,
the public and pharmaceutical industry for traditional medicines and natural products,
limited information is at present available on Tibetan pharmacology and on the medical
practice that relates to medicament formulation and fabrication. Notably scientific
studies aimed at understanding the nature and the functioning of Tibetan medicaments
are rare. The extension of the area of study and the variability of the medical practice
do not facilitate the task of scientists wishing to study these topics.
In Tibetan medicine the term sman2 exhibits a few different meanings. It is commonly
employed to designate any medicinal substance independently from its nature, medicinal
preparations and, more in general, any other type of remedy. According to traditional
doctors, the term sman points out to any substance that cures (phen pa) and is beneficial
to health and is given to the patient to relieve his sufferings. Thus it is opposed to
whatever agent causing harm (gnod pa) to the body. It is worth noting that the expression
sman connotes a broader meaning amongst the Tibetan practitioners who, keeping on
to practise this discipline according to the tradition, see medicine as strictly connected
to the Buddhist doctrine and may also use religious rituals as remedies.
According to the rGyud bzhi3, there are four types of therapeutic antagonists (gnyen
po): behaviour (spyod lam), diet (zas tshul), medicaments (sman), and external therapy
(dpyad), which includes treatments such as moxibustion (me btsa), bloodletting (gtar),
and fomentations (lums). In the same text4 medications are divided according to their
potency into two groups of designated pacificators (zhi pa) and evacuators (sbyang
ba). The former includes all medicinal preparations (pills, powders, decoctions, )
that will be described further on in this article, the latter includes purges (bshal sman),
emetics (skyugs sman), nasal medications (sna sman), strong enemata (ni ru ha) and
mild enemata (jam rtsi).
Medicaments are prepared by mixing the different types of medicinal agents (of
mineral, plant and animal origin) that compose Tibetan materia medica. Although they
are mainly collected over the Tibetan plateau and Himalayan regions, several of them
come from the tropical and sub-tropical regions of India, Nepal, and China.
Tibetan traditional doctors reckon that any substance in the world, independently
from its nature and origin, has the property of alleviating illnesses. According to the
elemental theory of the matter5, one of the main principles of the Tibetan medical
science, all substances of the universe, either sentient or non-sentient, are composed of
five fundamental elements, Earth (sa), Water (chu), Fire (me), Wind (rlung) and Space
(nam mkha), which are responsible of all their features and qualities. Particularly the
elemental constitution of a substance is connected to its property of curing a disease.
Indeed Tibetan pharmacology exhibits sophisticated criteria of attribution of therapeutic
properties to medicinal substances, which are based on the above theory.

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The task of medicaments consists in maintaining and restoring the equilibrium within
the body and between the body and the outer world. In Tibetan medicine great emphasis
is attributed to medicament property of regulating the humoural6 equilibrium through
the intrinsic qualities of medicinal agents.
According to Tibetan practitioners, medicinal substances are seldom effective when
used alone and the best therapeutic efficacy is obtained by mixing several of them.
However this process should not be seen as the simple combination of the ingredients
according to analogous pharmacological properties. A significant aspect of the
fabrication consists in modulating the action and effectiveness of medicinal agents by
adjusting their amounts and/or by adding other medicinal substances. The compounding
of medicines is therefore a complex multi-step process carried out according to several
criteria and usually based on a pre-existing therapeutic model. The result of the
combination is a formula including different kinds of ingredients whose properties are
variable owing to the necessity of coordinating the therapeutic action, equilibrating
possible side effects, and rendering the medicine suitable to the patient. It is worth
noting that, according to most practitioners, all treatments should be prescribed and
even formulated, when possible, ad personam7.
This article aims at examining medicaments with particular reference to the following
points: the evaluation of the different types of medicaments and of the criteria upon
which their assembling is based, the procedure of mixing the ingredients, and the
functional groups of a medicinal formula. After assessing the general structure of
medicaments, I evaluate their fabrication methods and their traditional utilisation. The
second part of the article is devoted to examining the formulation process. I have also
tried to work out a medicament model that helps to explain the principles upon which
the organisation of formula ingredients is based.
The fieldwork has been carried out with traditional doctors from different Tibetan
cultural regions and in particular with independent8 practitioners who actually prepare
medicaments9.
The Four Tantras, its famous commentary The Blue Beryl, some modern formularies
and pharmacopoeias10 are the main reference sources that have been employed.
As concerns the results, I would like to point out that the classification and role of
the functional groups that compose medicaments, which have been dealt with in the
section The ingredient organisation, originate from the examination of a relatively
limited number of formulas, when compared to the many existing ones. Therefore
from the examination of broader data other inferences and outcomes might arise.
GENERAL FEATURES OF MEDICAMENTS
Tibetan medicaments are described in different ways such as on the basis of their
general features, method of preparation, main components, therapeutic properties and
administration.
The enumeration and description of the medicament types proposed by Tibetan
medical texts present some discrepancies. According to the rGyud bzhi11 and to its
commentary Vaidurya sngon po12, there are ten different categories of compound
medicines (sman sbyor gyi rigs): pills (ril bu), powders (phye ma), decoctions (thang),
concentrated medicines of type A13 (lde gu), medicinal wines (sman chang), medicinal
butters (sman mar), concentrated medicines of type B (khan da), medicinal ashes (thal
sman), precious pills (rin chen ril bu)14, and medicines from herbs (sngo sman). Yet
some recent medical publications describe fewer types. For example the volume edited

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... 93

by bSam gten15 does not mention medicinal ashes and medicinal wines, and precious
medicines are dealt with in the section devoted to classifying preparations on the basis
of potency. A few modern formularies16 mention only three-four types of preparations:
pills, decoctions, powders, and concentrated medicines of type B.
In The Four Tantras the description of the general therapeutic activity of each
medicament type is provided17. Thang, phye ma, ril bu, lde gu, and sman mar are
general treatments for both hot and cold diseases; khan da, thal sman, and sman chang
are respectively recommended for hot, cold and wind diseases. The remaining types of
medicaments, rin po che and sngo sbyor, are cited in the rGyud bzhi as the famous
ones (grags pa), owing to their efficacy in curing different kinds of diseases, including
particular types as the ones caused by demons and malevolent spirits.
As far as the category sngo sbyor (preparation of herbs) is concerned, it exclusively
consists of herbaceous medicines (sngo sman)18. Yet most informants have quoted the
term sngo sbyor as not really indicating a type of medicament although it is mentioned
in the rGyud bzhi amongst the different categories of compound medicines. Few
medicaments at present employed include herbaceous medicines only, which are usually
mixed with other types of medicinal substances. In the rGyud bzhi and in the Vaidurya
sngon po it is stated that the sngo sbyor is used when an easy-to-prepare medicament
is needed and that this preparation is accessible to anyone, made of cheap ingredients,
and easy to get. The sngo sbyor is ideally opposed to precious medicaments (rin po
che), which mainly wealthy people can afford.
Literary sources also describe medicaments according to their specific potency (nus
pa) and the illnesses cured. The rGyud bzhi19 classifies illnesses in 404 different types.
They are also separated into several groups according to different criteria. For example
male (skyes pa nad), women (bud med nad), and children (byis pa nad) diseases,
geriatric diseases (rgas pa nad), humoural (rlung, mkhris pa, bad kan), poisoning
(dug nad), and infections (rims nad). Diseases are also classed according to the
anatomical part where they manifest: for example upper body diseases (lus stod nad),
head diseases (mgo nad), liver diseases (mchin pai nad), heart diseases (snying gi
nad), lungs diseases (glo bai nad). However informants have affirmed that disease
categories may be reduced to 20-30 general types.
Traditional doctors often employ the following two general categorisations. The
former separates medicaments according to their hot or cold properties: hot medicines
cure cold diseases (grang bai nad) whereas cold medicines cure hot ones (tsha bai
nad). The latter differentiates two categories: medicaments that cure chronic diseases
(rnying nad) and medicaments that cure acute diseases (gsar nad). According to several
practitioners, the capacity of curing chronic diseases represents one of the most
important features of Tibetan medicine.
ACTION AND USE OF MEDICINAL PREPARATIONS
In the introduction I have mentioned medicaments according to informants and medical
literature. However only some of them are commonly employed by traditional doctors
whereas the use of others is rare or has been apparently abandoned. The most commonly
used medicaments are pills (ril bu), powders (phye ma), decoctions (thang), medicinal
ashes (thal sman), and concentrated medicines of type B (khan da). Why other
medicaments are less employed? Which are the criteria of selection?
Traditional doctors chose a specific therapy after attentively examining each case
and notably taking into consideration several factors such as medicament potency and

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efficacy, target type, patient condition, diet, habits, and local climate. Some aspects
mainly related to manufacture and practical use of medicaments are also considered,
for example the availability of the ingredients both in the wild and on the markets,
their cost, the feasibility and the fabrication expenses of the medicine: some substances
for example need an expensive purification process. Important issues are also how the
medicine meets the patients preference, the results obtained during the therapy, and
the possibility of easily managing the medicine as far as its administration and durability
are concerned. In addition, when medicament action produces contraindications, they
have to be administered to patients with particular attention.
The choice of producing medicaments may also be influenced by local traditions
and environmental conditions. For example cauterisation is frequently used by some
doctors from the region of Ladakh and of the Litang County owing to the scarcity of
medicinal substances in the area (Ladakh) and to local medical traditions (Ladakh and
Litang).
Medicinal pills and powders are the medicament most frequently employed by Tibetan
traditional doctors. Both are described in medical texts and modern formularies as two
distinct types of preparations, each one with its specific formulas. Yet, owing to the
analogous therapeutic use and rather similar composition of some pill and powder
formulas, the choice to fabricate one or the other depends on practical reasons.
Interestingly, I have observed a few practitioners from Litang preparing a medicinal
powder according to a pill formula. Some explained that they acted in this way to save
time. Others alleged reasons related to pill potency, effectiveness, facility of being
administrated, digested and assimilated, and in particular to the possible interference
with the functions performed by the so-called fire-heat of the stomach (pho bai me
drod)20. The evaluation of these factors may lead practitioners to administer a formula
in a different form from the standard one. According to most practitioners, pills have a
rough (rtsub)21 and direct (rno) action on the body, which may represent a hindrance
during some treatments. A too powerful and incisive action may have an effect on the
whole body and particularly on the digestive system. That is why some doctors may
chose not to process the finely grinded ingredients into a pill but prefer to administer
them as a powder, claiming that in this way the medicine potency is less aggressive, its
action is smooth (jam) and it is more easily assimilated. Other informants affirm that
when the ingredients are not finely grinded, medicinal powder nature is rough and they
can be harmful to the body and particularly to the stomach.
Decoctions (thang) are commonly administered to patients. Informants have reported
that they are employed to cure various diseases, that their administration is easy, and
that they do not interfere with the stomach functions having a gentle (jam) nature.
Decoctions are described according to their general action which is usually rapid (myur)
and direct (rno). Their classification is worked out according to the disease cured and
to the specific action performed. Some decoctions collect (sdud) the disease in a certain
part of the body clearly defining the target. Others have the property of ripening (smin)
the disease, which arises and clearly manifests its symptoms. Others have the property
of dissociating (byed), destroying the disease with an action similar to breaking a rock
into several pieces. Basically these three functions recall the natural disease progression:
arising, development and withdrawal. Thus different thang may be used in succession
during the medical treatment.
Some medicaments have as specific use, for example medicinal ashes (thal sman)
and medicinal concentrates of type B (khan da).

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Medicinal ashes are prescribed to cure cold diseases, particularly of the digestive
system, and to alleviate stomach pain. Disorders of the digestive system are quite
frequent among local populations. They mainly originate from inappropriate diet and
bad hygienic conditions, but are also caused by the extreme climate of these regions.
Traditional doctors commonly respond to this necessity with two or three ready-to-use
medicinal ashes preparations in their pharmacy.
Khan da medications present some peculiarities. They are usually not administered
solely to the patient, but they are mixed with other ingredients to fabricate a pill or a
medicinal powder. In this case khan da is considered as a single ingredient and is
added to a formula as other medicinal agents. Several medicinal recipes require to add
medicinal substances that have undergone this processing. Khan da is also used as a
diet complement and general tonic.
Although my informant from Dhorpatan sometimes employed them, medicinal butters
(sman mar) and medicinal wines (sman chang) are less used than all other preparations.
Medicinal butters are generally prescribed to cure Wind imbalances, and in particular
to stimulate sensory organs (dbang po) and increase body vigour (lus stobs). They are
also employed as a topical treatment for skin diseases, in particular infections and
insect bites. In this case a little quantity of old butter is mixed with a medicinal powder
to produce a cream that is applied to the skin.
The administration of medicinal wines is particularly rigorous and usually connected
to Wind diseases22. This medicine cannot be administered to anyone owing to its
important side effects.
Another type of medicament that is nowadays rarely employed is the concentrate lde
gu, prescribed to eradicate several forms of chronic diseases of Wind, Phlegm and
Bile and in particular chronic fever (rnying tshad). The occasional utilisation seems to
be related to the difficult fabrication procedure and specific features of this preparation.
Practitioners have stated that this concentrate has an unpleasant taste and is therefore
scarcely appreciated by the patients who often prefer not to assume it.
Precious pills (rin chen ril bu) represent a case on its own. As I have reported in the
above section, this medicament is renowned for its efficacy against a great number of
complex illnesses (serious and compound diseases). The potency of the rin chen ril bu
is linked to the presence of ingredients that belong to the precious medicines (rin po
chei sman), which are seen as exceptionally powerful both on the basis of
pharmacological criteria and religious beliefs. Actually the administration of these
remedies is frequently associated with religious rituals23. Precious pills are employed
to cure many different diseases and are commonly classified according to their specific
target, function, and group of patients. For example, a precious pill is beneficial to
elderly people, another cures eye diseases, and another has the properties of rejuvenating
and giving longevity. It is commonly believed that precious pills are useful to revitalise
and regenerate the body and produce long-lasting results.
Despite their therapeutic relevance, precious pills are often omitted from the list that
has been reported by the informants firstly because they are considered as belonging to
the pill category and their fabrication process is in part analogous. Yet at present
independent practitioners rarely manufacture precious pills because they include several
expensive ingredients such as precious and semi-precious stones. In addition the
fabrication process is often very complex, long and expensive, and some ingredients
may need to be purified before the utilisation. The informants consider precious pills a
high quality medicament.

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Nowadays precious pills are industrially produced by the major medical centres in
Tibetan Chinese Provinces, India and Nepal. I have noticed that only 5-6 types of
these preparations are actually fabricated. Likewise other types of medicaments, they
are traded in different regions and sold in pharmacies and dispensaries. Generally
independent doctors purchase precious pills in the factories in order to sell them to
patients in their own villages. Nevertheless in several Tibetan regions, owing to their
high price, doctors moderately prescribe this medicament.
THE MANUFACTURE OF MEDICINES
The manufacturing process consists of several phases. Some are similar for every type
of medicament whereas others are exclusive. The formulation, the collection of the
ingredients, their drying, processing, and mixing are the main phases of the preparation
for all types of medicaments. The collection and the drying are notably performed
under strict guidelines. For example medicinal plants must be gathered according to
the features of their growing site (including soil, aspect, altitude, presence of other
plants, man and animals) and the functional time to exploit the substance. Plant
processing is related to the part collected (such as roots, leaves, and flowers) and to the
specific therapeutic use. For some medicinal substances such as poisonous medicinal
plants (for example bong nga nag po, Aconitum spp.) and mineral substances (for
example dngul chu, mercury) the manufacture includes a detoxification process which
is peculiar for each case and may consists in discarding useless parts, thoroughly cleaning
the drug and/or properly processing it (through physical and chemical treatment).
The next phase of the manufacture consists in grinding and mixing the ingredients in
order to produce the powder which is processed into different types of medicaments.
Regarding the crushing process, the methods used are mainly mechanical. A mortar
and a pestle or a little mill are used mainly by independent practitioners while in big
medical centres modern machineries are diffused24. The grade of refinement of the
powder may vary according to the type of medicament. When medicinal pills are
fabricated, the ingredients are commonly grinded into a fine powder. Differently,
decoctions and medicinal powders are prepared from a roughly powdered mixture.
The fabrication process goes on differently according to the type of medicament.
Here follows its description for the most common of them.
Medicinal powders and pills have a similar preparation method. The ingredients of
plant origin are grinded together and the powder obtained is repeatedly sieved until the
right consistency is obtained. The other ingredients are separately crushed.
As far as phye ma is concerned, the refinement of the powder is sometimes adjusted
according to the patient and his/her health, on the assumption that refined powders are
assimilated more easily than rough ones although their action is also more incisive.
As concerns pills, once all ingredients have been mixed and grinded, the powder has
to be cooked in hot water (the time of cooking and the amount of water are variable)
until a kind of paste is formed. At the end a supplementary substance is usually added
to the recipe: the so-called Horse of the medicine (sman rta)25, described as helper
and vehicle for the medicine. Its aim consists in facilitating the amalgamation of the
ingredients and the absorption of the medicine. Yet the Horse is not completely neutral
to the action of the formula collaborating to its pharmacological activity. Tibetan pills
are traditionally prepared by hand. They have a round shape, sometimes irregular, and
hard texture, their colour may vary from grey to black and from reddish-brown to
dark-brown. Size, varying approximately from 0,5 to 1 cm in diameter, normally depends

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... 97

on potency. Thus pills whose potency is strong usually have a small size. They are
dried over a tissue for several days (the exposition to the light is variable) and finally
polished by rolling them over a cloth.
As concerns pill dimensions, a few informants describe three categories that are
associated with the size of some objects. The smallest pills are comparable to the
excrements of the pica26 (a bra). The medium size pills correspond to peas (sran ma)
and the biggest are like the head of femur (ser ba rus). Pill size is also related to the
presence of toxic ingredients. Small pills are less tolerated than medium size ones
while bigger pills usually do not contain any potentially toxic substance.
To conclude with this type of preparation, it is important to recall some more features
that make pills the favourite medicament to traditional doctors: they are easy to
administer, the dosage is set and their potency lasts more time than the one of other
medicament types. As most informants have stated, pills may be utilised up to one or
two years after their fabrication. Patients also prefer to take pills than other preparations.
Less durable than pills as far as their potency is concerned, medicinal powders must
be carefully stored in a dry container and kept away from sunlight. Practitioners calculate
the dosage with the aid of a spoon and the medicament is given to the patients in small
plastic bags or wrapped in a piece of paper. A label describing dosage and time of
administration is usually inserted in the packet. Drawings are often used for uneducated
patients.
The procedure employed to prepare decoctions (thang) is simple. Drugs are first
roughly grinded and then mixed with water. After boiling the solution for a few minutes,
drug deposits are discarded and the liquid left is drunk. The temperature to serve
decoctions is regulated according to the type of disease to be cured. Particularly
decoctions are administered hot against cold diseases and lukewarm against hot ones.
Practitioners give decoctions to the patients as a powder. The patient has to boil it in
water by himself according to the doctors instructions.
Medicinal ashes (thal sman) have the aspect of a grey and fine powder. They are
obtained through the incineration of several medicinal substances, among which mineral
ones are often included. Once separately crashed and reduced in size, the ingredients
are mixed and accurately grinded. They are afterwards dropped in a large metal container
that is hermetically covered and placed directly over the fire. The process consists in a
slow consumption of the drugs by the action of the fire. The doctor periodically monitors
the process to attain the right degree of incineration.
Medicinal butters (sman mar) are obtained by mixing butter with several ingredients,
mostly of plant origin. The result is a medicine which has the potency of herbs and
butter at the same time. Two different medicinal butters are prepared. One is prescribed
to cure cold diseases, the other to cure hot ones. The preparation process consists in
moderately crushing the drugs and in pouring abundant water on them. The solution is
boiled and during the cooking, whose time may vary according to the recipe, water is
refilled several times. At the end of the cooking the solution is filtered and some butter
is added. The mixture is heated again over the fire. According to informants, when
butter is not available, a different substance with similar qualities such as oil or fat may
be used. The final product is a solid and mouldable paste that is prescribed in small
doses similar to pills. Likewise other types of medicaments, medicinal butters are
preserved in a dry and non-aerated place because humidity and air modify their
properties.

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The khan da or concentrate of type A is fabricated only with medicinal agents of
plant origin. Instead of grinding them more or less finely as in previous recipes, plants
are in this case cut in small pieces. In the different regions where the fieldwork has
been carried out khan da are always prepared with one ingredient only. These
preparations are obtained by boiling the drug in water for long time to concentrate the
solution, thus the cooking process may last hours or days. During the process solid
residues are constantly eliminated from the solution, which slowly changes its colour
and consistency. When cooled off, the solution becomes solid. Some types of drugs,
especially fruits and berries, undergo a preliminary process before the heating. They
are pressed and squashed mechanically and/or by hand several times in order to collect
their juice, which is later filtered. That is for example the case of star bu khan da,
concentrated of seabuckthorn (Hippophae rhamnoides subs. turkestanica) that is
fabricated in Ladakh as well as in other Tibetan regions. The preparation is employed
either alone or as an ingredient of other medicaments.
THERAPY AND MEDICAMENTS
Traditional doctors evaluate the quality of medicaments from the observation of their
effectiveness when administered to patients. An important aspect regards the rapidity
of the therapeutic action medicament effectiveness is usually inversely proportional
to its rapidity and its suitability to each target. As reported in the section devoted to
describing their general features, some medicaments, such as pills, have a more direct
and incisive action than others, for example butter preparations and decoctions.
Practitioners also consider the way medicines affect the body, the patient general health
and how they interfere with the digestive process and with the stomach power.
The presence of side effects is frequently regarded as an indicator of low quality.
According to practitioners, the tolerance of the patient to the treatment is also related,
besides potency, to the method of processing drugs during the different phases of the
fabrication (crushing, cooking, drying) and to the way a medicine is conserved. However,
the suitability of a medicine can be completely assessed only by matching it with the
patient, his general health state, age, behaviour and gender. Patient diet and behaviour
are seen as crucial factors during remedy administration because they may be either
supporters of or antagonists to a disease. Informants have also stated that patients
condition should be constantly monitored during the treatment, which may be modified
if necessary.
I would like to point out that some traditional doctors from different regions, in
particular those in contact with foreigners interested in holistic medical systems and
natural remedies, have affirmed that all Tibetan medicaments are side effects free. Yet
this assertion has been probably made with the intention of increasing the reputation of
Tibetan remedies.
The therapy commonly includes different types of medicaments and treatments. It
starts for example with a decoction, continues with a powder medicine and eventually
with a pill. Some medicaments, such as thang, are often insufficient to completely
eradicate a disease. In this case a supplementary treatment is required and another type
of medicament (for example ril bu or phye ma) is administered.
Precious pills are prescribed for chronic and severe disease conditions and as a
general panacea as well, but their high cost limits their use among the population.
According to Tibetan medical theory, external treatments such as moxibustion,
bloodletting and cauterisation have to be used only after pharmacological therapy.

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Actually treatment have to be administered starting with the mildest ones and, only if
really necessary, the strongest ones should be employed. In the rGyud bzhi 27
moxibustion, bloodletting and cauterisation are included among the so-called sbyang
ba remedies, those that remove, which are opposed to the pacifying or zhi pa (such
as pills and decoctions) remedies. Due to the possible risks of employing the sbyang
ba treatments, their utilisation also depends on the patient condition. Yet in different
regions such as the Litang County and Ladakh I have observed traditional doctors
frequently administering external treatments instead of pharmacological ones and
sometimes using them at the beginning of the therapy. The majority of doctors are
aware of the risks that these therapies imply. However, they have good experience and
familiarity with these techniques28. When I enquired the informants about the recurrent
utilisation of external treatments, some replied that one of the reasons of this habit is
that pharmacological treatments take time to give a response and patients are often on
the move. Nomads, who are regular patients of traditional doctors, often undertake
long trips in order to be visited and cured, but they cannot settle in towns for long time.
In some remote areas, such as in Ladakhi Changthang, the trend, as reported above,
seems to be also linked to the scarcity of medicinal substances.
FORMULATION AND FORMULAS
The fabrication of remedies is often linked to education, economic, environmental and
personal motivations that lead several practitioners to exclusively carry out the diagnosis
and the distribution29 but not the manufacture of medicines, which are bought in medical
centres.
However a number of doctors, notably independent doctors that belong to a family
lineage and have studied medicine with several masters, are still involved in the
production of medicines. During my field research I have considered whether they
also carry out medicine formulation.
Most traditional Tibetan doctors who produce medicines on their own are nowadays
rarely involved in their formulation and carry out only the assemblage of the ingredients.
Only few learned doctors who have good knowledge of pharmacological theories are
able, if necessary, to devise new medicinal formulas but they are not really familiar
with this undertaking.
The fabrication of medicines is commonly carried out in all the regions visited by
taking as a reference the formulas reported in specific texts.30 The formularies describe
ingredients, their amounts, medicament pharmacological properties and dosage, but
the procedures to make them are concise or omitted. Practitioners often know recipes
by heart and they may not need to consult written sources. In addition, some formulas
are passed down from master to disciple only through medical lineage and are not
found in texts.
Owing to the great extension of the area over which Tibetan medicine is practised,
modifications and adaptations of medicinal formulas according to cultural and
environmental conditions have occurred throughout the centuries. Medical schools,
such as the major Byang lugs and Zur lugs from the XIV to the XVI Century, and local
traditions have aroused, each one with possible peculiar identification of certain
components of the materia medica, procedure of compounding remedies that may
include substitutes and/or different ingredients. In the last few decades the Tibetan
medical tradition has spread in many countries such as India, Europe and USA. Medical

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education is provided by employing classical and modern medical texts and
formularies31, which have been updated or published anew and include old and revisited
formulas.
The research also consisted in examining types and general features of formulas that
are commonly used by traditional doctors practising in different regions. Comparable
data have been collected in medical centres and dispensaries.
According to field data, three groups of medicinal preparations may be differentiated:
-The first group consists of medicines having a simple formula that includes 3 to 10
ingredients. Powders and decoctions are recurrent. For example the preparation of Li
shi sum thang (decoction 3 of Eugenia caryophyllata) that contains three ingredients
only and is employed to cure hot diseases of the spleen (mcher tshad); another example
is Ma nu bzhi thang (decoction 4 of Inula racemosa), which includes four ingredients
and cures infectious diseases of hot type (rims tshad).
-The second group consists of medicines with a substantial number of ingredients. It
represents the most common type of medicament utilised by practitioners. Many pills
are included in it. The ingredient number spans from 11 up to 25. For example the two
pills Tig ta nyer lnga (Swertia chyrayita 25), which is employed to cure Bile diseases
(mkhris nad), and Ga bur nyer lnga (Cinnamomum camphora 25), which cures
infectious diseases of hot type (rims tshad).
-The third group of medicines consists of formulas with more than 30 ingredients.
Some of them have up to eighty different substances. Precious pills (rin chen ril bu)
are included in this group.
Medicaments that are most commonly found in clinics and dispensaries usually
include an important number of ingredients. Yet those that contain more than 10
ingredients are difficult to fabricate for independent traditional doctors, especially when
considering that several medicinal substances are often lacking.
According to practitioners the complexity of a formula usually guarantees its
therapeutic effect. Notably they affirm that to adjust and improve medicine action and
effectiveness the adding of several ingredients is often required. Yet a formula having
numerous ingredients that are not properly combined will not be effective. The Tibetan
pharmacological theory corroborates this assessment by saying that the potency of
medicinal preparations (sman sbyor gyi nus pa) is stronger than the one of simple
substances.32 An informant from the region of Chamdo has explained this concept in a
typical metaphorical way: as a corps composed by a few soldiers has poor chances of
winning against a numerous enemy, a big division has more chances to beat the enemy
and succeed. The big division of soldiers represents the medicine in its complexity
which fights against the disease.33
In contrast with the trend in most of the areas visited, few doctors sometimes prefer
to employ medicaments that consists of three to five ingredients. I have observed this
practice particularly in Ladakh where it seems to be linked to regional and familial
traditions. I point out that this difference does not imply a lack of knowledge because
practitioners are generally able to fabricate and use more elaborated medicines too.
Sometimes the choice to fabricate simple medicines is influenced by the availability of
medicinal substances in the region as well as to practical problems related to their
supplying. Yet as concerns the concept of medicinal preparation, all informants agree
on mixing several ingredients to form a therapeutic unit within which every ingredient
contributes with its potency.

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In the following section I will focus on the methods of mixing the ingredients and on
the theory upon which the internal organisation of a medicine is based. I will also try to
delineate medicament general structure by describing the functional units that compose
it.
THE INGREDIENT ORGANISATION
The internal organisation system of medicaments is not a usual topic of conversation
among traditional doctors who have little familiarity with the compounding of
medicaments. In fact they tend to manufacture medicines quite mechanically according
to recipes and methods of drug processing and do not consider pharmacological
parameters such as taste and potency. Moreover, as I have pointed out in a previous
section, a relevant number of doctors met in the different regions neither carry out the
formulation of medicines nor their fabrication.
I would like to stress that none of the informants has deliberately explained the
criteria upon which the medicament assemblage is based. Only few and highly learned
practitioners who are also skilled at teaching have collaborated and helped me to outline
a general model of medicament and to define the fundamentals of its synthesis. This
medicament model only helps in the comprehension of the formulation criteria, it is
not employed by practitioners during the fabrication of remedies, it cannot be applied
to all medicaments and may vary according to doctors education and experience.
The results obtained are also based on the translation of a short fragment of the
rGyud bzhi and its commentary Vaidurya sngon po, but in particular arise from the
analysis of some formulas.34
a) The general structure of medicaments
I would like to point out that fundamental medical texts such as the rGyud bzhi35 do not
give in-depth explanations of medicament structure and compounding, and of the
significance of ingredient subdivisions. The method of assembling medicinal substances
is illustrated in the chapter of The Blue Beryl on medicinal herbs preparations (sngo
sbyor)36. However the application of a similar model to different types of medicaments
is not clearly stated and this subject is not mentioned any further in the text.
As reported by several informants, to prepare a medicine firstly consists in
coordinating the activity of all ingredients. In a formula several substances are therefore
combined in small Units or groups of ingredients. The action of the medicine results
from the sum of the actions exerted by the different Units, whose functions are always
coordinated on the basis of a specific therapeutic goal. Each Unit contains substances
that usually produce similar or correlated therapeutic effects towards a specific target.
Unit ingredients may also direct their action on several targets and carry out different
tasks. The targets can be connected in physiological terms or to disease progression.
The study of the formulas in collaboration with Tibetan doctors has shown the
existence of a hierarchical organisation of the ingredients and more precisely of the
different Units that compose the medicament. The following designations are used to
identify the groups of substances included in the medicine: rgyal po (King), rgyal mo
(Queen), blon po (Minister), and dmag mi (Soldiers). The last Unit is also designated
mi dmangs and bangs (Servants). The utilisation of these expressions is helpful to
describe the Unit function and significance and it emphasises the predominance of
certain groups on the others.

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The Kings potency and therapeutic action usually coincide with the principal function
of the preparation. This Unit is commonly composed of a single and occasionally of
two or three substances.
As concerns the function of the Queen, it normally consists in assisting and
emphasising the one of the King. Yet the Queen may be absent when the Kings
therapeutic properties are strong enough to counteract the disease. The Queen is often
composed of one, two or three substances that work in synergy having the same
therapeutic properties and action. Although the Queens function is commonly similar
or strictly related to the Kings one, it may sometimes be directed towards another
therapeutic target in a different part of the body. Another task of the Queen may consist
in alleviating secondary symptoms.
Differently the Minister often consists of several substances which perform multiple
tasks and its function does not usually correspond to the one of the King. Actually the
designation Minister connotes a unit that, although subordinate to the King, performs
its action quite independently from it, for example curing collateral symptoms and
enhancing body health (by acting on the three humours).
The three Units described to this point represent the crucial components of most
formulas. Yet also the other substances that are added are absolutely important and
compulsory for remedy effectiveness.
The next Unit is named, as shown above, either Soldiers or Servants (both designations
are equally employed). It includes several medicinal substances and represents the
majority of formula components. Its task is considered complementary to the one of
the main Units, particularly as far as counteracting side effects is concerned. Practitioners
have frequently omitted to described Soldiers in detail because the group is composed
of a relevant number of substances which perform various functions and focus on
many targets. Ingredients with similar therapeutic properties work in collaboration by
joining their potency to cure different aspects and symptoms of the disease. In this
case several substances work on the same organ or the same part of the body producing
a massive action. Yet all Soldiers action must be synergetic and well coordinated.
Units differ in structure and way of functioning. The King and the Queen (and seldom
the Minister) commonly consist of a single ingredient and sometimes of few ingredients
that share a similar potency and therapeutic properties. Differently Soldiers (always)
and Minister (often) consist of many ingredients that operate in teamwork. The
ingredients do not necessarily perform the same functions, but their overall action is
correlated. It is worth noting that, according to the complexity of the formula, some
medicaments do not include all the Units above described.
The description of a medicinal formula is not complete without mentioning the last
category of ingredients: medicinal Horse (rta sman). It consists of one substance whose
action is not properly therapeutic but supportive. Its aim is to convey the medicine
throughout the body and to help the assimilation. Yet the task of the horse is not
completely independent from the therapeutic action of the medicine and its choice is
commonly related to medicament nature (hot or cold), to the disease cured and, if
necessary, to the specific type of preparation. This substance should not negatively
affect medicine therapeutic action as well. The Horse is selected according to the humour
imbalance: molasses (bu ram) is used to cure cold Wind (grang rlung) diseases; sugar
(ka ra)37 to cure Bile (especially khrag mkhris pa, Bile and blood) diseases, which are
hot; honey (sbrang rtsi) is mainly utilised for Phlegm (Bad kan) and chu ser38 diseases.

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Hot and cold water, according to the disease cured, are considered good substitutes for
the above substances.
It is interesting to observe that the author of the rGyud bzhi describes the three
Horses after enumerating the categories of the materia medica39. Yet their task is not
explained as well as the one of the other Units.
Medicaments frequently include other fixed groups of ingredients which are integrated
in the Units, in particular among Minister and Soldiers. I have designated them
functional groups. They will be dealt with further on in this section. Neither Units
nor functional groups are reported in the formularies except for the Horse that is
mentioned at the end of the formula ingredient list.
b) The compounding of the ingredients.
A few general guidelines and principles allow the practitioner to appropriately mix the
ingredients.
Ingredients are mixed according to their taste (ro), post-digestive taste (zhu rjes)40
and potency (nus pa)41, the fundamental parameters of Tibetan pharmacology, which
indicate specific therapeutic properties. The key steps of the sman sbyor bai thab,
the way of mixing medicinal substances, are the nus sbyor and the ro sbyor, the
combination of potencies and tastes. Both parameters are used to characterise medicinal
substances, which present at least one of the six basic tastes (mngar mo, sweet; kha ba,
astringent; tsha ba, hot; lan tshwa ba, salty; skyur mo, sour; bska ba, bitter) and one of
the eight potencies (lci, heavy; snum, oily; bsil, cool; rtul, blunt; yang, light; rtsub,
rough; tsha, hot; rno, sharp). Tastes may be combined in pairs, triplets, quartets for a
total of 63 different combinations (ro sdebs). It is therefore possible to fabricate a
medicine that presents specific tastes and post-digestive tastes, and whose potency can
be easily calculated on the basis of the potencies of single ingredients. Similar potencies
are summed up while opposite potencies annul each other, for example hot (tsha) and
cold (grang).
An important aspect of the compounding process is named jam btsal ba, to make
smooth. It consists in moderating and harmonizing the action of the ingredients and
implies the adding of medicinal agents that present smooth (jam po) qualities to the
formula. The term smooth does not refer to the substance physical features but to the
action produced on the medicine. An ideal medicament has to be both effective and
gentle (not rough) on the organism and should not engender over-sensitivity and/or
side effects.
The procedure of assembling the ingredients in a smooth way is carried out
according to different methods. In a first case one or more medicinal agents are added
to the formula to support the therapeutic action on an organ or a part of the body that
are affected by the disease. This process, which is called kha dzin byed pa (to assist,
to govern), is employed in the case of hot/cold/lung diseases and also diseases such as
chu ser and infections (gnyan srin). Among the organs that may be assisted there are
the five solid organs (don lnga)42; the six hollow organs (snod drug)43, the five sensory
organs (dbang po lnga)44, and the blood (khrag).
The presence of functional groups (introduced in this section) is strictly connected
to this phase of the processing. Practitioners identify several functional groups45 which
are usually composed of three-six medicinal agents. Their therapeutic action may be
either specific or directed towards different targets.

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Here follows the most common among them: bras bu gsum, the three fruits, which
includes the following three medicinal substances: a ru ra (Terminalia chebula), ba ru
ra (Terminalia bellerica), and skyu ru ra (Phyllantus emblica). The task of the three
fruits is to equilibrate the three humours. It is carried out by the simultaneous activity
of the three components, which consists in curing Phlegm, Bile, Wind and blood
diseases. This group is recurrent in several formulas46 and the informants have judged
it very positively in terms of therapeutic effectiveness.
As concerns the five vital organs, the following six substances called bzang po drug,
the six excellent ones are added to support their function: dzwa ti (Myristica fragrans)
for heart, cu gang (Bambusa textilis) for lung, gur gum (Crocus sativus) for liver, sug
smel (Elettaria cardamomum) for kidney, and ka ko la (Amomum subulatum) for spleen.
The function of blood vessels and nerves is supported by using li shi (Eugenia
aromatica). To support the action of the medicine while curing the organs of sense
mdung rtse smug po (Goethitum) is added for sight; ru rta (Jurinea souliei/Saussurea
yakla) and a ru ra (Terminalia chebula) for hearing; sug pa (Melandrium glandulosum/
Silene sp.) for smell; dbang po lag pa (Gymnadenia latifolia) and sle tres (Tinospora
cordifolia) for the limbs; sbal nag lce (frog tongue) and spyang ki lce (wolf tongue) for
taste. To direct the action of the medicine against chu ser diseases three medicinal
substances are added: so ma ra dza (Abelmoschus moschatus), thal ka rdo rje (Cassia
tora) and phur dkar (Micromeria barosma). These three medicinal plants are named
chu ser sman gsum (the three medicines for chu ser). In the case of infectious diseases
gla rtsi (musk from Moschus spp.) and gu gul (Commiphora mukul) are added.
It is also relevant to point out that the mixing of numerous medicinal agents may
generate a medicine that is not harmonious and whose action causes imbalances in the
bodily equilibrium thus producing side effects. They manifest as the alteration and
weakening of the general condition of the body, as an imbalance of the humour Wind,
vital breath, stomach power, body strength and temperature or as disorders of the seven
constituents of the body47. According to practitioners side effects are caused for example
by herbaceous medicines48.
This leads to a third method of combining the ingredients, named gnyen po
(antagonist), whose function is to counteract/moderate the potency of the medicine,
increase its smoothness and thus enhance its therapeutic action. In this case a new
ingredient, an antagonist, is added to the formula. For example, according to the nature
of side effects, the adding of the following ingredients is suggested: old molasses (bu
rnying) and meat (sha) to control Wind imbalances; pi pi ling (Piper longum) and se
bru (Punica granatum) to increase stomach heat; a ru ra (Terminalia chebula) to
increase body power. These three substances are commonly mixed all together in several
formulas.
CONCLUSION
Field data have shown that in Tibetan therapy the role of medicinal preparations is
important. Except for few regional/local cases, medicaments are in general
homogenously employed in all the different regions visited.
Among the different types of medicaments described, some (such as pills, powders,
and decoctions) are commonly employed by independent practitioners while others
(such as concentrate of type A, butter medicines, and medicinal wines) are nowadays
less recurring.

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Tibetan formulas exhibit a complex internal organisation and include a relevant

number of ingredients of different origin whose assemblage is based on defined criteria.
In particular I have identified two types of ingredient groups: Units and functional
groups, which have particular functions and are responsible of medicament therapeutic
properties.
Although pharmacological principles should be taken into account during medicament
formulation, doctors activity is often limited to the simple application of pre-existing
formulas that are known by heart or listed in the formularies.
The comparison of the knowledge of practitioners from different regions has shown
that a limited number of doctors are skilled in the formulation while many do not
distinguish the role of the different groups of ingredients and are not able to describe
neither the method of compounding nor the general pharmacological features of the
medicines. Only few erudite masters are acquainted with the procedure of assembling
the drugs and can explain how the ingredients of the formula are organised. This seems
to be also related to the evolution of the medical knowledge. In several modern medical
schools (in R.P.C. and in India) the training has been simplified. Many new doctors are
not familiar with the manufacture of medicaments owing to the standardisation and
industrialisation of drug processing, and to the specialisation of practitioners in different
medical professions. Some disparities in the utilisation of medicaments are probably
also connected to these recent transformations of Tibetan medicine
To conclude I point out that the practice of independent traditional doctors is hindered
by several factors such as the high cost of drugs, their availability, and the competition
of big medical centres that produce medicines by employing highly productive and
sophisticated industrial methods.
Notes
1. Tibetan terms are given according to the Wylie (1959) system of transliteration (minus
the hyphen in between syllables).
2. Kunsang (1996) proposes the following meaning for the term sman: herbal, medicine,
remedy.
3. g.Yu thog Yon tan mgon po, 1992. Chapter 21, II Tantra: 77.
4. Ibidem.
5. This cosmological theory of Indian origin arrived in Tibet through Buddhism and its related
disciplines such as medicine from the VII century onwards.
6. The three humours, Wind (rlung), Bile (mkhris pa) and Phlegm (bad kan), are responsible
of the functions of the body and, when balanced, they determine and sustain its health.
Their functions are explained in terms of intrinsic qualities such as hot, cold, heavy, light,
sharp, and blunt, all determined by their elemental composition. Among them the hot and
the cold qualities are the most important. So far, the Bile is hot, the Phlegm is cold and the
Wind is either hot or cold. The humour increases in the body when one of its qualities
meets an identical quality either in the environment or in the season or in man behaviour
and diet. On the contrary, the humour is decreased when one of its qualities meets an
opposite one. Humours may increase or decrease also when influenced by evil spirits and
by the karma related to past lives. When a humour, influenced by the above conditions, is
not any more balanced, a disease arises. Illnesses are also caused by the simultaneous
imbalance of two or three humours.
7. Besides medicaments practitioners frequently prescribe a specific diet and recommend an
appropriate behaviour.

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8. The research has also concerned the medical centres of different Tibetan regions.
Nevertheless, the results reported in this article mainly relate to the practice of independent
doctors and not of the ones that operate in those institutions.
9. The data have been obtained during a research project conducted by the author from 1998
to 2002 in different Tibetan regions: the Litang County (Sichuan, China), the region of
Baragaon (Mustang District, Central Nepal), Dhorpatan (Baglung District, Central Nepal),
and Ladakh (Jammu & Kashmir, India). Medicinal plant samples gathered on the field
have been identified and have been deposited at the Herbarium of the Musum National
dHistoire Naturelle de Paris, France. I would like to thank professor J. F. Dobremez
(Laboratoire dEcologie Alpine, Universit de Savoie, France) for collaborating in the
identification of some specimens from Nepal. Participant observation and open-ended
conversations have been mostly used as methods of investigation.
10. Karma chos phel, 1993; dGa bai rdo rje, 1998. The medicinal substance identification
according to modern science presented in this article has been made, besides referring to
the specimes collected during fieldwork, on the basis of these texts.
11. A description of medicaments is presented in the rGyud bzhi (g.Yu thog Yon tan mgon po,
1992: 572-608) in the 3 - 12 Chapters of the Fourth Tantra.
12. sDe srid Sangs rgyas rgya mtsho, 1982. IV Tantra, Chapter 3-12: 1235-1304.
13. In the case of concentrated medicines, lde gu and khan da, the letters A and B have been
added to differentiate the two types of medicaments. The attribution of these designations
is a personal choice and they do not appear in the literature.
14. This category of medicines is quoted in the rGyud bzhi with the name of rin po che (the
precious). Informants usually designate this category rin chen ril bu (precious pills).
15. bSam gten, 1987.
16. For example, sMan sbyor legs bsgrigs yang gsal sgron me zhes bya ba bzhugs so (Thub
pa tshe ring, 1992).
17. g.Yu thog Yon tan mgon po, 1992, IV Tantra, Chapters 3 12: 572-608.
18. The term sngo sman is used to designate both a category of medicinal substances
(herbaceous medicines) and a category of medicinal preparations (medicines from herbs).
19. g.Yu thog Yon tan mgon po, 1992, II Tantra, Chapter 12: 46.
20. The fire heat of the stomach or digestive fire heat (me drod) is located in the stomach and
is responsible of food digestion. It also plays a relevant task as far as metabolic
transformations are concerned, being at the origin of the metabolic chain that produces
the seven bodily tissues.
21. The term rtsub connotes a medicine which has a strong and heavy action.
22. A type of disease that is cured with medicinal wine is for example the irritability of aged
people.
23. Notwithstanding the recent transformations of Tibetan medicine, the practice of traditional
doctors is commonly connected to Buddhist religious concepts. The accomplishment of
several tasks, as medicament manufacture, may be associated with rituals, gestures, and
prayers.
24. It is worth noting that some learned practitioners criticise the remedies manufactured with
the aid of new machines in the modern institutes. They affirm that the procedure is not the
most appropriate to get powerful medicines and that modern technology may negatively
affect medicament potency.
25. See also the section The ingredient organisation, where the three types of medicinal
horse are described in detail.
26. The pica is a rodent (Ochotona spp.) that lives in Himalayan regions and Tibet.
27. g.Yu thog Yon tan mgon po, 1992, II Tantra, Chapter 21: 77.
28. Cauterisation and bloodletting have to be administered exclusively to cure particular types
of diseases, otherwise serious side effects may arise.
29. See Cardi, 2005: 21-29.
30. bSam gten, 1987; Thub pa tshe ring, 1992.

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31. Among these: sMan sbyor legs bsgrigs yang gsal sgron me zhes bya ba bzhugs so (Thub
pa tshe ring, 1992), gSo rig zin tig gces bsdus, (Yon tan rgya mtsho, 1976), and rGyal
yons bod lugs gso rig bring rim slob grani tshod bltai slob deb, (bSam gten, 1987).
32. According to the rGyud bzhi, potency prevails over taste, post-digestive taste prevails
over potency, and medicaments (sman sbyor) overcome all of them. g.Yu thog Yon tan
mgon po, 1992. Second Tantra, Chapter 20: 76-77.
33. As it will be shown further on in the article, similar metaphorical correspondences as the
one reported to describe the therapeutic effect of the medicine, are also employed to connote
the hierarchical organisation of the ingredients of the formula. See the section: The
ingredient organisation.
34. The formulas that have been employed to delineate a general model of medicament are
reported in my Ph. D. dissertation where I have described several of them in detail and
explained the role of each ingredient. See Cardi, 2004: 303-320.
35. g.Yu thog Yon tan mgon po, 1992. II Tantra, Chapter 21: 76-77.
36. sDe srid Sangs rgyas rgya mtsho, 1982. IV Tantra, Chapter 12: 1295-1304..
37. In Tibetan medicine Sugar is employed in several forms and types. Among them, there are
for example phye ma ka ra and shel ka ra, respectively sugar powder and crystal sugar.
38. Chu ser diseases (yellow water) are characterised by small, flat pimples, itching, swelling
of various parts of the body, dark and rough skin, loss of hair and eyebrows. (Drungtso &
Drungtso, 2005: 135) Chu ser diseases consist of several types of health problems often
connected to the accumulation of interstitial and synovial liquids in several parts of the
body.
39. g.Yu thog Yon tan mgon po, 1992, Second Tantra, Chapter 20: 75.
40. The three post-digestive tastes arise after the digestion of a substance and depend on its
taste. Particularly, the post-digestion of sweet and salty tastes is sweet, the post-digestion
of sour is sour. The post-digestion of bitter, hot, and astringent is bitter.
41. The term potency (nus pa) points out to the action that a substance originates through
its features and qualities. In Tibetan medicine this expression designates both therapeutic
properties or qualities (the eight nus pa) of medicinal substances and their therapeutic
effect.
42. The five solid organs are: the heart (snying), the lungs (glo ba), the liver (mchin pa), the
kidney (mkhal ma), and the spleen (mcher pa).
43. The six hollow organs are: the stomach (pho ba), the gall-bladder (mkhris pa), the small
intestine (rgyu ma), the large intestine (long ga), the urinary bladder (lgang ba), and the
reproductive fluids (bsam seu).
44. The five organs of sense are: eyes (mig), rna ba (ears), sna (nose), lus (body), lce (lingua).
45. In this section I have described some of the existing functional groups used in medicament
formulation.
46. See Cardi, 2004: 228-263.
47. The seven constituents of the body are: nourishment (dangs ma), blood (khrag), flesh
(sha), fat (tshil), bones (rus), marrow (rkang), and regenerative essence/fluids (khu ba).
48. Medicinal substances that compose the Tibetan materia medica are separated into several
categories. Among these, plants categories are devised on the basis of the following criteria:
plant morphological, biological, ecological features, and therapeutic properties. Herbaceous
medicines are included in the categories of the materia medica named thang sman
(medicines of the plains) and sngo sman (herbaceous medicines) (Deu dmar dge bshes
bstan dzin phun tshogs, 1994: 74-75). It is worth noting that a modern trend consists in
grouping together thang sman, and sngo sman. Nowadays several practitioners and modern
texts include them in a single group named sngo ldum sman. See Cardi, 2004: 31-75.

108 THE TIBET JOURNAL

Bibliography
Boesi A., Cardi F., 2006. Tibetan Herbal Medicine: Classification and Utilization of Natural
Products Used as Materia Medica in Tibetan Traditional Medicine. Herbalgram (in press).
Cardi F., 2004. De lapprovisionnement des substances mdicinales la production des
mdicaments : lvolution contemporaine de la pharmacope tibtaine. Thse de Doctorat,
Unit dAnthropologie et Adaptabilit Biologique, UMR 6578, CNRS-Universit de la
Mditerrane, Facult de Mdecine de Marseille. Unpublished
Cardi F. 2005. Evolution of Tibetan medical knowledge in the socio-economic context: the
exploitation of medicinal plants among traditional doctors. In: A. Boesi & F. Cardi (eds.).
Wildlife and plants in traditional and modern Tibet: conceptions, exploitation, and
conservation. Memorie della Societ Italiana di Scienze Naturali e del Museo Civico di
Storia Naturale di Milano, 33 (1): 19-32.
sDe srid Sangs rgyas rgya mtsho, 1982. gSo ba rig pai bstan bcos sman blai dgongs rgyan
rgyud bzhii gsal byed be daura sngon poi malila ka. Bod ljongs mi dmangs dpe skrun
khang, Lhasa (this text is known as Vaidurya sngon po).
Deu dmar dge bshes bstan dzin phun tshogs, 1994. Shel gong shel phreng. Tibetan Medical
& Astro Institute, Dharamsala.
Drungtso & Drungtso, 2005. Tibetan-English Dictionary of Tibetan Medicine and Astrology.
Drungtso Publication: 135.
dGa bai rdo rje, 1998. Khrungs dpe dri med shel gyi me long. Mi rigs dpe skrun khang,
Beijing.
Karma chos phel, 1993. bDud rtsi sman gyi khrungs dpe legs bshad nor bui phreng mdzes.
Bod ljongs mi dmangs dpe skrun khang, Lhasa.
Kunsang E. P., 1996. The Dharma Dictionary. Tibetan-English Dictionary of Buddhist Teachings
& Practice. Rangjung Yeshe Translations & Publications, Kathmandu-Boulder.
bSam gten, 1987. rGyal yongs bod lugs gso rig bring rim slob grwai tshod bltai slob deb.
mTsho sngon mi rigs dpe skrun khang.
Thub pa tshe ring, 1992. sMan sbyor legs bsgrigs yang gsal sgron me zhes bya ba bzhugs so.
dkon mchog phrin las. Kan suu mi rigs dpe skrun khang.
Wylie T. V., 1959. A Standard System of Tibetan Transcription. Harvard Journal of Asiatic
Studies, 2: 261-67.
Yon tan rgya mtsho, 1976. gSo rig zin tig gces bsdus. mTsho sngon mi dmangs dpe skrun
khang.
g.Yu thog Yon tan mgon po, 1992. bDud rtsi snying po yan lag brgyad pa gsang ba man ngag gi
rgyud. Bod ljongs mi dmangs dpe skrun khang, Lhasa (This text is commonly known as
rGyud bzhi, The Four Tantras).

Nyes pa: A brief review of its English translation*

Yonten Gyatso
Actually there is not much room left to discuss about how to translate the term nyes
pa1 into English, as it has already been translated as humor and has become a standard
at least in terms of current translation practice. Everyone including Tibetan doctors
and scholars, seems to follow the trend. It may, however, be wrong to assume that
these doctors and scholars, by mere subscribing to this translation practice, actually
do or do not agree with the equivalence of the two terms. There are factors other than
ones intellectual conviction, which are based on practicality and convenience that
decide the choice of terms in their translation or discourse. There is also a section of
Tibetan-Tibetan doctors, who seem to be uncomfortable with the idea of translating
important terms such as nyes pa, rlung, mkhris pa, bad kan etc. into English. They
are skeptical and find it hard to believe that English words such as humor can convey
faithfully all the meanings of its Tibetan original. The opinions of this group, however,
are not articulated into any formal means of expression, their concern is genuine and
therefore needs to be addressed.
So, on the issue of translation of nyes pa as humor, we have on the one hand a
popular trend that everyone follows for one reason or the other and on the other a
lingering question of whether the translation is appropriate or not. And the fact that it
has not been addressed adequately as it deserves, it is important to examine if this
translation is actually faithful or not. Let us start this examination by trying to trace
how this trend actually came about.
The earliest publication known, to me at least, in the Western language dealing
with Tibetan medicine is the article written in English by Alexander Csoma de Krs
(1790-1842), which appeared in 1835 in the Journal of the Asiatic Society of Bengal.2
The article is a translation of manuscript prepared for the author by a Lama
introducing Tibetan medicine by enumerating the content of rGyud bzhi, the
fundamental text for Tibetan medicine.3 In that article the Tibetan term nyes pa is
translated as humor which makes this article, according to my knowledge, the first to
use the English term humor for nyes pa.4
Since there is no additional note or remark by the author regarding the use of the
term humor, it is not explicitly clear as to why and on what basis he chose to use this
term, which is a technical term with specific meaning embedded in it in old Western
medicine as is the term nyes pa in Tibetan medicine. It makes one wonder why didnt
he, being the first to translate the term nyes pa into English, opt for a more cautious
and culture- sensitive approach, such as: transliteration, literal translation, or use the
Ayurvedic term dora from which the Tibetan term was originally translated literally.

This paper was prepared to be presented at the Second International Congress on Tibetan
Medicine held in 2003 in DC, where the author was initially invited. The invitation was later
withdrawn due to some budgetary problem. I sincerely thank my wife, Kathy Rugh, with
whose full support I have been able to engage in research and writing.

110 TIBET JOURNAL

Perhaps the answer lies in the qualification of the author to translate Tibetan
medicine. It is very unlikely, as can be seen from the depth of the article prepared for
him by the lama, that he was exposed to all the complexities of the meaning of this
Tibetan technical term nyes pa, at least at the time of translation. Moreover, Csoma
de Krs, although unquestionably a great scholar in the vast field of Tibetological
studies, was strictly speaking, a non-specialist as far as Tibetan medicine is concerned.
So, at this point we can say on the basis of above information that the Tibetan
medical term nyes pa was first translated by a Tibetologist, who is not a specialist in
Tibetan medicine, and whose translation approach for this particular term seems to
be one of matching words from one culture with the other on the basis of resemblance.
Whether the two terms resemble enough to qualify to represent one another, or
whether humor is a good translation or mistranslation, is a different question but
obviously an important issue to resolve. But in the meantime, to trace the evolution
of this translation trend, it is important to recognize the fact that despite the accuracy
and validity of his translation, the English term humor served as an easy way to
render the Tibetan term nyes pa especially during 19th and early 20th century when
the access to Tibetan medical knowledge was very limited. Besides, it is an
impressively attractive rendering coming from a well-respected scholar. So it has
been adopted by all the scholars and translators, many of whom were Tibetologists
rather than Tibetan medical specialists, and Tibetan medicine was not their primary
focus in their writings. But repeated use and increasing number of people who use
the term humor for Tibetan nyes pa have gradually set the trend that is now transformed
into what is considered as standard translation. So, in my view, this translation trend
is very much a result based primarily on popular use.
Before we move on to the issue of translation, I would like to discuss briefly about
my earlier comment on Csoma de Krss translation approach. His approach of
matching word from one culture with another on the basis of resemblance should be
seen from the point of view of what I call primitive notion of translation where
immediate goal of presenting a text from one language into another is the only purpose
of translation. In this type of translation, translators search for equivalents (words
that match) in the target language becomes the only technique to fulfill its only
purpose to replace the source language. This primitive notion of translation ignores
other issues and concerns. To hold such a notion for translation is understandable
and natural, especially in the early period of translation when translation of any field
(Tibetan medicine in this case) is still in the process of development, because the
very notion we just described is actually what the word translation literally means.
However, this notion does not hold good for long. Because as soon as more and more
information emerge upon closer look at the cultures and other specifics of both the
source and the target languages, it becomes clear that terminologies, especially those
representing ideas, have developed in their own cultural environments, and therefore
there is no overlapping equivalent words of such kind between two independently
developed cultures.
So, people who are involved in translation of ancient traditional medical literatures
have come to realize that assigning English equivalent terms is not always the
justifiable thing to do in translation. They found out that techniques such as literal
translation and even not translating in some cases are more justifiable approach.5 In
other words, translation should be seen as a mean rather than a purpose. Translation

NYES PA: A BRIEF REVIEW ... 111

is used to serve its purpose, which is to transfer or convey knowledge from one
language to another.
Now let us turn to the question of whether the term humor is appropriate or not for
Tibetan nyes pa. In order to examine the appropriateness of this translation we have
to find out how accurate or faithful is this term humor as translation for nyes pa. In
the case of this particular term, given the approach of its first translator and the fact
that both the terms are technical terms in their own medical traditions with their own
technical meanings in their respective systems, this would mean to measure how
much do the two terms resemble each other. So, let us first try to see what each term
means in their respective systems and then try to find out if they resemble.
The term humor of ancient and medieval Western medicine means fluid or moisture,
and is derived from the Latin word humor and khymos (English derivative chyme) of
Greek.6 In ancient and medieval Western medicine there are four humors. They are:
blood, black bile, yellow bile and phlegm, also true to the literal meaning of the term,
as they are all considered as fluids.
Whereas the Tibetan term nyes pa literally means fault, defect, punishment and
bad. The term nyes pa that we find in Tibetan medical texts in connection with its
three referents, rlung (wind), mkhris pa (bile), and bad kan (phlegm), is a medical
term, and should be treated so. In other words, nyes pa, as a medical term, denotes
the three referents. Therefore the medical term nyes pa is a collective name or term
for rlung, mkhris pa and bad kan. Medical meaning of nyes pa should therefore be
sought from the meanings of the three referents it stands for, and the meanings of
which are wide in range and multi-faceted. So, according to various data in rGyud
bzhi, the diverse meanings of nyes pa as a medical term can be classified into four: 1)
disease, 2) cause of disease, 3) force or energy with physiological functions, 4) gross
and subtle component of our body.
According to Tibetan medicine, the disturbed state of three nyes pas manifest
themselves as diseases, thus portraying the phenomenon of disease as a fault or defect
in undisturbed or balanced state of nyes pa. Therefore in this metaphor, the vernacular
nyes pa connotes the first medical meaning, disease, of the technical nyes pa. However,
the other three meanings do not have any link to the literary meaning of nyes pa. So,
nyes pa is both a vernacular and a technical term with two very distinct sets of
meanings. It should also be mentioned that there are instances even in rGyud bzhi
where nyes pa is used as a vernacular word with its literal meaning fault or defect,
and with no medical connotation.7
Now, do the two terms (nyes pa and humor) resemble each other? I think the answer
is yes and no. Yes, because they do resemble each other in some sense, albeit in a
very general way. Both are necessary components present in our bodies, as well as
potential causes of disease. They both mean disease (at least nyes pa does). These
two general resemblances, although not many, are significant as they are the main
meanings associated with the two terms. No, because we do not find any more
resemblance apart from the two already mentioned. Furthermore the ones that resemble
at the general level show differences at specific level. For example, humor has four
referents where as nyes pa has three, and all four humors are considered as fluids
where as three nyes pas are not.
Since the publication of Csoma de Krss article in 1835, a fairly significant number
of books and articles on Tibetan medicine have been published in different languages.8
As far as I know, there is no single paper devoted to discuss the issue of translation

112 TIBET JOURNAL

of nyes pa and its three referents, although these are some of the most important
terms in Tibetan medicine. A very few scholars have touched on this issue with some
details in their writings, and among them the most notable ones are: Claus Vogel,9
Marianne Winder10 and Fernand Meyer.11
On the meaning of nyes pa as a technical term, Claus Vogel, in his classic work of
translation and critical comparative study of a portion of a major medical text, remarks
that in medical literature nyes pa denotes a morbific agent not necessarily defective
itself and therefore he thinks nyes pa can conveniently be called humor.12
Marianne Winder is of the notion that the three, wind, bile and phlegm, are
necessary in the body. They are causes of diseases only when they are unbalanced.13
She differentiates the meanings of humor and nyes pa by accurately pointing out that
the English term humor, having a meaning of fluid or moisture, does not fit the Tibetan
term nyes pa.14 However, she thinks the two terms can be made comparable despite
their difference if we take humours not in the literal sense of fluid but rather in a
metaphorical one for a substance permeating many parts of the body, a case can be
made out for it.15
Similarly, regarding the meaning of nyes pa, Fernand Meyer explains that the three
humours confer life and health as long as they remain in a reciprocal equilibrium. But
they are equally the primary causes of pathological phenomena when this equilibrium
is upset by various kinds of secondary causes.16 But according to him, unlike
Marianne Winder, three nyes pas are indeed the humoural fluids in the ancient
Western sense of this word [humor] and because of which he says it is proper to
translate these terms literally by wind or pneuma, bile and phlegm.17 I agree it is
proper, as long as they are considered as literal translation, to translate the three nyes
pas literally by the English words wind, bile and phlegm. But translation of term nyes
pa is different, because nyes pa and humor have different literal meanings, as we
already discussed, and whether the two should be considered as having same
metaphorical meanings in their respective medical traditions as medical terms is a
question we are trying to answer.
Judging by the statements cited above, our three authors seem to seek to justify the
translation of nyes pa into English word humor, and in doing so they all use basically
the same point. The one based on one of those two general resemblances that both
the terms mean bodily component that has potential to cause disease. It is also apparent
from their writings that they all have the same notion that nyes pa means a bodily
component necessary in our body with the potential to cause diseases. This notion is
selective and therefore an incomplete picture, for it does not portray all the meanings.
It must be pointed out here that the other general resemblance between the two
terms, that they also mean disease is, however, not stated in the statements of our
three authors. However, in saying so, an explanatory note may be required for Claus
Vogels statement concerning his notion of nyes pa. The expression not necessarily
defective itself [nyes pa] in Claus Vogels remark implies that it is, however, possible
to be defective. But whether he recognizes this possible defective humor as a disease
and therefore considers it as a meaning of nyes pa or not is not clear. So, in any case,
his remark, which lacks explicit expression of this particular notion, shows that he
does not consider disease as an important meaning of nyes pa worth mentioning as
one of its meanings.
Is it because this meaning is not there in the English humor which somehow
influenced our authors to ignore this meaning in nyes pa as well? I am not an expert

NYES PA: A BRIEF REVIEW ... 113

in ancient and medieval Western medicine to say whether or not humor has this
meaning like Tibetan nyes pa clearly does in Tibetan medicine, nor do I have any
easy access to resources for a comprehensive research into the matter. I presume on
the basis of nyes pa in Tibetan medicine that that meaning is contextual, inherent and
implied, and therefore to be understood because of the fact that English humor denotes
its four referents, namely: blood, black bile, yellow bile and phlegm. Interestingly,
trained in Tibetan medicine and an expert in the field, Dr. Pasang Yonten Arya in his
book on Tibetan medical history has a section on the relation between Tibet and
Persia (ta zig) in which he discusses about Greek medicine.18 In that discussion he
calls blood, black bile, yellow bile and phlegm of ancient Western medicine diseases
(nad).19
If the English humor does have the meaning, disease, then it immediately raises the
question why didnt they include this meaning in their notion of nyes pa, and use
it as another resemblance to justify the translation? It seems like such a strong point
to miss on their part to enhance their argument.
But if we look, a little bit more carefully, at their notions of nyes pa and how they
are perceived, as can be determined from the already mentioned explanations provided
by Marianne Winder and Fernand Meyer, it is almost clear that they would not have
included that meaning or the point anyway. They did not miss to include it in their
notion. The sense of disease as a meaning of nyes pa is not there in their understanding
of the term, because they failed to exactly understand the notion of nyes pa as presented
in Tibetan medical literatures, particularly rGyud bzhi.
Marianne Winders explanation that three nyes pas are causes of diseases only
when they are unbalanced, that is, when there is too much or too little of any of them
compared with the other two,20 and Fernand Meyers they [three nyes pas] are
equally the primary causes of pathological phenomena when this equilibrium is upset
by various kinds of secondary causes: climate, environment, conduct, nutrition, trauma
and demons,21 are fundamentally wrong according to Tibetan medicine.
It is clearly stated in rGyud bzhi that three nyes pas are causes of disease when
they are in the state of balance. But when disturbed and rendered imbalance they are
the characteristic entities of diseases, for they harm and bring sufferings to body and
life.22 This important statement makes a few things clear. First of all it makes clear
that nyes pa does have the meaning, disease, apart from its well-recognized meaning,
cause of diseases. Secondly it clarifies that unbalanced state of nyes pa is the state
where nyes pa has passed its state of being a potential cause of disease and transformed
into a disease state or entity. Thus the notion that nyes pa is a cause of disease when
unbalanced is wrong. Besides this there are many other instances in rGyud bzhi as
well as other medical texts where nyes pa and its three referents clearly mean disease.
Here are a few simple and clear examples from rGyud bzhi:
These precious gems cure 404 diseases resulting from wind disease,
bile disease, phlegm disease, diseases of combination of two nyes pas
and diseases of combination of all the three nyes pas.23
The first [of 15 divisions], which is the division of the treatment of
three nyes pas.24
Diseases, physical constituents and waste products are three components.25

114 TIBET JOURNAL

If the English humor of ancient and medieval Western medicine does not have the
sense of disease as its meaning, then the resemblance between the two terms, humor
and nyes pa, drops down to only one. Is this one resemblance enough to claim that
the two terms are equivalent or same in meaning, although the Tibetan term nyes pa,
as explained earlier, has multitude of meanings? I think the resemblance is very small
and general to consider them having the same meaning.
The theory of nyes pa in Tibetan medicine is taken from Indian Ayurvedic medicine.
As said earlier, the term nyes pa is a direct literal translation of Ayurvedic term dora.
It is in this connection that we should be interested to look into the translation issues
of dora.
Generally speaking, dora and its three referents vata, pitta and kapha are considered
as terms that are too complex to faithfully translate into English that is as humor,
wind, bile and phlegm respectively. This view is firmly held and defended by Indian
Ayurvedic doctors and scholars themselves and is reflected in their writings in English
where the terms are always left untranslated. Whereas most of the Western scholars
(usually non-practitioners) of Ayurvedic medicine seem to end up in compromise and
translate these terms into English. As a result, unlike in the case of Tibetan medicine,
there are two translation trends, one that does not tolerate the English words or
equivalents and another that prefers to use the so-called English equivalents.26
Upon examination, the arguments put forward by Indian Ayurvedic doctors and
scholars reveal that issue of translation of dora is two-fold: translation of dora itself
and the names of its three referents. While taking issues with both, their arguments
mostly overlook the issue of dora and direct towards the translation issues of the
three referents. Therefore I do not want to go any further into this matter in order to
focus on our concern, which is the issue of translation of nyes pa and, in that respect,
of its Ayurvedic corresponding term dora. Moreover, we are also more interested in
the second trend where dora is translated into English term humor, and examine the
arguments put forward by those who follow this trend, and compare with those put
forward for nyes pa.
As such, I think Francis Zimmermanns symposium paper27 is a fine specimen
representing that second trend, because he is a Western scholar highly regarded for
his knowledge in Ayurvedic medicine. And the subject of his paper is on the difficulties
of editing and translating Indian medical text in which he discusses among other
things the problems and issues relating to the translation of the word dora.
In his discussion, while agreeing to the common view that in translation, words like
dora are difficult terminological problems to solve, he goes on to try to solve the
problem by seeking justification for translating dora as humor, firstly because he
thinks the two words are conceptually equivalent. So, quite naturally his approach is
one where he compares the conceptual meanings or meanings represented by dora
as a technical term with the meanings of this Greek medical term humor.
Regarding dora as a medical term in Ayurvedic medicine, Francis Zimmermann
says that it is to designate the fixed set of three entities (conventionally understood
as [vata] wind, [pitta] bile, and [kapha] phlegm), that are organic flows, or fluids, and
pathogenic factors at the same time.28 In other words he is saying that dora denotes
three entities it represents which is so true but that also means its meanings should
also be sought from them as I mentioned earlier in the case of nyes pa. So when he
says that the three entities are organic flows and pathogenic factors at the same time,
he is leaving out a rather ignored but an important meaning of dora namely, disease,

NYES PA: A BRIEF REVIEW ... 115

or disorder, which is very much a part of doras technical or medical meaning. He is of

course aware of this meaning in dora as can be seen in his statement that humors as
peccant, morbific entities, which can only be the case in a limited number of
occurrences.29 Whether this meaning occurs in a limited case or not is secondary,
subjective and highly arguable. I think it is wrong and harmful to delete this meaning
on the basis of such an opinion. It only helps to show the authors overzealous
endeavor to justify the translation of dora by trimming the original meaning to fit or
match the definition of its proposed English equivalent humor.
His other justification comes from his view that untranslated words are illusory
metaphors in a translation, and by that, he means that words like dora, and chi of
Chinese medicine, when left untranslated, will adorn our translations with a tinge of
exciting but delusive mystery, or exoticism which he says is unjustified.30 This
may very well be true, and I can imagine people, especially those who are new to the
subject, getting illusory impressions. But such impressions are just an initial experience
that everybody goes through as a part of initiation into any new sphere of knowledge.
Mistaken notions and impressions at this initial stage are not permanent, and it is the
duty of responsible translators and teachers to clarify the matter by providing necessary
information in the form of notes, explanations and other details. Use of foreign terms
in, for example, English-language literature is nothing strange. Many Sanskrit words
that have no equivalent terms in English, matching their conceptual meanings, have
always been left untranslated, and many of them have now been adopted as loan
words and can be found even in mainstream English dictionaries.31 Given the fact
that such conceptual terms are so vulnerable to conceptual corruption in the course
of interpretation and in translation, leaving them untranslated is a safe approach in
the absence of accurate translation.
Speaking of conceptual corruption, we have already discussed how the concepts
of nyes pa and dora are being perceived and portrayed by the above mentioned
authors in order to justify the translation, and also discussed whether their perceptions
and portrayals are accurate or not. Another such example where the concepts of nyes
pa and dora are misinterpreted is when they flatly declare that three nyes pas and
doras are fluids as three humors are in ancient Western medicine.
For example, Fernand Meyer says that these [three nyes pas] are indeed the
humoural fluids in the ancient Western sense of this word.32 According to Tibetan
medicine, this is not true. The theory of three nyes pas in Tibetan medicine is a welldeveloped theory with sophistication of its own. If we are supposed to classify the
nyes pas into solid, liquid /fluid and gas, a classificatory notion compatible to modern
sciences, there is no way we can do that definitively. I think it is like trying to answer
a wrong question. Characteristic properties of solid, liquid and gas are there in three
nyes pas but they are found so haphazardly among them and their various aspects
that it is not possible to have a clear-cut classification on the basis of these
characteristics. It is too simplistic and radical to say that the three nyes pas are fluids.
So, as much as nyes pa and humor resemble in some general sense, perhaps just in
one general sense if English humor does not have the meaning of disease, they also
are different in many more ways. Why, then, are the two considered equivalent? We
have already discussed this question with reference to its translation in Csoma de
Krss article. We have also touched on the resemblances that we found and their
significance, but what is also significant that I would like to point out is the type and
nature of diseases refer to by these two terms, and the concept of bodies associated

116 TIBET JOURNAL

with them. The diseases and the bodies they refer to are conceptually very different
from the modern medical science. Perhaps it is this resemblance in being different
from modern medical science and belonging to the category of old and non-Modern
scientific medicine which might have set the stage for scholars and translators to
compare as if they are comparable. Because there is a general tendency to view,
perceive and categorize medical systems of pre-modern medical science as being
similar, despite significant differences amongst them. So, the very idea of trying to
compare the two systems in the hope of finding parallels may have been done with
some degree of this mentality, consciously or subconsciously.
If there is any valid justification for translating the Tibetan term nyes pa into English
as humor, it would be on the ground that its use has now been so widespread that it
has assumed the position of English equivalent of nyes pa, and that it seems to be
relatively the closest resemblance one can find between the two different cultures.
So, if we accept humor as a valid translation for Tibetan nyes pa which we do in one
way or the other, we might as well do it to honor, Csoma de Krs, who is the first
person to translate this term as humor, and whose article on Tibetan medicine marked
the beginning of Tibetan medical study in the West or in fact beyond the traditional
geographical boundaries of Tibetan medicine.
Finally, whether the term humor is an accurate translation, or it is an inadequate
one where the translators could not appreciate the essential details of the term nyes
pa in Tibetan medicine. Or whether it is a popular trend followed by everyone. Or
whether it is a translation whose validity scholars think can be justified on the ground
that the two terms, nyes pa and humor, mean the same; although they are, as
demonstrated before, not same in many ways. Or whether or not we should use it for
Tibetan nyes pa in our translations. Of all these ideas and opinions, whichever we
may want to follow for whatever reason that we may or may not have, it is important
and also imperative to look as fairly and fully as possible into the meanings the
respective terms carry, so that the meanings underlying the words remain intact.
Notes
1. This Tibetan term is profusely mentioned throughout this paper because it is the subject
of discussion. So to help ease interested readers, who may not be so familiar with reading
Tibetan transliteration form, to pronounce this Tibetan word and familiarize saying it
while reading the article, its phonetic transliteration nyepa is provided here.
2. Alexander Csoma de Krs: Analysis of a Tibetan Medical Work, Journal of the Asiatic
Society of Bengal, 1835, 4, pp. 47-65
3. Ibid., p. 47
4. Ibid., p. 49
5. Paul U. Unschuld (ed.), Approaches to traditional Chinese Medical Literature:
Proceedings of an International Symposium on Translation Methodologies and
Terminologies (Unschuld 1989 in subsequent references), Kluwer Academic Publishers,
Dordrecht, 1989
6. Marianne Winder, Tibetan medicine compared with Ancient and Medieval Western
medicine, (Winder 1981 in subsequent references) Bulletin of Tibetology, 1981, No. 1,
Sikkim Research Institute of Tibetology, Sikkim, p. 6
7. For example, in the 2nd chapter of rTsa rgyud (Root Tantra), the first part of rGyud bzhi,
we find: snyoms par zhugs ma thak tu thugs ka nas od zer kha dog brgya stong du ma
phyogs bcur phros pas phyogs bcui gro ba sems can thams cad kyi sems kyi nyes pai
skyon bsal /. The line translates as: As soon as [the sage Rig pai ye shes, the mind

NYES PA: A BRIEF REVIEW ... 117

emanation of medicine Buddha] sat into meditation, from his heart emitted rays with
hundreds and thousands of different colors towards the ten directions which dispelled the
faults of the minds of all the sentient beings in the ten directions. In this line the term nyes
pa means fault or defect. The faults or defects of mind (sems kyi nyes pa) referring to the
three mental poisons (nyon mongs dug gsum) arising from ignorance as taught in Buddhism.
See bDud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud (rGyud bzhi 1984
in subsequent references), Tibetan Medical and Astrological Institute, Dharamsala, 1984,
p. 18.
8. For a comprehensive list of mostly western language publications, see: Jrgen C. Aschoff,
Annotated Bibliography of Tibetan Medicine (1789-1995), Fabri Verlag, Ulm; Garuda Verleg,
Dietikon, 1996.
9. Claus Vogel, trans. and ed., Vagbhatas Artaogahpdayasamhita: The first five chapters of
its Tibetan version (Vogel 1965 in subsequent references), Franz Steiner Verleg, Wiesbaden,
1965.
10. Winder 1981. pp. 5-22. This is perhaps the only article that has dealt with the comparison
between nyes pa and humor in greatest detail, comparatively.
11. Yuri Parfionovitch, Fernand Meyer and Gyurme Dorje, Tibetan Medical Paintings
(Parfionovitch 1992 in subsequent references), Serindia Publications, London, vol I, 1992
12. Vogel 1965, p. 51 remarks.
13. Winder 1981, p. 5.
14. Ibid., p. 6
15. Ibid., p. 6.
16. Parfionovitch 1992, p. 4.
17. Ibid., p. 4.
18. Menrampa Pasang Yonten, Bod kyi gso ba rig pai lo rgyus kyi bang mdzod g.yu thog bla
ma dran pai pho nya, Yuthok Institute of Tibetan Medicine, Leh, Ladakh, 1998. See pp.
8-22 about Greek Medicine in imperial period Tibet.
19. Ibid., p. 12. His note (see ibid p.12 note 17) shows that he is citing the information from
his source: Charles Singer, A history of anatomy and physiology from the Greeks to Harvey,
Dover Publication inc., New York, 1957, pp. 10-12.
20. Winder 1981, pp 5-6
21. Parfionovitch 1992, p. 4
22. This is a translation of the Tibetan original lines from the 8th chapter of bShad rgyud
(Explanatory Tantra), the Second part of rGyud bzhi. It goes like this: rnam par ma gyur
nad kyi rgyur gyur la / rnam gyur ma snyoms nad kyi ngo bo yin / lus dang srog la gnod
cing gdung bas so /. See rGyud bzhi 1984, p. 51.
23. Translation of the Tibetan original from the 1st chapter of rTsa rgyud. It goes: nor bu rin
po che des ni rlung gi nad dang mkhris pai nad dang bad kan gyi nad dang ldan pai
nad dang dus pai nad las gyur pai nad bzhi rgya rtsa bzhi sel bar byed pa / See Ibid.,
p. 15
24. Translation of the Tibetan original from the 2nd chapter of rTsa rgyud: dang po nyes
gsum gso bai skabs / See ibid., p. 19
25. Translation of the Tibetan original from the 3rd chapter of rTsa rgyud: nad dang lus zungs
dri ma rnam pa gsum / See Ibid., p. 23. Diseases here refer to three nyes pas. Even though
it is rather unsuitably odd and arguably a mistake to use the word disease (nad) in this
particular context, when the discussion concerns healthy body, but what is important,
however, is that it gives us a sense that sense of disease in the meaning of nyes pa was
prevalent as it is now, may be enough so to cause to treat the two words nyes pa and nad
as interchangeable by the Tibetan author which is why it is cited here as an example.
26. In a discussion dealing with translation trends in Tibetan medicine in general, and of the
term in question in particular, Vaidya Baghwan Dash must be mentioned because of the
sheer number of his translation of Tibetan medical literatures into English, which is till
date the largest by a single translator. However, his translations do not become particularly

118 TIBET JOURNAL

noteworthy in our current discussion about the translation issues of nyes pa, because he
simply uses the Sanskrit term dora instead of supposed English equivalent humor to
translate the Tibetan terms nyes pa in his every work of translation and more importantly
without any explanation as to why he does so. Moreover, his way of translation does not
enjoy any following to be considered as a significant trend.
27. Francis Zimmermann, Terminological problems in the process of editing and translating
Sanskrit medical texts (Zimmermann 1989 in subsequent references), in Unschuld 1989,
pp. 141-151
28. Zimmermann 1989, p. 145
29. Ibid., p. 146
30. Ibid., p. 146
31. Such as: karma, nirvana, tantra, yoga.
32. Parfionovitch 1992, p. 4.

An excellent measure: the battle against smallpox in

Tibet, 1904-471
Alex McKay
INTRODUCTION

The elimination of smallpox as an active disease has probably been the greatest
medical triumph in human history in terms of lives saved. Notably, it was achieved
with the development of a cure that did not generate resistant strains of the disease,
as has the invention of antibiotics. Victory over smallpox required a long series of
regional campaigns and in this essay I will describe the preliminary battles fought
against smallpox in Tibet during the British colonial period. In conclusion, the
analysis of this process will be located in the wider field of the medical history of
the world-wide war against smallpox.
In pre-colonial Asia, variolation against smallpox was known in both Chinese
and Indic cultures,2 and it was also known to the Tibetans in various forms. Ahmad
Shah, an Indian Christian who lived in Ladakh, reported that The scab of the
small-pox is dried and swallowed3; Sarat Chandra Das, who travelled to Lhasa in
1881, reported that the lymph taken from an infected child and mixed with camphor
was inhaled though the nostril.4
But given that Tibets highest authorities, the Dalai and Panchen Lamas (who
presumably received the highest standard of indigenous medical treatment) were
among those who had, historically, suffered or died of the disease,5 the efficacy of
these methods must be in doubt. Throughout recorded history, smallpox epidemics
had regularly devastated Tibet, where the crowded conditions in monasteries and
urban centres favoured the rapid spread of the disease. It appears that once smallpox
manifested, the Tibetans had little treatment for it beyond isolation; Shah describes
how:
When, however, anyone is afflicted with it, whoever it may be even a dear parent, the
person is removed to a deserted place and left with food and water to recover or die
there..When an epidemic breaks out they adopt a singular expedient to prevent one
village from taking the infection to another. This is nothing less than to pile up thorns
and thorny bushes on all paths which lead from one village to the other [to keep
away the devils].6

Earlier, the Jesuit Desideri, writing in the 18th century, recorded that
Every ten or twelve years an epidemic of smallpox carries off many people. It is so
deadly because anyone showing symptoms of the malady is driven out of his house
into the country, where under a tent, exposed to the bitter cold and the bad weather he
is shunned by all save perhaps some relation who has had smallpox.7

Although the understanding of the disease had a spiritual dimension, the Tibetans
do not appear to have considered smallpox as a manifestation of the divine in the
sense that it was regarded in parts of eastern India where the smallpox deity Shitala
was worshipped. Thus, as the prevention of smallpox through the biomedical system
of vaccination became a possibility, Tibetans must have seemed likely to welcome
the elimination of smallpox without reservation. Yet, for a number of reasons as

120 TIBET JOURNAL

will be seen, it took a decade or more for the vaccination process to gain general
acceptance there.
THE IMPERIAL MEDICAL PROJECT

Here I shall briefly digress to set these events in their wider context. Throughout
the 19th century, the British empire had gradually expanded until it shared more
than 2000 miles of its northern border with the Tibetan state, then under the ultimate
authority of the Chinese emperor. The general expansionist tendencies of the British
empire, the increasing weakness of the Chinese empire, and what the British saw
as an increasing threat from the rapidly growing Russian empire, meant that the
imperial Government of India was increasingly drawn towards involvement in
Tibetan affairs.8 While the Tibetans sought to isolate themselves from the growing
power to the south rejecting any diplomatic communications with the
British agents of the Government of India set about compiling information on
Tibet and, in 1903-04, despatched an armed mission under the diplomatic command
of Colonel Francis Younghusband. The imperial mission fought its way to Lhasa
and forced the Tibetan Government to enter into treaty relations with British India.
The Government of India then established permanent missions in Tibet and
maintained a diplomatic presence there until Indian independence in 1947. Their
aim was to exert an influence over the Tibetans in order to ensure the security of
their northern frontier from Russian infiltration, and, in the usual imperial manner,
medicine was used as a means to obtain the goodwill of the indigenous peoples.
During the 19th century, when the British had introduced vaccination against
smallpox into their Indian empire, the spread of its renown was stimulated by
imperial agents such as Sarat Chandra Das. Chandra Das, the Bengali headmaster
of the Bhutia Boarding school in Darjeeling, was a British intelligence agent who
twice visited Shigatse and reached Lhasa in 1881. In Shigatse he cultivated the
friendship of the Panchen Lamas Prime Minister, who arranged for him to make a
semi-clandestine visit to Lhasa. Smallpox was raging in Tibet at the time, fatally
infecting the then Panchen Lama, and the Bengalis host was keen to introduce
vaccination. Chandra Das arranged for supplies of vaccine to be sent to Shigatse
from India, but the batch was spoiled and after the Lhasa authorities discovered
Chandra Dass role, the Shigatse Prime Minister was executed for treason, ending
this particular chapter of cross-border initiatives.9
In India, however, the vaccination project was gradually achieving its clinical
aims in regard to the eradication of smallpox. These aims were threatened, however,
by external sources of the disease and it was recognized that the trade route from
central Tibet to Sikkim and eastern India could as easily become a route for the
passage of smallpox from Tibet to India. In 1900, following an outbreak of smallpox
in Tibet that spread to the Chumbi Valley, the Government of India had closed the
Jelap la route from Chumbi to India until arrangements were made for vaccinating
all those who crossed the border into Sikkim and every bale of wool was fumigated
at Kalimpong as it arrived there in order to prevent the disease reaching India.
This caused considerable loss and annoyance to traders, with the annual crossborder trade declining by a third.10 Given that trade was the most public rationale
for the opening of Tibet, and that promoting the interests of local Indian crossborder traders was part of the strategy for ensuring the security of the frontier, it
was important to avoid such disruptions.

THE BATTLE AGAINST SMALLPOX IN TIBET

... 121

When they established a position in Tibet, therefore, the British were keen to
encourage smallpox vaccination there. A handful of Tibetans were vaccinated by
the medical teams accompanying the Younghusband mission and soon after the
British established their diplomatic outposts in Tibet, the Political Officer of Sikkim
advised that a proper and unified system of vaccination should be carried out all
along this frontier as well as in Tibet and Bhutan.11 The multiple benefits of this
were pointed out by the Director-General of the Indian Medical Service, who noted
that
Vaccination seems to be very desirable from a humanitarian point of view, and will in
some degree protect our own territory from the introduction of smallpox. It is also a
means of impressing the natives.12

A bridge-head for vaccination at elite level in Tibet already existed in that

most of the ruling elites in the British-controlled Himalayan regions had already
accepted vaccination. The half-brother of the Maharajah of Sikkim, for example,
was a British ally with estates in Tibet where he resided, and such individuals must
have assisted in promoting an understanding of the benefits of vaccination to their
Tibetan aristocratic associates.
It appears that during and immediately after the Younghusband mission, only a
handful of Tibetans were vaccinated.13 But in May 1905, Steen firstly vaccinated
the Tibetan servants and followers attached to the Gyantse Trade Agency and then
instituted a vaccination campaign for local children. He recruited three intelligent
Tibetans and instructed them in the necessary procedure, while approaching the
Gyantse Jongpon [rdzong dpon: District Administrator] and all the leading men
to explain to them the benefits of vaccination. Steen later reported that they were
unanimous that it would be an excellent measure and all promised to assist in
bringing children forward. These leading men rendered great assistance and
by the end of 1905, 1,320 children in the Gyantse area had been vaccinated.14
It is interesting that Steen was at pains to point out that
No compulsion of any kind, it is needless to say, was resorted to. When the people
saw that the application of the vaccine caused little or no discomfort and when they
understood that the measure was intended to prevent small pox the children were
brought forward quite voluntarily.15

Given that obtaining the support of the indigenous elites was a crucial aspect of
British political strategy in regard to the imposition of imperial authority, the most
significant medical initiative of this period involved the Panchen Lama. As the
focus of British Trade Agent Captain W.F.OConnors attempts to obtain an alliance
with the Tibetan authorities, the consent of the Panchen Lama to vaccination was
critical. Late in 1905, OConnor persuaded the Panchen Lama to visit India, and
Tibetan tradition dictated that several hundred members of the Panchens court
should accompany him on his tour. Before they departed in November 1905, the
entire party of Tibetans, including the Panchen Lama himself, were vaccinated
against smallpox.
Steen accompanied the party to India, and on its return in February 1906, he
escorted the Panchen back to Shigatse and remained there for a fortnight, presumably
in case any diseases contacted in India should manifest during that period. That
was a very real danger, among the many members of the Tibetans party who had

122 TIBET JOURNAL

became ill on the journey to India was the Panchen Lamas uncle, who died of
malaria in Darjeeling. He had, however, failed to take the medicines provided by
Steen and the Gyantse diary, in headmasterly tone, claims that The Lama and
other Tibetans thoroughly understand that his death was due to his neglect to follow
Captain Steens advice, or to take European medicines.16
In a farewell conversation at an audience prior to his departure from Shigatse,
Steen reported that the Panchen Lama expressed a wish that I might introduce
vaccination into Shigatse.17 (Steen may, however, have been following the common
imperial practice of attributing to a local ruler an initiative favoured by the British.)
CHINESE PROTESTS AND INDICATIONS OF TIBETAN RESISTANCE

By October 1906, when Steen left Tibet, the British vaccination project appeared
to be developing well. The vaccination of the Panchen Lama was regarded as a
clear signal that the Tibetans viewed the process favourably (and in later years the
precedent was regularly cited as evidence of that). But British plans then suffered
a serious setback. In occupying, but then withdrawing from Lhasa, the British had
left a power vacuum in Tibet. Whitehall refused to allow the Government of India
to strengthen the British position there, and Russia had proved to have no power
there at all. So with the Dalai Lama in exile and a politically weak Regent as the
nominal head of the Tibetan state, the Chinese were able to fill the power vacuum.
They considered Tibet to be a part of their Empire, and although by 1900 their
position there had declined to the point where they lacked any real political power,
their authority over Tibet was recognised by the British government and represented
by diplomatic representatives the Ambans who were stationed in Lhasa. After
the Younghusband mission withdrew, the Ambans slowly began to reassert their
former power.
As a part of their strategy, the Chinese sought to eliminate the British positions
in Tibet, or at least to reduce them to a purely administrative function in regard to
trade. Recognising the threat posed to their position by the growing alliance between
the British and the Panchen Lama, the Chinese attempted to cut communications
between the two parties, and isolate the Gyantse Trade Agency from any contact
with the Tibetan elites. OConnor had gone on leave after escorting the Panchen
Lama in India, and his replacement, Lieutenant F.M. Bailey, while a highly promising
officer and a veteran of the Younghusband mission, lacked diplomatic experience.
China, meanwhile, had posted a skilled diplomat, Mr Gow, in Gyantse.
Gow set about creating various difficulties for the British, demanding that they
deal with the Tibetans only through him and, by 21 November 1906, Bailey was
effectively isolated from all contacts with the Tibetans. Gow then filed a number of
complaints against various British actions, and one of the more serious of these
was the charge that British vaccination campaigns constituted interference in the
internal administration of Tibet, which was forbidden under the terms of the AngloChinese Agreement of 1906. Gow also claimed that the British were making
vaccination compulsory.18
British officials in India, temporarily bemused, checked with Bailey that
vaccination was not compulsory, but were clearly uncertain as to whether the medical
initiatives were technically in breach of their Agreement with China. When Gow
asked Bailey as a personal favour to stop all vaccination until further orders

THE BATTLE AGAINST SMALLPOX IN TIBET

... 123

were received, Bailey acquiesced, and the campaign was stopped, although no
official orders were passed.19
In April 1907, however, the imperial authorities in the north Indian town of Almora
(who were probably unaware of the related events in central Tibet) received a
request from the Jongpon and the Head Lama of Taklakot (Purang: in western
Tibet near Gartok), for Indian vaccinators to visit Taklakot to combat an outbreak
of smallpox. The Tibetans shrewdly pointed out that the outbreak would affect
cross-border trade in the region, and expressed their willingness to pay all of the
expenses of the vaccinators. The Deputy Commissioner in Almora promptly sent
two vaccinators to Taklakot, and then sought sanction from the Government of
India. Government approved the action, noting that the request on the part of the
Tibetan authorities is very satisfactory, as it shows they have a belief in our
medical skill.20 The vaccination of the Panchen Lama and his followers was cited
as prior evidence of this, and the Indian Foreign Secretary observed that the
Tibetans appear to realise fully the advantages of vaccination and this last incident
confirms us in the opinion that Mr Gows action in stopping vaccination at Gyantse
was entirely opposed to Tibetan sentiment in the matter.21

Gows campaign to isolate the Gyantse Trade Agency ended with his transfer in
mid-1907, and although from 16 July 1907 the British were again able to deal
directly with the Tibetans, Gows actions had effectively established Chinese
paramountcy there. But Bailey soon raised the issue of resuming vaccination in
Gyantse with the local Tibetan Trade Agent, and two months later, no objections
having been made by any party, the vaccination campaign resumed. Confirmation
that the Chinese objections were part of a wider agenda and not actually aimed
against vaccination came the following year, when Chinas Amban in Lhasa was
reported to have issued an order that all Tibetans should be vaccinated.22
Chinas support for vaccination in Tibet is evidence of the essential similarity of
British and Chinese aims in that region. Both sought to encourage the modernisation
of Tibet under their influence. Although, as will be seen, China and the Government
of India were to compete for a controlling influence over Tibet throughout the
1904-47 period, with China herself following the Western model of modernisation
during this period, there was no dispute over the model of modernisation both
parties sought to impose on Tibet. The dominant Western model of development
included a state public health system, and so both China and Britain sought to
develop public health structures within Tibet. But the prevailing tendencies of
Tibetan government were anti-modernist for all but the decade from 1913-23, when
there were cautious experiments with aspects of Western modernity. This meant
that British and Chinese innovations in various areas, including medicine, met with
conservative resistance from powerful elements within Tibetan society. As was
characteristic of Tibetan government, the conservative tendency often manifested
in a failure to act, rather than in acts of active resistance of the type that are
recognised in India.23
The first manifestation of resistance indicated in the British sources occurs in
the Gyantse dispensary report for the year ending 31 December 1910.24 When the
British resumed their vaccination programme in 1907, it was carried out by two
Tibetans they had trained (although it is unclear if these were the same men trained
by Steen). In the 1909-10 year this pair carried out 389 vaccinations,25 and the

124 TIBET JOURNAL

Gyantse Medical Officer confidently reported that the next outbreak of smallpox
would demonstrate the efficacy of vaccination.26 So it proved. In the following
year there was an outbreak of smallpox which caused numerous deaths in Lhasa
and Shigatse, but few in Gyantse. The number of vaccinations carried out that year
leapt to 2,131, as might be expected. The Medical Officers report recorded that
Many vaccinations were performed in the dispensary, when the outbreak was at its
height locally. In addition to this, many Tibetans and Chinese officials and gentlemen
got me to procure lymph for them on payment to be sent to all parts of the country.
The people much appreciate the benefits of vaccination.27

But the report also noted that

On arrival here I found the old vaccinators (2) had been demanding money to let the
people escape vaccination. These men were dismissed. Only one suitable candidate
presented himself for the post of vaccinator, and I regret to record his death while
vaccinating at Shigatse during a serious outbreak there in December.28

Earlier indications that the vaccination campaign had not proceeded entirely
smoothly may be detected, however. It is interesting that Steen found it necessary
to emphasise the voluntary nature of the vaccination campaign a year before Chinese
allegations to the contrary while the fact that the vaccinators were being bribed not
to vaccinate people suggests that the Chinese allegation that some form of coercion
was used in the process may not be entirely unfounded. Of relevance in this regard
is an obituary of Lieutenant-Colonel Kennedy, Gyantse Medical Officer in 190710 (which was apparently written by his Gyantse contemporary, F.M. Bailey). It
notes that Kennedy vaccinated a large number of the local inhabitants, at first by
guile and persuasion, but later at their urgent request.29
The British sources do claim that Tibetans were keen to be vaccinated. Thus in
reports around the time of this outbreak we read that the Tibetans are very
appreciative of the value of vaccination; during one month representatives from
villages, many of them five days journey from Gyantse, came to hospital to say
that smallpox was raging with them, and asking that the vaccinator be sent out.30
But a subsequent report clarified the nature of the Tibetans enthusiasm for
vaccination. They were, it stated, reluctant to undergo vaccination unless the disease
is actually amongst them.31
THE TIBETAN ACCEPTANCE OF VACCINATION

Smallpox became, however, increasingly rare in Gyantse, where large numbers of

people had been vaccinated, and in the Chumbi Valley, where by 1911, the majority
of the population had been vaccinated.32 In Shigatse and Lhasa, however, and other
parts of Tibet where vaccination had not been widely introduced, smallpox was
still common. To those who had been vaccinated, the efficacy of the vaccine must
have been empirically established, and Tibetan and Chinese officials were thus, as
we have seen above, already requesting the British to provide them with lymph
with which to institute their own vaccination programmes.
One final indication that vaccination was becoming accepted by the Tibetans
came in 1913, when a group of Nepalese vaccinators found it profitable enough to
travel around vaccinating people for a small fee.33 This demonstrates that a demand
for vaccination did exist in Tibet. While there were cultural and traditional links

THE BATTLE AGAINST SMALLPOX IN TIBET

... 125

between the Tibetans and the Nepalese, relations between the two countries were
historically hostile and we cannot necessarily conclude, therefore, that the Nepalese
were in any sense more welcome than the British Medical Officers. What was
welcome was vaccination.
Further indications of indigenous support for vaccination came in 1920-21, when
Dr Kennedy, who accompanied Sir Charles Bell on his mission to Lhasa, established
links with Men-tse-khang hospital. Kennedy had imported equipment for preparing
calf lymph, and he presented this to the Chief Tibetan medico, Men-tsiba Lama,
whom I instructed how to vaccinate a calf and [how] to collect and prepare the
lymph in due course.34
In 1922, a case of smallpox occurred among the Tibetan troops in Gyantse and
the garrison was subsequently vaccinated in its entirety, the first recorded case of
the Tibetan states personnel being systematically vaccinated.35 In 1925-26, when
a smallpox epidemic broke out in central Tibet the British vaccination services
were greatly in demand. Not only were 3,525 people vaccinated in Gyantse, a total
probably larger than the population of the town itself at that time,36 but it was noted
that none of those previously vaccinated were among those who died there. The
Tibetan state also signalled its acceptance of vaccination when they requested the
Sub-Assistant Surgeon in Gyantse be sent to Shigatse, where he vaccinated a total
of 1,379 people. In addition, the Tibetan government and various influential
officials by which was probably meant those favourable to the British received
free vaccine from the Government of India.37
There are some indications of lingering resistance, however; Frank Ludlow,
headmaster of the English school that existed in Gyantse from 1923-26, recorded
in his diary the case of a woman with smallpox whose family were not vaccinated
because their lamas had said that evil would result from it.38 But in general the
Tibetans had, by the mid-1920s if not earlier, accepted vaccination against smallpox
as a medical practice. It was noted that in this sense vaccination was something of
an exception; Though other forms of European medical treatment are often looked
on with suspicion, vaccination is greatly appreciated by Tibetans of all classes.39
It is notable that the Tibetan states adoption of vaccination appears to have
come at a time when the confrontation between tradition and modernity was reaching
a climax. The strengthening of the Tibetan military forces and the introduction of a
police force in Lhasa had bought to a head tensions within society, including
monastic concerns over the increasing allocation of economic resources to those
new secular power sources. After a crisis in 1924, the Tibetan state turned away
from modernity,40 yet against the prevailing tendencies of the era, this medical
aspect of modernity was eagerly embraced. By the 1930s, references to smallpox
in the British records are devoid of any indications of resistance, and demonstrate
an increasingly wide distribution of lymph from the British to outlying areas of
Tibet such as Poyul and Kham.41
During the final decade of the British presence in Tibet, tens of thousands of
Tibetans were vaccinated annually at the IMS dispensaries. With virtually the entire
population of Gyantse and the Chumbi Valley having been vaccinated by the 1940s,42
smallpox was effectively eliminated from central Tibet, saving countless lives. While
in humanitarian terms this was unquestionably a biomedical triumph, it does not
seem to have been celebrated as such by the IMS officers, for whom it was rather
just one step towards the Tibetans acceptance of the entire biomedical system.

126 TIBET JOURNAL

Nor did the later IMS officers even appear to have recognised the fact that they had
achieved the original aim of virtually eliminating the likelihood of smallpox
spreading down the trade route into India. By the late 1940s the possibility of
eliminating smallpox worldwide was recognised, and its eradication from (central)
Tibet had become merely a small step towards that ultimate aim.
CONCLUSIONS

In retrospect, the Tibetan reception of vaccination represents not simply a wider

example of biomedical lineal triumph, but rather an interesting example of the
gradual assimilation of a particular medical practice into the indigenous
understanding. Within a decade or two of its introduction the acceptance of
vaccination had been signaled by both the Tibetan state and by Tibetan individuals
of all classes despite continuing resistance to other aspects of biomedicine. While
variolation was apparently not unknown to the Tibetans, and may therefore have
paved the way for acceptance of the technique of vaccination, this does not
necessarily follow. The Tibetan precursors of surgical procedures did not lead to
similar unqualified acceptance of British surgical methods and particularly when
we consider that the vaccination technique was both bodily invasive and scarring,
it is difficult to account for this acceptance other than as a consequence of
vaccinations empirically demonstratable efficacy.
This provides a contrast with the situation in India, where the efficacy of
vaccination had not prevented continuing resistance. One reason for this was that
the Tibetans did not have the caste, gender, and purity concerns that strengthened
resistance to smallpox vaccination in India. In contrast to her Hindu or Muslim
counterpart in India, for example, an aristocratic Tibetan woman would have had
no particular cultural objections to a male medical practitioner of lower social
status being in close contact with her and introducing an animal-based serum into
her body. Perhaps most crucially, however, resistance in the sense that it occurred
in India did not arise due to the absence from Tibet of a specific nationalist agenda,
such as that represented by the Congress Partys drive for an independent India.
While Indian nationalism was a recognised and increasingly powerful force by
the beginning of the 20th century, it has become clear that Tibet at that time was
largely lacking in a sense of nationalism in the sense of identification with a Nationstate on the Western model. Tibetans undoubtedly had a sense of shared identity
as a group speaking Tibetan, eating tsampa, enjoying cultural expressions such as
the Gesar of Ling saga, etc. That identity enjoyed a close, though not unproblematic,
association with Buddhism, and was often expressed, particularly at the elite level
of state rhetoric, in those terms. These shared understandings had persisted over
time, and a sense of proto-nationalism can be traced to at least the 14/15th
centuries.43
Tibet, lacked, however the association of that identity with a state possessing
fixed borders and central authority over foreign relations, use of force and so on.
Tibetan identity in that period was primarily local or regional, rather than national,
and no one body or territory commanded the loyalty of all of the Tibetan-speaking
peoples. In recognition of this, the British explicitly sought to stimulate the growth
of national feeling in Tibet, as a means of strengthening the Tibetan state. But in
many senses Tibetan nationalism fully emerged only in the post-1950 period, in
response to the communist Chinese take-over.

THE BATTLE AGAINST SMALLPOX IN TIBET

... 127

Tibet was not, in the period 1904-47, under the undisputed control of any outside
power and it was effectively independent from 1913-47. Biomedicine was not,
therefore, a system imposed on a subject nation by its colonial masters, as it was in
India, and in the absence of any national feeling, nationalist resistance did not
arise. Certainly the dominant tendency was for the Tibetans to regard the
British and British initiated elements of modernity as a potential threat to their
social system, and there is very little evidence indeed of any internal challenges to
the Tibetan system, suggesting a certain unity of comparative satisfaction with the
system as it existed. Biomedicine was clearly a foreign system and was not therefore,
regarded without some doubt and suspicion, but this derived from cultural, rather
than nationalist concerns in the sense that we understand nationalism in the West
today,44 and the efficacy of vaccination overcame these cultural objections.
In the wider context, a study of the actions of the IMS officers in Tibet illustrates
the necessity of seeing imperialism, and the actions of the colonial state, not as a
monolithic process, but as one in which different layers of imperial authority were
in constant negotiation. Issues were debated within the imperial system in the context
of prevailing and competing ideologies, practices, and social and scientific
understandings, as well as as a result of the ambitions of, and relations between,
individual colonial officers. The British Government, the Government of India,
provincial and district authorities, as well as the diplomatic representatives in Indias
Princely and neighbouring states all formulated and implemented policies, and
while the formulation of policies was often bitterly fought out, the implementation
was often piece-meal and subject to numerous other factors, not least financial
restrictions.
Of almost equal importance is the fact that policies were negotiated at every
level of imperial authority with local and regional power structures, social groups,
and organic cultures. The simplistic domination-resistance model is as redundant
in analysis of Tibetan medical history as it has been shown to be in the works of
scholars such as Clive Dewey in regard to Indian agricultural statistics and my
colleague Sanjoy Bhattacharyas work on both censorship and medicine in Indian
history.45
Notes
1. A version of this paper, entitled Guarding the Borders; the battle against smallpox on
the Indo-Tibetan frontier, was delivered at the Medicine at the Border conference;
University of Sydney, July 2004; my thanks are due to Alison Bashford, the conference
organiser, for this opportunity. This paper is part of a wider study of the introduction of
biomedicine (the allopathic, or Western medical system) into the Indo-Tibetan
Himalayas, funded by the Wellcome Trust Centre for the History of Medicine at UCL
(London).
2. Dunn, F.L. Traditional Asian Medicine and Cosmopolitan Medicine as Adaptive
Systems, in Leslie, C. (ed.) Asian Medical Systems: A Comparative Study, Delhi 1998.
(first published, 1977), pp.133-58 quoting Joseph Needham, Science and Civilization,
1954, p.58.
3. Ahmad Shah, Four Years in Tibet, New Delhi, 1991 (1st pub. 1906) p.61.
4. Sarat Chandra Das, Lhasa and Central Tibet, Delhi, 1988 (first published 1902), p.257.
5. For example, during the late 19th century the Thirteenth Dalai Lama survived smallpox,
but the Fifth Panchen Lama died of the disease in 1882.
6. Ahmad Shah, op cit.

128 TIBET JOURNAL

7. Filippi, Filippo de, An Account of Tibet. The travels of Ippolito Desideri of Pistoia,
S.J., 1712-1727, London, 1932, p.87. But smallpox may also have been one condition
for which hospitalisation became known in Tibetan society. Chinese records indicate
that In 1794, the Tal [Dalai] lama, under orders from the Emperor, erected special
hospitals for small-pox patients, in which they were supplied with food and every
necessary, and which were under the care of a special officer. Rockhill, W.W., Tibet: A
Geographical, Ethnographical and Historical Sketch, Derived from Chinese Sources,
1891, p.235, quoting from the Hsi Tsang fu, p.28.
8. See McKay, A.C., 19th century British expansion on the Indo-Tibetan Frontier: A
Forward Perspective in The Tibet Journal, XXV111.4, 2003, pp.61-76.
9. See McKay, A.C., The Drowning of Lama Sengchen Kyabying: A Preliminary Enquiry
from British Sources, in Tibet Past and Present: Tibetan Studies I. the Proceedings of
the 9th International Seminar for Tibetan Studies, Leiden 2000, H. Blezer (Gen. Ed.),
Brill, 2002, pp.263-80; Chandra Das provided numerous accounts of his journey; see
for example Sarat Chandra Das, Journey to Lhasa and Central Tibet, Delhi, 1902.
10. National Archives of India (Delhi) [hereafter NAI], Foreign Department [hereafter,
FD], External B, May 1906, 156-158, J.C. White to India 5 February 1906: FD, External
A, Sept. 1906, 40-46, J.C. White to India, 20 March 1906;
11. NAI, FD, Proceedings March 1905, Report of Captain H.J. Walton, Medical Officer
Tibet Frontier Commission, 22 September 1904; NAI, FD, External A, Sept. 1906, 4046, J.C. White to India, 20 March 1906.
12. NAI, FD, External B May 1906, 156-158, file note by G. Bomford, 22 March 1906.
13. NAI, FD, Proceedings March 1905, Report of Captain H.J. Walton, Medical Officer,
Tibet Frontier Commission, 22 September 1904.
14. Oriental and India Office Collection [hereafter, OIOC], MSS Eur F157- 304, Dispensary
report for the year ending 31 December 1905, attached to Gyantse Report, October
1904 31 March 1906; NAI, FD, External B May 1906, 156-58, Steen to OConnor,
14 December 1905.
15. OIOC, MSS Eur F157- 304b, Gyantse report, October 1904 31 March 1906.
16. NAI, FD, Secret E, May 1906, 47-76, Gyantse diary entry of 18 January 1906.
17. NAI, FD, Secret E, May 1906, 47-76, diary of Captain Steen at Shigatse, entry of 26
February 1906.
18. NAI, FD, Secret E, Feb.1907, 295-353, various correspondence, esp., Gow to Bailey, 4
December 1906. The correspondence indicates that Gows first action had been to deny
transportation to the vaccinators some days previously.
19. NAI, FD, Secret E, Feb.1907, 295-353, Bailey to India, 6 December 1906; although
the dispute between Gow and the British officials in Gyantse was often petty and personal,
the usual diplomatic conventions were observed. Thus, even during the isolation of the
Agency, Bailey sent a communication to Gow along with an electric bell and two
batteries, some Reuters telegrams and a goose, which I hope you will accept with my
compliments; NAI, FD, Secret E, Feb.1907, 295-353, Bailey to Gow, 22 November
1906.
20. NAI, FD, Secret E, June 1907, 375-389, J.M. Holmes, Govt., of United Provinces, to
(Indian Foreign Minister) Sir Louis Dane, 25 April 1907; file note by R.E. Holland,
Assist. Sect., Government of India Foreign Department, 29 April 1907.
21. NAI, FD, Secret E, June 1907, 375-389, Sir Louis Dane to India Office (London), 8
May 1907.
22. OIOC, L/P&S/7/220-1625, Gyantse Annual report 1907-08; NAI, FD, External B, June
1911, 289, file note by T.W., 6 June 1911; NAI, FD, Secret E, February 1908, 467482, file note by E.H.S. Clarke, 26 November 1907. The Gyantse Trade Agent recorded
that the Chinese were sending vaccinators to Lhasa, one of whom had already arrived
although he had not begun work; NAI, FD, External B, October 1908, 194-216, Gyantse

THE BATTLE AGAINST SMALLPOX IN TIBET

... 129

Agency diary entry, 10 September 1908. I have not located any further reference to
them.
23. On resistance in India, see David Arnold, Touching the body: perspectives on the
Indian plague, 1896-1900, in R.Guha, (ed.), Subaltern Studies V, Delhi, 1987, pp.5590. Arnolds conclusions have been assumed by many to have Pan-Indian application,
a claim Arnold has not, however, made.
24. OIOC, L/P&S/7/249-1151, dispensary report attached to Gyantse Annual report, 1910
11.
25. OIOC, L/P&S/7/241-1058, Gyantse Annual report, 1909 10.
26. OIOC, L/P&S/7/229-923, dispensary report attached to Gyantse Annual report, 1908 09.
27. OIOC, L/P&S/7/249-1151, Gyantse Annual report, 1910 11.
28. Ibid.
29. OIOC, MSS Eur F157-224a, published obituary (source unclear) contained in Kennedy
to Bailey correspondence. Emphasis added.
30. OIOC, L/P&S/7/249-1151, dispensary report for the year ending 31 Dec. 1911.
31. OIOC, L/P&S/10/218-2396, dispensary report for the year ending 31 Dec. 1914.
32. OIOC, L/P&S/7/249-1151, Gyantse Annual report 19101911. No distinction is made
in the British records between vaccination and revaccination.
33. OIOC, L/P&S/10/218-2396, dispensary report for the year ending 31 Dec. 1914.
34. OIOC, L/P&S/12/143-69, Kennedy report, 12 October 1921, forwarded in Bell to India,
5 December 1921.
35. OIOC, L/P&S/10/218-2120, Gyantse Annual report 192223.
36. Although no accurate figures are available, a population of 3,000 is a common
contemporary estimate for Gyantse.
37. In the Gyantse Annual Reports for 1925 and 1926 (OIOC, L/P&S/12/4166-2080; L/
P&S/12/4166-3690), these officials are not identified, but the 1931 Gyantse Annual
report (OIOC, L/P&S/12/4166-3129) identifies Tsarong Shape as one such individual,
while the 1941 Gyantse Annual report (OIOC, L/P&S/12/4166-6895) mentions
individuals including local Tibetan officials and landlords of Gyantse, along with Dzasa
Lama, and the Jonpons of Shigatse and Serkya [sic: Sakya?] monastery, the latter sent
through the Tibetan trade Agent in Gyantse. We may suspect that in recognising various
individuals as well as the State government as equipped to distribute the lymph the
British favoured their allies among the indigenous elites; certainly the British considered
Tsarong and the Abbot of Sakya as favourable to them, on the latter, see the 1926
Gyantse Annual report (op cit), where the Sakya Rimpoche is described as having
charming manners and it is stated that he asked to be vaccinated by the Agency
Surgeon, and this was done.
38. OIOC, MSS Eur D979, Ludlow diary entry, 31 March 1926.
39. OIOC, L/P&S/12/4166-1984, Yatung Annual report 1925-26.
40. See, on this period Melvyn Goldstein, A History of Modern Tibet, 1913-1951: The
Demise of the Lamaist State, Berkeley, 1989, pp.89-138.
41. OIOC, L/P&S/12/4166-2808, Gyantse Annual report, 1932-33.
42. OIOC, L/P&S/12/4166-3159, Gyantse Annual report, 1942-43: L/P&S/12/4166-3385,
Yatung Annual report, 1942-43.
43. See, Dreyfus G, Proto-Nationalism in Tibet in Kvrne, P. (ed.), Tibetan Studies:
Proceedings of the 6th International Seminar of the International Association for Tibetan
Studies, Fagernes 1992, Oslo (The Institute for Comparative Research in Human
Culture), 1994, vol.1, pp.205-218.
44. This may, of course, represent further evidence that our understanding of nationalism
needs significant revision from a less Eurocentric perspective!

130 TIBET JOURNAL

45. See Clive Dewey, Patwari and Chaukidar: Subordinate Officials and the Reliability of
Indias Agricultural Statistics in Dewey, C., & Hopkins, A.G. (eds.), The Imperial
Impact; Studies in the Economic History of Africa and India, London 1973; and Sanjoy
Bhattacharya, Propaganda and Information in Eastern India, 1939-45: A Necessary
Weapon of War, London, 2001.

Zurkharwa Lodro Gyalpo (1509-1579) on the Controversy

of the Indian Origin of the rGyud bzhi
Olaf Czaja
Since Karmays illuminating article, the Tibetan controversy regarding the origin of
the famous rGyud bzhi had become also well-known to the Western audience.1 Here
it will be attempted to make some addition to this long standing discussion based on
the view of Zurkharwa Lodro Gyalpo (Zurkharwa Lodro Gyalpo, 1509-1579), one of
the main exponents of the zur lugs medical tradition. Recently some of his writings
were published which allow a precious insight into this issue. This paper will give a
short biography of him and outline his standpoint in this controversy.
HIS BIOGRAPHY
Zurkharwa Lodro Gyalpo was one of the most celebrated physicians of the 16th
century. He was renowned for his erudition and his fervent endeavour to discuss
controversial issues publicly.2
He was born in 1509. The documents do not give the place of birth and the names
of his parents. They also stay silent on what happened during the two first decades
of his life. At first he bore the name Tshe brtan rgyal. When he was ordained by
Karma phrin las pa (1456-1539), he received the name dPal ldan Don grub rnam rgyal.
Later he was given the name Legs bshad tshol by the Eighth Karma pa Mi bskyod
rdo rje (1507-1554). Still another name, Lodro Gyalpo, was given to him by the Zhva
dmar ba.3
It is obvious that he was closely affiliated to the Karma pa school. Between 1532
and 1539 he studied at the Karma pa college for higher philosophical studies (bshad
grva) and became particularly well-versed in prosody and reasoning.4 The former
subject was taught to him by Rin chen bkra shis (b.15th cent.) alias sKyogs Lo tsa ba.
It is not clearly stated in the sources, when he began to learn medicine. He was
related to the celebrated physician Zurkharwa Nyamnyi Dorje (Zurkharwa mNyam
nyid rdo rje, 1439-1475), who initiated a particular medical tradition known as zur
lugs. Therefore one can assume that because of his family background Lodro Gyalpo
had already a basic medical knowledge at an early age.5
As already noted Lodro Gyalpo himself held the view that he was an reincarnation
of Nyamnyi Dorje. He was assured in this by the Zhva dmar ba.6
During his stay at the Karma pa monastic settlement, or perhaps at the end of it, he
was urged by his lama to thoroughly study medicine. He composed his first dated
work, a biography on Zurkharwa Nyamnyi Dorje, at Chos kyi sde gnyug, which
belonged to the Sakyapa school, during the second half of the ninth month in 1539.7
Then Lodro Gyalpo studied for three months with Glang phu Chos rje.8 He was a
pupil of Tsomed Khenchen (mTsho smad mkhan chen) who in turn had relied on
Kong po Phrag dbon, a famous disciple of Nyamnyi Dorje. From Glang phu Chos rje
he received the initiation and the reading transmission of the g.Yu thog snying thig,
and the reading transmission of the rGyud bzhi, Bye ba ring bsrel, Pad ma gces
phreng, and bDud rtsi bum pa.9 This was followed by an extensive study with many
famous doctors of his time regardless to which medical school they were affiliated.10
Despite this he felt the necessity to search for the original writings of Yuthok Yonten

132 TIBET JOURNAL

Gonpo and set off to his birth region at upper and lower Myang.11 There his endeavours
were crowned with success and he found the personal copies of the rGyud bzhi that
had golden explanatory notes.12 In the coming years he remained in this region and
began to compose commentaries on the rGyud bzhi known as the Mes poi zhal lung.
In 1542 he completed his commentary on the rTsa rgyud, the first part of the rGyud
bzhi.13 He was supported in this endeavour by Chos rgyal rGyal dbang rdo rje grags
pa rgyal mtshan. Three years later, in 1545 he finished the commentary on the bShad
rgyud in the vicinity of Pa snam Lhun grub rtse sponsored by the same patron. At the
end of 1545 he was stricken with smallpox, but he recovered. The following year he
seems to have stayed for a while at the so-called medical town of Sakya (Sa skya
sman grong). There he met the provost (zhal ngo) of Brang ti, father and sons.14 In
about that time he also went to Lhasa. On a stone pillar, he put up his famous pamphlet
containing questions about several medical issues.15 In the same year of 1546 the
famous Gra thang rGyud bzhi was carved in blockprints, based on a revision made by
Lodro Gyalpo.16 Moreover at this time he went as an attendant of sGar chen to Zur
phu.17 Of the following years nothing is recorded until the spring of 1554 when he met
the famous Brug pa scholar Padma dkar po (1527-1592) in rGyal chen gling.18 In 1566
he wrote a commentary on the first chapter of the Phyi ma rgyud that deals with pulse
diagnosis.19 Obviously this work was planned to cover the entire Phyi ma rgyud but
he did not succeed in this. During all this time the thoughts of Lodro Gyalpo revolved
around the medical issues raised by him on the Lhasa pillar. Eventually in 1570 he
wrote an treatise in which he gathered all questions and replies so far together with
commentarial notes.20 Two years later in 1572 he composed a short treatise that
investigates the origin of the rGyud bzhi. In 1573 he made a new edition of the Bye ba
ring bsrel of Nyamnyi Dorje and wrote a table of contents for it.21 In the last years of
his life he began to compose a khog dbubs that remained unfinished probably because
of his death.22 The year when he passed away is not certain.23
HIS TREATISE ON THE ORIGIN OF THE RGYUD BZHI
As noted above, in 1572 he wrote his short treatise, The Thorough Distinction (of)
the Four Tantras (between) Authentic words and Treatise, The Torch that Dispels
Darkness (rGyud bzhi bka dang bstan bcos rnam par dbye ba mun sel sgron me).24
This discussion whether the rGyud bzhi was expounded by Buddha or composed
by a Tibetan author played out over centuries of Tibetan medical thinking. The
earliest medical history known to us, the Khog dbug khyung chen lding ba which
had been written by Yuthok Yonten Gonpo and is preserved in the compilation called
the Eighteen Parts (Cha lag bco brgyad), had already dealt with this point.25
Reviewing other medical histories it seems that it formed indeed an indispensible part
of the medical discourse.26 One gets the impression that, right from the beginning,
medical writings concerning the rGyud bzhi had to takes sides in the discourse about
whether it was the authentic words of Buddha, Indian works or medical compositions
of indigenous origin. In this it shares this proceedure with textual sources of ritual or
meditational purpose as well, but it appears that it centered on the rGyud bzhi insofar
as medicine was concerned.
Lodro Gyalpo was a fervent follower of the bka ma thesis. In his works he frequently
expounded his view on this and he was lavish in his critique, which included wellfounded arguments and pedantic polemics, as well as crude insults.27

ZURKHARWA LODRO GYALPO

(1509-1579) ... 133

He structures his composition The Torch that Dispels Darkness into three topics:
(1) that explains the rGyud bzhi outwardly as the word (bka) of Buddha, (2) inwardly
as a treatise (bstan bcos) of a Pandita and (3) secretly as a Tibetan treatise.
At the beginning Lodro Gyalpo gives an introduction on what words of Buddha
and treatises are and ends this paragraph by a citation from the Prajnaparamita in
Eight-Thousand Verses (brGyad stong). This says that whatever the pious laymen of
the Buddha say, talk, explain and teach is not in contradiction to the Dharmata (chos
nyid). Also those who explain that Dharmata are not in contradiction to the Dharmata.
This is in accord with the cause that Buddha expounded the Dharma. Then Lodro
Gyalpo launches into the first topic.
ON HOW THE BUDDHA EXPOUNDED THE RGYUD BZHI
THE VIEW OF THE OTHERS THAT IS WRONG AND OBSTRUCTED
Zurkharwa Lodro Gyalpo continues to say how it was expounded by Buddha. He
states that what is explained by the rGyud bzhii rnam thar bka rgya ma is of special
intent (dgongs pa can) and does not fit with the basic meaning (don).28 Although in
this very source it is maintained that it was taught at O rgyan, this is not to be
understood as the true meaning (don). There are no accounts that bring it together
with reliable sources and trustworthy reasons but just accounts that take an unseen
O rgyan as the basis, he explains. Then he introduces the different notions that exist
regarding the place where this teaching was given. They are indeed abundant as the
author himself sadly remarks.29 In his opinion, these are not even as much as one
single little hair related to reliable sources and reasons, epistomological explanations
and reasoning. Then he starts to express what in his view should be seen as truthful.
THE OWN VIEW THAT IS CORRECT
He begins this new paragraph by quoting the Bye brag tu bshad pa written by
Vasubandhu. According to this work, Buddha stayed for four years in the Forest of
Medicinal Herbs (sman gyi nags su lo bzhi).30 Then he continues by saying that this
forest or grove of medicinal herbs is the place where Buddha turned the wheel of the
Four Noble Truths, his first authentic words. In the centre of this forest is a huge
mountain with medicinal herbs. On the summit, there is a city of medical herbs called
Pleasing to See (lTa sna sdug). Thus it is stated by the rTsa rgyud, the first part of the
rGyud bzhi. On the four side of this very mountain are special herbs which are
endowed with the power of sun and moon and are hot and cooling as indicated by
their four names of these sides, namely Piercing (Bigs byed), Aromatic (sPos ngad
ldan), Having Snow (Gangs can) and Ma la ya.
The intention of Lodro Gyalpo is appearantly twofold. He argues against O rgyan
as the locality where the rGyud bzhi was taught and tries to relate the narration of the
rGyud bzhi to authorative sources that are linked with Buddha.
He continues by saying that in short the place as described by the rTsa rgyud is
explained in the bShad rgyud. The mountain still exists nowadays but because the
city was a magical creation, Rig pai ye shes together with a group of attendants
withdrew their magical creation (sprul ba bsdus pa) and the city does not exist
anymore.31 Up to now there is an oral tradition among doctors (lha rje) maintaining
that this city exists but this is not reliable, according to Lodro Gyalpo.

134 TIBET JOURNAL

At that place the one who expounded the tantras was the real Sakyamuni. It is the
true and authentic word that was spoken by him, because Rig pai ye shes together
with the four families and Yid las skyes had had a dialogue. Therefore these Rig pai
ye shes are the true Buddha.32
Perhaps it might be helpful to insert at this point the statement of someone who
belongs to the opponents party in order to illustrate what their arguments were and
to indicate the background of Lodro Gyalpos composition.
One should refer to a contemporary of Lodro Gyalpo, namely the learned Kempa
Tsewang (sKyem pa Tshe dbang, b.1514?). He is one of the few physicians who
wrote commentaries on all four parts of the rGyud bzhi. His commentary on the Man
ngag rgyud formed for a long while the best-known analysis of this third part.33 He
received his medical education from Kempa Tshe bum rdo rje, one of the four
celebrated disciples of Zurkharwa Nyamnyi Dorje. Both doctors knew each other
very well. In fact Lodro Gyalpo had written his first part of the Mes poi zhal lung in
1542 at the behest of the Kempa Tsewang.34 Later he was one of the doctors who sent
replies to the questions that Lodro Gyalpo put up on a stone pillar at Lhasa. But
obviously they did not agree on the Buddhist nature of the rGyud bzhi. Kempa
Tsewang treats this issue from his point of view very briefly in his commentary on the
rTsa rgyud composed in 1538. Here he rather straightforwardly disregards in seven
arguments any claim that it could have been expounded by Buddha.35
(1) According to him what the Medicine Buddha and his emanation Rig pai ye
shes have expounded cannot be regarded as an authoritative text, because it is
certain that for one teaching two teachers cannot emerge. (2) Moreover the medical
city Pleasant to See and the groves of the mountain in all four directions are not
mentioned in other sutras and tantras. Surely Kempa Tsewang was not the only one
who held this argument.36 (3) The following argument of Kempa Tsewang is that one
cannot establish a correct (rnam par dag) authoritative reading transmission and
logic (lung rig) for the rGyud bzhi. (4) His next point focuses on the particular time
when the rGyud bzhi have been taught and on the teachings itself. Kempa Tsewang
states that because Buddha taught during his life-time, he let (his listeners) understand
through the fourfold (turning of) the wheel in the mode of a teacher, each for one
speech. In the colophon of the rGyud bzhi it is stated:
(Buddha taught) the gSo dpyad bum pai rgyud to the group of gods (lha), the Tsa ra ka
sde brgyad to the group of seers (drang srong), the dBang phyug chen poi skor to the
group of non-Buddhists (mu stegs / phyi pa) and the Rigs gsum mgon poi skor to the
group of Buddhists (nang pa).37

Kempa Tsewang continues to discuss this issue. (5) He says, if it is necessary to

maintain the so-called tradition of drang srong as being the Tsa ra ka sde brgyad,
then it is demonstrated that everything is compiled (thams cad dus pa) in this gSo
dpyad rgyud (i.e. the rGyud bzhi), because the Tsa ra ka sde brgyad is known to
have been composed by the eight pupils of Indra (brGya byin). Certainly this is a
noteworthy point made by Kempa Tsewang. Indeed, if one follows the view of Buddha
having expounded a drang srong-version of the rGyud bzhi, than one should expect
that Tsa ra ka sde brgyad has not been compiled in the way which is widely accepted.38
Untiringly Kempa Tsewang is pressing on this track of arguments. He states that if
this is the case one has to consider the following scenarios. (6) He says that if it was
taught after the main tenets of the four medical tradition (of gods and so on) had been

ZURKHARWA LODRO GYALPO

(1509-1579) ... 135

compiled, the rGyud bzhi would have become a treatise. If it was taught earlier, than
it is necessary to assume that it was earlier than the gSo dpyad bum pa and the Tsa
ra ka sde brgyad. Therefore one is not able to bring it in line with the attendant
Ananda (Khor Kun dga bo).39 If it was expounded at the same time, it will become
necessary to assure it as both the drang srong tradition and the tradition which
states that everything was compiled (thams cad dus pa).
Then he criticizes the framework of the rGyud bzhi as contradictory. (7) The
questioner is Yid las skyes pa (i.e. born from the heart,) who thoroughly examines the
parts that are fully comprehended by others. The dharma that is condensed in Buddha
through his heart vanishes, being his own mind-continuum (rang rgyud), and because
he is born (skyes pa) from (las) the heart (yid). Thus one regards him as dead
(nongs). If it is truly similar to the mode of a questioner, than he can not give an
answer, in case one recognizes that he is dead.
These are some of the arguments that followers of the bstan bcos thesis bring
forth.40 Surely, Lodro Gyalpo was familiar with them. The second topic he deals with
concerns the suggestion that it was composed by an Indian Pandit.
EXPLAINING THE RGYUD BZHI INWARDLY AS A TREATISE OF A PANDIT
Here he confines himself to a general exposition on what a treatise is. On the other
hand he just enumerates the varying opinions on the authorship of the rGyud bzhi.
For the first point, he refers to the rNam bshad rig pa, which distinguishes treatises
as follows. There exist treatises without real meaning, with wrong meaning and with
real meaning. The latter are valid (tshad) treatises. Then there are some that were
written for selfish reasons, some that lack compassion and some that dispel suffering.
The latter are correct (yang dag) treatises. Furthermore one can find treatises that are
mainly concerned with learning or with argumentation but also with realization (sgrub).
These treatises focusing on realization are correct and valid. The rGyud bzhi, however,
is not a treatise that deals with realization. It is, however, a correct treatise that has
true meaning and dispels suffering.
Secondly Zurkharwa Lodro Gyalpo gives in a very condensed form all views that
differ from the accepted authorship. Some maintain that it was composed by O rgyan
Padmasambhava while some by O rgyan Padmasambhava, Kha che Zla dga and
Vairocana together. There are also some who say that it was collectively written by
Grva pa mNgon shes, dBus pa Dar rgyas and sTon chen dKon mchog skyabs at
Tshar pa snai ri gdong in sKyid sman. Again some say that, immediately after
Padmasambhava and Vairocana had translated it, it was hidden as treasure in a vase
in a pillar at bSam yas. Afterwards Grva ba mNgon shes discovered it. Some say that
it was not hidden as treasure. According to them, there exists a transmission line from
Trisong Deutsen to the present kings of mNga ris. Lodro Gyalpo concludes this
overview by dryly remarking that all these are assumptions which lack a proper
understanding of the truth. He eventually gives his attention to the claim that it was
composed by a Tibetan.
EXPLAINING THE RGYUD BZHI SECRETLY AS A TIBETAN TREATISE
He briefly lists those who hold this view and gives short quotations. Then he explains
the main reasons for thinking of rGyud bzhi as a Tibetan treatise.

136 TIBET JOURNAL

DIFFERING NOTIONS
According to him, Bo dong Phyogs las rnam rgyal (1376-1451) wrote that he studied
the rGyud bzhi, which was composed by a skilled Tibetan doctor.41 Furthermore sTag
tshang Lo tsa ba Shes rab rin chen (b.1405) said that, with regard to the diagnosis by
means of taking the pulse and urine analysis there was no such explanation in India.
It was made by a Tibetan doctor, a Bodhisattva.42 Zurkharwa Lodro Gyalpo says that
Pan chen Shakya mchog ldan (1428-1507) agrees with both, being of the opinion that
it is a treatise composed by a Tibetan.43
ON THE TIBETAN COMPOSER OF THE RGYUD BZHI
Our author starts this passage by saying that there existed those who were known as
the Nine Experts in Tibet (Bod du mkhas pa mi dgu) and the Nine Personal Physicians
of King Trisong Deutsen (chos rgyal Khri srong ldeu btsan gyi bla sman mi dgu).44
Those nine experts were the teachers of Zhang Ri bong gZi brjid bar and the pupils
of A tsa ra Phyag rdum.45 Among them was Yuthok rGya gar Badzra. His son is Yuthok
Yonten Gonpo.46
Then Lodro Gyalpo explains how the name Yuthok originated. He tells that Yuthok
rGya gar Badzra practised as the doctor of the sDug dre of rGya brag ka ba phrang
who belonged to the Bre family of Myang stod, which had possession of the clans
of Bre and Khyung. As a reward he obtained the corpse of a woman which was
lavishly adorned with jewellery made of turquoises. When he spread this jewellery
on the roof terrace to dry it, a shepherd and his children saw it from a nearby mountain.
They thought that the roof was made of turquoise. Henceforth the family became
known as the one of the turquoise roof (g.Yu thog pa).47
Then Zurkharwa Lodro Gyalpo continues to explain how Yuthok composed the
rGyud bzhi. If one says that, because Yuthok took the authentic words of Buddha as
the base, there can not be any mistakes at all, then one should explain it as follows.
If it is not composed as though it were an authoritative text (bka), than it is hard to
trust all those Tibetans who are wise, stupid and who are of medium intellect. If it is
not composed as though it were an authoritative text in the face of those who do not
investigate the meaning but just comprehend the words, than it is not just collected.
Otherwise it is very clear that on the issue of medicinal tea (na ja), porcelain (dkar
yol) and examination of pulse and urine (rtsa chu brtag pa) it is a basic textual source
of Chinese astrology (nag rtsis kyi gzhung) and a Tibetan treatise like the one entitled
the Singing of the Cuckoo (Khu byug gi skad don).48 But it is necessary to recognize
this mode of explanation that rGyud bzhi is arranged like authentic words.
As the next step Lodro Gyalpo analyses the rGyud bzhi as a textual composition
by traditional means of reasoning.49 It is accomplished by a threefold approach
consisting of
(1) the intentional subject (dgongs gzhi)
(2) the necessity or motive for expounding it (dgos) and
(3) the criterion that conflicts with the real state of things (dngos la gnod byed).50
Regarding the intentional subject (dgongs gzhi) Lodro Gyalpo writes that the birthplace of Yuthok Yonten Gonpo had the effect of hot and cooling and was endowed
with the power of sun and moon. By this statement he brings it close to the description
the city of lTa na sdug where the rGyud bzhi was taught.51 The ensuing conversation
between Rig pai ye shes and Yid las skyes as it is found in the rGyud bzhi corresponds
to Yuthok Yonten Gonpo and his pupil Sum ston Ye shes gzungs. For this Lodro

ZURKHARWA LODRO GYALPO

(1509-1579) ... 137

Gyalpo cited the rNam thar bKa rgya ma written by Ye shes gzungs that states: I
think that (my) bla ma is the true Rig pai ye shes. I am Yid las skyes.52 Therefore
Yuthok Yonten Gonpo himself is Rig pai ye shes. Sum ston Ye shes gzungs is Yid las
skyes.
The motive (dgos pa) was that all people who have difficulties in being satisfied
should be guided.
The contradicting criterion (dngos la gnod byed) is that the city lTa na sdug and
the mountains like Gangs can and Bigs byed are not real. One should imagine that
their effective and beneficial qualities (nus pa yon tan) are equal. As already mentioned,
Lodro Gyalpo had already broached this question concerning the real state of the
medical city lTa na sdug, holding the view that this very city does not exist anymore
since it was a mere illusion (sprul pa). By this he dismisses the criterion that would
have been in conflict with the rGyud bzhi being the authentic word of Buddha.
Therefore Zurkharwa Lodro Gyalpo is obviously a follower of the tradition that
regards the rGyud bzhi as of Indian origin and ultimately expounded by Buddha. He
clearly rejects all views that claim its author as Yuthok Yonten Gonpo. But he cannot
refute all the arguments of his opponents who refer to passages and expressions that
can hardly be of Indian origin. Nevertheless he attempts to solve contradictions in
the rGyud bzhi by means of reasoning. From his point of view he affirmed the claim
that the rGyud bzhi is bka instead of bstan bcos.
This article could probably end here but there are some details which must be
added. They can be gathered from the khog bugs of Sangye Gyatso.53 At the end of
the biographical sketch on Lodro Gyalpo, there is a list of his works. When it comes
to the entry that concerns the present treatise, Sangye Gyatso gives a description
that is undoubtedly a citation of the words of Lodro Gyalpo.54 The passage that is
slightly paraphrased here goes:
With regard to removing contradictions of the rGyud bzhi (as) Authentic Text (and)
Treatise. (rGyud bzhi bka bstan) there are successively former masters of scholars who
regard (the rGyud bzhi) outwardly (as) an authentic text of Buddha, inwardly (as) a
treatise of a Pandit and secretly (as) a Tibetan treatise. In particular there exist the
remains from fragments of the sPyi don dngul dkar me long55 of the rJe Dharmasvamin
of my own family and commentaries on the rGyud bzhi as the Pod shal khra mo56 and so
on. In the fragment of the dNgul dkar me long that did not come to my sight earlier it is
that the unchanged (sor gnas) authentic words (bka) of the rGyud bzhi are (in fact a
composition) fashioned inwardly as a tantra (rgyud) and in the writings of Bla rta Tshe
dbang the Bai duryai chu rgyun of Tshogs gnyis rgya mtsho of Gro sa in Phan yul is
criticized. Therefore I understood that even the Dharmasvamin Nyamnyi Dorje was in
agreement with that thorough tradition and regarding the loud roar of disrespect in the
very clear khog bugs of the teacher of my lama, Tsomed Khenchen. Sa skya Pandita
Kunga Gyaltsen (1182-1252) wrote, Those who go beyond modesty that is spoiled from
the ground, carry their own bad rumours as response, some royal families of the country
of Kan tsa, beat the drum of victory having killed the father, or in colloquial language
(one says:) the head of ones own medical tradition is crushed from inside of the helmet.57

This is his statement but what does it mean? Why does Lodro Gyalpo give such
rather unexpected comments on his own treatise? For this it is most helpful to turn to
the khog dbubs that Lodro Gyalpo had started to write but that he left unfinished.
Here one gains an understanding as to what Lodro Gyalpo meant by this and it is
unquestionably rather amazing. In short, he had completely changed sides. At the

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end of his life he is of the opinion that Yuthok Yonten Gonpo had written the rGyud
bzhi and any claim that it was expounded by Buddha is dismissed. He clearly writes
that Yuthok had written the Lag len pod chung and the rGyud chung bdud rtsi
snying po artificially designing it as it would have been composed by Kha che Zla
dga. Later he expanded them to his rGyud bzhi.58 For the sake of his pupils, in order
to generate their devotion, he had composed it as though it were the authentic words
(bka) of Buddha. Lodro Gyalpo could not have been farther away from his previous
convictions. Furthermore as already said Lodro Gyalpo had made fieldwork in Myang
for his search of the rGyud bzhi and therefore it seems that he also came in contact
with the descendants of Yuthok. According to Lodro Gyalpo those held believes that
Yuthok became the personal physician of the kings of China and India and he passed
away at the age of 74. Such notions are now seen by him in a rather unfavourable
light. He says that for all such beliefs the writings of Yuthok are responsible, in which
such legendary accounts are expressed.59 Although Lodro Gyalpo had trusted these
sources until the age of 63 or even later, by now he offers, however, a rather down-toearth evaluation of the scholarly activities of Yuthok, which has been stripped of any
legends.
Moreover other treatises written by later generation in support of the bka ma
origin of the rGyud bzhi were all rejected by now.60 One of the opinions he mentioned
is of particular interest and should therefore be singled out. According to him there
are some doctors who maintain that this was taught by the Medicine Buddha. The
seers who put forward questions were embodiments of his body, speech, mind,
qualities and deeds.
Clearly, one doctor who had expressed such a view was Tsomed Khenchen. He
was a teacher of Glang bu Chos rje who in turn taught Lodro Gyalpo. When Lodro
Gyalpo refers rather sarcastically to the very illuminating (shin tu gsal) khog bugs,
he means The Khog bug of the Art of Healing, Fully Illuminated the Objects of
Knowledge (gSo ba rig pai khog bug shes bya rab tu gsal ba) and The Khog
bugs, the Mirror of Silver of Elegant Sayings (Khog bugs legs bshad dngul dkar
me long).61 It is obvious that he had completely broken with Tsomed Khenchen, even
though he was part of his teacher and pupil lineage. It must be that the fragments of
the khog bugs of Nyamnyi Dorje let him understand that the latter did not belong to
the party who regarded the rGyud bzhi as Buddhas words. This was seemingly
something that caused him serious trouble.
In all his former scholarly compositions he had strongly emphasized the bka ma
thesis. In the biography on Nyamnyi Dorje he duly reported that Yuthok Yonten
Gonpo passed away in a mass of rainbow light.62 In his Mes poi zhal lung, e.g. his
two commentaries of the rTsa rgyud and bShad rgyud written between 1542 and 1545,
he firmly regarded the rGyud bzhi as bka ma and profoundly expressed this view.
The pamphlet of the next year also dealt with this point.63 In his commentary on the
Phyi ma rgyud of which he just finished the first chapter on pulse diagnosis he takes
this opinion as common sense and insults those who differ from this.64 Six years later
he had composed this very treatise that defends the bka ma thesis.
Besides, he was a recognized reincarnation of Nyamnyi Dorje, the celebrated founder
of the zur lugs tradition. For such a gifted logician as Lodro Gyalpo this was
unquestionably a kind of challenge, that he differed in such an essential point from
his former existence. At the same time one has to stress that obviously this was not
the only reason, rather that he has been also affected by the arguments of Kempa

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(1509-1579) ... 139

Tsewang. It speaks for this fascinating and strong personality that he had chosen a
way of completely reviewing his arguments and taking an entirely new stand instead
of simply questioning the authenticity of the fragments and explaining away this
troublesome issue as it can be found in intellectual history and in Tibetan as well.
But what did Lodro Gyalpo mean by maintaining that Tsomed Khenchen had shown
disrespect to his own tradition and had betrayed zur tradition? As is known, one of
the teachers of Tsomed Khenchen was Phrag dbon bSod nams bkra shis, who was a
personal disciple of Nyamnyi Dorje.65 Unfortunately, until now none of the writings
of Phrag dbon bSod nams bkra shis have come to light.
Therefore we must rely on the khog bugs of mNga ris Tsho byed Chos skyong
dpal bzang (b.1479).66 With regard to the nature of the rGyud bzhi, he is of the opinion
that it is a treatise composed by Yuthok. In his own words he found himself in
agreement with scholars like Sakya sMan grong pa, Dvags po Pandita, and most
significantly here, with Kong sman bSod nams bkra shis.67 Based on this, one might
conclude that Phrag dbon, alias Kong sman bSod nams bkra shis, one of the teachers
of Tsomed Khenchen, was a follower of the bstan bcos thesis. Perhaps Lodro Gyalpo
might have known this but, presumably, as long as he had not found a clear evidence
of the hands of Nyamnyi Dorje, he preferred to follow the bka ma thesis, most likely
also due to the writings of Tsomed Khenchen. The situation changed completely
when the above-mentioned fragments fell into his hands. Now he accused Tsomed
Khenchen of taking up a position that is entirely in contradiction to the zur tradition,
as Lodro Gyalpo has suddenly realized. Certainly, he did not regard him as representing
the zur school of medical thinking anymore. Instead of this he compares the views of
Tsomed Khenchen as being similar to killing his own parents.
Now the crisis Lodro Gyalpo underwent becomes clear. After he had written his
treatise The Thorough Distinction (of) the Four Tantras (between) Authentic Words
and Treatise, The Torch that Dispels Darkness (rGyud bzhi bka dang bstan bcos
rnam par dbye ba mun sel sgron me) he had to experience that his torch was shedding
darkness instead of dispelling it. The fragments of the khog bugs of his former
existence, Nyamnyi Dorje, caused a sudden awakening on this. Tsomed Khenchen is
made responsible for the formerly erroneous views of Lodro Gyalpo.68
It would be of utmost interest to have now a closer look on the other part of the
statement of Lodro Gyalpo which in the writings of Bla rta Tshe dbang the Bai
duryai chu rgyun of Tshogs gnyis rgya mtsho of Gro sa is criticized. As has been
outlined above Bla rta Tshe dbang alias Kempa Tsewang does not follow the bka ma
thesis in his commentaries of the rGyud bzhi. But beyond this we do not know much
about him and his views. It is known that Kempa Tsewang had composed a treatise
entitled sPyi don legs bshad dod jo, because Sangye Gyatso refers to it at the end
of his khog bugs.69 Here he reviews several treatises and shortly states what these
have to say on the nature of the rGyud bzhi. For the work of Kempa Tsewang he
notes that he regarded it as outward, inward and secret tantra (rgyud).70 Possibly
Lodro Gyalpo had this outline in mind when he wrote his treatise but naturally it
could be also the reverse, as we do not know the time of composition for Kempa
Tsewang. Unfortunately concerning the Bai duryai chu rgyun of Tshogs gnyis rgya
mtsho of Gro sa nothing substantial can be said. It is just clear that in this text the
view is expressed that the rGyud bzhi was spoken at O rgyan during the middle
turning of wheel of teachings but he did not regard it as a gter ma.71

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This reorientation of Lodro Gyalpo marks a break in his life. How he had mastered
it is surely noteworthy. His turn to the party that supported the thesis of the rGyud
bzhi as an original Tibetan treatise had a strong influence on the zur tradition.
According to the testimony of Sangye Gyatso, the works of this school which were
composed later did follow Lodro Gyalpos convictions. His polemics against this
clearly show that Lodro Gyalpos khog bugs, although unfinished, still had a
tremendous impact.72 Sangye Gyatso who utilized all his political influence to
strengthen the bka ma thesis and the claim that it was hidden as gter ma was surely
frustrated by this. In this regard he was certainly favourably inclined to the Byang
school that held a view corresponding to his own. It says something for Sangye
Gyatso that nevertheless he patronized the new edition of the Mes poi zhal lung but
it speaks for itself that he did not bring forth evidences against the opinion of Lodro
Gyalpo, except for polemics. Nowadays Sangye Gyatso has asserted himself against
Lodro Gyalpo but surely not by means of superior argumentation. His opinion became
accepted as standard and is virtually regarded as the fundamental Tibetan notion on
Tibetan medicine in the majority of Western and Tibetan publications. Contrary to
this it seems that Lodro Gyalpo is largely forgotten today, although he was truly
outstanding in his intellectual endeavours and his writings belong unquestionably
to the most fascinating and enduring works of Tibetan medicine.

Notes
1. This article was originally published in Tibetan Medicine, Dharamsala: 1990, no.13, 1931. Many invaluable informations can also be found in Taube 1981: 31ff.
2. The main source for his life is the account by Sangye Gyatso, KhB [349/8-355/9]. This is
the sole base for Jampa Thinley 2000: 226-229, Lama Kyab 1997: 237-240, Pasang
Yonten 1988: 112-116, Kalsang Thinley 1997: 378-380, Gerke / Bolsokhoeva 1999. It
seems that Kalsang Thinley 1997 had also access to another source, the rGan poi kha
chems (on this see below). Beside this none of them made use of the compositions of
Lodro Gyalpo except Taube 1981: 63-66. Schaeffer 2003 gives a precious insight into
some aspects of this personality.
3. This is stated by Sangye Gyatso, KhB [349/11]. It is repeated by Jampa Thinley 2000:
226, Lama Kyab 1997: 239, Kalsang Thinley 1997: 378. It is not sure which Zhva dmar
pa is meantthe 4th Zhva dmar ba Chos grags ye shes (1453-1524) or his successor the
5th Zhva dmar ba dKon mchog yan lag (1525-1583). The name Lodro Gyalpo has to be
seen in connection with his status of being an incarnation of Nyamnyi Dorje (see below).
The colophons of the works of Lodro Gyalpo give a variety of names. In his earliest dated
work of 1539 he gives his name as dPal Don grub rnam rgyal dbang poi sde jigs pa med
pa phyogs kyi go cha. Although this composition makes mention of a prophecy that
Nyamnyi Dorje will be reborn as Lodro Gyalpo, the author does not indicate that he is
actually this very reincarnation. This is possibly a hint that at that time he was not yet the
recognized incarnation of Nyamnyi Dorje. It becomes evident, however, in the colophon
of commentary of the bShad rgyud of 1545. Here he styles himself as the second A po
Chos rje (i.e. Nyamnyi Dorje), MPZhL II [541/6]. Perhaps this can be regarded as a proof
that Lodro Gyalpo was recognized as an reincarnation between 1539 and 1545 and received
the name of Lodro Gyalpo. One can speculate that this can also be linked with his search
for the rGyud bzhi of Yonten Gonpo, although admittedly other scenarios are also possible.
Based on this one can be inclined to favour the 5th Zhva dmar ba dKon mchog yan lag
(1525-1583) as the one who bestowed the name upon him. Based on chronological
considerations Gerke / Bolsokhoeva 1999 suggest that it is the 4th Zhva dmar pa, ibid.

ZURKHARWA LODRO GYALPO

(1509-1579) ... 141

4. This detail comes from his own pen as some of following statements. They are at the
beginning of his rGan poi kha chems, STsCT [10/7-]. His affiliation to the Karma pa
school can also be seen in his writings. In his rGan poi kha chems and his commentary on
pulse diagnosis he discusses a particular issue related to pulse taking, namely the exact
beginning of the Tibetan year. There he refers to biographies of Karma pa personalities,
STsCT [51/14], MPZhL IV [60/5]
5. Cf, KhB [349/13]
6. KhB [354/10]. Cf. also n.1. In the biography of Nyamnyi Dorje a passage is included that
consists of a prophecy. A Mi bskyod rdo rje and a Lodro Gyalpo are named as future
incarnations, STsCT [91/9]. A similar but in some respects differing passage is also found
in a short treatise entitled Zur mkhar kun mkhyen tsho byed grub pai skyes rabs nyung
ngu contained in one version of the Bye ba ring bsrel, BBRS I [427/5-429/5].
7. It is dated to the white half of smin drug can in earth male pig year. It seems that he had
done much research for this. He based himself on the informations given by Karma phrin
las and drawn from the collected writings of Nyamnyi Dorje. He also made enquiries from
elderly people. This meticulous research method is certainly something that characterizes
him through his life. One may note here that in the colophon of this biography he gives his
name as dPal Don grub rnam rgyal dbang poi sde jigs pa med pa phyogs kyi go cha. In his
medical writings of later date he preferred the name Legs bshad tshol.
8. There are alternative spellings: Glang bu Chos rje or Glang phu Chos rje. The first part of
the name seems to be a toponym, because Lodro Gyalpo calls him Chos rje from Glang
phu, glang phu nas chos rje STsCT [10/18]. Samten 1992: 91, Jampa Thinley 2000: 226
give Glang bu Chos rje. At one instance one can find the spelling Gling bu Chos rje, KhB
[353/16].
Glang phu Chos rje is otherwise unknown. There are no writings of his mentioned in any
documents. One may assume that he was not so influential a doctor as the teachers Lodro
Gyalpo attended to in later times. His report on him is rather laconic. Due to the order of
his lama he was searching for a good teacher and regarded him as suitable in the current
situation, STsCT [10/18].
9. STsCT [11/1-3]. Cf., also KhB [349/19].
10. Namely the Byang pa brothers, dPon tshang Phan dar and his pupils, Sa skya sman grong
father and son, the nephew of Phyag sman Rin rgyal from mNga ris, A pha tshe ring from
Gu ge, the nephew (dbon po) of Bi ji, the nephew (tsha bo) of Ug pa, the sTag rtse doctor
from Byang, STsCT [11/3-10]. Cf. also Jampa Thinley 2000: 226. Sangye Gyatso identifies
the Byang pa brothers as probably belonging to the generation of bKra shis dpal bzang,
KhB [350/1-5].
11. Yonten Gonpo had lived at sGo bzhi re thang, near Ra lung in Upper Myang.
12. This is the so-called Phyag dreg ma. In secondary sources it is always stated that he found
a copy of this text. But one must stress here that it were several versions of the same text
he came across. He explicitly says that this text came from sKyil khud and Lung dmar and
so on. Therefore it were more than just one. Both places are situated in Myang, the home
region of the Yuthok clan. The grand-father of Yonten Gonpo had three sons, namely brJid
po, Grags seng and Khyung po. The eldest took possession of sKyil khud and Yuthok
proper. The middle took Lung dmar and the youngest, the father of Yonten Gonpo, got
sGo bzhi re thang, the birth-place of Yonten Gonpo, SBPKhB [314/3-5].
The version with golden explanatory notes is said to be made by Yuthok Yonten Gonpo
for his sons. In later times there was obviously a need for manuscripts with the authentic
words of Yuthok Yonten Gonpo. Nyamnyi Dorje had already made a critic edition of the
rGyud bzhi that became known as the Zur mkhar bai rgyud bzhi rnam dag ma, STsCT
[99/15].
13. Cf. Czaja 2003.

142 TIBET JOURNAL

14. This formulation leaves it open, if they were actually of the Brang ti line or not. Gerke /
Bolsokhoeva 1999 interpret this phrase as the Zhalngo (Tib. zhal ngo) family, a father and
son partnership, of Dangti, ibid. But this seems to me not convincing.
This famous family of doctors claims to go back as late as the Tibetan empire during
which personalities of this family served as personal physicians of the Tibetan kings. For
more details, see for instance KhB [291/17-], Taube 1981. Indeed, this claim is also
accepted by Ye shes gzungs, the disciple of Yuthok Gonpo, in his commentary of the
bShad rgyud that forms part of the Cha lag bco brgyad, ChLCG [290/5-8]. Brang ti Jam
dpal bzang po, brother of the famous Brang ti dPal ldan tsho byed, has met Yuthok
Gonpo. Subsequently the rGyud bzhi together with minor works that follow it (cha lag)
became an essential part of the medical knowledge of this family line. Nevertheless the Yan
lag brgyad pa was still highlighted by them as well as by the Sakyapa. Their special
medical treatises, however, were the so-called gSer bre and dNgul bre. It seems that in
later times the Brang ti were closely related to the Gong sman pa, cf. Taube 1981: 67ff. It
is known that Lodro Gyalpo was also in contact with the latter. He had written a letter
with questions known as Dri ba tsu tai khri shing to Gong sman dKon mchog phan dar
(1511-1577), KhB [353/5], Samten 1992: 91, Jampa Thinley 2000: 227.
His stay at Sakya gave him the opportunity to extend significantly his medical studies.
There he learned the Yan lag brgyad pa with its self commentary, the Zla zer, the rGyud
bzhi, the Cha lag bco brgyad and a text that has the appearance of a dKar chag that is
linked with both works (dkar chag gi nang bzhin), the reading transmission (lung) of the
gSer bre and dNgul bre, STsCT [12/7-10]. Cf. also KhB [350/9-10]. In his khog dbubs
Lodro Gyalpo says that the gSer bre and dNgul bre were based on the Yan lag brgyad pa,
BGGP-KhB [309/1-2]. Moreover he states that he got his precepts from Chos rgyal bKra
shis kun dga don grub, ibid. [307/19].
15. Lodro Gyalpo calls it the Medical Questions, the Embellishments of the Lhasa Stone
Pillar, a Letter of Gold (sMan dpyad kyi dri ba lha sai rdo ring mdzes byed gser gyi pa
tra), or shortly Embellishment of the Stone Pillar, STsCT [73/13]. For his own disciples
he wrote a commentary on it entitled Rin po chei khra tshom, STsCT [73/15], gSer gyi
phra tshoms, KhB [350/19]. Cf, also Czaja 2003. There it is said that it consists of 14
versified questions. This was based on the reply to this work by Bod mkhas pa Mi pham
dge legs (1618-1685), without having access to the newly edited collected writings of
Lodro Gyalpo. Therefore one should note that the rGan poi kha chems, however, has
eight questions. Therefore it seems that one should correct this. An in-depth study of
these works will shed more light on this discrepancy.
16. This rGyud bzhi is named after Gra thang where it was carved. He did not rediscover it as
stated by Gerke / Bolsokhoeva 1999, Czaja 2003. Cf., also Jampa Thinley 2000: 227,
Lama Kyab 1997: 240. Kalsang Thinley 1997 states that Lodro Gyalpo went to Lho kha
Dra thang but he gives no textual evidence for this, ibid.379. Sangye Gyatso reports that
at the beginning the Rin spungs pa promised to sponsor the carving, but then he did not
keep it. Instead of him the ruler of Yar rgyab became the patron, KhB [351/11-18], [354/
18-355/3]. Pasang Yonten 1988 maintains that the carving started in 1566 and was completed
in 1572, but he does not indicate on what these data are based, ibid.114. The Dra thang
rGyud bzhi became a widely used version of the rGyud bzhi, cf. Czaja 2003.
17. STsCT [12/11]. At another occasion he speaks of sGar chen as sGar chen Thams cad
mkhyen pa, STsCT [52/4]. Perhaps one can identify him as the Eighth Karma pa Mi
bskyod rdo rje (1507-1554). In 1545 the Eighth Karma pa visited the places of Ya brog
gshag rtse, dGa ri, Zul phu and Bu shang rdo. In 1546 he was again in the vicinity of Zul
phu monastery, Jam dbyangs tshul khrims 1997: 166/1-6. Therefore it might be that one
should read Zul phu instead of Zur phu.
18. PKP [230/2].
19. The year of composition can be ascertained from a short remark in this very treatise.
Therefore he says that he had put forward a specific question on pulse taking in the rDo

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(1509-1579) ... 143

ring mdzes byed. Even though twenty years have passed since then, he did not receive a
reply that answered this point, MPZhL IV [44/5]. Kalsang Thinley 1997 is of the opinion
that this commentary was written in Pa nam after those on the rTsa rgyud and bShad
rgyud and then he proceed to dBus in order to put up his pamphlet, ibid.379. This is not
the case, I believe.
20. This is the rDo ring mdzes byed kyi dris lan rgan poi kha chems mtshan mo mun nag gi
glog od, STsCT [10/1-]. He was about to turn 61 at that time. Because he was ill, he was
unable to write and needed the help of the nephew of Bri gung Kun spangs pa, Rin chen
chos dbang, as a scribe, STsCT [73/18-74/10]. Perhaps the title of this work: The Will of
an Old Man (rGan poi kha chems) reflects how serious he considered his illness.
Regarding this work, the comment of Gerke / Bolsokhoeva 1999 confuses the facts. They
state that he had written this work at his own expenses, because the sponsor Rin spungs
pa did not finance it, ibid. The latter fact, however, is only be applicable to the Dra thang
rgyud bzhi.
21. This dKar chag is entitled Bye ba ring bsrel gyi dkar chag mkhas pai yid phrog gi lhan
thabs dad ldan snyim mai me tog, BBRS II [3/1-7/2].
22. KhB [354/2], Samten 1992: 92. Sangye Gyatso names a title that slightly differs from the
published one: Chos gyi chos byung gang dag byang chub sems dpai spyad pa spyod par
dod pai sman pa rnams kyi mi shes su mi rung bai phyi nang gzhan gsum gyis rnam
bzhag shes bya spyii khog dbub pa gtam pa med pai mchod sbyin gyi sgo phar yangs
por phye ba. He gives an outline of its contents, KhB [566/1-18].
23. Pasang Yonten 1988 states that he lived approximately 69 years, ibid. 116. Gerke /
Bolsokhoeva 1999 give the year 1579. The Bod rgya tshig mdzod chen mo (Peoples
Publishing House, 1993) gives at the entry for Zurkharwa Lodro Gyalpo that he had lived
for more than 69 years. Schaeffer 2003 states that he lived until at least 1673, when he
composed his treatise on bka ma and bstan bcos, ibid. 627. Samten 1992 gives the year
1572, ibid.92. He relies on the assumption of Sangye Gyatso. Sangye Gyatso is of the
opinion that he died not much later than the age of 61, KhB [355/5]. He cites the rGan poi
kha chems in support of this, although he was aware that Lodro Gyalpo wrote also the
rGyud bzhi bka bstan, the text that is in the centre of this paper, KhB [352/5]. Moreover
on should note that the fragmented but voluminous khog dbubs of Lodro Gyalpo is
certainly written some time after this treatise of 1672.
24. The colophon states that because some doctors who were at bShad sgrub gling did not
agree whether the rGyud bzhi is authentic word (bka) or a treatise (bstan bcos), he made
his mind up that it was necessary to make a thorough investigation of it. He wrote his
treatise during a tea-break on the 13th of the ngos month, when he got 63 years old. In the
concluding remarks of his work, he says that one should thoroughly study his composition
because, if one carefully examines it, one will get a firm knowledge of the truth, MSGM
[71/10-21].
25. On the Cha lag bco brgyad, see Taube 1981: 39ff. He already notes the difficulties to
establish the authorship of the Khog dbug khyung chen lding ba, ibid. 40. In the colophon
of this text the author is Yuthok Yonten Gonpo, ChLCG, [33/6].
26. One should mention the khog bugs of Desi Sangye Gyatso, of Tsomed Khenchen Kunga
Gyaltsen and of Zukharwa Lodro Gyalpo.
27. In his writings there are abundant examples for this. The statement by Gerke / Bolsokhoeva
1999 that Although he regards debate as one of the necessary actions of a scholar, he
seemed to have kept a diplomatic policy in his talks, showing his great respect for other
scholars, is an misunderstanding of a passage given by Jampa Thinley 2000: 228. But
Gerke / Bolsokhoeva 1999 also acknowledge that In his writings, however, he became
well known for his critical approach, ibid.
28. This source is contained in the Cha lag bco brgyad under the title of brGyud pai rnam
thar med thabs med pa bzhugs, ChLCG [690/1-]. The title in its colophon is brGyud pai
rnam thar bka rgya ma dang bcas pa. Although a continuous text, its contents can be

144 TIBET JOURNAL

divided into two partsthe transmission line of the rGyud bzhi (brGyud pai rnam thar)
that is written in seven syllables and obviously authored by Ye she gzungs and the secret
order (bKa rgya ma) composed in nine syllables by Tsho byed gZhon nu ye shes. This
was already noted by Taube 1981: 40.
29. He names: (a) the land of O rgyan, (b) on the peak of Mt. Kailash, (c) in a palace in
accordance with what is said in the rNam dbyei rgyud, (d) between Mt. Kailash and lake
Mansarovar, (e) at Vajrasana etc. See also Meyer at al.1992 who refers to the khog bugs
of Sangye Gyatso, ibid.4, and especially Taube 1981: 34.
Sangye Gyatso states that the Fifth Dalai Lama Blo bzang rgya mtsho (1617-1682)
favoured O rgyan, KhB [274/17], [562/17]. In his Vaidurya sngon po he took up this issue
and treats it in some length giving also the names of those who held such an opinion, cf.
VNg [11/9-]. It seems that in the eyes of Sangye Gyatso this issue was at the core of the
discussion. In the lengthy colophon of his khog bugs he distinguishes all other medical
treatises he had used on the basis of their opinion about O rgyan as the place where the
rGyud bzhi was expounded.
30. This verse included in a longer quotation is found in the Mes poi zhal lung and in the
Vaidurya sngon po by Sangye Gyatso, MPZhL I [43/2-4]. According to the latter he cites
from the fragmentary reading transmission tradition (lung dum bu) of the Bye brag tu
bshad mdzod chen mo, VNg [12/20-13/4], [1448/12-18]. It is a condensed list on how
many years Buddha stayed at each place. Gos Lo tsa ba gZhon nu dpal reports in his Blue
Annals that sTengs pa Lo tsa ba Tshul khrims byung gnas (1107-1190) had studied this
work in India and after his return started to translate it in co-operation with Alamkaradeva,
but he passed away before he could complete this task. It is said that two-third of the text
were already finished, Roerich 1988: 1054. sTag tshang dPal byor bzang po too states
that it was never completely translated into Tibetan, GBYTsh [70/14]. This citation given
by Lodro Gyalpo and Sangye Gyatso was used to provide textual evidence that, in the
literature related to Buddha, mention is made of a place that is or could be lTa na sdug, the
medical city where the rGyud bzhi was expounded.
31. The four groups of attendants (rigs bzhi) are the gods (lha), the seers (drang srong), nonBuddhist (mu stegs) and the Buddhist (nang pa). It is said that the Medicine Buddha
imbodied in four siblings each called Rig pai ye shes. These four simultaneously taught
the rGyud bzhi to each group. VNg [24/17-25/15], Cf. Meyer et al. 1992: 17.
32. One should note here that Rig pai ye shes has incarnated for four times: therefore he is
treated by the Tibetan writers in the plural. See also ChLCG [37/3].
33. Cf. Czaja 2003, see also there for further references.
34. Cf. Czaja 2003
35. KPTshB I [18/1-21].
36. Indeed bKra shis dpal bzang critizes a similar position. He argues with those who point
out that this city Pleasant to See did not exist at all and cannot be seen. His arguments are
not dissimilar to those of Lodro Gyalpo. He stress the nature of this city as an illusion
(sprul) and defends his position in detail but does not deal with the issue that there is no
reference to this very city in sutra or tantra literature, KG [76/20-]
37. Cf., VNg [24/17-25/15]
38. One should add that one must consequently regard the Tsa ra ka sde brgyad as bka, if this
applies for the rGyud bzhi. A point that is taken up by Lodro Gyalpo in his Mes poi zhal
lung, MPZhL I [91/5-6]. He says that others state that according to the bDud rtsi snying
po the sMan gyi lung, gSer od dam pa and gSo dpyad bum pa are bka. (The bDud rtsi
snying po is the rGyud chung bdud rtsi snying po by Yonten Gonpo. For this citation, see
ChLCG [755/11]). But the Tsa ra ka, mDo lnga and so on are treatises written by
Buddhist, non-Buddhist and seers. For Lodro Gyalpo it is not problematic to regard the
Tsa ra ka as a treatise. Because of the work of different compilers for the eight sections of
the Tsa ra ka sde brgyad it was called a treatise. As an example he gives the seven sections

ZURKHARWA LODRO GYALPO

(1509-1579) ... 145

of Abhidharma. Although it is bka, it is a treatise, because it was compiled by seven

Arhats.
39. Ananda belongs to the Buddhist group of listeners. He is also depicted in the series of
Tibetan medical thangkas, Meyer et.al 1992: 173.
40. Perhaps one should emphasize that regardless if the rGyud bzhi is from Buddha or a
Tibetan treatise Kempa Tsewang always notes the full line of transmission that starts
with the medicine Buddha, KPTshB I [23/21], KPTshB II [1/12-]. The line of transmission
given by him does also include the hiding of the rGyud bzhi and its rediscovering by Grva
pa mNgon shes. Apparently this authorization of a valid, unbroken transmission line was
still upheld, even though one would harbour doubts on its authenticity.
41. MSGM [69/16]. Phyogs las rnam rgyal (1376-1451), the famous Bo dong pa scholar, is
said to have composed seven treatises: (1) De nyid dus pai rgya mtsho la jug pai sgo
bzhi, (2) Leu nyis khri chig stong, (3) (Man nga bdun khri nyis stong), (4) Chos kyi
tshoms brgyad khri bzhi stong yod pai rgyas pa glegs bam brgya dang bcu, (5) Bring bo
la nyi shu, (6) bsDus pa la glegs bam gnyis and (7) Shin tu bsdus pa snying bo la glegs
bam gcig, Lama Kyab 1997: 178f., Jampa Thinley 2000: 181.
42. MSGM [69/17]. Naturally the phrase bod kyi sman pa byang chub sems dpas mdzad can
mean both one doctor or doctors. Karmay 1988 gives the information that Sog zlog pa Blo
gros rgyal mtshan (1552-1624) in his treatise entitled rGyud bzhi bka sgrub nges don
snying po also groups both Bo dong Phyogs las rnam rgyal and sTag tshang Shes rab rin
chen (b.1405) together as not accepting the thesis of its Indian origin, ibid.232.
sTag tshang Lo tsa ba Shes rab rin chen (b.1405) is said to have written four works: (1)
gSo dpyad byng tshul gyi lo rgyus sman gyi spyi don dang bcas pa mkhas pai yid phrog,
(2) sMan gyi lag len gces bsdus leu bcu ba pa reg pas nad sel, (3) gSo rig ming tshig ga
zhig don gyi bzhin ras ston pai me long and (4) Rig gnas kun shes, Lama Kyab 1997: 126,
Byam pa phrin las 2000: 205. Sangye Gyatso gives a khog bugs and the Lag len gces
bsdus of sTag lo, KhB [296/10].
43. MSGM [69/19]. The voluminous collected works of Shakya mchog ldan possibly contain
several references for this. The one I came across is a letter to rNam rgyal grags bzang
(1395-1475), the celebrated founder of the Byang tradition in medical thinking, that
contains questions on three different issues, Byang pa rnam rgyal grags bzang la dge
gshegs snying po sman dpyad dus khor gsum gyi dri ba in his collected works, ShChP
[325/1-329/1], the medical part, ShChP [325/6-326/4].
One of them is about medicine. In order to document the position of Shakya mchog ldan
and also to give an idea what kind of opposition Byang bdag rNam rgyal grags bzang faced,
the entire passage should be given here in translation.
Shakya mchog ldan writes: If one seems to regard the rGyud sde bzhi po of medical
science (sman dpyad) as the very words of Buddha (sangs rgyas kyi bka), than the rGyud
bzhi is just a general and different designation for the Yan lag brgyad pai snying po bsdus
pa written by sLob dpon dPa boi sde and its commentary composed by Zla ba la mngon
par dga ba and then how is it that there is not even a bit distinctive reading transmission
(lung) that is cited as proof (khungs)?
If one discusses how medical science (sman dpyad) came into being at this and that
treatise that possess reliable sources (khungs), one explains how it was transmitted by
Brahma to the seers of the non-Buddhist (phyi rol pa) like Prajapati and so on. What are
the reasons that it is not discussed even briefly, how the exposition of Buddha came into
being?
If that Brahma of that time was Buddha himself, than it is necessary to accept the
composer, however, of the ayurveda (tshei rig byed) that forms the major part of the veda
(rig byed), as the Buddha himself. Therefore how does it count for that this our teacher
had expounded what the four veda are before he had turned the wheel of dharma?
Moreover while one is able to understand the words of Buddha (bka) just by having
read them, one is not able to understand treatises without extensive commentaries. Therefore

146 TIBET JOURNAL

of what kind is that (rGyud bzhi) that it will not make revert the order of rank of the words
of Buddha and treatises?
If one accepts that those very treatises are non-Buddhist, than what is the difference of
Non-Buddhist and Buddhist medical science? How many distinctions of elegant sayings
exist that do not exist anywhere?.
44. MSGM [70/1]. The lists of both differs significantly, Taube 1981: 15f, Jampa Thinley
2000: 71ff, see also, KhB [296/16], GBYTsh [197/12]. There have existed different lists
at different times. Here Lodro Gyalpo distinguishes between the group of doctors during
the reign of Trisong Deutsen and another one, although these are usually mixed up in
Tibetan writings. Apparently he did it in order to avoid chronological discrepancies.
Jampa Thinley 2000 has noted that this group of nine doctors consists of personalities
that were not contemporaries. Some lived during Trisong Deutsen and some during mNga
bdag rTse lde (b.11th cent.), ibid.71. But this does not apply for Lodro Gyalpo. According
to him the so-called nine royal physicians of Trisong Deutsen were: (1) Shan ti garbha
from India, (2) Gu hya badzra from Kashmir, (3) sTong gsum gang ba from China, (4) Ha
shang ba la and (5) Hang ti pa ta from China, (6) Ha la shan ta from sTag gigs, (7) Seng mdo
od chen from Gru gu, (8) Khyol ma ru rtse from Dol po, and (9) Dharma shi la from Bal
po, BGGP-KhB [295/1-296/3], [299/4], Cf. KhB [169/10-]. The nine experts, however,
comprised the lower group: g.Yo rui g.Ya gyong po, sTod lung gi Lha rje sum ston, dBu
rui mTha bzhi, the middle group: Yuthok rGya gar rdo rje, Mi nyag Zla grags and Brang
ti rGyal po, and the upper group: Bi ji Lhun ne, Ug pa Chos seng, and Che rje rTag (sic)
la dga, BGGP-KhB [304/10-17]. The royal physicians did not remain in Tibet but left for
their own countries. At the end of the life of Trisong Deutsen, he fell ill and sTong gsum
gang ba was invited from China. He stayed in Tibet and his family was granted the right to
act as recognized royal physician. Lodro Gyalpo says that other families of doctors,
namely the Bi ji, Brang ti, sTong and Zhang, claim this, BGGP-KhB [299/6-]. Lodro
Gyalpo regards the foreign doctors only as the so-called nine royal physicians. The group
of the nine experts, however, flourished during the 11th century.
It is noteworthy that Sangye Gyatso even though making ample use of the khog dbubs
of Lodro Gyalpo differs here in some respects. His list of nine royal physicians is
identical. The nine Tibetan experts or skilled doctors, however, differs. Even more
significantly he places them during the reign of Trisong Deutsen. When the latter fell ill, he
says, the foreign doctors were again invited because of the requests of the ministers, even
though there were also the nine Tibetan doctors, KhB [175/3]. sTong gsum gang ba only
accepted the invitation. Sangye Gyatso had obviously a particular interest in bringing
forward the life-time of these nine skilled doctors. According to him these doctors were:
the upper group: Cher rje Zhig po, Ug pa Chos seng and Be che (sic) Legs mgon, the
middle group: Yuthok Yonten Gon po, Mi nyag Rong rje, Brang ti rGyal bzang, and the
lower group: gNya ba Chos bzang, mTha bzhi Dar po and sTong pa Grags rgyal, KhB
[174/15-19]. Moreover he notes that the mTha bzhi family of doctors was granted
permission to act as royal physicians and he suggests that this also applies to the remaining
eight, KhB [175/15-18].
One might see this statement of Sangye Gyatso as an attempt to establish the superiority
of the rGyud bzhi and its author - the nine skilled doctors are said to be of the eighth
century, one Yuthok Yonten Gonpo (the elder) is included and all these were granted royal
permission to practice as physicians.
One should note that this is even in contradiction to the writings of Sum ston Ye shes
gzung, the pupil of Yonten Gonpo (the younger), that Sangye Gyatso had known. Yonten
Gonpo gives in his rGyud bzhi a classification of doctors. One category are the doctors
that were permitted by the Tibetan kings to practice as doctors and were a family line of
doctors. Ye shes gzungs illustrated this in his commentary on the bShad rgyud by giving
the examples of sMan pa Tsho byed gzhon nu in India and Brang ti rGyal in Tibet.
Yuthokpa is not named in this regard but he is just mentioned as an example of doctors

ZURKHARWA LODRO GYALPO

(1509-1579) ... 147

who studied with skilled doctors, ChLCG [290/6-]. Consequently in his Vaidurya sngon
po Sangye Gyatso does not examplify this statement of the rGyud bzhi, VNg [411/3-].
Lodro Gyalpo did not feel tempted to construct history by such means. Therefore there
was no need for him to distinguish between a former and latter Yuthok Yonten Gonpo.
45. gZi brjid bar lived in the 11th cent. His life-story is told by Sangye Gyatso, KhB [180/
3-]. This is the base for Jampa Thinley 2000: 101ff, Lama Kyab 1997: 231ff., Pasang
Yonten 1987: 48f, Kalsang Thinley 1987: 273ff. Sangye Gyatso on his part had relied on
the khog dbubs of Lodro Gyalpo, BGGP-KhB [304/2-]. gZi brjid bar was born in Yar
klungs. He studied successively under the doctors known as the nine experts (mkhas pa
mi dgu) in dBus and gTsang. Later he went to India to study there. On the way he met
rNgog Blo ldan shes rab (1059-1109). The names of the nine experts as told by Lodro
Gyalpo were given in the preceding footnote. Sangye Gyatso gives the same list but puts
them apart from the one that flourished during Trisong Deutsen by stating that gZi brjid
bar relied on the lineages of the nine experts and not the nine experts themselves, KhB
[180/9].
On A tsa ra Phyag rdum alias sKyes bu me lha, see the article on Tsomed Khenchen in
this issue.
46. This is not in agreement with all other sources on the life of Yuthok Yonten Gonpo. His
father was Khyung po rdo rje and his grand-father was rGya gar Ba dzra. This is reported
for both Yuthok Yonten Gonpo the elder and the younger. (One should add here that the
elder Yonten Gonpo is probably a later fabrication.) Obviously Lodro Gyalpo made an
oversight. In his khog dbubs he gives the correct genealogical account, BGGP-KhB [313/
12-].
47. Some Khyung and Bre alias Dre clans lived traditionally in this region. Unsurprisingly
there are different versions on how the appellation of Yuthok came into being. See, for
instance Taube 1981: 43. KhB [214/9-215/18], VNg [1451/20-1452/10].
48. bKra shis dpal bzang ye shes mchog ldan gives these two arguments regarding tea and
porcelain. The Indians did not possess both items, Karmay 1988: 236. Not listed by
Karmay 1988 but treated with by bKra shis dpal bzang is also the examination of urine
and pulse, KG [74/1-5]
Sangye Gyatso encountered the same difficulties. Being a proponent of the party that
regarded the rGyud bzhi as Buddhas words he says that such issues were added by
Yuthok Yonten Gonpo to adjust the rGyud bzhi to Tibetan conditions. Therefore he
admits the following adjustments: with regard to the rTsa rgyud the number of chapters,
the bShad rgyud - tea, diet and so on, the Phyi rgyud the examination of pulse and urine
and the mother-son and friend-enemy relation, and porcelain for tea and so on, the Man
ngag rgyud the issues that are in accordance with them, KhB [275/8-12]. Certainly, one
should make mention here of the Chinese Tibetan Annals (rGya bod yig tshang chen mo)
written by sTag tshang dPal byor bzang po in 1434. He devotes an entire chapter on the
introduction of tea and porcelain to Tibet, GBYTsh [172/5-176/17], cf.also [2401-244/7],
[244/8-253/13]. According to him the initial point was that a Tibetan king fell ill and its
introduction was partly for medicinal purposes. Beside this dPal byor bzang po offers a
rather unique approach on the character of the rGyud bzhi. In his opinion incarnations of
the Buddhas (bDe gshegs pa) taught the preparation of medicine (sman gyi sbyor) in India,
moxibustion (me btsa) and cleansing of the channels (rtsa sbyongs), blood-letting (gtar
kha) and examination of pulse and urine (rtsa chui brtags pa) in Tibet, ibid. [194/5-8]. In
such an all-embracing attempt he did also describe the medical treatises of the early
translation period. Therefore during the reign of Trisong Deutsen several doctors translated
medical works the Indian Shinta gar pa all tantras (rgyud) expounded by sMan bla, the
Chinese Ha shang Ma ha ya na all tantras spoken by Jam dpal and so. For a full list, see
GBYTsh [191/16-192/7].
49. MSGM [70/20-71/9]. In section three of the mKhas pa jug pai sgo of Sakya Pandita
Kunga Gyaltsen (1182-1251) on debate based on scriptures one can read in the translation

148 TIBET JOURNAL

of David P. Jackson a passage that neatly fits into this context here: Furthermore, other
texts [of ones own school] that contradict ones [position] will become acceptable if one
knows how to establish ones own tenets as being of ascertained meaning or as of direct
intent, after establishing through the force of reasoning that [the contradictory text] is of
interpretable meaning ... or [was taught] with special intent. But if one does not know
how to establish in that way [that the text one follows is of definitive meaning, etc.] by
means of reasoning, one cannot escape a contradiction of scripture., (additions in square
brackets made by David P. Jackson), ibid. 339.
Furthermore one should take this occasion to stress once more the formal education
Lodro Gyalpo has received. He employed this skill also in his commentary on the rTsa
rgyud by the threefold analysis, MPZhL I [6/4-].
50. dgongs gzhi dgos pa dngos la gnod byed kyi sgo nas bshad dgos te MSGM [70/20]. The
interpretation of these terms is based on, Jackson 1987: 393,n.83.
51. Cf, also Taube 1981: 33.
52. Karmay 1988 notes that there are two texts of the same name that should not be confused.
One is the biography of the earlier Yuthok Yonten Gonpo written by Jo bo Lhun grub bkra
shis. The other work is also called sKu lnga lhun grub ma and rNam thar med thabs med
pa which was composed by Sum ston Ye shes gzungs, ibid. 229,n.5. The biography of
Lhun grub bkra shis is known today in form of an edition prepared during the 17th century
by the celebrated doctor Dar mo sMan rams pa Blo bzang chos grags (1638-1710) together
with two of his pupils, La ra ba Blo bzang don ldan and Mer mo Blo gros chos phel.
Obviously they had some difficulties to obtain a complete and correct original of this
work but eventually they succeeded and obtained it from one who belonged to the family
of Yuthok. These two pupils faithfully copied this work. Then they made the proofreading, YThNTh [312/1-14]. Cf. also Taube 1981: 48,n.199, Czaja 2003. The biography
entitled sKu lnga lhun grub ma or g.Yu thog pai rnam thar bka rgya ma was composed
by Ye shes gzungs, a pupil of Yuthok Yonten Gonpo, KhB [289/10], Taube 1981: 44,n.188,
It seems that this work is identical with the rNam thar med thabs med pa or brGyud pai
rnam thar bka rgya ma, although it is certainly not a biography about Yonten Gonpo but
an account how the rGyud bzhi was transmitted. The first verses of this treatise are sku
lnga lhun grub las byung bai / gso ba rig pai rgyud chen di, ChLCG [690/3-4]. Most
likely the title sKu lnga lhun grub ma derives from this. The citation from this very work
given by Sangye Gyatso shows that the sKu lnga lhun grub ma and the rNam thar med
thabs med pa are identical, KhB [286/18]. For the opinion of Sangye Gyatso on its
authorship, see KhB [278/14-].
53. KhB [352/5-353/2]. Although Pasang Yonten 1987, Lama Kyab 1997 and Jampa Thinley
2000 exclusively rely on the khog bugs of Sangye Gyatso with regard to Lodro Gyalpo,
they all cut off this passage for reasons unknown to me.
54. One of the argument for his view is the phrase: Tsomed Khenchen, teacher of my lama,
KhB [352/15].
55. Lama Kyab 1997 gives the work gSo rig skor dri tshig dngul dkar me long for Nyamnyi
Dorje, ibid.109. Jampa Thinley 2000 writes that he composed two works on the general
topics of difficult points of the rGyud bzhi, namely the Dri tshig dngul dkar me long and
the Legs bshad nyi zer, ibdi. 216, see also KhB [345/12].
56. Jampa Thinley 2000 dPal ldan rgyud bzhii grel chen pod shel phra mo, 216. Lama Kyab
1997 bDud rtis snying bo yan lag brgyad pa gsang ba man ngag gi rgyud kyi grel chen
pod shel phra mo, ibid.109. Sangye Gyatso lists the dPal ldan rgyud bzhii grel chen pod
shal khra mo as one of Nyamnyi Dorjes works, KhB [345/12].
57. phral skad gso dpyad rang lugs kyi mgo rmog nang nas bcag pa, KhB [353/1]. Cppers
/ Srensen 1998 offer three sayings that provide a better understanding of this phrase.
One saying goes the head is broken by the helmet, the deity is smashed by the steward,
mgo rmog gis bcag / lha dkon gnyer gyis brdungs, ibid.57. Or another example would be:
The head is not broken by soldiers, the head is broken from the inside of the helmet; the

ZURKHARWA LODRO GYALPO

(1509-1579) ... 149

feet are not broken by clay, they are broken from the inside of the shoes, mgo dmag nang
nas ma chag / rmog nang nas chag / rkang rdza nang nas ma chag / lham nang nas chag,
ibid.
58. Both these works form part of the Cha lag bco brgyad. Obviously Sangye Gyatso omits
this point that these treatises were modelled on Kha che Zla dga, (for his section on the
Cha lag bco brgyad, KhB [277/-]). But it was taken up by Jaya Pandita Blo bzang phrin
las, although naturally the rGyud bzhi is not regarded by him as the extended version of
the rGyud chung, Cf. Taube 1981: 47. This opinion of Lodro Gyalpo, however, seems to
be justified. The rGyud chung represents a condensed version of the rGyud bzhi in which
important parts are missing. It cannot be seen as a commentary on the rGyud bzhi or its
part, Man ngag gi rgyud as it is the standard view by Tibetan writers. For example on the
treatment of kidney diseases the rGyud bzhi distinguishes between four kinds of renal
disorders and gives short instructions of curing them. These are all found in the rGyud
bzhi. They are explained in more detail and more significantly other renal disorders too are
explained that form an integral part of healing kidney diseases.
59. Namely the colophon of the Shog dril skor gsum, the g.Yu thog snying thig gi lo rgyus
nges shes dren byed, the gSung mgur and the bKa rgya ma rnam thar, BGGP-KhB
[315/9-]. On these works, cf. Taube 1981.
60. On this new approach to discuss bka ma and bstan bcos with regard to the rGyud bzhi,
see BGGP-KhB [309/3-].
61. Because of the plural particle one can conclude that both are meant, shin tu gsal rnams,
KhB [352/16]. For the former treatise, see the article in this issue. The other work is not
extent anymore, it seems. Sangye Gyatso gives a short overview of this work by naming
its main tenets. Therefore the rGyud bzhi was expounded by Buddha (ston pa) at O rgyan.
He handed it over to Drang srong Yid las skyes. Later when he was about to die just in an
illusory way (rdzu phrul gyis) at Mt. Kailash, beams of light emanated from the face of
the Buddha. Because of this Yid las skyes came. He expounded the rGyud bzhi to Tsho
byed gZhon nu. The son of Vaishravana, rGyal ba khyu mchog, or Zhang blon rDo rje
bdud dul was appointed as guardian of the rGyud bzhi and so on, KhB [563/18-564/7].
62. STsCT [113/15]
63. STsCT [18/15], [22/4] etc.
64. He shortly remarks that the opinion that the rGyud bzhi was translated from Sanskrit is
the basis of marvellous and flawless detailed commentaries. Those who do not know
anything, however, state that Yuthok Yonten Gonpo composed the rGyud bzhi as his own
fabrication. They pass off material that is an indecent hallucination as detailed
commentaries, MPZhL IV [17/1-2].
65. Jampa Thinley 2000 cites from the Khog bugs legs bshad dngul dkar me long by Tsomed
Khenchen. It seems that Phrag dbon Bsod nams bkra shis commissioned a print of the
Phyi rgyud, ibid. 219. See, also KhB [347/12], [348/10].
66. Jampa Thinley 2000: 268ff. According to him it is entitled gSo ba rig pai chos byung
bdud rtsis chu rgyun, but he calls it also gSo ba rig pai khog bugs bdud rtsi chu rgyun.
Jampa Thinley found a manuscript of this text at the library of Norbulingka. He summarizes
its contents and gives most interesting quotations. Therefore Chos skyong dpal bzang is
much concerned on the controversy regarding bka ma or bstan bcos and discusses it in
some detail. One should note that in the entry of Lama Kyab 1997 two personalities are
mixed up. The name and the title of the medical treatise are of mNga ris Tsho byed Chos
skyong dpal bzang but the biography given is that of bDe chos sman pa Ratnai ming can,
ibid.73.
67. ibid.
68. Sangye Gyatsos view on this is rather ambiguous. For him Lodro Gyalpo was one of the
most celebrated doctors who wrote medical treatise that were indispensable for dealing
with Tibetan medicine. Therefore he also patronized a new edition of the Mes poi zhal
lung.

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Otherwise he did not agree with the view that Lodro Gyalpo has expounded in his khog
dbubs. He openly challenged the quality of this work by maintaining that it is somehow
confused and remembered on a Chos byung. He fully disapproved, in his critique, of
Tsomed Khenchen, whom Sangye Gyatso held in high esteem. One should note that
Sangye Gyatso had also learned the most important work of Tsomed Khenchen, the Man
ngag snying po bsdus pa, and therefore he is included in its transmission line.
At the end of his entry on Lodro Gyalpo, Sangye Gyatso sarcastically remarks that it is
obvious that even Kempa Tsewang, let alone the heirs of the late Nyamnyi Dorje, does not
exist apart from the bluish she-dragon that roars that she had easily learned prosody,
reasoning, the mahamudra system, and other sciences, KhB [354/11-14]. The interpretation
of Gerke / Bolsokhoeva 1999 seems to me problematic: The Blue Turquoise Dragoness
(Tib. g.yu brug sngon mo) reveals another glimpse on the personality of Lodro Gyalpo:
It is like that on the mode of healing: Lodro Gyalpo was following the footsteps of the
previous Zurlug [might refer to the famous Zur lineage founder Nyamnyi Dorjee]. But he
even did not have a satisfactory life force. This short critical note is very interesting.
Although an excellent physician and scholar, his personal physique and life force must
not have been very strong, which for a person with so much medical knowledge, seems
strange and inappropriate.. (Brackets made by both authors. JT is the 1991 Dharamsala
edition of the work that is refered as Jampa Thinley 2000 in this present study), ibid.30
Sangye Gyatso continues to say that Lodro Gyalpo fundamentally held in contempt his
own pupil affiliation (slob rgyun), the precious words (gsung) of Tsomed Khenchen. He
offended other doctors (the exact phrase is that he wounded art of healing, gso rig la rma
byin) by using sophistry to attack the fundamental, standard traditions of earlier generations
like the Byang ba and through refutations of the standardized knowledge of prosody, KhB
[354/14-18].
Moreover his disagreement can also be seen by his short, conclusive remark on Tsomed
Khenchens khog dbugs that was already introduced in this paper, see n.61. His outline
ends with the phrase: the exceptional zur teachings, zur khyad can KhB [564/7]. This
labelling signifies most of the short treatises of Nyamnyi Dorje in his Bye ba ring bsrel
and were somehow used as an quality mark indicating the profound and original source of
teaching or method of treatment. In this sense it was also applied at this instance by
Sangye Gyatso.
69. KhB [565/18-], Lama Kyab 1997: 22 gives a work of the title bDud rtsi snying bo yan lag
brgyad pa gsang ba man ngag gi rgyud las gso dpyad kyi spyi don legs bshad dod jo. Cf.
also Jampa Thinley 2000: 220.
70. It is not certain how to understand the term of rgyud in this context. It seems that Sangye
Gyatso abstains from labelling the rGyud bzhi a treatise (bstan bcos) even though he is
citing proponents of this view.
71. KhB [563/1-5]. Tshogs gnyis rgya mtsho maintains that the rGyud bzhi is not a gter ma
but belongs to the vinaya section of the tripitaka. Beside this he is known to have written
commentaries on all four parts of the rGyud bzhi, Taube 1981: 37, n.156. The Bai duryai
chu rgyun was well-known to Lodro Gyalpo. In his Mes poi zhal lung are several
attached notes that name this composition. He names it in his khog dbubs, BGGP-KhB
[252/4].
72. He states that one pupil of Lodro Gyalpo named Ruddhananda wrote a khog bugs that
was very similar to that of his teacher. All treatises that followed later in the zur tradition
maintained that Yuthok Yonten Gonpo has taught the rGyud bzhi. The place of exposition
was the Buddha field in the Eastern direction named Baidurya snang and so on. According
to Sangye Gyatso there exist many writings that were composed inappropriately like the
upper jaw of a lion and the lower jaw of camel, KhB [567/6-568/2].
Some additions should be made to the abusive comments of Sangye Gyatso. One must
underline that in his khog bubs Lodro Gyalpo did not only give up the bka ma thesis but
makes a fundamental revision of the medical historical knowledge of Tibet that include

ZURKHARWA LODRO GYALPO

(1509-1579) ... 151

also his own point of view that he had earlier. It took him certainly some years to compose
such a detailed khog bubs. In his chapter on how medical knowledge developed in Tibet,
he first gives a description of the mistaken views (gzhan lugs) that are represented by the
Khog dbug khyung chen lding ba and so on. Then he demonstrates contradictions in these
views and eventually he gives a profound explanation that is based on reliable proof
(khungs), BGGP-KhB [276/1-]. Actually a good part of this voluminous chapter is
employed to refute the legends that have grown up around the rGyud bzhi and its author.
The khog bugs of Sangye Gyatso must be partly read as a response to Lodro Gyalpos
last composition.
For example Lodro Gyalpo states that the notion of nine royal physicians that consists
of Bi ji and so on is just thoughtless talk. Even if one agrees that at that time some doctors
like Bi ji and Brang ti lived, the other names like Yuthok do occur only in later times.
Moreover the appellation of Yuthok came into being during rGya gar badzra or Yonten
Gonpo, he says. Furthermore if those five doctors were appointed as royal physicians,
than why one should summon sTong gsum gang pa, when the king fell ill?, BGGP-KhB
[285/4-]. Because of this Sangye Gyatso was compelled to create an alleged request made
by the ministers side, that foreign doctors should be invited, although there were also the
nine Tibetan doctors, KhB [175/3].
Primary Sources:
BBRS I
Zurkharwa Nyamnyi Dorje. Bye ba ring bsrel. Instructions of the great Zur-mkhar-ba Mnyamnyid-rdo-rje on medical treatment comprising the Ma yig, Bu yig, and Kha thor collections. Leh:
S.W.Tashigangpa, 1974.
BBRS II
Zurkharwa Nyamnyi Dorje. Bye ba ring bsrel : A Collection of Instructions on the Practice of
Tibetan Medicine. New Delhi: Tibet House, 1985.
BGGP-KhB
Zurkharwa Lodro Gyalpo. Shes bya spyii khog dbub. (= Gang dag byang chub sems dpai spyad
pa spyod par dod pai sman pa rnams kyi mi shes su mi rung bai phyi nang gzhan gsum gyis
rnam bzhag shes bya spyii khog dbub pa gtam pa med pai mchod sbyin gyi sgo phar yangs po.).
Chengdu: Sichuan Peoples Publishing House, 2001.
ChLCG
Yuthok Yonten Gonpo. Cha lag bco brgyad. Lanzhou: Gansu Peoples Publishing House, 1999.
2 vols.
GBYTsh
sTag tshang rdzong pa dPal byor bzang po. Rgya bod yig tshang chen mo. (= rGya bod kyi
yig tshang mkhas pa dga byed chen mo dzam gling gsal bai me long). Chengdu: Sichuan
Peoples Publishing House, 1985.
KG
Tashi Palsang. rGyud kyi bka bsgrub drang srong bkra shis dpal bzang gi mdzad pa. In Bod rang
skyong ljongs sman rtsis khang (ed). Bod kyi sman rtsis ched rtsom phyogs bsdus. Lhasa: Tibet
Peoples Publishing House, 1986. 72-116.
KhB
Sangye Gyatso. dPal ldan gso ba rig pai khog bugs legs bshad baiduryai me long drang srong
dgyes pai dga ston bzhugs so. (=gSo rig sman gyi khog bugs). Gansu: Peoples Publishing
House, 1982.
KPTshB
Kempa Tsewang. rGyud bzhii grel. Dharamsala: Tibetan Medical & Astro Institute. 3 vols.
MSGM
Zurkharwa Lodro Gyalpo. rGyud bzhi bka dang bstan bcos rnam par dbye ba mun sel sgron me.
In Bod rang skyong ljongs sman rtsis khang (ed). Bod kyi sman rtsis ched rtsom phyogs bsdus.
Lhasa: Tibet Peoples Publishing House, 1986. 64-71.

152 TIBET JOURNAL

PKP
Padma Karpo. Sems dpa padma dkar poi rnam thar thugs rje chen poi zlas gar. In Rwa lung
dkar brgyud gser phreng. vol.IV (khi through chi). From Ngag-dbang-grags-pa through Padmadkar-po. Palampur: Tibetan Craft Community, 1978. 129-346.
ShChD
Shakya Chogden. sMan blai mdo chog gi dri pa me tog mda joms dang byang pa bdag po la dri
bai skor bzhugs. In Shakya mchog ldan. gSer mdog pan chen shakya mchog ldan gyi gsung bum:
Legs bshad gser gyi bdud rtsi. Collected writings of gSer mdog Pan chen Shakya mchog ldan.
Reproduced from the unique manuscript prepared in the 18th century at the order of rJe Sakya Rin
chen the 9th rJe mKhan po of Bhutan preserved at the Monastery of Pha jo sdings og min gnyis pa.
New Delhi: Ngawang Topgyal, 1988. - 24 vols., 17: 319-329
STsCT
Bam kho and Dakpa (eds). Zur mkhar blo gros rgyal poi gsung rtsom gces btus. Kunming:
Yunnan Peoples Publishing House, 2003.
YThNTh
g.Yu thog gsar rnying gi rnam thar. Beijing: Peoples Publishing House, 1982.
VNg
Sangye Gyatso. gSo ba rig pai bstan bcos sman blai dgongs rgyan rgyud bzhii gsal byed bai
durya sngon poi malli ka zhes bya ba bzhugs so. 2 vols. Dharamsala: Tibetan Medical & Astro
Institute, 1994.
Secondary sources:
Samten 1992. Bod kyi gso ba rig pai byung phel brjod pa, in Bod ljongs zhib jug, vol.1 87-99
Cppers, Christoph and Srensen, Per K. 1998. A collection of Tibetan proverbs and sayings:
gems of Tibetan wisdom and wit. Stuttgart: Steiner.
Czaja, Olaf 2003. The Making of the Blue Beryl - Some Remarks on the Textual Sources of the
Famous Commentary of Sangye Gyatso (1653-1705), in Mona Schrempf (ed.), Soundings in
Tibetan Medicine. Historical and Anthropological Perspectives. Proceedings of the 10th Seminar
of the International Association for Tibetan Studies (PIATS), Oxford Sept. 06-12.2003, Leiden,
Brill Publishers. (forthcoming).
Gerke, Barbara and Bolsokhoeva, Natalia 1999. Namthar of Zurkha Lodo Rgyalpo (1509-1579).
A Brief Biography of a Tibetan physician, in AyurVijnana vol.6, spring 1999.
Jackson, David P. 1987. The Entrance Gate for the Wise (Section III). Sa-skya Pandita on Indian
and Tibetan Traditions of Pramana and Philosophical Debate. Wien: Arbeitskreis fr Tibetische
und Buddhistische Studien Universitt Wien. 2 vols.
Jamyang Tsultrim 1997. dPal karma pa sku phreng rim byon gyi mdzad rnam bzhugs so. Gansu:
Peoples Publishing House.
Jampa Thinley 2000. Gangs ljongs gso rig bstan pai nyin byed rim byon rnam thar phyogs
bsgrigs. Beijing: Peoples Publishing House.
Karmay, Samten G. 1988. The Four Tibetan Medical Treatises and their Critics In Samten G.
Karmay, The Arrow and the Spindle. Studies in History, Myths, Rituals and Beliefs in Tibet.
Kathmandu: Mandala Book Point, 1998.
Lama Kyab 1997. Bod kyi mkhas pa rim byon gyi gso rig gsung bum dkar chag mu tig phreng ba.
Lanzhou: Gansu Peoples Publishing House.
Meyer, F., Dorje, G. and Parfionovitch, Y. (eds) 1992. Tibetan Medical Paintings. London: Serindia
Publications.
Pasang Yonten 1987. Bod kyi gso ba rig pai lo rgyus kyi bang mdzod thog bla ma dran pai pho
nya. Leh: Yuthok Institute of Tibetan Medicine.
Roerich, George N. 1988. The Blue Annals. Dehli: Motilal Banarsidass. Reprint.
Schaeffer, Kurtis R. 2003. Textual Scholarship, Medical Tradition, and Mahayana Buddhist Ideals
in Tibet In Journal of Indian Philosophy. 31: 621-641.

A Hitherto Unknown Medical History of mTsho smad

mkhan chen (b.16th cent.)
Olaf Czaja
This paper will explore a khog bugs written by Tsomed Khenchen Kunga Gyaltsen
(mTsho smad mkhan chen Kun dga rgyal mtshan). It aims at presenting historical
data on its author, adding a few considerations regarding the discussion on the genre
of khog bugs and introducing this treatise by briefly outlining the contents of this
work. The later will form the backbone of this paper, as this composition was previously
unknown and is generally not easily accessible.
The title can be rendered as, The Pierced Interior of the Art of Healing, Fully
Illuminating the Objects of Knowledge (gSo ba rig pai khog bug shes bya rab tu
gsal ba).1 It clarifies several issue that are related with the fundamental work on
Tibetan medicine, the rGyud bzhi.
A SHORT BIOGRAPHY ON ITS AUTHOR
Its author is known as the abbot of mTsho smad (Tsomed Khenchen), sKa ba Shakya
dbang phyug alias Kunga Gyaltsen. The surviving records do not provide many data
on him. A precious glimpse on this personality, however, is offered by one of his
writings, The Khog bugs, the Silver Mirror of Elegant Sayings (Khog bugs legs
bshad dngul dkar me long) from which a longer passage in form of a quotation is
preserved in the record of teachings received (thob yig) by Jaya Pandita Blo bzang
phrin las (1642-1708), and by the khog bugs written by Desi Sangye Gyatso (sDe
srid Sangs rgyas rgya mtsho, 1653-1704).2
According to these sources he was born at Glang grong in sTod lung.3 It is not
possible to establish his dates but it might be assumed that he lived circa in the
middle of the 16th century.4 The names of his parents are not known but his lineage,
namely the sKa ba, are said to have had some outstanding personalities such as
sKyes mchog sKa ba dPal brtsegs.5 Sangye Gyatso states that Kunga Gyaltsen gave
himself the name of sKa ba Shakya dbang phyug after an individual of the same
lineage and name who lived during the time of Atisha.6 He remembered that in a
former existence he was Lha rje dGe ba bum, a famous physician.7
Based on the quotation of his own work, we are able to name his teachers.8 From
Bya ba tsho byed dPal byor bkra shis he received the Mig byed rde don dmar
khrid zab mo. Padmai mtshan conferred upon him the reading transmission (lung) of
the rGyud gsum and Bye ba ring bsrel. Another teacher, mNga ris mkhas pa Chos
skyongs rgyal mtshan, was apparently affiliated to the Brang ti and Sa skya school of
medical thinking. From this teacher, he learned the Yan lag brgyad pa together with
its commentary the Zla zer. Moreover he got from him the reading transmission (lung)
for the gSer bre and the Khu tshur bum. He received a complete detailed explanation
of the rGyud bzhi, Cha lag bco brgyad and Bye ba ring bsrel from rGya ma Tsho
byed dBang phyug blo gros, while the physician sMan pai rgyal po dKon mchog
dpal bzang taught him practical issues. He gave him the reading transmissions of the
exposition of the rGyud bzhi and Bye ba ring bsrel with practical instructions like the
Rin chen sbyong sde mgo rma, Bras kyi dra gshags sgrog chings khra and Mig thur

154 TIBET JOURNAL

rde don. Eventually from Kong po Bla chen Nam mkha dpal ldan he received the
complete initiation and reading transmission of the sNying thig.
Additionally the work of Sangye Gyatso names Phrag dbon bSod nams bkra shis,
a personal disciple of Nyamnyi Dorje, as his teacher.9
At an unknown date he became abbot of the temple of Tsomed in sTod lung that is
situated in the vicinity of Lhasa. Beside this he is said to have stayed at the mountain
hermitage of Ngo bo yab phu dpal.10
He had composed several medical works but until now they have not turned up
yet. Tsomed Khenchen shortly enumerates his compositions as khog phub, six
commentaries on the rTsa rgyud, bShad rgyud and Phyi ma rgyud, the Compendium
of Advices (Man ngag bsdus pa) and so on.
One may compare these works with the biographical sketch given by Sangye
Gyatso.11 According to him Kunga Gyaltsen authored:
(1) Khog bugs, the Silver Mirror of Elegant Sayings (Khog bugs legs bshad dngul
dkar me long),
(2) the Commentary on the Subsequent Treatise, the Torch that Illuminates Difficult
Points (Phyi rgyud grel ba bka gnad gsal sgron),
(3) Clarification of the Five Sciences, the Garland of Flowers (Rigs lngai gsal byed
me tog phreng ba),
(4) the Compendium of Advices (Man ngag snying po bsdus pa) arranged as practical
instructions (lag len dmar khrid du sdebs pa).
Two of his pupils are known by the name of Glang bu Chos rje and gSang phu dpal
ri ba Lodro Gyalpo.12
Based on the composition of this present study we may add a few pieces of
information. The transmission line of the rGyud bzhi given by him names one sTong
ston mKhas pai dbang po. Perhaps this individual is identical with one of his teachers
from whom he received the rGyud bzhi as recorded in his other khog bugs. Further
research, however, has to be done to confirm this. Moreover the colophon states that
this work was written at the behest of dBang phyug blo gros. This is undoubtedly the
same individual listed among his teachers. The date of composition is not given but
the place only: he wrote it at sKyor mo lung.
SOME REMARKS ON THE GENRE OF KHOG BUGS
The genre of khog bugs (with its alternating spellings of khog dbug, khog dbubs
and so on ) is still unexplored by Tibetologists.13 Therefore a clear delineation of this
genre is not found in works on Tibetan literature. Just recently, Schaeffer 2003 offered
a noteworthy point for discussion: with regard to the khog bugs of Sangye Gyatso,
he writes that the term gSo rig khog bugs could be roughly translated as Interior
Analysis of the Medical Arts.14
Here the following reading might be offered. In the Khog dbug khyung chen lding
ba written by Yuthok Yonten Gonpo, it is said that there is a twofold character of his
khog dbug, if one distinguishes the perspectives (dmigs). One is piercing (dbug pa)
in a general mode in order to recognize the five fields of knowledge. One is piercing
(dbug pa) the interior (khog) of this very tantra (i.e. the rGyud bzhi), because it is the
essence (nying khu) of all arts of healing.15 Indeed, this twofold approach can be
observed. By piercing it is demonstrated that the rGyud bzhi should be
unquestionably regarded as a text belonging to the five sciences. This is applied in

A HITHERTO UNKNOWN MEDICAL HISTORY ... 155

sketches and without going into detail. The next step penetrates the core of the
rGyud bzhi. By this the juice or essence that it is the extract of medical texts can come
out. Unsurprisingly, medical issues are not dealt with. They are left for the commentarial
literature on the rGyud bzhi. A close investigation of the textual structure reveals that
at the centre is the rGyud bzhi, but not medicine in its theoretical or practical sense or
even medical literature. It is an eulogy on the qualities of this very composition. At
the same time it is a defence statement to prove its claim to be the authentic word of
Buddha (bka ma) and that it would meet all criteria that are mandatory for being a
tantra. Therefore a khog bugs does not aim to represent a medical history. The four
medical traditions (for which see below) are employed simply because the rGyud
bzhi was taught in different forms to these respective retinues. Consequently they
are dealt with and en passant other medical systems are described in an inclusive
manner. It allows us to explore Tibetan scholarship on medicine but the definite core
is firmly the rGyud bzhi that is surpassing all other medical texts. Therefore the
textual history of this composition is diligently outlined and its self-styled nature as
bka and rgyud is firmly established in defence against all doubts which others may
habor about this. The detailed exposition on the classification of authentic texts and
treatises and its sub-points gathers evidence for this purpose and is written with this
intention. It might be therefore partly misleading to expect a balanced account of
medical traditions and therefore to translate khog bugs as medical history.
Moreover one should stress that in his khog dbug, Yonten Gonpo discusses six
means of teaching. The first of them is to pierce the interior of the truth (don gyi khog
dbug pa), i.e. to write khog dbug treatises. Other means of teaching are for example to
set breaks of length (dkyus kyi sa bcad pa), i.e. to write topical outlines (sa bcad pa),
and to add comments on words (tshig gi bru non pa), i.e. to write detailed commentaries
(bru grel).16
Obviously in the opinion of Yonten Gonpo one can transport nothing less than the
true meaning to pupils by a khog dbug. It might be not too far-fetched to assume that
by doing this it has the features of a commentary, although it is not labelled as a
commentary on the meaning (don grel). The etymology (nges tshig) of the term
khog dbug as understood by Yonten Gonpo has been already given at the beginning
of this section. The other criteria of a textual composition as seen by Yonten Gonpo
should be added here. Therefore the nature (ngo bo) of a khog dbug is an acceptable
understanding of the meaning or truth (don) of that teaching that should be taught.
It shows the significance of the origin, analysis and how it should be explained.17 The
motive (dgos pa) is that if one intends to grasp the truth of teachings, then one has
to know a teaching method.
Based on this one might assume that a khog dbug serves many purposes. It
should illustrate the true meaning of a fundamental text, for instance, and enhance
the understanding of the disciples. It shares this with manuals and commentaries.
Concerning the rGyud bzhi an additional notion is brought in. In this particular case
it is also employed as a defence statement and an account of its superiority. In this
sense it was also used by Yonten Gonpo and, as will be shown, by Tsomed Khenchen
as well. In the 17th century, Sangye Gyatso promotes this position, but this is surely
not applicable for all works of this genre. Lodro Gyalpo for example did not write his
khog dbubs as a defence of the bka ma character of the rGyud bzhi at all. The
opposite of it is the case, as he attempts to prove that the rGyud bzhi was a work
written by a Tibetan. Nevertheless he retains, to a certain degree, in the compositional

156 TIBET JOURNAL

structure of his treatise, principles of this genre that are of earlier date. Furthermore it
is known that khog dbug were also composed on the Yan lag brgyad pa.18 These will
be indispensable for further enquiries into the nature of the genre of khog dbug.19 A
notable addition to this study is the work written by Tsomed Khenchen.
THE KHOG BUG OF TSOMED KHENCHEN
The treatise opens with Buddha and his activities, which eventually lead to the five
fields of traditional learning. Among them the art of healing is singled out.20 The same
approach show the works of Yuthok Yonten Gonpo, Lodro Gyalpo and Sangye Gyatso
and some similarities are also discernible in commentaries on the rGyud bzhi.
With regard to medicine Tsomed Khenchen firstly tells how medical knowledge
developed in India. The four traditions described by him are regarded as four
distinctive traditions of transmitting the rGyud bzhi, expounded by Buddha in different
forms to his four retinues, namely the gSo dpyad bum sde to the gods, the Tsa ra ka
sde brgyad to the seers, the dBang phyug chen poi skor to the non-Buddhists and
the Rigs gsum mgon poi skor to the Buddhists.
He starts with the tradition of bhadrakalpa gods by retelling the famous story of
churning the ocean and obtaining ambrosia, when Rahus head was severed.21 Brahma,
being filled with compassion, remembered the gSo dpyad bum sde taught to him by
Buddha and thus healed Rahu. This is followed by the textual tradition that is related
to this.22
The tradition of the Seers represents the inclusion of the Indian ayurvedic tradition
in form of its famous fundamental work, the Carakasamhita. In Tibetan view this
treatise was composed by the eight seers, who were pupils of Indra. sKa ba Kunga
Gyaltsen shortly enumerates them but slightly dissimilar to the khog bugs of Sangye
Gyatso who gives a separate list of the eight seers and the eight parts of the Tsa ra ka
sde brgyad.23
The commentary was composed by Drang srong dPal ldan phreng ba and is divided
into two parts: the first commentary (stod grel) entitled gSer gyi spar khab and the
second commentary (smad grel) entitled Phrul gyi lde mig.24
The non-Buddhist tradition is merely mentioned.25 The Buddhist tradition, however,
as would be expected, is given in some more detail.26
The following chapter on the development of the medical knowledge in Tibet starts
with the rise of the Tibetan royalty. The king Mahasammata is placed at the beginning
of this part. It follows closely the traditional accounts that are found in Tibetan
historiography. Then, during the reign of Songtsen Gampo, Thonmi Sambhota and
rLangs khams pa Go cha were sent to invite doctors from India came Dhar ma ra dza,
from China Mahaa kyin, from Pho brang (sic) Tsam pa shi la.27 While the first two
returned to their homeland Tsam pa shi la remained as personal physician of Songtsen
Gampo in Tibet and translated medical works such as the three cycles of dialogues of
cock, peacock and parrot (rMa bya ne tso dang bya pho gsum gyis zhus len skor
gsum). During the time of Trisong Deutsen several doctors were invited - Shanti gar
bha from India, sTong gsum gang pa and Bha la ha shang from China, Gu hya badzra
from Kashmir, Ha la shanti from sTag gzigs, Sen do od chen from Gru gu, Khyom pa
seu from Dol po and Dharma shi la from Nepal.28 The king in his royal palace faked an
illness. The doctors had to remain at the gate and were told to give a diagnosis. A
thread was fixed to the hand of the king and the other end was given to the doctors
so that they might examine the pulse.29

A HITHERTO UNKNOWN MEDICAL HISTORY ... 157

They gave the correct diagnosis. The king was amazed by this and lavishly awarded
them. He urged them to work for the welfare of the Tibetan people. Therefore many
medical treatises were translated, as Tsomed Khenchen tells us, but unfortunately he
does not name any of them.30 When the translated texts were presented to the king,
he was very pleased and bestowed upon them all the title of lha rje (celestial lord).31
Later all doctors returned to their respective countries.32
Here the next folio (14b) is blank, which means that we are not informed about what
Tsomed Khenchen wrote at this time. The narrative starts again with the story of
scholar sKyes bu me lha (fol.15a). He came to Tibet and began to translate medical
treatises together with lJang sman Lo tsa ba. Tsomed Khenchen names the Phyi
grangs kyi sde bskor, the Nang don gyi sde bskor and the gSang ba lag len gyi sde
bskor. The fame of the so-called A tsa ra Khrug bsdums [Phyag rdums] spread widely,
it is said.33 Because the descendants of the so-called Nine Experts (mkhas pa mi dgu)
learned from him, he was later called the friend of the Nine Experts.34 With this Tsomed
Khenchen finishes his account of the spread of medicine during the later diffusion of
Buddhism.
Then the seventy-one doctors who were famous in Tibet (bod du grags che bai
sman pa bdun bcu rtsa gcig) are mentioned. They are given in some detail but not in
full, because the next folio is again blank (15b).34
It seems that the missing passage was concerned with the last section of the
seventy-one doctors and that it started with the transmission of the rGyud bzhi.
Then, on folio 16a, we read that Vagbhata gave it to Candrananda. He gave it to
Vairocana. From him king Trisong Deutsen received it. He hid it in the middle storey
of the dbu rtse at bSam yas. After a period had elapsed equal to three days of the
worldly gods (dod lha) (i.e. 150 years), Grva pa mNgon shes discovered it. This
short sentence, by which Tsomed Khenchen documents the rGyud bzhi as belonging
to the category of treasure (gter ma), is followed by a sudden change in the narration.
Now Buddha and Shariputra are on the scene. When Buddha received an invitation
to the summer residence of King Padmai dpal, he said to Shariputra: Listen
Shariputra! In future those who possess bodies will be afflicted by many diseases,
and Shariputra asked him something but unfortunately the question or petition is
missing in this version, as the folio is blank again (16b).35
It appears that in this missing passage a transition was probably included to the
exposition of the rGyud bzhi. The narration of events starts again with the transmission
line of rGyud bzhi that ends with our author Tsomed Khenchen.36
Having shortly outlined this, the interior is further pierced, so to speak. Now the
essence of the rGyud bzhi being the authentic word of Buddha is brought out into
the open.
Tsomed Khenchen treats the following three main points in a way that that is fully
in line with the Khog dbug khyung chen lding ba. In this latter composition the
succession of arguments is rather straightforwardly announced.
It goes as follows: all authentic word (bka) has to be explained by the five perfect
circumstances. The rGyud bzhi is not a treatise but bka. bKa consists of tantra,
reading transmissions and essential instructions. Because it is a tantra, the four limbs
of a tantra apply. Because it has a reading transmission, the six beliefs of a reading
transmission apply. Because it has essential instructions, the nine superiorities of
essential instructions apply.37 This is the strategy to prove the rGyud bzhi as being

158 TIBET JOURNAL

the authentic word of Buddha. As already noted above the first khog dbug on the
rGyud bzhi should be read as defending this claim.
Therefore the five perfect circumstances that this very rGyud bzhi was expounded
by Buddha himself are given by Tsomed Khenchen as (1) excellence of time - Buddha
was personally existing, (2) the place the city of Pleasant to See (lTa na sdug), (3)
the teacher Medicine Buddha, (4) attendants - the four retinues, and (5) the teaching
the rGyud bzhi.38 He keeps on this track by listing the six beliefs of the reading
transmission of a tantra:
(1) the rTsa rgyud originated from the heart of the Buddha: the belief in the reading
transmission of the rTsa rgyud, the chos sku;
(2) the bShad rgyud originated from the body of the Buddha: the belief in the reading
transmission of the bShad rgyud, the longs sku;
(3) the Mang ngag rgyud originated from the qualities (yon tan) of the Buddha: the
belief in the reading transmission of the Man ngag rgyud, the ngo bo nyid sku;
(4) the Phyi ma rgyud originated from the deeds (phrin las) of the Buddha: the belief
in the reading transmission (lung) of the Phyi ma rgyud, the sprul sku;
(5) from the speech of the Buddha originated the petitioner: the belief in the reading
transmission of the valid truth of petition (zhus don), the padma;
(6) the rGyud bzhi are naturally occurred five bodies (sku lnga lhun grub): the belief
in the reading transmission of the Medicine Buddha.39
This is followed by the Nine Superiorities of Instructions, although in fact Tsomed
Khenchen gives ten:
(1) the superiority that one is of constant benefit for the migrants, because medical
treatment is a link between merit and karma;
(2) the superiority that one is venerated like a lord of whatever countries, because
one enhances the good qualities and the life-force of the migrants;
(3) the superiority that one has influence over all, enemies and friends, because it is
impartial to its benefit for others;
(4) the superiority that one has not to look on other fundamental textual traditions
(gzhung), because it has completely all explanations and practices;
(5) the superiority that one has not to stick to other religious systems (theg pa),
because an attitude appears effortlessly of generating the mind for enlightenment
by doing an aspiration prayer;
(6) the superiority that one is endowed with the supreme, pure view, because it is free
of the limits of wrong remedies;
(7) the superiority that it is free of wrong meditation, because the Four Immeasurable
constantly guard the evenness of mind and its subsequent results (mnyam rjes);
(8) the superiority that it is free of improper behaviour, because it avoids the ten nonvirtues, confusion, sins and bad behaviour;
(9) the superiority that one has not to make false accumulations, because all practices
are becoming the six transcendental perfections;
(10) the superiority that one will not return to the samsara, because the result is that
one will achieve Buddhahood.40
Tsomed Khenchen summarizes that the rGyud bzhi is a flawlessly authentic
composition that consists of a tantra, a reading transmission and essential instructions.
Then he concludes this paragraph by referring to the Cha lag bco brgyad. He states
that Yuthok composed the treatise known as the Eighteen Parts (Cha lag bco brgyad)
in order to explain the design of his rGyud bzhi.41

A HITHERTO UNKNOWN MEDICAL HISTORY ... 159

THE CLASSIFICATION OF AUTHENTIC WORDS
Tsomed Khenchen states on the nature of authentic words that these are the vehicle,
equal to the mind tamed by all flawless dharma, which appeared because of Buddha
being the main condition (sangs rgyas kyi bdag rkyen).42
In accordance with the rGyud bla ma, he defines authentic words as whatever is
endowed with truth and that which is closely related to the dharma, dispels defilements
from all three realms and reveals the benefits (and) the qualities (of) calmness.43
Thirdly he distinguishes bka ma by means of a threefold differentiation. bKa ma
are those expositions actually given by Buddha, that were authorized and that are
blessed.
He begins this paragraph by pointing out to the Prajnaparamita in Eight-thousand
Verses (brGyad stong). Therefore the teacher gave the order that the vinayapitaka
should be compiled by his close followers; the sutrapitaka should be compiled by
Ananda; and the abhidharmapitaka be compiled by Mahakasyapa. At the beginning
one should generate virtue through the phrase thus I heard once, in the middle the
exposition should be written and at the end should be added the phrase they enjoyed
very much the speech of the Buddha. According to these instructions the authentic
words of Buddha were written down.44 The explanation of Tsomed Khenchen is
slightly confused as he does not clearly differentiate in this passage between the
first both kinds of bka ma. Beside the speeches of Buddha that he had held, there
also exist approved teachings that are formally indicated by phrases as those mentioned
by Tsomed Khenchen.
Then he continues to explain teachings of Buddha which are authentic due to
being blessed, although they might not be spoken directly by the Buddha. Tsomed
Khenchen is here in agreement with the Khog dbug khyung chen lding ba that
briefly names them.45
Tsomed Khenchen demonstrates three different kinds of blessed authentic words.
The first are blessed by the body of Buddha. It is like Buddha sang in praise the sutra
of displaying the behaviour of ones true characteristics, when Buddha had placed
his hands on the forehead of Samantabhadra.46 The second is the blessing of speech.
These are the sounds of dharma from mountains, trees and drums that were blessed
by Buddha. The Pha rol tu phyin pa rgya cher sbyang pa states that the sounds that
come from the mountains blessed by the teacher, stones and trees, large drums, and
wish-fulfilling trees and lotuses are the authentic words of Buddha.47 Concerning the
blessing of mind it is like the glorious rGyud bzhi that is like testing his power and
strength during the questioning and answering between both seers, while Buddha
bound all conceptions of Buddhahood in a meditative concentration of mental
quiescence.48
In Tibetan scholasticism, different principles were chosen to categorize authentic
words. Obviously Tsomed Khenchen was once more strongly influenced by the
Khog dbug khyung chen lding ba that made use of this categorization on the basis
of the main condition (bdag rkyen), i.e. the personality of Buddha, although also in
medical writings others were known as well. Two later works of Lodro Gyalpo and
Sangye Gyatso also deal with this question but employ several principles for
categorizing the authentic words.49 Concerning the words that are authentic, because
they were blessed, Sangye Gyatso, for his part, prefers a fivefold distinction.50

160 TIBET JOURNAL

The fact that the rGyud bzhi is regarded as bka ma that originated in a blessing by
the mind is not shared by both authors. This is, however, a notion already formulated
by Yonten Gonpo. He states that the Medicine Buddha remained in a meditative
concentration called the King of Medicine that pacifies the four hundred four kinds
of diseases. Due to this blessing the dialogue between the two seers, Drang srong
Rig pai ye shes and Drang srong Yid las skyes, ensued.51
It is not surprising that Lodro Gyalpo does not agree with either opinion, as his
khog dbubs is based on the newly acquired conviction that the rGyud bzhi is not the
authentic word of Buddha. Sangye Gyatso prefers to strengthen his position that
centres around the older Yuthok. Therefore the rGyud bzhi was expounded by the
Medicine Buddha at O rgyan.
THE CLASSIFICATION OF TREATISES
Tsomed Khenchen employs a fivefold division for this topic.52 His first point is the
nature (ngo bo) of a treatise. He characterizes it as a work composed by a
knowledgeable individual who has relied on the words of Buddha. In the following
point he treats the etymology (nges tshig) of the term bstan bcos by a short quotation
of the rNam bshad rig pa.53 On the motive (dgos) he refers to Aryadeva who said that
it is to obtain works of beauty, to compile fragments, to reveal the profound, and to
restore what became spoiled.54 The fourth point deals with the definition (mtshan
nyid) of treatises. He gives four verses from the rGyud bla ma.55 Therefore treatises
are determined by some teachings of Buddha. They are attentively expounded and
are in agreement with the road to salvation. They are venerated like the words of the
seers.
When it comes to the classification of treatises he cites the Thos pa stan [gtan] la
dbab pa.56 According to this there exist treatises that are without meaning, that have
wrong meaning, that stresses study, that stresses debate, that are deceptive, and
that are devoid of compassion.57
THE CLASSIFICATION OF STUDYING AND VOWS
This topic already forms part of the earliest known khog dbug on the rGyud bzhi,
namely the Khyung chen lding ba. It is also integrated in the works of Lodro Gyalpo
and Sangye Gyatso. While Lodro Gyalpo stresses a thorough study, Sangye Gyatso
emphasizes the three classes of vows.58 Moreover it is found in the commentarial
literature on the rGyud bzhi like the treatises of Kempa Tsewang. In comparison to
Tsomed Khenchen these sources are more detailed and specialized in their approach
and give more attention to the particular requirements for studying medicine. Even
though Tsomed Khenchen speak of vows in the heading of this topic, he just describes
one ethical rule in the conduct with a patient.
At the beginning he cites Nagarjuna on the importance of learning: If one draws
knowledge from books and does not study with lamas, one is not handsome among
many like a cormorant among geese.59
On the methodological side of learning and composing he observes a sixfold rule
(1) the part on origin and history is like streams of water that pound against secrets;
(2) the part of naming the core meaning is like the leap of a tiger;
(3) the part of setting textual caesurae and chapters is like a wisely chosen bolt;
(4) the part of adding the comments of a commentary is like walking in the mode of a
frog;

A HITHERTO UNKNOWN MEDICAL HISTORY ... 161

(5) the part of giving a rebuttal is like the sword of a hero;
(6) the part of revealing the profound meaning is like opening the eyes of a blind
person.60
This is neatly interwoven with the four modes of explaining. Therefore one should
teach general subjects (shes bya stong thun) in the mode of brilliantly increasing
gems (nor bu gsal phel), solve difficulties and remove contradictions (dka tshoms
gegs sel) in the mode of a wheel of meteorite iron (gnam lcags khor lo), demonstrate
the subtle and broad meaning of words (tshig don zhib rgyas) in the mode of a rosary
of pearls (mu tig phreng ba) and give practical instructions (lag len dmar khrid) in
the mode of an old woman pointing her finger (rgan mo mdzubs tshugs).61
The mode of teaching should be adjusted to the intellect of the disciples. Pupils
with keen intellect understand the tantra just by hearing it. While pupils with less
intellectual capabilities will be taught by practice. The main text together with
instructions should be taught to pupils with medium intellectual capabilities.
Otherwise a pupil should avoid learning without purpose, like one avoids to lie
face down, one should avoid to learn emphatically, like one avoids having cuts on the
feet through too much walking and one should avoid to learn with wrong expectations
like one avoids poison.62
Tsomed Khenchen concludes these methodological considerations with the advice
that one should view the lama as the true Medicine Buddha and one should have
faith in his instructions as in the flawless words of Buddha. Moreover the student
should generate pious thoughts wishing to benefit the patient.
Thus, the fourth topic of the khog dbugs is finished. It is certain that Tsomed
Khenchen relied on the Khyung lding chen po to an amazingly high decree. The
classification of bka and bstan bcos closely resembles the scheme of that composition.
But he did not complete his khog dbugs without having presented a general lecture
on learning and teaching that seemingly formed a regular part of khog bugs literary
productions or at least of those that are known today. The treatise of Tsomed
Khenchen is not very innovative but repeats principles and notions that appear to be
just a version of those of Yuthok Yonten Gonpo. This rather conservative approach
stays in contrast to the compositions of Lodro Gyalpo and Sangye Gyatso.

TABLE OF CONTENTS
The Pierced Interior of the Art of Healing, Fully Illuminating the Objects of Knowledge
(gSo ba rig pai khog bug shes bya rab tu gsal ba) [1a/1]
Verses of Homage [1b/1-2a/3]
1.
1.1.
The Classification that Describes the One Who Gave Precious
Expositions (bka gsung ba po ston pai rnam par bzhag) [2b/2]
1.2.
The Classification that Describes His Deeds (phrin las ston
pai rnam par bzhags)
1.1.1.
1.1.2.
1.1.3.

How He Generated His Mind (thugs skyed tshul) [2b/4]

How He Gathered Accumulations (tshogs bsags tshul) [3a/3]
How Each Buddha Turned the Wheel of Dharma (sangs rgyas
re chos khor bskor tshul) [3b/1]

162 TIBET JOURNAL

1.2.
1.2.1.
1.2.2.

The Classification of the Showing His Deeds (spyi don gnyis

pa de dag gi phris bstan pai rnam par bzhag pa) [5a/2]
In General the Classification of the Five Fields of Knowledge
(phyir shes bya rig pai gnas lngai rnam bzhag)
In Particular the Classification of the Art of Healing (bye brag
du gso ba rig pai rnam bzhag)

1.2.1.1.
1.2.1.2.
1.2.1.3.
1.2.1.4.

Buddhist philosophy
Logic
Grammar
Art and Craft

1.2.2.

The Classification of the Art of Healing (gso ba rig pai rnam

par bzhag pa) [6a/4]
How Ordinary Medical Therapies Came into Being (thun mong
gi gso dpyad ji ltar du byung bai tshul)
How Extraordinary Medical Therapies Came into Being (thun
mong ma yin pai gso dpyad ji ltar du byung bai tshul)

1.2.2.1.
1.2.2.2.

1.2.2.1.
1.2.2.1.1.
1.2.2.1.2.
1.2.2.1.1.
(1.2.2.1.1. )
(1.2.2.1.1. )
(1.2.2.1.1. )
(1.2.2.1.1. )

1.2.2.1.2.
(1.2.2.1.2.1.)
(1.2.2.1.2.2.)
(1.2.2.1.2.)
(1.2.2.1.2.)
(1.2.2.1.2.)

(1.2.2.1.2.)
(1.2.2.1.2.)
(1.2.2.1.2.)
(1.2.2.1.2.)

[5b/1]
[5b/2]
[5b/5]
[6a/2]

How Ordinary Medical Therapies Came into Being (thun mong

gi gso dpyad ji ltar du byung bai tshul) [6a/5]
How It Originated in India (rgya gar du ci ltar byung tshul)
How It Came to Tibet (de bod du gyur tshul)
How It Originated in India (rgya gar du ci ltar byung tshul)
[6b/1]
The Tradition of the Gods of Pure Era (skal bzang lhai lugs)
[6b/2]
The Tradition of Holders of Knowledge, the Seers (rigs dzin
drang srong gi lugs) [7b/4]
The Tradition of the Non-Buddhists (phyi rol mu stegs pai
lugs) [8a/3]
The Tradition of the Buddhist (nang pa sangs rgyas pai lugs)
[8a/4]
How It Came to Tibet (de bod du gyur tshul) [8b/3]
During the Reign of Songtsen Gampo
During the Reign of Trisong Deutsen
(blank side 14b)
About sKyes bu me lha [15a/1]
The Seventy-one Doctors who Are Famous in Tibet (bod du
grags che bai sman pa bdun bcu rtsa gcig) [15a/3] (blank
side 15b)
Transmission, Hiding and Rediscovering of the rGyud bzhi
[16a/1]
Story of Buddha and Shariputra [16a/3] (blank side 16b)
Transmission Line of rGyud bzhi
The Five Excellences (phun gsum sum tshogs pa lnga) [17b/1]

A HITHERTO UNKNOWN MEDICAL HISTORY ... 163

(1.2.2.1.2.)
(1.2.2.1.2.)
(1.2.2.1.2.)
1.2.3.

The Six Beliefs of Tantra (rgyud kyi yid ches drug) [17b/3]
The Nine Superiorities of Instructions (man ngag gi che ba dgu)
[18a/3]
The Treatise Cha lag bco brgyad [18b/5]

1.2.3.1.
1.2.3.2.

The classification of the authentic words (bka) and the treatises

(bstan bcos) (spyi don gsum pa bka bstan bcos kyi rnam par bzhags
pa) [19b/5]
The Classification of Authentic Words (bkai rnam bzhag)
The Classification of Treatises (bstan bcos gyi rnam bzhag)

1.2.3.1.
1.2.3.1.1.
1.2.3.1.2.
1.2.3.1.3.

The Classification of Authentic Words (bkai rnam bzhag) [20a/2]

The Nature of Authentic Words (bkai ngo bo) [20a/3]
The Definition (mtshan nyid) [20a/4]
The Importance (gal pa) [20a/5]

1.2.3.1.3.1.

The Authentic Words that Were Expounded during Lifetime

(zhal nas gsungs pai bka) [20b/1]
The Authentic Words that Were Authorized (rjes su gnang
bai bka) [20b/3]
The Authentic Words that Are Blessed (byin gyis rlabs pai
bka) [20b/4]

1.2.3.1.3.2.
1.2.3.1.3.3.

1.2.3.1.3.3.1.
1.2.3.1.3.3.2.
1.2.3.1.3.3.3.

The Blessing of Body (skui byin gyis brlabs pa) [20b/4]

The Blessing of Speech (gsung gi byin gyis brlabs pa) [20b/5]
The Blessing of Mind (thugs gyi byin gyis brlabs pa) [21a/2]

1.2.3.2.

The Classification of Treatises (bstan bcos gyi rnam bzhag)

[21a/3]
The Nature (ngo bo) [21a/4]
The Etymology (nges tshig) [21a/5]
The Motive (dgos pa) [21b/1]
The Definition (mtshan nyid) [21b/2]
The Division (dbye ba) [21b/4]

1.2.3.2.1.
1.2.3.2.2.
1.2.3.2.3.
1.2.3.2.4.
1.2.3.2.5.
1.2.4.
(1.2.4.)
(1.2.4.)
(1.2.4.)
(1.2.4.)
(1.2.4.)
(1.2.4.)
(1.2.4.)

Classification of Studying and Vows (spyi don bzhi pa chad

nyan dam tshig gi rnam par bzhag pa) [21b/5]
On the Importance of Thorough Learning [22a/2]
The Six Limbs of Teaching (yan lag drug) [22a/3]
The Four Modes of Explaining (tshul bzhi) [22b/1]
The Teaching in Accordance with the Intellectual Capability
of a Pupil [22b/3]
The Three Faults that Hurt Pupils (slob bu gnod kyi skyon
gsum) [22b/4]
The Attitude Towards Teacher and Patient [22b/5]
Dedication Verses [22b/5] colophon [23b/3]

164 TIBET JOURNAL

Notes
1. A table of contents is given at the end of this paper. This manuscript consists of 24 folios
sized 6,3 x 35 cm. The text is written in dbu med. The lines per page are: 2 lines [1a], 3
[1b], [2a], 4 [2b], 5 [3a-23b], 1 [24a]. The reverse sides of the following folios are missing:
14b, 15b, 16b. The manuscript was microfilmed by the Nepal German Manuscript
Preservation Project (NGMPP) in 1997 under the Reel No. E 53248. The place of deposit
is Gangtok Palace (or more specifically Dolung Gonpa) and the manuscript belongs to
Chogyal Wangchuk Namgyal.
2. The modern writers have based themselves on them. Cf. Taube 1981: 61f. For a detailed
study, see also Jampa Thinley 2000: 230ff.
3. KhB [348/5], Samten 1992: 91
4. Taube 1981: 62
5. KhB [348/2] Samten 1992: 91
6. KhB [348/10]. He met him, when Atisha was invited to Mang yul. It is said that he
received many teachings from him. For meditation practices he relied on Brom ston. He
died in Klung shod mngal valley, LCh [236/5-237/4]. See also the biography on dGe bshes
sTon pa, LCh [251/5], [286/6].
7. KhB [348/5], BZPhL [201/4]. For Lha rje dGe ba bum, cf. Jampa Thinley 2000: 169
8. The quotation is in verses with nine syllables that might apply for the entire composition
of the Khog bugs legs bshad dngul dkar me long. This impression is supported by the
entry found in the colophon of the medical history of Sangye Gyatso. Here it is described
as Legs bshad dgnul dkar me long tshigs bcad ma, hence a versified text, KhB [563/19].
9. KhB [348/10]. Cf. Jampa Thinley 2000: 230. On Phrag dbon bSod nams bkra shis, see for
example, Jampa Thinley 2000: 219.
10. KhB [348/7]
11. KhB [348/12-]
12. KhB [348/15]. Samten 1992: 91, Jampa Thinley 2000: 226, 232. He was one of the
teachers of Zurkharwa Lodro Gyalpo (1509-1579). About him, see an article in this issue.
13. The different spellings are kept here in accordance with the very treatise is refers to.
14. Schaeffer 2003: 624
15. KhChDB [4/20-5/2], For a full presentation see there.
16. Naturally the phrase bru gnon means carefully reading word by word. In this context
I believe, however, that it should be understood as meaning a literary composition.
17. The word analysis is an attempt to render the term bshad ral. According to Yonten
Gonpo one who explains (chad pa po) should heed that a full word of explanation is half
achieved by wrapping up the meaning and half achieved by cutting open a problem
through elucidation, tshig thems don drel bshad ral phyed, KhChDB [3/11]. Therefore an
explanation has an analytical part and a conclusion.
18. So for instance by Brang ti dPal ldan tsho byed, KhB [294/6], BGGP-KhB [307/16].
19. Invaluable informations will surely provide the research of Mr. Dan Martin who came
across the sMan gyi byung tshul khog dbubs rgyal mtshan rtse mo[r?] bar ba zhes bya
bai bstan bcos composed by Che rje Zhang ston Zhig po Thugs rje khri od. Initial
findings were presented by him at the Xth IATS, Oxford, Sept. 06-12.2003.
20. Although it is surely of interest to make a comparable study of the notion of the five
sciences as found in Tibetan medical literature, it should be left out here because of the
brevity of this study.
21. There are slight differences to KhChDB [16/2-], KhB [21/7-]
22. Brahma composed the gSang bai snying po don bsdus pa based on the gSo dpyad bum
sde. This was explained to sKyes dgui bdag po myur ba. He wrote the Phrul gyi me
long and taught it to both Asvin brothers, they composed the gCes par grub pa. Then
it was explained to Indra who made the bCes pa bsdus pa. Cf. KhChDB [18/10-], KhB
[87/17-].

A HITHERTO UNKNOWN MEDICAL HISTORY ... 165

23. KhB [88/4-89/17]. According to Tsomed Khenchen the eight sections of the Tsa ra ka sde
brgyad were composed by rGyun shes: sKor stan pai sde, (2) Me zhin [bzhin] jug: gZhi
sgrub pai sde, (3) Mu khyud dzin: bDud rtsi chen poi sde, (4) Gro ba skyong: Mi jigs
pa mtshon chai sde, (5) bShogs gro skyes: bDud rtsii bsgrub lugs kyi sde, (6) Ka [bKa]
gnyis spyod: Srog gi sgrom bui sde, (7) Thang la bar: gSo byed sman sbyor gyi sde, and
(8) Nam so skyes: sByong byed rnam lngai sde. Cf. Taube 1981: 10, n.38. But the earliest
known khog bugs differs here. It briefly names three tantras that belong to the seers:
Drang srong snying boi rgyud, bDud rtsi snying bo and Tsa ra ka sde brgyad, KhChDb
[20/5-6], for their names, see [18/18-].
24. Sangye Gyatsos description slightly differs but he gives also some more details. According
to him the first commentary Zla bar bkab consists of 80 divisions. The second Phrul gyi
lde mig consists of 40 divisions, KhB [88/18-]. sTod grel bloi spar khab and sMad grel
phrul gyi lde mig, KhChDB [19/10].
25. Tsomed Khenchen gives two examples only, the tantra of the throat of Siva (dBang phyug
chen poi ke [ske] rags), the Tsa ra ka bum sdei rgyud and so on. The Khog dbug khyung
chen lding ba states that the non-Buddhist have six tantras: sKra shad dzing bai rgyud,
Me ltar bar bai rgyud, rDo rje kha msrai rgyud, Ri bo brtsegs pai rgyud, dBang phyug
chen po ske rags kyi rgyud and Tsa ra ka bum sde, KhChDB [20/6-9]. More detailed is
Sangye Gyatso, who gives an explanation for the tantras that orginated from various parts
of the body of Siva, but who does not list the Tsa ra ka bum sdei rgyud, KhB [89/17-90/
10].
26. Therefore for instance Manjusri composed the bDud rtsi lhung zed [bzed], Avalokitesvara
- bDud rtsi chu brgyun [rgyun] che chung, Vajrapani - Ro khrang phrul gyi me long and
Nagarjuna - mDo lnga dpyad gzhungs bcu. Cf. KhChDB [18/8], [18/16], [19/18], [20/1],
KhB [86/8-], esp.[86/17], [87/8], [87/11].
27. On the invitation of doctors during the snga gyur, cf., Taube 1981: 10ff. Indispensable is
still the remarkable study of Beckwith 1979. Since the khog bug of mTso smad mkhan
chen and the one of Lodro Gyalpo has not have been at his disposal at that time, some
additional data should be given.
Other sources state that these three doctors came during the reign of Trisong Deutsen,
KhB [156/9-], see also [135/16-], BGGP-KhB (his own view) [292/5-]. In their opinion,
however, the Indian doctor Bha ra dhva dza, the Chinese doctor Hen len hang de and the
doctor of sTag gzigs or Khrom, Ga le nos, were present at the court of Songtsen Gampo.
Ga le nos translated the mGo sngon bsdus pa and the medical treatise of the three cock,
peacock and parrot (De pho rma bya ne tsho gsum gyi dpyad), KhB [150/8-]. He stayed
in Tibet as the personal physician of the king. He married and had three sons who
established different medical lineages. The eldest was sent to gTsang stod and from him
the lineage of Bi ji among others originated. The middle went to g.Yor po. There the
doctors of Lho rong proliferated. The youngest stayed with his father. The doctors of Sog
pa originated from him, KhB [151/5-]. Lodro Gyalpo records the very same for the view
of his opponents but Ga le nos is replaced by bTsan pa shi la ha, BGGP-KhB [253/14].
When he explains his point of view, he notes the same doctors as Sangye Gyatso but the
treatises that were translated by Ga le nos are the mGo sngon bsdus pa, the De poi gtar
dpyad and so on, BGGP-KhB [288/3-]. Ga le nos remained in Tibet and changed his name
(rus ming) to Dzo ro, ibid. [288/19]. As already indicated by Sangye Gyatso, Lodro
Gyalpo holds the view that Tsam pa shi la came to Tibet in the time of Mes ag tshoms,
KhB [169/15]. Indeed, in the latter khog dbub one can read that this individual was invited
from Khrom. Doctor (sman pa) was in his language bi ji. (As already shown by Beckwith
1979 and Taube 1981 the term bi ji is related to the Persian and Indo-Iranian word for
doctors etc., Beckwith 1979: 303, Taube 1981: 15,n.53.). His personal name was bTsan
pa shi la ha, BGGP-KhB [289/13]. Furthermore he is mentioned as one of three doctors
who were at the court after Mes ag tshoms had passed away and the young Trisong
Deutsen had ascended to the throne, ibid. [292/5-]. When he was about to return to his

166 TIBET JOURNAL

homeland he imparted several medical teachings to his son, namely the gDams pa beu
bum nag poi skor jal tshad dang bcas pa, the Drang srong snying bgyud mgo byang
khog yan lag gi pra khrid skor said to be composed by Tsa ra ka and the mGo byang khog
yan lag du ba thor bu dang bcas pai bcos thabs that became known as the Bi ji pu ti kha
ser. The original of it was known as the rGyal poi bla yig od bar, ibid. [294/6-].
According to Lhamo Kyab 1997, Tsam pa shi la ha came in 742 from Khrom to Tibet. He
composed the Bi jii po ti kha ser and presented it to the king. A original version (ma phyi)
of this work exists at the Mentsikhang of the Tibetan Autonomous Region. Its contents
are: combat wounds of the head, of the upper body, the lower body and four limbs, ibid.
91. Sangye Gyatso names the Bi byi bu ti kha ser among the sources for his rGyud bzhi
edition, KhB [384/3].
Moreover one should note that Sangye Gyatso refers to some unknown authors that
present distinguished lines of tradition of medical expertise according to their respective
land of origin, KhB [176/3-16]. Here one finds the tradition of Khrom like the Tshad pa
bros ded of Tsam pa shi la ha, ibid. [176/14].
28. The enumeration of eight doctors only is probably a mistake. The usual number of them
is nine. Tsomed Khenchen speaks also of nine messengers to whom gold was given and
dispatched. KhB [169/10-], BGGP-KhB [255/7-], [295/15-]. Cf. also Taube 1981: 15ff.
29. This story that strikes one as odd has probably a complex background. Naturally the king
wanted to test them. But one should remark that seemingly there existed an early notion
in Tibetan medicine that the pulse of all twelve viscerae (twelve as counted in the case of
pulse diagnosis) could be described as being like a braided string(s) (thi gu sgril ba) or a
braided multi-coloured thread(s) (tshon skud sgril ba). In the rGyud bzhi this metaphor
was not employed and therefore it is just of rare occurance in its commentaries. Sangye
Gyatso leaves it completely out. Kempa Tsewang and Lodro Gyalpo name it only in
order to refute it. Nevertheless by this one gets known that this notion existed at all.
Proponents of this view were for example Tsho byed Thugs rje, Bya pa Nang so bKra
shis rnam rgyal and Byang pa bKra shis dpal bzang. It is also noteworthy that both,
Kempa Tsewang and Lodro Gyalpo, refer to the Zla bai rgyal po, the earliest known
medical treatise today that is possibly of the eighth century. Here the metaphor of the
braided string(s) was used and worried these both commentators of the rGyud bzhi. The
passage they quote is not preserved in the Zla bai rgyal po published today (snying rtsa
mkhrig mai gong na yar / thi gu sgril ba lta bu ste MPZhL IV [42/5-], snying rtsa mkhrig
mai gong dag nas / thi gu sgril ba lta bu ste / mtheb moi og tu rgyu ba / mthil du phyin
nas khug par ro // KPTshB III [34/2-]).
Furthermore one should mention that pulse diagnosis in this form occurs also in Chinese
novels and Korean opera plots, when the pulse of well-to-do ladies is taken.
30. For this see KhB [171/6-], BGGP-KhB [290/4-], Taube 1981: 13ff.
31. According to Tsomed Khenchen the king said that the subjects should venerate them. The
gods (lha) of the Tibetan race are fierce, because they bestow life. They should venerate
them (like lords, rje). Therefore they were called lha rje. Cf., KhB [170/10-13], BGGPKhB [290/1-2]. Both these sources give the story on examination immediately followed
by this conferring of the title, KhB [169/15-], BGGP-KHB [289/14-].
Lodro Gyalpo tells this story with regard to Mes ag tshoms, bTsan pa shi la ha and the
other doctors. Cf. Taube 1981: 15. Furthermore one should remark that beside this
explanation of the term lha rje as found in khog bugs literature there also exists another
mode of explanation handed down in the commentaries on the bShad rgyud. Therefore in
the Grel ba bum chung gsal sgron nor bai phreng mdzes composed by Ye shes zungs
it is stated that the title or name (ming) of the kings was lha as a polite address. Because
the lha venerated (the doctors) as lords (rje), (the doctors) were called lha rje, ChLCG
[289/6-8]. This can be also found in the commentaries on the rGyud bzhi composed by
Kempa Tsewang, Lodro Gyalpo and Sangye Gyatso.

A HITHERTO UNKNOWN MEDICAL HISTORY ... 167

32. The succession of events differ in the Tibetan sources. In the opinion of Lodro Gyalpo it
was as follows: BGGP-KhB: his own view: (a) test of doctors under Mes ag tshoms,
BGGP-KhB [289/8], (b) translations by three doctors [292/5-] and (c) invitation of nine
doctors under Trisong Deutsen [295/19]. Sangye Gyatso (a) translation by three doctors,
KhB [156/9], and (b) invitation of nine doctors [169/10-], (c) test of doctors [169/16-], (d)
their translations [171/5-] under Trisong Deutsen. Lodro Gyalpos description of the
view of his opponents is largely identical with the one given by Sangye Gyatso, BGGPKhB [255/3-].
33. Sangye Gyatso reports the following account. The son of Dzi na mi tra was the personal
physician of the king. When he treated the queen, he showed improper behaviour. Therefore
he was sentenced to death but his hands were cut and he was sent in exile to Tibet. Known
as the Old Crippled Hands (Bha ro Phyag rdum) alias sKyes bu me lha he came to Tibet
during the reign of mNga bdag rTse lde, KhB [290/1-], Cf. also Lama Kyab 1997: 23ff.,
Jampa Thinley 2000: 121, see also KhB [223/16], [283/7], [301/19]. These sources do not
explicitly speak of translations. Only in the Vaidurya sngon po does he mention Indian
translations. At this point, Sangye Gyatso names the bDud rtsi zla bai snying po of
sKyes bu me lha, VNg [1465/20]. (The entire passage from which this is taken is very
close to the khog bugs, KhB [383/11-19], VNg [1465/16-21]. In the former this
composition of sKyes bu me lha is not mentioned.). The writings of sKyes bu me lha were
practical instructions (man ngag) like the sNyan rgyud be bum nag po, Chung dpyad be
bum sngon po, Bum khu chur and rDe [sDe] skor phyi nang gsang gsum, KhB [290/6-8].
Lodro Gyalpo provides the following overview on the works of sKyes bu me lha.
Therefore he had translated: the mDo lnga, Khrugs bcos sprin bral zla zer, bDud rtsi ku
mu ta spyi don bzhi, Leu bco lnga pa, gSo ba stong dgu bcu rtsa gcig that were taught to
him by his father, mGo dang tshad pai skor known as Bu gdams. He composed the Phyi
grangs kyi sde skor, Nang don gyi sde skor and gSang ba lag len gyi sde skor together
with commentary and additional, short treatises (cha lag). These were known as the gSo
dpyad skor gsum, BGGP-KhB (the opponents view) [263/17-264/5]. Moreover he gives
a long quotation from unnamed source. Therefore rGya gar sKyes bu me lha composed the
sTong thun sum cu rtsa gcig, sKor tshoms bzhi bcu zhe lnga, Yang dag tshig bsdus don and
Don grel nyi shu pa, ibid. [271/16-18].
34. Presumably Tsomed Khenchen had mentioned these nine experts in one of the folios that
are blank now. It seems that he is of the opinion that these have lived during the time of the
Tibetan empire. Cf. the paper on Lodro Gyalpo in this issue, n.44, 45. Future research
must show in as far this claim that sKyes bu me lha was a friend or teacher of the nine
experts or their descendants is justified. Naturally this must include an in-depth study on
medical issues of their medical treatises. There are indications that the works of sKyes bu
me lha were indeed of lasting influence in Tibetan medicine. For example Jam dpal bzang
po of the Brang ti line had studied the A tsa ryai gso dpyad skor gsum under his father
bSod nams bum, KhB [292/9]. He also relied on lJang sman pa Ye shes bzang po for a long
while. Jam dpal bzang po was a contemporary of Bla ma bDag nyid chen po dpal bzang
po (1262-1324). Undoubtedly he will have imparted this teaching on his sons rGyal ba
bzang po and the famous dPal ldan tsho byed.
Furthermore in the commentaries of Kempa Tsewang there are several instance, when he
refers to treatise of sKyes bu me lha, Bum nag KPTshB I [132/23], [145/14] etc. It seems
that during the time of Sangye Gyatso, works of sKyes bu Me lha were still extant as he
mentions that he used his sMan bcos be bum for his Lhan thabs. Apparently this work
entitled sNyan brgyud be bum nag po is preserved. In this a biographical sketch is contained,
Jampa Thinley 2000: 121ff.
35. Namely (1) The scholar who is like a great Pandita (pan chen ltar mkhas pa gcig), (2) The
one who comes through everything like the sky / space (nam mkha ltar kun la khyab pa
gcig), (3,4) the two who are famous like sun and moon (nyi zla ltar grags pa gnyis), (5-13)
the nine personal physicians of the ruler (mnga bdag gi bla sman dgu), (14-23) the ten

168 TIBET JOURNAL

who benefitted the migrants of the tulku (sprul skui gro don mdzad ba bcu), (24-29)
(sbyang stobs yon tan che ba drug) and (30-39) the ten who are like famous kings (yongs
grags rgyal po lta bu bcu). There were various standardized lists of physicians who were
renowned in Tibet (yongs su grags pai sman pa chen po). gTsug lag phreng ba says that
there exists list of sixty-five, seventy-one or one hundred and four doctors, KhPGT [863/
14]. A list that agrees with this given by Tsomed Khenchen is named by Lodro Gyalpo
(his opponents view) BGGP-KhB [264/19-], and Sangye Gyatso, KhB [304/1-11]. These
are identified with certain personalities, cf. BGGP-KhB (his opponents view) [265/5267/8], KhB [304/11-306/11].
36. The narration how the rGyud bzhi was transmitted ends with: .. It was taken out by Grva
pa mNgon shes can. He became the lord of Jambudvipa. Thus it is explained. Gra pa
mngon shes can gyis gton [bton] / dzam bu gling gi bdag por gyur / ces bshad pas [16a/
2-3]. Therefore it is unlikely that this passage is a prophecy made by Buddha.
37. The first individuals are missing. It might be not too far-fetched to assume that these were
Buddha and his several aspects, which can be related to the respective parts of the rGyud
bzhi. It begins with the one who transmitted the Phyi ma rgyud and the deeds, Rig pai ye
shes who was perfectly accomplished from the secret place / the one who asked the
questions and made the transmission of the authentic words (bka brgyud ba po), Yid las
skyes who is infinite light from the throat / sMan pai rgyal po Tsho byed gzhon nu /
mGon po Klu sgrub / dPal ldan dPao / Kha che Zla dga / Bai ro tsa na / Trisong Deutsen
/ Grva pa mNgon shes / dBus pa Dar grags / mTsho byed dGon skyabs / g.Yu thog mgon
po / Sum ston Ye shes gzungs / Tsho byed gZhon nu ye shes / g.Yu thog Bram seng /
gTsang ston Sangs rin / mKhas pa Rin rdor / Brang ti Don grub rgyal mtshan / Brang ti dPal
ldan tsho byed / dGe slong Tshal pa Mi dbang dBang phyug grags pa / sLob dpon Phun
tshogs bzang po / Pan chen mNyam nyid rdo rje (1439-1475) / sTong ston mKhas pai
dbang po / myself (i.e.Tsomed Khenchen). For similar transmission lines of the rGyud
bzhi, cf. Taube 1981.
38. KhChDB [21/1-12].
39. Cf. KhChDB [21/19-].
40. The last point should certainly be seen in relation to the beginning verses of the brGyud
pai rnam thar med thabs med pa bzhugs contained in the Cha lag bco brgyad, ChLCG
[690/1-]. These say that this great tantra on the art of healing originated from the five
naturally occurred bodies, sku lnga lhun grub las byung bai / gso ba rig pai rgyud chen
di, ChLCG [690/3-4]. Cf. also the article of Lodro Gyalpo in this issue, n.52.
Tsomed Khenchen gives six points in contrast to the Khyung chen lding ba that gives
seven beliefs. The seventh belief is that because it is certain that a valid reading transmission
of bka exists, one has belief in the valid reading transmission of the rGyud bzhi, KhChDB
[23/11-13]. One should remark here that in the opinion of Jaya Pandita Blo bzang phrin
las are the Khog dbug khyung lding pa and the sTong thun mdzes pai ja ris the work of
a rNying ma ba or a Bon po, BZPhL [181/2]. This opinion was already expressed by
Zurkharwa Lodro Gyalpo (1509-1579) in his khog dbubs, BGGP-KhB [321/6-8]. It
seems that these both were not alone in casting doubts on the authorship of these treatises.
The edition of the Cha lag bco brgyad used for this article was printed at Lhun grub steng
monastery in an earth ox year (with the sources at my disposal, I cannot identify this
year) on the order of the sDe dge king Blo gros rgyal mtshan. In the colophon it is stated
that these parts (cha lag) were composed by Yonten Gonpo. Later scholars made these
both treatises in question to an object of investigation. But being included in the edition of
dGa ldan phun gling that formed the base for the sDe dge print and moreover being widely
known and having an uninterrupted line of reading transmission (lung) both treatises were
regarded as correct and remained in the edition of the Cha lag bco brgyad. ChLCG [1090/
1-].
41. For a comparable list, see KhChDB [23/19-24/20].

A HITHERTO UNKNOWN MEDICAL HISTORY ... 169

42. (1) for the piercing of the interior / innermost essence (khog bub) of the meaning of the
complete medical science (gso dpyad) Khog phubs khyung chen sding [lding] ba, (2) for
delimiting the boundaries of the main tradition (gzhung) - Sa bcad [dpyad] stag mo rngam
stags [thabs], (3) for untying the garland of difficulties of the tantra Ti kha [tikka] mun
gsel sgron me, (4) for refuting opponents in debate - rTsod bzlog gegs gsel khor lo, (5)
for clearly explaining the bShad rgyud - Grel pa bum chung gsal sgron, (6) for
understanding the bShad rgyud - sTong thun mdzes [pai] sa ja rigs [ris], (7) for dispelling
the darkness of ignorance - Lag len dmar khrid yig chung, (8) for an oral transmission of
condensed instructions - Med thabs med pa rnams gsum, (9) as a supplement of personal
advice - Yang sbas gab pa bco brgyad, (10) for separately hiding the precious - Khyad par
zab pa nas [rnam] pa su [gsum], (11) for clearing (the rest is illegible) brDa sprod sde
tshan rnam lnga, (12) for commenting on other and particular issues - mKhas khyad ngo
mtshar bzhi sprugs, (13) for expounded the medical therapies in short sequences - rGyud
chung bdud rtsi snying po, (14) because of the wish to satisfy those with less intellectual
capabilities - gSo dpyad mu tig phreng mdzes, (15) for an easy understanding of newly
learned facts for students sKor mtshoms stong thung bcu gcig, (16) for completely
removing thor bu diseases - Kha thor rin chen spung pa, (17) for putting up the ornament
of beauty - Phan bya sngags bum dkar po.
Cf. KhB [277/12-278/2], Taube 1981: 39.
43. dang po bkai ngoo [ngo bo] ni / sangs rgyas bcom ldan das kyi bdag rkyen la byung bai
rnams dkar gyi chos thamd [thams cad] dul byai blo dang tsham [mtsham] pai theg pa
o / [20a/3-4].
44. gnyis pa mtshan nyid ni / rgyud bla ma las / gang bzhig don ldan chos dang nyer brel
zhing / khams gsum kun nas nyon mongs spong byed gsungs / zhi bai phan yton [yon tan]
ston par byed pa de / di ni drang srong gsungs yin log pa gzhan / ceso [ces so] / [20a/45]
45. brgyad stong pa ltu i [lta bui] / ston pai zhal nas / dul ba nye ba khor gyi sdus gcig /
mdo sde kun dga bos bsdus gcig / mngon pa od srungs gi [gis] bsdus gcig / di skad bdag
gi [gis] thos pai dus gcig na dge slong gcig / bar du smra ba khod gcig / mthar bcom ldan
das kyis gsungs pa la mngon par brjod do zhes bsdus gcig ces gnang ba byin pa las
brtsams te bkai tshams [mtshams] sbyor rnams so [20b/1-4]. For this rendering I made
a few changes. The phrase mngon par brjod seems to me a mistake. One should read:
mngon par dga.
46. KhChDB [14/14-16].
47. dang po skui [skus] byin gyis brlabs pa yin / ton [ston] pai [pas] phyag kun tu bzang poi
spyi bor bzhag nas / rang stags [rtags] kyi spyod pa ston pai mdo sngags pa ltu [lta bu]
[21b/4-5]. This is obviously an illusion to a text that I could not identify until now. Lodro
Gyalpo and Sangye Gyatso both speak of the Kun tu bzang poi spyod pa ston pa and Kun
tu bzang po rang rtags spyod pa ston pai mdo respectively, although one should note that
they state that it is bka ma blessed by the mind, BGGP-KhB [140/19], KhB [253/2].
They exemplify this kind of bka ma by the mDo sde sa bcu pa, BGGP-KhB [140/18], Sa
bcu pai mdo KhB [253/1].
48. gsung gi byinlabs [byin rlabs] pa ni / ston pai [pas] byinlabs [byin gyi rlabs] kyi ri dang
shing dang rnga la sogs pa las chos kyi sgra byung ba te / pha rol tu phyin pa rgya cher
sbyang pa las / bde ??ags [gshegs] dgaldan [dga ldan?] rin po che / ston pa dei [des]
byin slabs [rlabs] kyis ri dang rdeu shing bu dang / rnga o [bo] che dang dpag bsam
shing / padmo las ni byung bai sgra / rgyal bai byinlabs [byin gyis rlabs] phyir bka /
ceso [ces so] / [20b/5-21a/2]. Seemingly Tsomed Khenchen does not refer to a text of this
category, if this rendering is correct. Lodro Gyalpo names as an example the Ma skyes
dgrai gyor pa gsal bai mdo, BGGP-KhB [140/19]. Sangye Gyatso does the same, KhB
[253/2].
49. thugs kyi [kyis] byinlabs [byin rlabs] pa ni / ston pa sangs rgyas nang [snang?] thamd
[thams cad] zhi bai tinge [ting nge] dzin la stor [bstar?] zha [ba?] nas / drang srong

170 TIBET JOURNAL

gnyis la zhu ba dang shad [bshad] par rtobs [stobs] rtsal bai dpal ldan rgyud bzhi ltu [lta
bu] bo / [21a/2-3].
50. BGGP-KhB [131/9-], the bdag rkyen categories, BGGP-KhB [140/15-], KhB [250/19253/12], the bdag rkyen categories, KhB [252/17-253/12]. It seems that Sangye Gyatso
partly modelled this particular passage on Lodro Gyalpo. He does, however, employ six
kinds of blessings.
51. Perhaps this might be interpreted as being closely affiliated to the rNying ma pa view in
this regard as it is found for instance in the work entitled gSang bdag zhal lung by sMin
gling lo chen Chos dpal rgya mtsho (1654-1718). Cf., The Tibetan & Himalayan Digital
Library, under http://iris.lib.virginia.edu/tibet/collections/literature/shechen/texts/
52. KhChDB [15/4-]. Cf. also ChLCG [159/11].
53. Kempa Tsewang and Sangye Gyatso give three categories only, namely definition (mtshan
nyid), etymology (nges tshig) and division (dbye ba), KPTshB I [17/12-], KhB [253/13-].
54. Unfortunately at the time of writing I had no access to the books of Jong Cheol Lee on
Vasubandhu and his work Vyakhyayukti. The citation of Tsomed Khenchen might be
tentatively interpreted as: (Treatises) repair (chos) enemies (of) all defilements. They
save one from (the fear of taking) bad rebirths (and of) the samsara. Because (of these
both) qualities (of) repairing (chos) and saving (skyob), (they) are called repaired (bcos)
teachings (bstan). These both (qualities) do not exist in other tradition.nyoongs [nyon
mongs] dgra rnams ma lus choms [chos] pa dang / ngan groi srid las skyobs pa gang
yin pa / chos skyobs yoen [yon tan] phyir na bstan bcos zhes / gnyis po di dag gzhan gyis
[gyi] lugs la med, [21a/5]. A citation of the same passage that is similiar can be found in the
khog bugs of Sangye Gyatso who devotes a chapter on this, KhB [263/15-]. It said to be
from the fifth chapter, KhB [264/15-265/4].
55. dgos pa ni arya de bas / mdzes mos [moi?] bya ba lang [langs] ba dang / thor bsdus zab
bkrol nyam [nyams] pa gso / zheso [zhes so] [21b/2].
56. gang zhag [zhig] rgyal ba ston pa ba bzhag [zhig] gis / dbang byas rnam yang [g.yeng]
med yid can gyi [gyis] shad [bshad] / thar pa thob pai lam dang rje [rjes] mthun pa / de
ni drang srong gsungs zhin [bzhin] spyi boi [bos] blangs [21b/2]. Cf. also KhB [253/17],
KPTshB I [17/16-17].
57. don med log ldog don ldan dang / thos cod [rtsod] sgrubs pa lhur len dang / ngan g.yo ce
[brtse] bral bsdul [sdug bsngul] spongs / bstan bcos grub gsum du bod [21b/4]. Cf., KhB
[266/7-].
58. Cf. KhB [266/4-]. The Khog dbug khyung chen lding ba gives a different scheme. It says
that there are two kinds of treatises one based on authentic words of Buddha (bka) and
the other not based on them. Those that are based on bka are treatises that (1) release
reading transmission and (2) gather reading transmission. Treatises that are not based on
bka are threefold: with truth, without truth and with misleading truth. The ones with
truth have four subdivision: treatises that stress (a) practice, (b) disputation, (c) prosody
and (d) benefit, KhChDB [14/16-15/4]
59. The vows of liberation, Bodhisattva and secret mantra, KhB [441/10-].
60. dgos pa yin te / klu sgrubs kyis / rigs pa glegs bam las blangs shing / bla mai nang nas
ma bslabs na / mang poi nang nas de mi mdzes / ngang pai nang na chu skyar bzhin /
ceso [ces so] [22a/2-3]. A similar citation is found in the khog bugs of Sangye Gyatso. It
is said to be drawn from the treatise Shes rab sdong bu that is in the tradition of Nagarjuna.
KhB [ 401/6-9].
61. yan lag drug dang ldan pas char tshul bzhii ched / byung tshul lo rgyus kyi yan lag chu
rgyun gsang la thug pa ltu [lta bu] / bsdus don pa bcad kyi ylag [yan lag] stag gi chong
pa ltu [lta bu] / tsham [mtshams] sbyor skabs sdeb kyis ylag [yan lag] stan [gtan] pa
mkhas pa ltu [lta bu] / grel pa gru [bru] gnon gyis [gyi] ylag [yan lag] rgyu (??) sbal
ltur gros ltu [lta bu] / brgal lan bcod pai ylag [yan lag] dpa boi ral gri lta bu / zab grol
ltag gi ylag [yan lag] long ba mig byed ltu [lta bu] [22a/3-22b/1].

A HITHERTO UNKNOWN MEDICAL HISTORY ... 171

62. One should note that these modes are identical with titles of works written by Cher rje
Zhing ston Thugs rje khri od except the first one. Cher rje Zhing ston Thugs rje khri od
is said to have composed several treatises like (1) dKa tshoms gegs sel gnam lcags khor
lo, (2) Tshig don zhib rgyas mu tig phreng ba rgyas bsdus gnyis, (3) Lag len dmar khrid
rgan mo mdzub tshugs kyi tshul du chad pa bdud rtsi thigs pa for the sake of Zhang ston
dul ba of sKyid smad khol ma, KhB [178/12-], BGGP-KhB [303/2-]. Cf. Taube 1981: 65,
n.243.
63. blob [slob] bu gnod kyi skyon gsum ni / ched du mi byed pa kha sbubs pa lta bu / nan tan
bur ba zhabs brdol ltu [lta bu] / log pai dun dug can ltu [lta bu] spang te [22b/4-5]. Cf.
KhChDB [3/12-].
Primary sources
BZPhL
Blo bzang phrin las. Collected Works of Jaya-Pandita Blo-bzang-hphrin-las. Reproduced by
Lokesh Chandra from the Collection of Prof. Raghuvira. New Delhi: 1981. 5 vols.
ChLCG
Yuthok Yonten Gonpo (g.Yu thog Yon tan mgon po). Cha lag bco brgyad. Lanzhou: Gansu
Peoples Publishing House, 1999. 2 vols.
BGGP-KhB
Zurkharwa Lodro Gyalpo (Zur mkhar ba Blo gros rgyal po). Shes bya spyii khog dbub. (=
Gang dag byang chub sems dpai spyad pa spyod par dod pai sman pa rnams kyi mi shes
su mi rung bai phyi nang gzhan gsum gyis rnam bzhag shes bya spyii khog dbub pa gtam pa
med pai mchod sbyin gyi sgo phar yangs po.). Chengdu: Sichuan Peoples Publishing House,
2001.
KhB
Sangye Gyatso (Sangs rgyas rgya mtsho). dPal ldan gso ba rig pai khog bugs legs bshad
baiduryai me long drang srong dgyes pai dga ston bzhugs so. (=gSo rig sman gyi khog
bugs). Gansu: Peoples Publishing House, 1982.
KhChDB
Yuthok Yonten Gonpo (g.Yu thog Yon tan mgon po). Khog dbug khyung chen lding ba. In
Yuthok mgon po. Cha lag bco brgyad. 1-33.
KhPGT
Chandra, Lokesh 1961. mKhas-pahi-dgah-ston of Dpah-bo-gtsug-lag (also known as Lhobrag-chos-hbyung). New Delhi: International Academy of Indian Culture: 1961. vol.1-3.
KPTshB
Kempa Tsewang (sKyem pa tshe dbang). rGyud bzhii grel. Dharamsala: Tibetan Medical &
Astrological Institute. 3 vols.
LCh
Las chen Kun dga rgyal mtshan. bKa gdams kyi rnam par thar pa bka gdams chos byung
gsal bai sgron me. A detailed account of the spread of the Kadampa sect in Tibet. New Delhi:
1972. 2 vols.
VNg
Sangye Gyatso (Sangs rgyas rgya mtsho). gSo ba rig pai bstan bcos sman blai dgongs rgyan
rgyud bzhii gsal byed bai durya sngon poi malli ka zhes bya ba bzhugs so. Dharamsala:
Tibetan Medical & Astrological Institute, 1994. 2 vols.
Secondary sources
Jampa Thinley (Byams pa phrin las) 2000. Gangs ljongs gso rig bstan pai nyin byed rim
byon gyi rnam thar phyogs bsgrigs. Beijing: Peoples Publishing House,
Lhamo Kyab (Lha mo skyabs) 1997. Bod lugs phyi bcos gso rig las gshags bcos skor gleng
ba. In Bod ljongs zhib jug 1: 90-98
Beckwith, Christopher W. 1979. The Introduction of Greek Medicine into Tibet in the Seventh
and Eighth Centuries. In Journal of the American Oriental Society 99.2: 297-313.

172 TIBET JOURNAL

Samten (bSam gtan) 1992. Bod kyi gso ba rig pai byung phel brjod pa. In Bod ljongs zhib jug
1: 87-99
Schaeffer, Kurtis R. 2003. Textual Scholarship, Medical Tradition, and Mahayana Buddhist
Ideals in Tibet. In Journal of Indian Philosophy. 31: 621-641.
Taube, Manfred 1981. Beitrge zur Geschichte der medizinischen Literatur Tibets. Sankt
Augustin: VGH Wissenschaftsverlag,

Book Reviews

Mahayanasutralamkara, The Universal Vehicle Discourse Literature, edited

by Prof. Robert Thurman, American Institute of Buddhist Studies &
University of Columbia Press, 2004, 368pp
The Universal Vehicle Discourse Literature is a translation of Asangas famous masterpiece,
Mahayana Sutralamkara as revealed to the great Indian acarya by bodhisattva Maitreya. Much
labour, hard work, dedication and scholarly research for almost three decades by Prof. Robert
Thurman, Lobsang Jamspal and their team have gone into producing this volume. A comparative
appraisal of Sanskrit, Tibetan, Mongolian and Chinese renditions lends an air of authority to the
present renderings of the texts. Prof. Thurman duly acknowledges his debt to earlier translators
like Sylvan Levi and others. Adherence to Vasubandhus Bhasya adds further credibility to the
painstaking efforts of the team. Arya-sang or Asanga as he is generally called lived from 294-376
AD and his work is included in the Tanjur compendium. Extreme self mortification and
extraordinary penance had brought to him a vision of the celestial bodhisattva from Tusita,
resulting in the transmission of the great text to Asanga. A great Brahmanical scholar turned
Buddhist Asanga had felt the need for a new synthesis of his erstwhile cultural foundations and
beliefs with the tenets of his newer acquisitions of Mahayana. The social and religious milieu of
his times provided ample scope for the fulfillment of this aim.
There is something to ponder about the translation of the title of the book. Alamkara has
been rendered as literature instead of the commonly known ornament. The explanation for
this (p.XIII), though innovative, looks rather far-fetched. The occasional use of pronoun she
for a bodhisattva in place of the often used he is also beyond comprehension.
However, the beauty of the present translation lies in the simplicity of its diction. Subtle
concepts and abstruse logic have been rendered into intelligible, easy flowing sentences without
sacrificing accuracy. This makes it a handy tool even for the lay reader to understand the
intricacies of the Universal Vehicle. At the same time, it provides a mine of information for the
researchers and the scholarly tribe. The footnotes are an ample guarantee for it. Quoting standard
and well-known authorities, extensive references to Sthiromati, Levi, Obermann and comparative
references to renditions of different languages to provide the enlightened reader with a vast and
variegated canvas to feast his eyes on. Adherence to an original, great commentators bhasya
always helped because his elucidation of terms, words and phrases are total and down to earth.
This approach seems to have aided the translators in explaining the text in such a readable style.
Every word and phrase has been elucidated and nothing left to guess work. Explanations have
also been offered to clarify why a particular rendition of a phrase or word has been preferred
which speaks volumes for the analytical acumen of Prof. Thurman and his team.
A copious and comprehensive introduction, a bibliography and a detailed index add to the
value of the book. As the founding corner stone of Asian Institute of Buddhist Studies (AIBS)
publications venture, the reader hopes for many more gems of Buddhist scriptures to be available
in the future from AIBS. A delectable volume like this deserves a place in the shelf of every
scholar of Tibetan religious literature.
Prof. Parmananda Sharma

174 TIBET JOURNAL

Britain and Tibet 1765-1947: A select annotated bibliography of British

relations with Tibet and the Himalayan states including Nepal, Sikkim and
Bhutan. Revised and updated to 2003. Julie G Marshall. With a Foreword
by Alastair Lamb RoutledgeCurzon, London/New York, 2005 ISBN 0 415
33647 3 Hardback; pp. 607, xxvi.
This work is a revised edition of the authors earlier monograph entitled Britain and Tibet 17651947: the background to the Indo-China border dispute. A select annotated bibliography of
printed material in European languages, which was published in 1977 by La Trobe University
Library (Melbourne). That earlier soft-cover edition took some effort to obtain but came to be
treasured by specialists, and the appearance of a substantially revised and updated hardback
version by a major publisher is welcome news indeed! A new edition is more than justified by the
considerable amount of scholarship in the field during the last three decades, the range of which
is indicated by the inclusion here of 4,020 relevant works published up to 2003, where the first
incarnation of this work recorded 2,874 titles published up to 1974.
Britain and Tibet begins with a Foreword by Alastair Lamb, the greatest authority on the
subject, which contextualises the material that follows. In addition to author and subject indexes,
and a list of sources consulted, that material is organised in 16 chapters, mostly pertaining to
particular regions and periods, although the Younghusband Mission to Lhasa in 1903-04 has
generated sufficient comment to justify a chapter to itself. Each chapter contains a number of
subject headings, many of which are further broken down into sub-headings. These organising
principles might not have succeeded in less skilled hands, but as users of the earlier edition will
testify, Marshall displays considerable knowledge of the material her bibliography records. This
is clear from her annotations, which are generally precise, informed, and often prescient, and her
classifications are consequently effective and lead the reader not only to the desired works but
to illuminating related material. The lay-out is exceptionally clear (a credit to the publisher),
with around seven or eight entries to the page, and it is almost impossible to avoid glancing over
the open pages and ranging beyond; a quick search soon turns into a much longer, but always
informative diversion.
Although significant works in European languages are included, the emphasis is on material in
English. Reviews of books are noted with the entries and in addition to popular and academic
monographs it records academic essays and theses at Masters and Doctoral level, official and
military publications, and articles from an enormous range of journals and magazines. The
reviewer can personally testify that some are so obscure they will take the reader years to track
down! Fosco Marainis poetic Secret Tibet is not listed, although the work of his better-known
travelling companion Giuseppi Tucci appears, but such omissions seem few and far between.
The author has made a vital contribution to the field, a study of which will greatly expand the
source base of any scholar and, as Lamb observes in the Foreword; We have here something far
more than a piece of dry librarianship: it is in its own right a scholarly study of the highest
quality. No serious scholar of modern Tibet, no library or bibliophile with an interest in the
region can afford to be without it, it is quite simply an essential work of reference.
Alex McKay

Bernstorff, Dagmar and Hubertus von Welck (eds.). 2004. Exile as

Challenge: The Tibetan Diaspora. New Delhi: Orient Longman.
Butler, Alex. 2003. Feminism, Nationalism and Exiled Tibetan Women. New
Delhi: Kali for Women.
The following review covers two recent books on Tibetan exiles. Exile as Challenge, a collection
of essays written by Tibetans and non-Tibetans, is an English-version, expanded edition of Tibet

BOOK REVIEWS 175

im Exil (Baden-Baden 2002). The essays were compiled and edited by two individuals who are
active in the Friedrich Naumann Foundation, the German Foundation for Liberal Policy, which
has played an instrumental role in developing democratic structures in the exile government. An
overview of that organizations work among exiles is provided in the final chapter of the book.
Most of the other essays pertain to various aspects of life in exile, with a special (but not
exclusive) focus on institutions. The volume commences with a brief introduction by the editors,
after which the essays are divided into three sections: Historical and Political Framework;
Tibetan Society in Exile; and Planning the Return to Tibet. In the interest of brevity I will refrain
from commenting on all the contributions. By no means does this diminish the importance of
those essays that do not receive attention in this review.
In the introduction Bernstorff and von Welck, the editors of the volume, outline three
remarkable feats achieved by the Tibetan exile community in South Asia: economic selfsufficiency, a school system that has fostered nearly universal literacy, and democratization of
the exile administration. The inclusion of the first of these is a strong hint that the editors did not
apply a rigorous critical approach to their topic. Economic self-sufficiency as a remarkable
feat is somewhat suspect given the fact that the Tibetan government-in-exile is heavily subsidized
by foreign organizations, most (all?) Tibetan NGOs would cease to function without foreign
support, and scores of Tibetan families still rely on sponsors to pay the school fees for their
children. The editors lack of background knowledge on Tibetan exiles is highlighted when they
state that their goal is to fill the gap in research on Tibetans in exile because, There is
comparatively little systematic research on the Tibetan community in exile. Sociological enquiries
date back to the 1960s, but almost ceased in the 1970s (p.2). To the contrary, scholarly
publications on the exiles blossomed during the 1980s and 1990s (e.g., Novak 1984; Saklani
1984; Forbes 1989; Frer-Haimendorf 1989; Havnevik 1989; Subbha 1990; Klieger 1992; Korom
1997 to cite just a few!), and continue to develop in topic matter, disciplinary perspectives,
and theoretical orientations (e.g. Dahl 2002). Unfortunately the editors seem oblivious to many
seminal works on Tibetan exiles.
The first section of the book, Historical and Political Framework, contains essays by Michael
von Brck (Tibet, the Hidden Country), Gerald Schmitz (Tibets Position in International
Law), Gyaneshwar Chaturvedi (Indian Visions), Joachim Glaubitz (Chinese Views), Victor Chan
(A Tale of Two Chinese Cities), and an interview with the Dalai Lama by Dagmar Bernsdorff and
Hubertus von Welck.
Michael von Brck makes a valiant attempt to summarize 1300 years of Tibetan history in a
brief essay, the presumed intent being to set the stage for the rest of the volume by showing that
Tibetans had developed indigenous administrative systems prior to those formed in exile.
Gyaneshwar Chaturvedis contribution provides an overview of the decisions made by Nehru
and others that had a direct affect on events in Tibet during the 1940s and 1950s. Joachim
Glaubitzs contribution on Chinese views is a disappointment. Instead of drawing from Chinese
writings on Tibet which are abundant he rehashes secondary Western sources on Tibetan
history. On one hand this makes the article redundant, since von Brck already provided the
historical overview. On the other hand, with the exception of one brief reference to Beijing
Review, Glaubitzs article contains nothing at all that can be characterized as Chinese views
despite the fact that the PRCs official perspective on Tibet can be found in any number of
propaganda publications. Furthermore, the author fails to acknowledge the proliferation of
recent academic writings that analyze Chinese official and popular perceptions of Tibetans and
other ethnic groups (e.g., Gladney 1994; Harrell 1995; Schein 1997; Heberer 2001). In contrast,
Victor Chans brief contribution tells us far more about the complexities of Chinese views than
we find in the lengthier Glaubitz article. In his poignant essay Chan relates the reaction a friend
and classmate from Hong Kong had when he called to arrange a meeting. When the friend heard
that Chan was writing a book about the Dalai Lama, he curtly instructed Chan to never contact
him again. The issue of Tibet is so provocative, and so politically sensitive, that some people
would pretend it doesnt exist rather than risk their livelihood by discussing Tibet, or consorting
with those who are actively engage in research on Tibet.

176 TIBET JOURNAL

The second part of the book, Tibetan Society in Exile, contains essays by Tsewang Phuntso
(Government in Exile), Tsering Tsomo (Parliament in Exile), Thubten Samphel (Virtual Tibet:
The Media), Dawa Norbu (The Settlements: Participation and Integration), Sherab Gyatso (Of
Monks and Monasteries), Gyaltsen Gyaltag (Exiled Tibetans in Europe and North America),
Tsepak Rigzen (The Tibetan Schools fo the Diaspora), Jetsun Pema (Caring for the Weakest:
The Childrens Villages), Dagmar Bernstorff (Vibrant Arts), Maura Moynihan (Tibetan Refugees
in Nepal), Tsering Norzom Thonsur (Women: Emancipation in Exile), Karma Lekshe Tsomo
(Tibetan Nuns: New Roles and Possibilities), and Jrgen C. Aschoff (The Spread of Tibetan
Medicine).
The first two articles in this section are written by members of the exile government and not
surprisingly represent more or less official perspectives and consequently are similar in
tone to informational brochures. This is not a negative point, because they provide succinct
summaries on how the current government structures came into being and how they operate.
The third article by Thubten Samphel is a useful historical review of Tibetan newspapers, the
first of which originated in India and were important means for spreading news about events
such as the Younghusband Expedition. The author then provides a succinct overview of
newspapers in exile, including details on their founders and their motivations. The 1990s witnessed
the birth of a more independent media, which the author attributes to recent arrivals from Tibet,
especially Amdo, who had a sparkling flair for writing in the exhilarating freedom of India.
Unfortunately, Mangtso, the provocative and contentious product of the Amnye Machen Institute,
is short-shifted in this article. Thubten Samphel does not provide any details about the demise
of Mangtso, which in many ways was more controversial than the forthright attacks made in the
newspaper against the ruling elite of the exile government. The author merely notes that Mangtso
led a brief but boisterous life. Certainly such an influential publication deserves more attention
in a historical review of Tibetan media.
Dawa Norbus contribution centers on the exile settlements, and serves as a vivid reminder
that there is far more to exile society than what one finds in Dharamsala. In addition to providing
a historical sketch of how the settlements came into existence, Dawa Norbu details their
administrative structures and outlines the nature of their relationships with the exile government
and various NGOs. Perhaps the most interesting part of this chapter is a brief note on the impact
that the refugees have had on their host populations, especially in their capacity as employers
for agricultural workers and carpet weavers.
One of the most interesting articles in this volume is written by Sherab Gyatso, a Westerner
who has taken ordination. Sherab Gyatso begins by providing an insiders perspective on the
structured and routine life in an exile monastery, specifically Gomang College of Drepung
Monastery in South India. The author contrasts the discipline and educational standards of
Gomang, one of the premier institutions in exile, with an unnamed monastery in Nepal where
monks have little to do beyond meeting for daily prayers. Furthermore, the author identifies a
major attitudinal shift that has occurred in exile, namely, that monks who return to lay life are no
longer considered social pariahs. Sherab Gyatsos frank and illuminating look at monasticism
provides considerable insight into social aspects of organized religion in exile.
Gyaltsen Gyaltags contribution on exiles in Europe and North America contains a useful
summary of successive migration waves to the USA, yet is deficient with respect to Canada.
The author refrains from acknowledging the most significant migration trend in the 1990s, being
the fact that many young Tibetans initially entered the USA on tourist visas and then skipped
to Canada once it became clear that they could obtain residence permits due to their refugee
status. This hitherto unwritten chapter on Tibetan migration is worthy of consideration by
scholars interested in Tibetan exiles.
Moynihans contribution centers on Tibetan refugees in Nepal, and concludes with some
observations about the instability of the Tibetans lives in Nepal, especially given the political
turmoil resulting from the conflict between Maoists and the government. She quotes an art
gallery owner who says, Anyone who can get to the West is trying to get out. Albeit this is no
doubt true, the major exodus of young Tibetans from Nepal to North America commenced in the

BOOK REVIEWS 177

mid-1990s before the Maoist rebellion gained much traction. The rest of Moynihans article is a
rather superficial overview that does not do justice to the dynamic nature of the communities in
Nepal, for example the depopulating of the rural settlements as the young became educated and
then moved to urban areas from where many underwent a second migration to North America.
Furthermore, the article is compromised by the fact that the author has a certain reluctance to
cite sources for any facts. For example, she states, Today official statistics show 30,000
Tibetan refugees registered with the Nepali government, but unofficial statistics put the number
as high as 100,000 (p.313). No source for these figures is cited, which is problematic given that
the Tibetan Government-in-Exile itself estimates their population in Nepal to number 13,720
individuals (Planning Council 2000:7). Furthermore, lets face it; an unofficial statistic is
nothing other than a glorified guess utterly lacking empirical validation. Citing what is in essence
a rumor (I used to hear the same figure quoted by Tibetans when I lived in Kathmandu 20 years
ago!) as if it has some form of statistical validity is not recommended for those who want to be
taken seriously. In all, this article contains far too many unreferenced statistical claims. The
editors of this volume bear responsibility for allowing such slipshod scholarship to infect the
overall quality of the book.
The final article in this section, The Spread of Tibetan Medicine, is written by Jrgen C.
Aschoff, a well-known scholar and one of the leading experts on the topic. He provides a lucid
introduction to Tibetan medicine, including a brief historical overview and a discussion of primary
and secondary sources. Only in the final summation does he address Tibetan medicine in exile.
Thus, although this is a well-written and informative article, one wonders why it was included
in this volume since it says very little about social institutions in exile.
The Third Section of the book, Planning the Return to Tibet, contains essays by Tsetan
Norbu (Rebels: The Tibetan Youth Congress), Wangpo Tethong (Between Cultures: Young
Tibetans in Europe), Eva Herzer (Tibets Future: Options for Self-Governance), Alison Reynolds
(Support for Tibet Worldwide), Samdhong Rinpoche (Education for Non-Violence), and Hubertus
von Welck (The Commitment of the Friedrich Naumann Foundation).
Despite the primary title of Tsetan Norbus article (Rebels), the tone of this contribution is
rather sedate and is not suffused with much defiance or insubordination. On the positive side,
Tsetan Norbu does shares some of his thoughts on the current political situation in exile and is
forthright in his opinions about the bureaucratic mindset and the lack of long-term vision among
the exile leadership. The article concludes with a brief interview with Kalsang Phuntsok Godrukpa,
the President of the Tibetan Youth Congress, in which he expresses opposition to the Dalai
Lamas middle path of autonomy.
Wangpo Tethongs essay is an interesting exploration of ethnic identity among Tibetan youths
in Europe. The author steers clear from the primordialists view of ethnicity (that it is innate and
unchanging) by referring to, Vague but vivid images of Tibets past that are deployed by
young Tibetans in songs, letters to editors, and articles in Tibetan youth magazines, and stating
that, The political mindset of the young Tibetans can, therefore, only be understood in the
context of the history of the Tibetan community in exile (p.412). The essay is then devoted to
a description, based in great part on first-hand observations, of youth movements in Switzerland
and elsewhere, and the forums where young Tibetans have been able to express their political
and cultural identity.
Bernstorff and von Welck are commended for compiling this volume, which is certainly a
worthwhile endeavor. However, the editors discernable dearth of knowledge about the academic
literature on Tibetan exiles is discouraging given their stated intention of filling a void in research.
In fact, there is very little original scholarship presented in the volume. Most contributions are
historical summaries of certain institutions or personal recollections of life in exile. Regardless,
the volume does contain quite a bit of valuable information written in some cases by key
members of the Tibetan exile community, and can therefore be gainfully employed for background
reference.
One significant organization that did not receive any attention in Exile as Challenge is the
Tibetan Womens Association, which is the focus of Alex Butlers book entitled Feminism,

178 TIBET JOURNAL

Nationalism and Exiled Tibetan Women. The Tibetan Womens Association (TWA) is one of the
most visible and influential organizations in the exile communities. As such, the development,
aims, and accomplishments of the TWA are a worthy topic for exploration. Butler, who has a
decade of involvement in Tibetan causes, proves to be a skillful analyst who has done justice to
the topic. This book provides a readable historical overview of the TWA: how it came into being,
how it emerged from having an internal focus to assuming a more international role, and how it
has impacted the exile community in numerous ways.
The first chapter introduces some theoretical perspectives, comments on the status of women
in pre-modern Tibet, and provides a brief history of the Tibetan exodus. The author then
ruminates on ethical issues pertaining to the researching and writing of the book. Afterwards, she
traces the historical origins of the TWA, noting that despite the organizations official
rhetoric there is only a tenuous connection between the Lhasa Patriotic Womens Association
(formed by members of the nobility in the early 1950s), demonstrations in Lhasa during March
of 1959, and the rebirth of the TWA in the 1980s. In Chapter Three Butler uses a survey
conducted by the TWA to present an overview of the organizations membership, and in Chapter
Four she describes the TWAs leadership. Chapters Five and Six are devoted to the TWAs
activities. As Butler points out, the organization transformed from one that focused on issues
pertaining to life in exile to political issues in Tibet; from an internal focus to an external focus.
Chapter Six centers on the seminal moment in the TWAs history their attempt to be included
in 1995s Fourth UN Womens Conference in Beijing. Many who are familiar with Tibetan
politics will certainly recall how Chinese authorities made disingenuous (but ultimately successful)
attempts to deny the TWA access to that conference, preferring of course that Tibetan women
be represented by a PRC delegation that could be counted on to sing the praises of the government.
In the process Beijing unwittingly shed a spotlight on human rights abuses against Tibetan
women, resulting in an unprecedented level of international support for the TWA. The final
chapter of the book is an overview of the TWAs place in Tibetan exile society, pointing out how
the organization plays both a supportive role and is instrumental in initiating some subtle yet
profound social changes.
This book provides a useful overview of the TWA, and is a commendable achievement given
the fact that Butler only spent a few months living in the exile communities. The author did an
admirable job of mining the literature emanating from exile. She also did a good job of illustrating
analytical points by integrating quotes from interviews she conducted with TWA members. In
addition, Butler proves to be a competent analyst. However, it struck this reader that analysis
was used too often as a substitute for description, perhaps a consequence of the fact that she had
little original data to work with. The result is that, for example, we are treated to a lengthy
discourse on the significance of the 1995 UN Conference on Women, yet the author failed to
interview key players about their own feelings, emotions, and strategies during this critical time
in the organizations history. Voices of the participants are noticeably lacking.
Another shortcoming of this book is that the main themes, nationalism and feminism, are not
fleshed out in sufficient detail. The author does pay homage to some of the usual suspects with
respect to theoretical contributions on nationalism (Anderson, Gellner, Hobsbawm), but then
fails to connect their ideas with Tibetan nationalism in exile. Kliegers seminal work on this topic
(1992) is completely disregarded. Feminism fares even worse. The book contains no discussion
of what feminism is, how it came about, who are the major theoreticians, and so forth. Based on
the title of the book, an unobservant reader could gain the impression that the TWA is a feminist
organization in the Western sense of feminism. It most certainly is not, as the author points out
and as members of the TWA emphatically maintain. The author could have made this book a
significant contribution to the social sciences by exploring the ways that the TWA diverges in
philosophy and practice from feminist political movements in other countries, such as in North
America and Europe. Instead, it must stand as an interesting case study that lacks substantive
connections with the theoretical literature on both nationalism and feminism.
In summary, this is a well-balanced and informative account of the TWA, an organization that
merits recognition for their social activities within the exile communities as well as their political

BOOK REVIEWS 179

activities on the worlds stage. Alex Butler deserves praise for documenting the development of
this remarkable organization, and for providing some insightful analysis on its impact. Feminism,
Nationalism and Exiled Tibetan Women is a welcome contribution to the literature on Tibetans in
exile.

References
Diehl, Keila. 2002. Echoes from Dharamsala: Music in the Life of a Tibetan Refugee Community.
Berkeley: University of California Press.
Forbes, Ann A. 1989. Settlements of Hope: An Account of Tibetan Refugees in Nepal. Cambridge,
MA: Cultural Survival.
Frer-Haimendorf, Christoph von. 1989. The Renaissance of Tibetan Civilization. New York:
Oxford University Press.
Gladney, Dru. 1994. Representing Nationality in China: Refiguring Majority/Minority Identities.
Journal of Asian Studies 53(1):92-123.
Harrell, Stevan (ed.). 1995. Cultural Encounters on Chinas Ethnic Frontiers. Seattle: University
of Washington Press.
Havnevik, Hanna. 1989. Tibetan Buddhist Nuns: History, Cultural Norms and Social Reality.
Oslo: Norwegian University Press.
Heberer, Thomas. 2001. Old Tibet a Hell on Earth? The Myth of Tibet and Tibetans in Chinese
Art and Propaganda. In Imagining Tibet: Perceptions, Projections, and Fantasies, T. Dodin
and H. Rther (eds.). Boston: Wisdom, 111-150.
Kleiger, P. Christiaan. 1992. Tibetan Nationalism: The Role of Patronage in the Accomplishment
of a National Identity. Berkeley: Folklore Institute.
Korom, Frank J. (ed.). 1997. Tibetan Culture in the Diaspora. Wien: Verlag der sterreichischen
Akademie der Wissenschaften.
Nowak, Margaret. 1984. Tibetan Refugees: Youth and the New Generation of Meaning. New
Brunswick: Rutgers University Press.
Saklani, Girija. 1984. The Uprooted Tibetans in India: A Sociological Study of Continuity and
Change. New Delhi: Cosmo.
Schein, Louisa. 1997. Gender and Internal Orientalism in China. Modern China 23(1):69-98.
Subbha, Tanka B. 1990. Flight and Adaptation: Tibetan Refugees in the Darjeeling-Sikkim
Himalaya. Dharamsala: LTWA.

The Autobiography of Jamgn Kongtrul: A Gem of Many Colors. Trans.

and annotated by Richard Barron (Chokyi Nyima). Ithaca: Snow Lion
Publications. pp. 549, xxii.
English-language students of the thought and writings of Jamgn Kongtrul Lodro Thaye (18131900) the great nineteenth century luminary of the influential ris med, or non-sectarian
movement, of Tibetan Buddhism have much to celebrate over the last ten years. A considerable
number of Jamgn Kongtruls main works and commentaries have made their way into publication
in English: foremost amongst them a growing proportion of his multi-volumed Treasury of
Knowledge (Shes bya mdzod), as well as shorter writings on mind training, mahamudra, creation
and completion, and retreat practices. Much of this appears under the Snow Lion label, who
have obviously taken this extremely worthwhile task to hand.
Something that has, however, by and large been missing (with the possible exception of
sections of Ngawang Zangpos Sacred Ground, also from Snow Lion) is a comprehensive insight
into the life of this most important Buddhist thinker himself. It was therefore with some
excitement that I took to reviewing Richard Barrons translation of the great teachers
autobiography.
The book comprises four main components:
A brief introduction.

180 TIBET JOURNAL

An annotated translation of Jamgon Kongtruls autobiography, A Gem of Many Colors (which
represents the larger part of the text);
A translation of Nesar Karma Tashi Chpels epitaph to Jamgon Kongtrul, The Marvellous
Gem-Like Vision;
Jamgn Kongtruls own The Mirage of Nector (an account of his past lives); and
Finally, a bibliographic appendix of Jamgon Kongtruls main works.
Of these, the vast majority of this tome is taken up by the Gem of Many Colors, and in what
follows I would like to concentrate on this. This text is itself effectively in two parts: the first
half is a systematic dream-diary maintained by the young and professionally unencumbered
Kongtrul; and the second, where his institutional obligations force him to give up his dream
diary, leaving it to describe the increasingly administrative and political world around him, as he
seeks to build up the collaborative religious networks that stood at the heart of the nineteenthcentury ris med movement.
In this last regard, it is difficult to shake off a deep sense of tragedy in Kongtruls own
understanding of his religious trajectory, from his candid depiction of the pragmatic and financial
motivations for his recognition as an incarnate (primarily associated with tax-obligations see
pp. 23-4), to the many causes he had for fearing for his own life. As he is drawn into the world
of incarnates and estates, his sense of his own religious practice fades. Kongtrul himself sums
this up in a single poignant passage:
Previously, from a young age I had leisure to write and put great stock even in whatever
dreams I had, good or bad; so up until the time I was in upper Do, I kept copious diaries, also
recording some accounts of such signs in my recitation and sadhana practice as seemed
useful. From this point on, though, I kept no records whatsoever of my dreams and so forth;
and while there were a few indications of receiving blessings (though I had in no way any ability
to develop signs of accomplishment in the various kinds of recitations and sadhanas), none
of these are clear in my memory, and I find myself deprived of anything of this nature to
relate. And besides, the greater my distractions became, the more my positive tendencies
were eclipsed and my confused ten-dencies encouraged. Because it was necessary for me to
be involved in all kinds of contamination due to articles offered to me in faith, especially
the contamination associated with deceased individuals, from this time on the clear and visionary
experiences of my earlier life became obscured; the positive signs in my dreams stopped,
[61 a] and I dreamed of numerous bad omens. Even the vigor of my experiences and
realization in meditation has suffered accordingly, and I find that I am quite dismayed at
having had to engage so recklessly in such negative and contaminating activities. (2003: 77)
For those interested in matters ritual and religious (and I cant imagine any other reason for
delving into this book), the core autobiography presents a treasure trove of nuanced allusion and
insight into three principal aspects of Jamgon Kongtruls life: his early endeavours to catalogue,
comprehend and gain mastery over his dreamworld (a key element of the completion stage yogas
and the practices of dzogchen); the quotidian interactions and gift exchanges between those
religious specialists enganged in terma discovery in Eastern Tibet, and; particularly in the latter
half of the text, Kongtruls growing concern with the physical and political dangers that
increasingly dog his life, and those around him. This last may appear somewhat mundane, but
for Kongtrul it is a cause for an ever more careful analysis of auspicious and inauspicious signs
in the landscape and weather around him, and the amplified performance of expelling and
purificatory rituals. In this respect, the passage of Kongtruls biography passes, over the course
of his life, from a profound inner concern (primarily with his dream life) to a growing outer
concern, although both of these remain highly ritualized in tone.
This is all well and good, and a substantial contribution it makes, too. However, those readers
hoping for an effective introduction to the great man and his works through this biographical
material would be advised to look elsewhere. Perhaps by virtue of the very quantity of basic
translated material that the author has sought to include in this volume, little or no space is left
for the kind of helpful preamble necessary for what is often difficult and obscure material. While

BOOK REVIEWS 181

the text is annotated and this is helpful, much knowledge is taken for granted and the translators
introduction is a mere six-pages long. In this regard, readers seeking to take on this work would
be well-advised to follow Barrons own advice and arm themselves in advance with a careful
reading of E. Gene Smiths excellent article Jam mgon Kong sprul and the Non-Sectarian
Movement, from his indispensable collection, Among Tibetan Texts.
In most cases, this would make The Autobiography of Jamgon Kongtrul effectively a source
translation for those who have neither the time nor the capacities to read the text in its original
Tibetan. That being so, however, it is more than a shame that the translator chose both to
circumvent the standard systems of transliteration for the multitude of names and terms involved
in the book, and to dispense with an appendix of transliterations. In this sense, there is a danger
that the translation becomes neither one thing nor the other.
Martin A. Mills

The Practice of Dzogchen by Longchen Rabjam, Introduced, translated

and annotated by Tulku Thondup. Snow Lion Publications, Ithaca, New
York, Boulder, Colorado, 2002, xi + 466 pages. $34.95, hardcover, ISBN
1-55939-179-0
Snow Lion produced yet another important publication on the philosophy of the Great Perfection
(Dzogs-pa chen-po) for Buddhist practitioners and researchers of Tibetan Buddhism. The Practice
of Dzogchen is, in its own right, an ambitious work of contemporary Tibetan scholarship with
over one hundred original sources consulted in its making. It is divided into two parts. Part I
includes an erudite introduction by Vajracarya Tulku Thondup inspired by Klong chen Rab
byams pas syncretic Grub mtha mdzod. Thondup, an established Tibetan luminary and prolific
writer, dedicates 88 pages of extensive quotations from sutras and tantras to the doxographical
task of situating the Atiyoga teachings as the pinnacle of the three inner tantras and explicating
on the range of Dzogchen thought according to its three internal philosophical divisions, i.e.,
Sems sde, Klong sde, and Man ngag sde. Here as in Part II, Thondup carefully selects quotations
from original sources to construct a polysemic hermaneutic where the reader can reflect on the
Buddhist teachings as the basis for Dzogchen philosophy and assess the Dzogchen view as the
condensed essence of all Mahayana teachings. This is followed by a cursory historical discussion
(pgs 89-122) that alludes to some of the controversies concerning the Great Perfection and other
Buddhist philosophies, such as the Mind-Only School and Madhyamaka. By relying exclusively
on Buddhist sources and interpretations, Thondup tackles what appears to have been a complex
encounter of cross-fertilization between the Bon and Nyingma Dzogchen lineages. He proceeds
by cautiously raising philosophically challenging similarities between Hashang Mahayanas
non-gradualist views on enlightenment and the Great Perfections position on primordial
liberation. Part I finishes with inspirational excerpts from the lives of Nyingma Dzogchen
Masters (pgs 123-144) followed by a hagiography of Klong chen Rab byams pa (pgs 145-188)
which draws information from more than a dozen Tibetan sources1 and contains concise reference
to his scholarly output and several instructional quotations from his writings.
Part II is in three main sections and thirteen subsections. It contains an anthology of eclectic
writings on Atiyoga by one of Tibets greatest thinkers, Klong chen Rab byams pa (13081363). A summary of the sections (pgs 191-202) prefaces a good number of referenced and fluid
translations by Thondup from Klong chen Rab byams pas large corpus of writings.2 These
translations are thematically arranged by Thondup according to the View (Basis) (pgs 203-280),
Path (pgs 281-404) and Result (pgs 407-420) of Dzogchen. The View and the Path sections are
equally balanced with corresponding insights and didactic clarifications while the last section on
the Result, much shorter in length, offers a general doctrinal reading of the attainment of the fruit
in terms of the Buddha-Bodies and corresponding Wisdoms in Mahayana, Tantra and Dzog pa
chen po. For descriptions on the accomplishment of the rainbow body the interested reader

182 TIBET JOURNAL

must search elsewhere, such as in Thondups introduction. Supplementing the section on the
View (Basis), the Practice of Dzogchen concludes with a short Appendix (pgs 421-425) on the
subject of karma from the Commentary on the mKhas pai tshul la jug pai msgoi mchan by
Khenpo Nus ldan of Khatog monastery. The Practice of Dzogchen is an informative introduction
to Klong chen Rab byams pas thought, life, and writings, and may prove indispensable to any
serious study of Dzogchen philosophy, especially as it is currently preserved and propagated
by a recognized master of the Nyingma tradition.

Notes
1. Some of which include: gTer byung rin po chei lo rgyus; Zhus lan bdud rtsi gser phreng; Lo
rgyus (of sNying Thig); Ngal gso skor gsum gyi spyi don legs bshad; Blo gsal ri bong gi rtogs
pa brjod pai dris lan lhai rnga bo chei lta bui gtam; sNga gyur rdo rje theg pa gtso bor
gyur pai sgrub brgyud shing rta brgyad kyi byung ba brjod pai gtam mdor bsdus legs bshad
padma dkar poi rdzing bu; De bzhin gshegs pas legs par gsung pai gsung rab rgya mtshoi
snying por gyur pa rig pa dzin pai sde snod dam pa snga gyur rgyud bum rin po chei rtogs
pa brjod pa dzam gling tha gru khyab pai rgyan. Reference works mentioned in the footnote
to the section on the Life of Kunkhyen Longchen Rabjam (pg. 145) abbreviated TRT, TTD,
ZDO, KNRT, NLC are not listed in the Bibliography of Works Cited (pgs 426-440).
2. Works translated by Tulku Thondup include: excerpts from the first four chapters of the
gSang ba bla na med pa od gsal rdo rjei gnas gsum gsal bar byed pa tshig don rin po chei
mdzod; abridged translations of the first section of the fourth chapter, the first and last section
of the eleventh chapter, and of the tenth chapter of the rDzogs pa chen po sems nyid ngal
sgoi grel ba shing rta chen po; an abridged translation of the rDzogs pa chen po sems nyid
ngal sgoi gnas gsum dge ba gsum gyi don khrid byang chub lam bzang; complete translations
of the rDzogs pa chen po sems nyid rang grol and the rDzogs pa chen po sem nyid rang grol
gyi lam rim snying poi don khrid; an abridged translation of the twenty-first chapter of the
Theg pa chen poi man ngag gi bstan bcos yid bzhin rin po chei mdzod kyi grel ba pema dkar
po; excerpts from the Chos dbying rin po chei mdzod, gNyis kai yang yig nam mkha klong
chen, and Thod rgal gyi yang yig nam mkha klong gsal.
Georgios Halkias

The Life of Buddhism, edited by Frank E. Renolds and Jason A. Carbine.

Motilal Banarsidass Publishers, Delhi. PP. X+ 230. Rs. 225
There is a rich corpus of literature on theoretical aspects of Buddhism while there are not many
books that describe how the Buddhist belief system is being practiced in numerous countries.
The book under review eminently fills the gap. A reader is taken on a tour of several Asian
countries where Buddhism is a practicing creed. One is made familiar with temple architecture
and iconography, consecration of sacred objects, monastic life and rituals, meditative practices,
devotional chants and pilgrimages.
In a scintillating introduction the editors explain the basic postulates of Buddhism- four noble
truths, middle path, liberation, arhathood in Hinayana School of Buddhism, the concept of
Bodhisattva in Mahayana stream and other related concepts. They recount the rise and fall of
Buddhism in India and its spread in several Asian countries where it still holds sway.
Buddhist temples and monasteries have been the hub of practicing Buddhist creed. They are
centers of sacred power and authority providing blessing and protection. Secondly, devotees
earn merit there to attain liberation. James Bisset Pratt examines the temple complex at Kyoto,
Japan with its shrines and altars, museum of Japanese paintings and several other things. Donald
K. Swearer describes image consecration in Thailand. The consecration ceremony involves
preaching, recitation of important Buddhist texts and presentation of gifts to the sangha.
Juliane Schobers treatment of state rituals and ceremonies in Myanmar deserves special
treatment. It clinically lays bare the mechanism adopted by the army ruling set up to acquire

BOOK REVIEWS 183

legitimacy through the Tooth Relic. In 1988 national constitution was abolished and the army
took the reins of power. People favoured a democratic multi party system in general elections in
1990. The army did not like the verdict and clamped its authoritarian rule. This created a crisis
of legitimacy. The army rulers took recourse to traditional religious means of legitimation.
Schober gives a graphic account of the Tooth Relic ceremony held in 1994. Buddhist symbols
have an important place in history and culture of Myanmar. The Tooth Relic ceremony was
tactically used to exploit peoples faith in the Buddhist creed.
A tooth supposed to be of Gautama the Buddha, kept in China, was brought to Myanmar
with great fanfare. The ceremony was organized at a grand scale that lasted for six weeks.
Government officials dominated the television, print and photo coverage of the ritual. This
shows how a religious relic can be used to lend legitimacy to the authority.
The ordination of monks occupies an important place in a Buddhist community. It denotes
monastic commitment and puts one in the organization and hierarchy of the community. A monk
is normally supposed to take the vows of celibacy in life. However, this is not a necessity in
every Buddhist community. For instance, in Japan there is a practice of clerical marriage. Robert
E. Buswell describes the ordination performed among the Zen monastics in Korea. The question
of female renunciates is highly important in Buddhism from the gender point of view. There is no
discrimination in Buddhism on grounds of caste or gender. Any living being, irrespective of ones
caste or gender, is capable of achieving nirvana. However, compulsions of the male dominated
society have its own pull. Even Buddha himself agreed to admit women for full ordination after
a lot of hesitation and male order of monks was rated as superior in hierarchy to female order of
nuns. Hiroko Kawanami describes the position of Buddhist nuns in Burmese society. They are
lower in the hierarchy of monastic life.
Rebecca Redwood Frenchs treatment of cosmology and law in Tibet too deserves special
attention. Jurisprudence and criminology in Tibet are very much conditioned by the Buddhist
world view. Buddhism as a belief system has cosmological dimensions. The truth in Buddhism
is related to the dynamics of structure of cosmic reality. Action of an individual, howsoever
heinous a crime it may be, is not to be considered in isolation in Tibetan society. It has to be
understood in the totality of his karma in past lives as well as the present one. Legal concepts are
to be understood in the context of illusion and reality. Worldly facts are not the ultimate in
deciding cases. Disputes arise of mental obscurations that hinder one from distinguishing
appearance from reality. While awarding punishment delusory aspect of the mental make up of
defendant is taken into view. One is not to be condemned as a gone case in all circumstances.
There is always a possibility of improvement if the environment and mental make up of one
undergoes a change with the compassionate attitude of those who have to deicide the fate of
defendant. This is illustrated by the story of a monk who was in the habit of committing petty
crimes like stealing food etc. However, he undergoes a total transformation when the headman
gives him shelter in his house and assigns the work to him.
The last piece by Philip Kapleau on the popularity being gained by the Buddhist tradition in
America also deserves special mention. People from Asian nations settled in America brought
Buddhist tradition along with them. Then Americans too are showing interest in Buddhism and
some of them have adopted it as their belief system. Kapleau describes the scene in a Zen center
in New York state. One is likely to be confused at the array of the buddha and bodhisattva
figures, chanting and the rituals. Prostration before images and making offerings to them and
confession and repentance ceremonies might look outlandish to a new comer. However, all this
has a great importance to get rid of the rigours of ego. Chanting has special importance in Zen.
It purifies and stabilizes the mind.
The book is highly informative and helps one to have a peep into the dynamics of praxis of
Buddhism. Theory is hollow without practice and practice without conceptual frame work is
superficial. The editors have selected the pieces carefully and they constitute a symbiosis of
theory and practice of Buddhism as it is lived by the people in day-to-day life.
D.R. Chaudhry

184 TIBET JOURNAL

The Power of Denial Buddhism, Purity and Gender, Bernard Faure.

Princeton University Press, New Jersey, USA., 2003. 466 PP. Price not
stated.
Oppression seems to be embedded in human history since time immemorial. The degree of its
intensity varies from time to time and from place to place but its nightmare continues to haunt
the mankind. Gender discrimination is a kind of oppression that cuts across race, ethnicity,
religious belief systems and socio-political organisations. Simone Weil hits the rail on its head
when she observes:
Among all the forms of social organization which history has to show, there are few which
appear to be really free from oppression... All of them correspond to an extremely low level of
production, so that the division of labour is pretty well unknown, except between the sexes, and
each family produces little more than its own requirements (Weil, Simone 2001:59).
The division of labour even in the primitive stages of human development underscored the
gender discrimination when man became provider for sustenance through hunting and food
gathering while woman became the recipient, looking after children and performing household
chores. This discrimination became more pronounced and oppressive with the passage of times
as the mode of production and division of labour became more sophisticated.
Before we examine Bernard Faures understanding of the gender question in Buddhism, with
special reference to Japan, it would be helpful to critically evaluate, albeit briefly, the gender
issue in major religious beliefs in the world. The Hindu way of life is among the oldest in the
world. Here the rationale behind the concept of ideal womanhood needs to be understood in its
proper perspective.
Sita and Draupadi are two towering female figures in Hindu mythology. Sita, the spouse of
Lord Ram in Ramayana, is gentle, docile and submissive. She is totally committed to her husband,
symbolising purity of the spirit as well as the body. Draupadi, the consort of five Pandavas in
Mahabharta, is aggressive, assertive and self willed. She is conscious of her rights and valiantly
fights for them. She is argumentative and her debating skill is exceptionally well developed.
Being polyandrous, she is the negation of the haloed concept of chastity.
In fair assessment, Draupati scores over Sita in many ways, yet she loses to Sita as Sita
symbolises ideal womanhood in the Indian psyche shaped by the patriarchal value system.
Blind devotion and fidelity to ones husband, good or bad, is the core of the code for woman laid
down by Manu, the Hindu law giver. While talking of the eternal duties of a man and wife,
Manu demands that Men must make their women dependent day and night ... Her father guards
her in childhood, her husband guards her in youth and her sons guard her in old age. A woman is
not fit for independence. (Doniger Wendy and Smith Brian K. 1992: 197). Draupadi does not
accept any such code and thus fail to fit into the Hindu concept of ideal womanhood.
Laws of Manu reduced the Hindu woman to perpetual servility to man in the male dominated
society. Goswami and Tulsi Dass Ram Chrit Maanas composed in medieval times has had a
powerful and lasting impact on the Hindu psyche. In this woman is clubbed with drum, savages
and animals that need to be thrashed. She becomes able (helpless) in modern times.
This is best summed by the modern Hindu poet Maithili Sharan Gupt in his well-known
poetical composition Saket where the pathetic tale of woman is that of milk in the breast and
tears in eyes. Mahadevi Verma, another modern Hindi poet, has compared woman to a cloudlet
of woes, suffused with tears.
Hindu religion is quite rich in feminine imagery and symbolism, giving pride of place to
woman in social arrangements, describing her as devi (pious woman) without whose presence
no religious ritual is said to be complete. However, the distinction between rhetoric and reality
must be kept in mind. As rightly pointed out by Ursula King, one must clearly distinguish
between the place given to woman in the world of religious imagination and that accorded to
them in the actual world of religious life. these often stand in an inverse relationship to each
other and remain poles apart (King, Ursula 1995: 16).

BOOK REVIEWS 185

The gender discrimination in India which is overwhelmingly a Hindu country can be best seen
in the treatment meted out to a girl child. The girl child is an unwanted creature in India today.
India contributes a great deal to what Amartya Sen calls missing women in Asia. Female
foeticide is common and there is a craze for male child. As per 2001 census the sex ratio in India
is pathetic 933 as compared to the world figure of 986. The sex ratio in the child population in
the age group 0-6 has come down from 945 in 1991 to 927 in 2001, indicating the increasing
genocide of the female child in this hoary land. India lags behind even countries like Pakistan and
Bangladesh in sex ratio.
Judaism is basically a patriarchal religion, with clearly defined roles for men and women. The
birth of a son is a matter of great celebration while there is a short blessing in case of a girl child.
This discrimination can be seen even in the education of children. Women do not take an active
part in the synagogue service and they are not even counted for the purpose of quorum for
worship. The discrimination in matter of divorce is appalling. Only man can divorce: women
have no such right (see Sherbok, Dan Cohn 1999: 103-105). Women are there, remarks a keen
observer of womans place in Judaism, Things female are there. But they have been inverted or
cloaked in order to be appropriate by male phallic history and mythology. (Goldenberg, Noami,
1995: 149).
The place of women in Christian can be best understood with reference to Biblical context.
The woman is presented as a weaker vessel through Eve in Paradise, easily given to temptation
and thus beguiled by the satanic serpent. In Shakespeares Hamlet woman is symbolised as
frailty. Frailty, thy name is woman, cries the Prince of Denmark in anguish as he reflects on the
perfidious role of his mother. Noami Goldberg holds male clergy responsible for erasing the
contribution of Christian women from recorded history. The appropriate role for woman was
complete submission to male. (Goldenberg, Noami, 1995: 150).
The duality of body and mind (or body and spirit, or body and soul) in the Christian theological
thought process sowed the seeds of gender discrimination in Christianity. Woman came to be
identified with matter, the body and the sensuality while man was identified with spirit, soul
and purity. This anti-feminine, anti-body, world-negating interpretation was generally accepted
without question by the Church Fathers and came to be built into Christian theology, observes
Felicity Edwards, and as body was inferior to spirit, so woman had to be submissive to man.
This became the generally accepted pattern in the west (Edwards, Felicity 1995: 180).
Islam in our times is seen by some through the prism of bearded Mullahs with Kalashnikovs
and women in black chadors, with revivalism and fundamentalism in the upswing. It is often
identified with world terrorism, especially after the massive terrorist attack on Americas symbols
of trade and military power in the year 2000. This is gross over simplification. The growth of
Islam is to be seen in the context of Arabian patriarchal tribal society where woman is no better
than chattel. Quran raised the status of woman. Female infanticide was outlawed. Woman was
granted right to contract marriage. She was granted inheritance rights and control over her dower
and property. The rights of widows and orphans were ensured. they were, in deed, revolutionary
steps in the tribal society of Arabia. A greater religious space was provided to woman by Sufism
in Islam.
Reformist like Asghar Ali Engineer are of the view that it is the patriarchal culture rather than
Islam which is responsible for the subordinate position of women in Islamic society. Quaranic
injunctions and Shariat are the product of evolutionary process of interpretation and thus not
immutable. Haideh Moghissi, a feminist from Iran, now teaching at a college of York University,
Toronto, however, does not agree with this interpretation. There are many different ways that
Islam can be adopted, observes Moghissi, but no amount of twisting and bending can reconcile
the Quaranic injunctions and instructions about womans rights and obligations with the ideas of
gender equality.. if Quaranic instructions are taken literally, Islamic individuals or societies can
not favour equal rights for women in the family or in certain areas of social life ( Moghissi,
Haideh 2000: 140). Akbar S. Ahmad, another commentator on Islam, finds the present
postmodernist phase as intrinsically hostile to Islam. How can Muslims retain their central
Islamic features family life, care for children, respective for elders, concepts of modernity and

186 TIBET JOURNAL

so on in the face of the contrary philosophy of the postmodernist age, asks Ahmad (Ahmad,
Akbar S. 1993: 5).
One can discern contrary pulls and pressures in Islamic society in the world today. Islam, on
the one hand, is egalitarian, liberative and forward looking while it is inequitous, constricting and
backward looking, on the other. The tug of war between the opposing forces is on and the final
verdict is yet to be pronounced. The issue of common civil law as opposed to the personal
Muslim law that militates against the female is indicative of the struggle between enlightened
sections of the Muslim community and the conservative Islamic clergy in India and some other
countries.
There has been a spate of studies on the gender question in the west but there is not much of
exercise of this kind in the Buddhist literature. Bernard Faure in the book under review fills the
gap to some extent by focusing on the place of woman in Buddhism, with special reference to
Japan. There is a general belief that history of women in Buddhism is a linear narrative of
progress from oppression to liberation. Faure challenges this view forcefully and holds that
patriarchal value system often bordering on misogyny has been quite pronounced in Buddhism.
This does not mean that women have been passive agents in the male-centric social order. Some
of his formulations are likely to generate controversy in the Buddhist circles though he defends
his position with logical rigour and passionate fervour.
Faures book deals with the place of women and construction of gender in androcentric
tradition like Japanese Buddhism. His central point is that Buddhism is paradoxically neither as
sexist nor as egalitarian as is commonly thought. The book combines two approaches the first,
the Buddhist bias against women and the attempts to overcome this bias, and second, the active
role of Buddhist women to counter the stereotype of women as passive cultural subjects.
Attention is drawn to two kinds of anti-feminism in Buddhism: first is the early monastic
attitude which stipulates that a Bodhisatva should wander alone like a rhinoceros. The fact of
lonely women being easy targets for rape makes it difficult for female ascetics to follow this
principle. Secondly, Buddhism, while trying to strike roots in patriarchal societies, tends to
adopt local gender prejudices, reducing the Buddhist Sangha, as a consequence, to a patriachal
institution. This explains the Sangha being suspicious of women in general, the gender bias in
eight rules (gurudharma) rendering nuns subordinate to monks irrespective of seniority, thus
making Sangha a bastion of male privilege.
The Buddhist misogyny finds its best expression in the domain of defilement related to female
body functions, evoking male repulsion towards female menstrual blood and its putrefying
power. What Faure calls politics of menstruation, as expressed through Blood Bowl Sutra in
medieval Japan, acquired an important position in the male discourse on female sexuality. This
goes counter to the basic Buddhist tenet of the role of intention in action. Woman, after all,
cannot be blamed for the defiling nature of menstrual blood.
The rhetoric of equality in Buddhism, so thinks Faure, tends to solve the problem by
denying it. The concepts of non-duality, non-differentiation between men and women from the
standpoint of the ultimate truth and such other postulates did not go far to undermine the
structure of domination. Japanese Buddhist scholars holds womens rebirth as man as prerequisite
for salvation. Women were excluded from scared places in Japan until 1873 during the Meiji
restoration. Earlier, women were allowed only half the way to the mountain shrine. This
prohibition, however, was not meekly accepted by women.
Faure admits that Buddhism may have contributed to the relative improvement of the feminine
condition, yet he laments that it also maintained a situation of relative inequality that it could
have more radically questioned. This, in the opinion of this reviewer, is a subjective statement
and much depends on how one looks at the problem in its historical context. Take, for instance,
his comment on buddhas initial reluctance to admit women in his community. Buddha rejected
caste system, Brahmanical rituals, the animal sacrifice etc. and yet, complains Faure, he, by his
initial hesitation to admit women into Sangha, endorsed the dominant ideology at times a little
more than was needed. What he overlooks is the gender inequality embedded into the structure
of the Hindu social order at that times, condemning woman to perpetual subordination to man.

BOOK REVIEWS 187

In such context, the very idea of permitting women in the Buddhist Sangha, howsoever hesitatingly,
was indeed a radical advance.
There is always a hiatus, a yawning gap between the ultimate ideal and the immediate social
practice which is inevitably impacted by the prevalent cultural norms, customs, traditions and
conventions. Take, as an illustration, the Sikh religion, one of the youngest in the world. There
is no place for any kind of discrimination in Sikhism on the basis of caste or gender. Yet the
discrimination of both kinds persists among Sikhs. A section of untouchables got converted to
Sikkhism to escape the caste oppression prevalent in the Hindu fold. They are still objects of
caste discrimination in rural Punjab dominated by Jat peasantry. There is no place for gender
discrimination in the Sikh religion. The Gurubani enshrined in the guru Granth Sahib, the most
sacred scripture of the Sikhs, makes it abundantly clear: So kiyon manda aakhiye jit Jamme
rajan (How can women be called inferior who gives birth to kings?) Yet the women musicians
are not allowed to sing at the Golden Temple at Amritsar, the Vatican of Sikhs. Women, too, are
not allowed to clean the sanctum sanctorum or give a hand when the Holy Book is brought into
Golden Temple in a procession from the Akal Takht. This does not mean that the caste or gender
discrimination is structured into Sikh theology. The conservative clergy often tends to perpetuate
the gap between social practice and the religious ideal.
Bernard Faure too admits the role of cultural practices in distorting the ideal. he states: The
relation between Buddhism and women are not simply determined by gender, but by various
cultural, social and political conditions, and in particular the relation between Buddhism and
local cults (p.235). He further observes that the egalitarian tendencies within Buddhism are
contradicted by various external factors (the rise of patriarchy, the role of popular conceptions
regarding defilement and so forth). To give one example, civil war in later medieval Japan did
probably more to lower the status of women than any sexist teaching (p. 333-334).
H.H. Dalai Lama candidly admits that in the past the position of woman may have been
neglected or not given much thought (Dalai Lama 2002: 172-173). He further states that it is
very important for women to try to appropriate all their rights... I have been continually making
an effort for the female side, and they also must take the full initiative thats important. (Dalai
Lama 2002: 176-177).
Women have to work out their salvation and Buddhism has enough potential for the
empowerment of women. The reviewer is full agreement with Faure when he affirms: We
should not underestimate the powerful message of liberation of Mahayana Buddhism; a message
that often offsets androcentric or misogynistic tendencies. (p.330). While talking about the
Buddhist stand on the issue of gender discrimination, H.H. Dalai Lama makes it clear that as far
as the presence of Buddha nature is concerned, there is no difference. Nor is there an difference
in terms of potential that an individual has for generating the highest altruistic aspiration to
attain Buddhahood or insight into the ultimate nature of reality and so forth (Dalai Lama 2002:
174). It is the task of enlightened Buddhist scholars, seers and practitioners to narrow and
eventually obliterate the gap between the cultural practice and the ultimate ideal insofar as the
position of woman in Buddhism is concerned.
Bernard Faures book is an important addition to the growing corpus of literature on Buddhism.
Provocative in tone, pithy and precise in style, the book is replete with thought provoking
statements made with no holds barred. The scholarly nature of the work is seen through notes
and bibliography that run into about 120 pages.

References
1. Ahmad, Akbar S. 1993. Postmodernism and Islam. Penguin Books, New Delhi.
2. Dalai Lama 2002. Power of Compassion. Harper Collins Publishers, India.
3. Deniger, Wendy and Brian K. Smith. The Laws of Manu. Penguin Classics, New Delhi.
4. Edwards, Felicity. Spirituality, Consciousness and Gender Identification: A Neo-Feminist
Perspective in Ursula King (ed.). Religion and Gender, Blackwell Publishers, Oxford, U.K.

188 TIBET JOURNAL

5. Goldenberg, Noami, 1995. The Return of the Goddess: Psychoanalytic Reflections on the
Shift from Theology to Thealogy in Ursula King (ed.), Religion and Gender, Blackwell
Publishers, Oxford, U.K.
6. King, Ursula 1995. Gender and the study of Religion in Religion and Gender, Ursula King
(ed.), Blackwell Publishers, Oxford, U.K.
7. Moghissi, Haideh 2000. Feminism and Islamic Fundamentalism. Oxford University Press,
Karachi.
8. Sherbok, Dan Cohn 1999. Judaism. Routledge, London.
9. Weil, Simone 2001. Oppression and Liberty. Routledge Classics, London.
D.R. Chaudhry

Heinrich Harrer: An Obituary

6th July 1912 7th January 2006
For the first time I am unable to plan, as in the past, the basis and conditions for the success of
an expedition. Instead, I have learned to enjoy each day as a gift. What then unavoidably happens
I can only await in peace and trust. So wrote Heinrich Harrer, in advanced age in 2002, as the
closing words of his autobiography of his long, eventful and adventurous life. From an early age
Harrer had lived for adventure.
Harrer is best known for his part in first ascent of the notorious North Face of the Eiger and his
classic book Seven Years in Tibet. In total he wrote nearly thirty books during six decades of
expeditions to the Andes, Amazon, Alaska, Congo, New Guinea, Nepal, French Guyana, Greenland,
Sudan, Borneo, India, Ladakh, Andaman Islands, Uganda, Kenya, Sikkim and Bhutan.
He was born in the simple home of Josef and Johanna Harrer in the Hamlet of Obergossen near
Knappenberg which lies above the town of Httenberg in the province of Carinthia, Austria. His
father was a Post Office official who at times worked on mail trains. The inside of the small
crowded family house, he recalled, was a sort of traditional Austrian fairy-tale dwelling where he
would often sleep in a hay loft above a stall containing a goat, a cow and a sheep. He was the eldest
of four and had two sisters and a brother. The family having moved to Bruck, he excelled at school
sports and dreamt of becoming a forester, but aged 13 he settled on becoming a teacher because he
was especially keen on geography. He developed an immense desire to visit new and strange
places. His first adventures into the mountains, the Julian Alps, at the age of 15, he described as
An unbelievable new world. In 1927 he moved to Graz and joined an Alpine Club where he found
much of great interest in the library especially in books about the expeditions of the Swedish
explorer Sven Hedin in Tibet.
Aged 16 he scrimped together enough money to buy skis and was soon winning competitions
his mother making use of the leaves from the laurel wreaths he won, for cooking! He prepared for
the 1936 Winter Olympics but due to the international political situation the Austrian team was
not to participate. Harrer went on to establish a ski school, which prospered, and one day, his
future first wife, Lotte Wegener, enrolled on a course. She was the granddaughter of the arctic
explorer Prof. Alfred Wegener, the propounder of the theory of continental drift. (Their marriage
was not to survive the separation of Harrers years in wartime internment). Harrer always sought
new challenges and climbed all the classic routes in the Dolomites where he got to know fellow
mountaineer Fritz Kaspareck. They often discussed their dream of climbing in the Himalayas - but
how to get there? They had no money and were unknown and so they decided to get themselves
noticed. All the major alpine ascents had been climbed apart from the biggest and hardest, namely
the deadly North Face of the Eiger. So on 21st July 1938, having driven on Harrers motorbike to
Grindelwald, Switzerland, having camped in a small tent, the pair set off on the ascent. In order to
save weight, Kasparek had the only crampons to lead on the ice work, whilst Harrer would tackle
the rock sections in nailed boots. That night they bivouacked and next day the German climbers
Anderl Heckmair and Wiggerl Vrg overtook them. Caught in a violent thunderstorm they teamed
up and reached the top on the 24th at 3.30 p.m. too exhausted to realise their success. Suddenly
famous, they were usurped by politicians as symbolic heroes and taken to the German Athletics
Festival in Breslau where they were congratulated by an enthusiastic crowd and introduced to
Adolf Hitler.
Harrer was determined on reaching the Himalayas and, to that end, turned down many job
offers. However, he accepted the main role in a film Easter Ski Trip which was to be made during
his honeymoon. On the first day of filming a longed for telegram arrived asking if he was ready to
go on a reconnaissance climb to Nanga Parbat, at 26,658 feet the worlds ninth highest peak a
quick decision was required as the ship left Antwerp in a week. This opportunity was worth
everything to Harrer who cancelled the film contract, his teaching career and even his honeymoon.
He immediately set off for Munich where he met the 40-year-old expedition leader Peter Aufschnaiter.

190 THE TIBET JOURNAL

Harrer wondered how such an old man could lead an expedition on a mountain that had already
killed 26 mountaineers. The other two climbers were Dr Ludwig Lutz Chicken and Hans
Lobenhoffer.
At the expeditions end, having explored the Diamir ridge, they travelled to Srinagar and hearing
of the immediate threat of war, they set off for Karachi and the ship Uhlenfels. However, the
ship had been instructed not to approach Indian harbours. Unable to find other transport, Harrer,
Chicken and Lobenhoffer attempted to reach Persia and home. Their attempt came to an end when,
after a night in the open, they were arrested for not having proper papers. All their possessions
were confiscated.
They were sent to the Central Internment Camp, Ahmednagar, east of Bombay. Here 500
German and 30 Austrian civilians were held under the Geneva Convention as Prisoners-of-War.
Aufschnaiter had his books, including a copy of Colloquial Tibetan, and maps returned via the
censor who thought that as the camp was close to the Indian Ocean they posed no harm, little
realising that the prisoners would eventually be transferred to the foot of the Himalayas.
In New Year 1941 the internees were moved to Deolali, which provided an escape opportunity.
Lobenhoffer and Harrer jumped from the back of a moving army truck, but they were seen and
were recaptured. Deolali was unbearably hot and dusty with accommodation in basic huts, so all
went on hunger strike. Consequently, the authorities directed an interned architect to design a new
camp at Premnagar, Dehra Dun, Mussoorie, 120 miles from Tibet, to where they were moved.
Harrer was determined to escape. He tried again in June 1943. He had few resources, so crept
one night with his friend Rolf Magener to the Italian sector to meet an Italian army general by the
name of Marchese who could finance escapes but needed a companion experienced in Himalayan
travel. They escaped at night by putting a ladder over the sentry-post roof. Twelve days later they
reached the Ganges; after six more Marchese, now totally exhausted, told Harrer to go on alone.
Suddenly Indians confronted and arrested them. One, who spoke perfect English, was the chief
Forester for Tehri-Garwhal. That night Harrer again escaped but two days later blundered into a
village and was recaptured.
Later, along with Harrer and Aufschnaiter, five others also resolved to escape they were Rolf
Magener, Heins von-Have, Friedel Sattler, Bruno Treipl and Hans Kopp. They broke out of camp
disguised as an Indian wire repairing party a common enough sight - with Magener and von-Have
dressed as British Officers in charge. On April 29th, 1944 at 2.30 p.m., having stopped to examine
the wires, they boldly marched through the main gate with the guard presenting arms. It was a heart
stopping procession none of them would ever forget.
They split, with Magener and von-Have heading for Burma and an eventual successful escape to
Japan. The others travelled to the Himalayas. At Nelang, Sattler, badly affected by altitude sickness,
turned back. At the Tsangchokla pass, the remaining four crossed into Tibet on May 17th. The
Tibetans ordered them out, so they travelled westwards to the river Sutlej. Treipl, suffering from
altitude sickness, his goal of reaching the Japanese via the Gobi now seeming impossible, gave up.
Without Aufschnaiters spoken Tibetan the remaining three would have got nowhere. At Tradom,
they requested permission to travel to Lhasa and waited months for a reply. In November Kopps
patience ran out. He had been offered work in neutral Nepal where he thought to claim asylum.
Near Kathmandu, he was given a military escort and taken directly to the British Embassy where
he was arrested and reinterned.
The remaining two, Harrer and Aufschnaiter were both hardy, experienced mountaineers, mentally
and physically fit for a lonely and strenuous life at altitude. Not obtaining permission to travel to
Lhasa, they were ordered to leave for Nepal in December. Upon reaching Kyirong, they appealed
to be allowed to stay. Their request was again referred to Lhasa. Nine months later, they learned
the war was over, but did not return to India, as they knew that POWs would not be immediately
released. Without permission, they set off for Lhasa across the Changtang plateau, correctly
reckoning that an approach to Lhasa from the northwest might go unchallenged. Their compass and
map, the local nomads and yak dung fires enabling them to survive an incredible, grim mid-winter
journey. Accompanied by a guide and a donkey, they reached Lhasa on 15th January, 1946 dressed
as nomads in tattered sheep skin chupas. Days later, the 11 year old Dalai Lama heard of their

OBITUARIES 191
arrival and asked his parents to entertain them. The British Indian authorities repeatedly requested
their return but the pair remained in Lhasa due mainly to the sympathetic intervention of Mr
Arthur Hopkinson, the British Political Officer of Sikkim, Bhutan and Tibet, who himself had been
a prisoner of war during the First World War and who had then made an unsuccessful escape
attempt.
Harrers time in Tibet is well known from his book Seven Years in Tibet and can be referred to
for further details. Harrer and Aufschnaiter remained in Lhasa until October 1950 when China
annexed the country. Harrer went to the Chumbi Valley on the border with Sikkim, from where he
secretly liaised between the young Dalai Lama and the American authorities in an attempt to reach
a settlement with the Chinese who had deliberately stalled their army on the Tibetan border and
demanded negotiations. The Americans advised that as a last resort Harrer should escort the Dalai
Lama to India into exile. In the event the Dalai Lama, fearing reprisals, returned to Lhasa. Harrer,
meanwhile, left Tibetan soil in March 1951 not to return for thirty years. His Holiness the Dalai
Lama fled into exile some eight years later.
Upon returning to Austria in 1952, Harrer met his 12-year-old son, Peter, for the first time and
he met his parents again after an absence of as many years. Austria at this time was still occupied
and split into four zones of Allied control. As a routine check Harrer was interviewed both by the
British and the Austrian authorities on his return to post-war Austria. Much nonsense has been
written in recent years about his membership of the Schutz Staffel of the NSDAP (commonly
referred to as the SS of the Nazi party). Just before the release of the Hollywood film Seven Years
in Tibet certain members of the press had started a witch-hunt against Harrer which was quite
undeserved. He admitted to having joined the SS in 1938 so as to take up employment as a ski
instructor for them (although he never gave a single lesson as he soon departed for Nanga Parbat)
and his membership had been backdated to 1933 in order to speed up his application for marriage.
In old age and with hindsight he admitted that this had been a mistake of youth. However, he did
no harm to anybody and there is nothing to remotely suggest that he did. In his autobiography
Mein Leben (My Life) he wrote Was it youthful opportunism or blind determination, to
subordinate oneself all for sporting objectives?... It was, in any case, a mistake. When today, 60
years later, I reflect upon my motivation of then I do it from the experience, that one acts
differently in youth than in old age.
Back home in 1952, he was approached by book publishers to tell his tale in Seven Years in
Tibet (five of his fellow escapers were also to write books). The publisher who obtained worldwide
rights was from Liechtenstein and Harrer bought a house there where he spent much time for the
rest of his life. In the same year he visited the renowned Swedish explorer Sven Hedin. In 1953 he
gave a lecture at the Royal Festival Hall, London, where he received a letter beforehand from his
former Camp Commandant, Colonel Williams, which Harrer read out As commander of your
prison camp in India I had to take the blame for your successful escape from headquarters in New
Delhi. Not only that, but adding insult to injury, tonight I even had to pay to listen to you as to
how you did it. Following this he travelled to Peru from when on he devoted his life to exploration
and reporting. He undertook a lecture tour of the USA and wrote an article about Tibet for the
National Geographic.
Subsequently he started a TV series in German called Heinrich Harrer Reports. When the
Dalai Lama fled Tibet in March 1959 Harrer was sent to India by the British newspaper The Daily
Mail to report the story. He accompanied His Holiness to Mussoorie and whilst there Harrer
visited his old internment camp and found a pawpaw tree laden with huge fruit that he had grown
from seed years before when he was a prisoner.
In 1958 he became Austrian golf champion and in 1962 he went on a seven-month expedition to
Western New Guinea and made the first north to south crossing of the country. In August that year
he married Carina Haarhaus in Kitzbhel. Over the years he was to write many books about his
adventures around the world. In his later years he often visited the Kingdom of Bhutan about
which he published his final book in 2005. An English translation of his 2002 autobiography may
possibly be published later this year.

192 THE TIBET JOURNAL

In 1992 he opened the Heinrich Harrer Museum in Httenberg, which was attended by the Dalai
Lama. In 1997 he advised on the production of the Hollywood movie Seven Years in Tibet. In
November 2002 he lectured to a sell-out audience at the Royal Geographical Society, London, and
said, With a portion of impudence one can even reach regions that are out of bounds. I have
secretly crossed at least eight times the so-called inner line, and I think unless you cross inner
lines you cannot encounter great adventure. It is not for me to encourage disobedience, but if some
of you need advice how to do it, I would gladly give it. To anybody who knew Heinrich Harrer,
this statement might best sum up his iron-willed character.
Of his erstwhile climbing companions, Dr Lutz Chicken is the last still alive, whilst of his fellow
escapees, the last alive is Bruno Treipl.

References
Brauen, Martin. (ed). 2002. Peter Aufschnaiters Eight Years in Tibet, Orchid Press, Bangkok,
Thailand.
Chicken, Lutz. 2003. Durchs Jahrhundert. Mein Leben als Arzt und Bergsteiger, Edition Raetia,
Bozen, Italy.
Harrer, Heinrich. 1953. Seven Years in Tibet, Rupert Hart-Davis, London.
2002. Mein Leben. Ullstein, Munich, Germany.
Kopp, Hans. 1957. Himalayan Shuttlecock, Hutchinson, London.
Magener, Rolf. 2001. Our Chances Were Zero, Leo Cooper / Pen & Sword Books, Barnsley.
(Originally published as Prisoners Bluff, Rupert Hart-Davis, London, 1954).
Sattler, Friedel. 1956. Flucht durch den Himalaja. Und Erlebtes beim Maharadscha von Bundi,
Das Bergland-Buch, Salzburg, Austria. Republished 1991 by Edition Dax, Hamburg, Germany.

Interviews with former internees

1. Rolf Magener (aged 89), Heidelberg, Germany. 23rd June, 1999
2. Heinrich Harrer (aged 91), Knappenberg, Austria. 12th May, 2003
3. Bruno Treipl (aged 88), Salzburg, Austria. 21st May & 30th August 2004
4. Peter Schmmer (aged 92), Cologne, Germany. 13th June & 27th August 2004

Roger Croston

OBITUARIES 193

HENRY GEORGE Hank BAKER: An Obituary

23rd June 1918 - 15th January 2006
Henry Baker, who died aged 87, following a long illness, was one of the last half dozen eyewitnesses
who travelled to the capital city, Lhasa, of an independent Tibet, before the Chinese annexation of
that country in 1950. Born on 23rd June 1918 into a Methodist family in Ryde, Isle of Wight, he
was the eldest of seven children, having four brothers and two sisters. One brother was to predecease
him by a day.
From working as a shop assistant, he was enlisted for 6 years into the Supplementary Reserve
of the Infantry of the Line, Hampshire Regiment, in Newport Isle of Wight on 7th September
1936. One day my grandfather came to me and said, You are coming with me lad! He took me
down the road into a building to see a gentleman I did not know. The next thing I discovered was
that Id been signed into the army. I suppose it was one less mouth to feed.
Initially based at Winchester, then, because he had a private interest in radio and electronics, he
was re-enlisted into The Royal Corps of Signals, Regular Army, on 1st December 1936 and trained
at Catterick Camp, Yorkshire, before transferring to Aldershot and then to India in December 1938.
INDIA
Upon arrival in India Baker was immediately posted from Karachi to Bannu on the notorious
North West Frontier and on to the Ahmedzai Salient for six month operations in outposts such as
Mir Ali, Damdil, Tal and Razmak. In this short period four hundred soldiers were killed or injured
by skirmishing tribesman. On one occasion British and Indian troops were holed-up in a fort, so
some Gurkhas who were with them Decided to show us how to sort them out. They dashed off
downhill with their Kukris to reappear some time later bearing several severed heads!
Baker was seriously injured during an attack when a gun carriage exploded and he was hospitalised
for six months. After recuperation he was posted to Southern Command Signal Company,
Jubbulpore, as wireless operator from where he was to tour with a mobile station to Lahore, Delhi,
Peshawar and Kohat using camel, mule and lorry transport. In September 1940, he caught malaria,
After recovering, he made acquaintance on air with a former Royal Signals man, now a civilian
employed by Government of India, who had operated the British Missions radio in Lhasa, Tibet,
since 1937. This link was regarded as vital as there were strong rumours that Chinese troops were
becoming active on the Tibetan border.
POSTED TO LHASA
The British Mission in Lhasa had been established in 1936. The radio station used equipment set
up in the Missions Deyki Lingka house by lieutenants Sidney Dagg (later Lt. Col.) and Evan Yorke
Nepean (later Lt. Col. Sir, Bt.), both of the Royal Corps of Signals. Towards the end of 1941, the
regular radio operator became seriously ill and was sent down to Calcutta for treatment and had to
be relieved. One morning my sergeant sent for me and gave me 24 hours leave to consider
volunteering to take over the radio station being told that if I declined, as there was a war on, I
would be posted there anyway!
Having volunteered Baker was examined by three doctors who told him how lucky he was,
but who would have marked him unfit had he not wanted to go. I was given a trade test to make
sure I could run the station at Lhasa. Needless to say none of the items I was tested on were
anything like what I found there. On 20th of October 1941 he was posted on what would be the
greatest adventure of his life. I am sure that anyone seeing me as I left Jubbulpore must have
thought I was crazy as I had been despatched carrying my kit bag, a rolled up army greatcoat and,
for some unknown reason, six pith helmets. In 1941 it was almost impossible for anyone, let alone
an uncommissioned soldier, to be posted to then almost inaccessible and near mythical, forbidden
capital city of Tibet, Lhasa.

194 THE TIBET JOURNAL

Baker proceeded to The Great Eastern Hotel, Calcutta, where he met the Civil Surgeon Bhutan,
Sikkim and Tibet, Captain Dr Harry W.G. Staunton of the Indian Medical Service. Staunton
proclaimed him Just skin and bone, and said Youll never survive a severe winter trek over the
Himalayas a journey he himself had often made adding, Well send you back in the morning.
However, Delhi HQ informed Staunton that nobody else was available and Baker had to go. Next
day the pair proceeded to Siliguri by train and from there some 70 miles by taxi to Gangtok the
capital of Sikkim where they were invited by Sir Basil Gould - known to all as B.J. - the Political
Officer Sikkim Bhutan and Tibet, to stay at the British Residency.
Gould had led the 1936 Political Mission to Lhasa, which had established the British presence
there and he had been knighted for his good offices when attending the Installation of the current
Dalai Lama in Lhasa in 1940.
Taking one look at Baker, Gould immediately sent for the local doctor, Dr Hendricks, who also
declared Baker quite unfit and asked Delhi for a replacement, but General Villumy at HQ, Delhi
gave the same response as before and instructed that Baker be sent as soon as possible. During
three days acclimatisation at 8,000 feet in Gangtok he was introduced to the Maharaja of Sikkim.
I still had not been given any details about getting to Lhasa, except my telegram from Delhi which
said You will fly from Gangtok. Your luggage will go by camel caravan. Staring at the paper, an
incredulous Gould told Baker that he had been told utter rubbish and that he faced an arduous trek
over the Himalayas.
Never having ridden in his life, Baker set out on the 21 days pony trek to Lhasa. Dr Staunton
accompanied him half way as far as Gyantse. At Karponang Dak Bungalow, Staunton warned him
The next two days over the high Himalayan passes would prove if I was going to Lhasa or back
to India in a pine box! However Baker was more worried about his body being devoured by the
local vultures. He was immensely impressed by the Chomolhari Mountain Range towering to over
24,000 feet. At the village of Phari my pony suddenly took off the saddle having slipped.
Staunton reprimanded me that I ought not to show off how well I could now ride. I protested that
I was not showing off but that I was simply unable to stop the pony. Suffering intense cold at
heights of over 15,000 feet, he survived and With a very sore posterior reached the British Indian
Army Garrison Fort at Gyantse.
After a brief welcoming ceremony, as a new visitor I was invited to inspect the Indian Army
Garrisons Escort Troops. After which it was a luxury to sleep in a nice warm bedroom in a very
comfortable bed. After several days rest, I travelled on alone with a young Tibetan Christian
missionary and his family. No foreigners were allowed to travel beyond Gyantse without government
permission. The going was very hard - breathing was difficult crossing the Karo La pass at 16,600
feet with heavy snowfall necessitating frequent dismounting to walk. Baker found the Tibetans
most friendly and he slept in village homesteads where he began to appreciate and learn more about
the land, its people and their customs. At the first house he asked about toilet facilities and was
directed to the roof where he was Shown a slit in the floor which was above a manure room there
was no door - it was a case of pulling down your trousers and squatting in full view of anyone who
wanted to watch. Unfortunately, as I was not Tibetan, I was the centre of attraction.
Nearing Lhasa, arrangements were made for passage across the fast flowing Tsangpo River at
Chushul in yak hide coracles about ten feet square. A 15-mile trip was made downstream. Having
spent the night in Nam village, a large group of Tibetan horsemen arrived to escort Baker into
Lhasa, and thanks to the missionary who translated for him, he got through the greetings ceremony
of exchanging long white silk scarves.
Arriving at the citys outskirts Baker was impressed with views of the Potala Palace and he was
introduced to leading government officials and taken to the Deyki Lingka, the British Missions
residency, only to discover that the then British Head of Mission, Rai Bahdur Norbhu Dhondup
Dzasa who was a Tibetan was a three days journey away on a gambling spree. Just outside the
residence, in the same compound, he was directed to the small brick building containing the radio
station that was to become his home.
On the ground floor was a petrol engine that drove the generator which charged the batteries and
supplied power to the buildings and the wireless station, which was upstairs in the living quarters.

OBITUARIES 195
As soon as everyone had left me, I bolted the large entrance doors downstairs, went upstairs and
cried like a baby. To think that I had survived the journey; that I had volunteered for it; was
completely alone with no one to talk to; and I now realised that the nearest European to me was
many a days journey away. I had no idea what to do other than to keep things going and keep in
contact with Jubbulpore. Each morning I transmitted weather reports and sent ciphered messages
from Rai Bahadur Norbhu Dhondup Dzasa who was later to receive the OBE.
The large radio batteries were in a bad state a relay in the charger had been wedged with a
piece of wood and they had been overcharged, so I sent for replacements. When new ones arrived
weeks later I emptied the old batteries into the garden but the acid seeped into the Kyi Chu River
and killed a whole load of fish which was not a very bright idea in a strictly Buddhist country. I
also ordered new radio valves but when they arrived, their cartons had been opened, and they had
been replaced by stones the Tibetans at times could be terrible thieves. The Chinese also had a
radio station in Lhasa, but of such antiquity, that it was a wonder it worked at all. I intercepted it
and obtained and decoded their information before it had even reached China!
Baker settled into life in Lhasa and got to know several notables including the Dalai Lamas
father and the Commander of the Tibetan Army. He was kept company by various nobles who
spoke English and he was invited to some of the many picnics and parties in which Lhasans greatly
liked to indulge themselves.
Early in 1942 after seven months in Lhasa, Baker was unexpectedly recalled when the usual
radio operator returned and Baker was posted to The British Residency, Sikkim to work radio until
the wars end and where he used his technical skills to help Sir Basil Gould establish both a Tibetan
language broadcasting station and a Tibetan language newspaper.
SIKKIM
In Sikkim Baker became good friends with the Maharaja and his children and on many occasions he
would go riding with them before having breakfast at the Palace, Gangtok. On one occasion when
an English lady aristocrat was staying at the British Residency, Gangtok, Sikkim, Sir Basil Gould
had her room painted and decked out in her favourite colour, blue. One morning her aide went to Sir
Basil with a complaint. Apparently the cook, who was always up to some sort of trick or other,
had gone a little too far this time by having the toilet rolls dyed the same colour at the carpet
factory, not realising the dye would come out.
Baker was invited by the Maharaja to many events at the Palace. On one occasion I was invited
to witness the annual War Dance, peculiar to the northern Buddhists of Sikkim. A festival to
celebrate the spirit of the War God Kangchen-Dzod-Nga when Maha-Kala, the Commander-inChief of all the guardians of the faith and overlord of all spirits, orders Dzod-Nga to bring peace,
prosperity and security to the people. He attended the wedding of Jigme Dorje, the son of Raja
S.T. Dorji, agent to the Maharaja of Bhutan, Kalimpong, to Tessala (Tsering Yangzom). He kept
the many invitation cards, embossed with the gold crest of the Maharaja, which, framed and
mounted, took pride of place in his later homes alongside a Tibetan Wheel of Life Thanka scroll.
Baker was given a privilege granted to a very select few a Permanent Frontier Pass authorising
him to enter Nepal, Bhutan and Tibet and he was instructed to make and wear what were probably
the most unusual shoulder epaulets in the history of the British Army. They had sewn into them
the words British Political Service Tibet. This was for tours of duty as radio operator in Sikkim,
Bhutan and Assam with Sir Basil Gould along with dignitaries from Government of India such as
the Vicereine Lady Linlithgow.
On leaving Sikkim on 8th November 1945, Baker received a letter from Mr S.J.L. Olver at The
(British) Residency, Gangtok. On the eve of your departure on leave, I should like to record my
appreciation of your work here; and I am sure that the Political Officer would wish to do the same
were he here. To have kept the transmitter and generating plant in more or less constant operation
over the last four years was a very considerable feat, accomplished in difficult working conditions
and bad weather, and in the face of a perennial shortage of spares and equipment. Should regular
broadcasting from Gangtok eventually be introduced, it will be on the basis of your pioneering
work.

196 THE TIBET JOURNAL

He had requested 6 months home leave to get demobbed and intended to accept a job as a civilian
wireless operator for the government of Tibet. In 1944, the American and British Indian Governments
had supplied a limited quantity of radio equipment to the Tibetan Government (via Ilya Tolstoy
and Brooke Dolan) and had planned the establishment of several wireless stations along the
Tibetan border in an attempt to help Tibet protect herself from Chinese incursion as well as to help
everyday traders. However, Baker was relieved in Sikkim by Robert Ford (author of Captured in
Tibet who is still alive) who had recently been demobbed from the RAF. Ford later set up a radio
station on Tibets eastern border at Chamdo. He was captured by the Chinese and held prisoner for
five years.
KENYA & USA
Having returned to England, the newly married and demobbed Baker took a job at Nairobi airport,
Kenya, as Communications manager for the British Overseas Airways Corporation where his son
was born in 1948. Returning to England a few years later, he and his family emigrated to the USA.
Baker started a small business making and selling rubber stamps, later taking a job with Eddystone
Radio and then Voicewriter Engineering where he worked on developing dictating machines. He
moved to another firm to develop television studio communication equipment and became a
technical writer. Leaving the electronics industry Baker joined the New Jersey Police Force at
Succasunna in 1963 and later the New Hampshire Police Force, meanwhile running his own
electrical repair shop as a sideline. From patrolling areas of high crime he became a Justice of the
Peace in August 1985.
Having been overseas for many years Baker lost contact with most of his family and in his 70s,
following the death of his wife, he moved to the northeast coast of England where he married for
the second time but was again widowed shortly later. He was to eke out his final years in poor
health and had almost lost the will to live when, in 2002, it became known to researchers that he,
one of the last few European eyewitnesses of the old Tibet, was still alive.
Baker was given a new lease of life. His recollections were very detailed and he was delighted to
be visited and interviewed at length by independent researchers, academics from The Namgyal
Institute of Tibetology (Sikkim), The Pitt Rivers Museum at the University of Oxford and the
daughter of his travelling companion in Tibet, Captain Harry Staunton.
Henry Baker was deeply saddened by the destruction wrought upon Tibet by the Chinese
Cultural Revolution. His opinion was that the old feudal Tibet he witnessed needed to change but
from within. At the end of his life he was encouraged and hopeful the progress made in recent years
by Chinas rebuilding and restoration of many things that had been destroyed.
Henry is still remembered by elderly people in Sikkim. Photographs he had bought in Sikkim
from Tsetan Tashi (1912-1972) - then Private Secretary to the Maharajas son, Prince Paljor
Namgyal - during the war, where the climate has since destroyed a number of photographic prints,
form part of a current photographic exhibition at the Namgyal Institute in Sikkim. Many people
were thrilled to see long lost images of their parents and grandparents.
Throughout his life Baker retained his interest in amateur radio and was still active with Morse
code until the last year of his life. He is survived by a son in the USA and a sister and a brother.
Following the death of Heinrich Harrer on the 7th of January and that of Henry Baker on the
15th, only five living Westerners remain who witnessed the old Lhasa, one in Great Britain, one in
Germany and three more in the USA.

Roger Croston

Contributors
Alessandro Boesi, Biologist (University of Milan, Italy), Ph.D. candidate (Musum
National dHistoire Naturelle de Paris, France), has carried out extensive fieldwork
in the Himalayan and Tibetan regions (1994, Ladakh; 1995, Nepal; 1996, Ladakh;
1998, Nepal; 1999, Khams; 2000, Khams; 2001, Nepal) focusing his interest in
the study of the Tibetan conception, classification and exploitation of the natural
world and of the materia medica of Tibetan medicine.
Alex McKay is a research fellow in Indo-Tibetan history at the Wellcome Trust
Centre for the History of Medicine at University College London, and an affiliated
fellow at the International Institute for Asian Studies in Leiden, The Netherlands.
He is the author of Tibet and the British Raj: The frontier cadre 1904-1947 (Curzon
1997) and the editor of the 3-volume History of Tibet (RoutledgeCurzon 2003).
Colin Millard received his PhD, entitled Learning Processes in a Tibetan medical
school, from the anthropology department of Edinburgh University in 2002. He
has carried out research on traditional medical practice in India and Nepal. His
present research concerns are Tibetan medical practice and ritual, the Bon religion
of Tibet, and complementary and alternative medicines in the UK.
Denise M. Glover holds a PhD in Anthropology from the University of Washington
(Seattle, WA, USA), where she is currently a Lecturer in the Department of
Anthropology. She conducted dissertation research in rGyal thang, southern Khams,
in 1999, 2001, and 2002. Her dissertation, titled Up From the Roots:
Contextualizing Medicinal Plant Classifications by Tibetan Doctors in Rgyalthang,
PRC (2005), examines plant classifications as well as the social and cultural milieu
in which they occur. She currently resides outside of Seattle, WA with her children
August and Saveria, a small flock of parrots, a restless cat, and her husband, Glen
Avantaggio.
D.R. Chaudry is a well-known columnist and reviewer in the Indian media world.
He retired as a Reader at the Dyal Singh College of Delhi University. He has
published several articles and over 100 reviews and review articles in the leading
English national dailies, including Times of India and The Tribune. Also he has
three books in his credit, the latest being Education and Social Change,
Radhakrishan Publications, Delhi, 2000.
Francesca Cardi
Frances Garrett is Assistant Professor of Buddhist Studies at the University of
Toronto. Her research focuses on Tibetan religious history and its relations with
other forms of Tibetan intellectual and literary culture, such as medicine.
Geoff Childs is an assistant professor of anthropology and environmental studies
at Washington University in St. Louis. He is the author of Tibetan Diary: From
Birth to Death and Beyond in a Himalayan Valley of Nepal (2004, University of
California Press) as well as several articles on demography, history, and culture in
Tibetan societies. His current research centers on aging and inter-generational
relations in Tibet.

Georgios Halkias is currently working on his D.Phil. at the Oriental Instutute,

Oxford University. His areas of research interest include Tibetan Buddhism, Tibetan
history & culture, and contemporary Tibetan developments.
Martin A. Mills is a social anthropologist specialising in religious and ritual
traditions, his research interests being born of extensive fieldwork amongst the
Tibetan Buddhist communities of Ladakh and Zangskar Regions and the Tibetan
refugee communities of India and Nepal. His first major monograph, Identity,
Ritual and State in Tibetan Buddhism: the Foundations of Religious Authority in
the Gelukpa Order, has been published by Curzon Press. He is presently working
on a second monograph, on the transformation and globalisation of the Dalai Lamas
theocracy brought on by the Tibetan diaspora of 1959.
Olaf Czaja is a PhD candidate at the Leipzig University/Germany. His main
interest are Tibetan history, medicine and art.
Yonten Gyatso is a Tibetan traditional doctor and an independent researcher living
in Chicago. He studied Tibetan medicine at the Tibetan Medical and Astrological
Institute (TMAI), Dhramsala, India, and graduated in 1987. He served at the
institutes research department for many years before becoming an independent
researcher. His main interest is in classical Tibetan medical literature, Tibetan
pharmacology and translation. His most important work is the development of a
modern herbarium at the TMAIs plant research section and he has done extensive
field study in Nepal and Indian Himalayas. He can be contacted at yongya@aol.com

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