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May 29, 2000

What does Tibetan Medicine have to offer?
Brian Boni, MD, MPH

Several decades ago, an American doctor had the opportunity to serve as host to an eminent Tibetan doctor, Dr. Yeshi Dhonden, during a lecture tour and international symposium in the United States. The following is a brief account of some of the impressions and conclusions gleaned from that experience.

The value of Tibetan medicine to the contemporary Western world may be that it is a link to a system that looks at reality in a different way, and offers a complement to our materialistic, mechanistic view of life.

Historically, Tibetan medicine represents a synthesis of elements and ideas derived from Chinese traditional medicine (especially acupuncture), Indian Ayurvedic medicine and ancient Persian medicine. In addition, there are major components derived from local folk-medicine and herbal lore, and from Asiatic shamanism and Bon-po culture. But the unique characteristic of Tibetan medicine is the intimate correlation of its guiding principles to those of Buddhism. Shakyamuni, the historical Buddha, is regarded as the first teacher of Tibetan medicine. He pointed out that all beings desire happiness and seek to avoid suffering, and that the causes and conditions of disease arise out of this desire/avoidance tendency. While disease may have many causes, physical and spiritual, immediate and remote, all these causes can be traced to the three poisons -- that is, desire, hatred and ignorance -- which arise from self-grasping. Ultimately the causes of disease can be traced specifically to primordial ignorance (that is, seeing the self and things in a way in which they do not really exist), which generates mental states leading to rebirth and to the causes and conditions of disease, through the mechanism of karma.

Tibetan medicine is an eminently holistic or complementary healing system, utilizing psycho-spiritual methods as much as physical. The human body is considered to be based on the five cosmic energies (space, air, fire, water, earth). The biological intermediaries of these five are called the three humors, wind, bile and phlegm, which govern the functions of the body (or, body- mind, in the Tibetan construct). Each of these three is considered to be a sort of chi (to use a familiar Chinese word) or force, which circulates along certain channels in the body (analogous to the meridians of Chinese medicine), and has the potency to cause disease when out of balance due to karmic causes and conditions.

Diseases may have primordial (remote) or immediate causes, both mediated by karma (which is, simply, action which produces results). There are said to be 4000 negative states of mind which bear upon this karma, but they condense into the three poisons, which ultimately are all caused by self-grasping (that is, seeing the self and objects in a way in which they do not really exist).

Having touched on some of the points which make the theory of Tibetan medicine unique, this introduction will conclude with a brief synopsis of the diagnostic and therapeutic methods employed.

With regard to diagnosis, the first step is the preparation of the doctor him/herself, by means of purifying practices, bathing, meditation, etc., in order to develop the proper receptive and compassionate attitude. Diagnostic techniques are often employed around dawn, when the baseline qualities of the patient will be most evident. The Tibetan doctor employs history-taking, consults astrological charts, and carefully observes the patient, including the face, the color, the aura and inspection of the tongue. The urine is examined for color, odor and the character of the froth produced by whipping. Of particular importance is pulse diagnosis, in which the radial pulses are palpated at various locations bilaterally. The pulses are measured at serveral different depths from the skin, and various sub- tle qualities are identified. From this data the Tibetan doctor draws inferences about the status of various internal organs and systems.

The therapeutic approaches of Tibetan medicine are multiple, including those primarily spiritual (meditation, mantra, visualization, prayer, incense), psychological (behavioral therapy, change of regimen, interpersonal relations, charity, compassion, altering sleep habits, dream yoga) and physical (acupuncture, diet, exercise, herbs, minerals, animal products and even surgery).

To observe a Tibetan doctor at work is a rare privilege. It is immediately apparent from his/her demeanor and concentration, when relating to patients, that he/she is going beyond mere material considerations. One gets a glimpse of an expanded state of being--in which the spiritual dimension enters and time, cause and effect take on a different perspective. Tibetan medicine is a truly holistic, well-balanced, traditional system of psycho-physico-spiritual healing, from which modern culture may have much to learn.

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