History in brief of Tibetan medicine

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

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

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

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

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

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

The 14th century saw the rise of the Qamba and Soika medical factions with treatment aimed at coping with the diverse climates of south and north Tibet. Tibetan medical masters created many medical works and wrote copies of annotations to the Four-Volume Medical Code.
During the 17th century, the 5th Dalai Lama, who set great store by Tibetan medicine, created such Tibetan medical schools as the Soirabzhobianling in the Zhaibung Monastery, the Soirab Changsun Duibaling in Xigaze, and Lhawangjor and Sangpo Nyimatang in the Potala Palace. Sanggyi Gyamco, a Degsi official under the 5th Dalai Lama, made an historical contribution to Tibetan medicine by completing the Blue Glaze, an annotation to the Four-Volume Medical Code in 1689. He also created the Outline of Medical Theory and the Feast for the Immortals in 1703. These became the major works for Tibetan medicine practitioners of later generations. Sanggyi Gyamco also created 79 of Tibet's first colored medical charts, based on the Medicine King on Medical Treatment, his own works including Blue Graze and Outline of Medical Theory, and medical theory of the Qamba school. He also contributed to the training of Tibetan medical workers by establishing the Rachizhobianling Medical School at Yaowangshan Mountain in 1696.
During the period of the 13th Dalai Lama, Tibetan medicine made new progress. Noted Tibetan medicine masters at that time included Gema Jigmei Qoigyi Senge, Lama Jigmei Chilai, Government Medical Doctor Wogyi Dainzin Gyamco, Doje Gyaincain, Zhakang Spyi-khyabmk Kampo Qamba Tubwang, Qaboba Dangqu Bendain and Qenrab Norbu. They wrote medical works and taught students. Of these, Qenrab Norbu was the most accomplished. Based on his study of Tibetan sutra classics, astronomy, calendaring and medical works including the Four-Volume Medical Code, he wrote a dozen additional works. Some of these are An Ocean of Medical Theory, Collected Samples of Medicinal Herbs, The Way to Deliver Babies, The Key to Classics, Notes to Pulse Taking, Urine Tests, and Bleeding Therapy.

At the direction of the 13th Dalai Lama, the Lhasa Medical School was launched in 1916, with Qenrab Norbu as the headmaster. The 1,000 students came from monasteries and, later, army barracks in Tibet as well as Tibetan areas in Qinghai and Kam. Additional students came from Bhutan, Sikkim and Ladakh. In 1959, the Lhasa Tibetan Medicine and Calendaring Academy became the Tibetan Medicine Hospital, with Qenrab Norbu, then 77 years old, serving as its director.

During the period of the 14th Dalai Lama, the few government-run Tibetan medical institutions were simply equipped and small in size. Representative of these were the one at the Yaowangshan Mountain and the Medicine and Calendaring Academy in Lhasa.
Before the peaceful liberation of Tibet in 1951, the Medical and Calendaring Academy had 73 medical doctors and students working in a clinic with a total area of 367 square meters. It provided medical treatment mainly to people from the upper echelons of the ruling class of Tibet. About 10,000 people a year received treatment and approximately 2,500 kg of Tibetan medicine was produced. But the vast masses of serfs and slaves were too poor to go to the clinic. During this period, there were fewer than 500 medical workers in all of Tibet.

In old Tibet, under serfdom, students of the Zhaibung Monastery Medical School (which was disorganized soon after its establishment), one in Xigaze and two in the Potala Palace as well as the Yaowangshan Mountain Benefiting-All School and the Tibetan Medicine and Calendaring Academy in Lhasa were all monks from Lhasa, Xigaze and Shannan. Only in 1939 were military personnel recruited, in accordance with a decree issued by the local government of Tibet. The two medical schools derived their income from monasteries and manors. In the vast rural and pastoral areas, there was not even one good clinic. The broad masses of peasants and herders lived lives at the mercy of nature. Driven by dire poverty, the sick in the lower levels of society turned to folk prescriptions and sorcerers. Many died as a result. For example, in the 150 years prior to 1951, Tibet was hit by smallpox four times, taking a toll of 7,000 people in Lhasa in 1925 alone. In 1934 and 1937, typhoid killed a total of 500 Lhasans.

The situation took a turn for the better following the peaceful liberation of Tibet in 1951.
In May 1959, the Yaowangshan Mountain Benefiting-All School and the Tibetan medicine hospital in Lhasa were merged and renamed the Lhasa Tibetan Medicine Hospital in September 1961. Qenrab Norbu and his student Qamba Chilai were made its director and deputy director. The hospital includes the medical, surgical, women and children, and acupuncture departments, plus the pharmaceutical workshop. It is geared toward providing medical treatment and, at the same time, cultivating medical workers. This is different from the past practice of primarily training medical workers. In 1965, the hospital set up its out-patient building and an in-patient building with 32 beds. This was the first time in history that a Tibetan medical hospital had out-patient and in-patient departments.

In 1965, Tibetan medical workers compiled the book, A Probe Into Tibetan Medicine, in which they added 300 kinds of medicinal herbs. Some of the veteran Tibetan medicine workers contributed articles in their areas of expertise, including stomach diseases, kidney diseases, gout, influenza, cerebral hemorrhage, kidney diseases-related dropsy and women's diseases.
The State Medical Code, compiled in 1974, takes in certain traditional Tibetan medicine, including Gyamchidainba (Tiemu 7), Ngakajiua (Chenshang 15) and Chuitang Ribo. The Tibetan Medicine Group composed of eight veteran practitioners from the Tibet Medicine Hospital was also formed in 1974. This group gathered Tibetan medicine classics from among the common people, and conducted clinical trials with their findings and documented prescriptions that proved to have a curative effect on certain diseases when combined with Western medicine.
The Tibetan Medicine Hospital Study Group published the newly compiled Tibetan Medicine Prescriptions in 1975. In the next two years, the PRC Ministry of Public Health dispatched two groups of medical workers and video people to shoot two films under the joint name of Tibetan Medical Science and Tibetan Medicine. Two of the group members collaborated with Qamba Chilai to compile the 80 medicine charts and some 4,000 photos into four albums in both Chinese and Tibetan. In 1977, Tibetan medicine specialists from Tibet, Qinghai, Gansu, Sichuan, Yunnan and Xinjiang met in Lhasa and Xining to determine the medical contents of 174 Tibetan medicines and 290 Tibetan medicine prescriptions. This paved the way for the production and application of Tibetan medicine.

The year 1979 saw a new phase in the development of Tibetan medicine. Work on the book, Chinese Medical Science: Tibetan Medicine, began in April that year, with Tubdain Cering and Qamba Chilai serving as chief editor and deputy chief editor respectively. This was followed with the publication of the Four-Volume Medical Code and its annotated versions titled Blue Glaze and Supplementary to the Crux.

In light of the Central Government's decision to energetically develop Tibetan medicine, astronomy and calendaring, the Lhasa Tibetan Medicine Hospital was renamed Tibetan Medicine Hospital of Tibet on September 1, 1980. The hospital has grown into Tibetan medical treatment, education, research, Tibetan medicine-making and calendaring center in the Tibet Autonomous Region. It has made impressive progress in the treatment of high blood pressure, acupuncture and children's mental diseases.

Since 1981, Tibetan medicine hospitals have been set up in five of the seven prefectures and five of the 75 counties. Tibetan medicine departments can be found in hospitals from 70 of the 75 counties. Major ones include the Shannan Prefecture Tibetan Medicine Hospital, the Ngari Prefecture Tibetan Medicine Hospital, the Xigaze Prefecture Tibetan Medicine Hospital, the Nagqu Prefecture Tibetan Medicine Hospital, the Qamdo Prefecture Tibetan Medicine Hospital, as well as Tibetan medicine departments in Konjo, Xainza, Baxoi and Gyangze counties. The Tibetan Medicine Hospital of Tibet has held five training classes for some 200 medical workers hailing from various parts of Tibet.

In September 1981, the Tibetan Medicine Society of the All-China Administration for Medical Sciences held its inauguration ceremony and its council meeting in Lhasa. Dozens of papers on the history of Tibetan medicine, theory, clinical practice, prescriptions and research results were read at the meeting. This played an important role in the inheritance and development of Tibetan medicine.

During the First Session of the Sixth PRC National People's Congress (NPC) held in June 1983, Qamba Chilai was cited as a representative of Tibetan intellectuals and Tibetan medical workers. The Second Tibetan Medicine and Traditional Chinese Medicine Association Meeting, held in Lhasa in July 1983, received approximately 80 papers.

In August 1983, the Tibetan Medicine Secondary School of the Tibet Autonomous Region was launched in Lhasa. Over the years, it has trained many outstanding medical workers.
The People's Government decided in 1985 that those who passed examinations given by the Yaowangshan and calendaring schools prior to 1959 be given Tibetan medicine diplomas; those who graduated from Gyigyinarge Medical School in Xigaze and those who studied Tibetan medicine and calendaring in and graduated from Mozhuling and Painbo Nalanto sutra lecturing schools be given respective diplomas. This was followed by more pay for these veteran Tibetan medical workers.

The In-Patient Department Building was built in August 1985 with a total investment of 11 million yuan earmarked by the people's government of the Tibet Autonomous Region. It has 150 beds.

In August 1987, the Tibet People's Publishing House published Chinese-Tibetan charts painted in accordance with the Four-Volume Medical Code.
In summer of 1988, the young and middle-aged Tibetan medical workers were taught the Outlines of Tibetan Medicine.
Beginning in April 1989, Tibetan and Western surgical methods were used in surgical operation with great success.
In September 1991, efforts were made to identify more than 600 kinds of Tibetan medicinal materials, including some 100 medicinal minerals that were from northern Tibet. Directors of Tibetan medicine hospitals from Xigaze, Shannan and Nagqu were invited to attend.
In December 1991, an exhibition displayed the achievements made in the development of traditional medicines in China. Also on view were books on medical science, including painted charts on the Four-Volume Medical Code which was honored with a gold medal, the Four-Volume Medical Code: A Treasure House which won a silver medal, and the Biography of Medical Masters in Tibet which was awarded the Outstanding Medal.

With the assistance of the Swiss Red Cross Society, the Shannan Qoingyi Songtsan Tibetan Medicine School was created in June 1992. The Swiss society had previously invested in the building of the Benxiong Tibetan Medicine School in Xigaze. Both schools recruit students from remote areas. After six years of study in the two schools, the students return home to serve.
Since the advent of the 1990s, Tibetan medicine scholars have gone abroad for exchange and cooperation. For example, Coru Cenam and Qamba Chilai went to Japan for a visit in March 1990, and Qamba Chilai and two others visited the United States in December 1992. The visits enhanced mutual understanding and promoted development of Tibetan medicine.

Tibetan medicine is also used to serve people of non-Tibetan nationalities. On November 10, 1992, the Shannan Prefecture Tibetan Medicine Hospital and the China National Center for Tibetan Studies jointly created the Beijing Tibetan Medicine Hospital. Two years later, they opened the Tibetan Medicine Section in the Tianjin Hedong District Traditional Chinese Medicine Hospital. Both the Beijing hospital and the Tianjin section have treated about 300,000 patients. Medical workers from 30 countries including Germany, Italy and Israel have visited them.

In September 1993, the State Medicine Dictionary Compiling Committee, the Medicine Standardizing Office of the PRC Ministry of Public Health and medicine offices in Tibet, Sichuan, Yunnan and Xinjiang gathered in Lhasa for the China Tibetan Medicine Standardizing Work Conference. The conference summed up experience gained in using scientific means to standardize Tibetan medicine.
The CPC Central Committee and the PRC State Council held their third national work conference on aid to Tibet in Beijing in August 1994. It was decided during the conference that Jiangsu Province would undertake to expand the Pharmaceutical Workshop of the Tibetan Medicine Hospital, with an investment of 53 million yuan (about US$6.6 million).
The regional goverment suppliedcapital for the establishment of the Tibet Autonomous Region Hospital of Tibetan Medicine and six prefectural4evel hos-pitals of Tibetan medicine, an addition of more than 350 hos-pital beds for patients receiving Tibetan medical treatment. Some counties have hospitals of Tibetan medicine and most county-level hospitals have a Tibetan medicine department with its own hospital beds. Every year, over 500,000 people seek medical treatment in these hospitals. A college and a research institute of Tibetan medicine have been established to continue and develop this traditional medical art. The gov-ernment encourages veteran doctors of Tibetan medicine to write books summarizing their precious experiences. The fa-mous Four- Volume Medical Code has been published in a new edition along with scores of newly compiled or written teaching materials and treatises including The Complete Four-Volume Medical Code Wall Chart Series, the "Tibetan Medicine " volume of the Encyclopedia of Medicine, Tibetan Medicine Physiology, Pathology, Pharmacology, and Bro-matology, and the New Compilation of Tibetan Medicine. In recent years research specialists in Tibetan medicine has qualitatively and quantitatively analyzed more than 1,000 plants used in Tibetan medicine to determine their specific name, pharmacological components, functions and effects, and their proper use and dosage, with the result that Tibetan medicine has become more standardized and scientific. At present, there are three fairly large factories producing Tibe-tan pharmaceuticals. In addition, some prefectural-and coun-ty-level Tibetan medicine hospitals and Tibetan medicine departments in other hospitals themselves have the capacity to produce Tibetan pharmaceuticals. The particular efficacy of traditional Tibetan patent medicines such as Tsodru 701n-gredients, Tsodru Tashel, Yunying 25 Ingredients and Chan-gior in treating common and stubborn illnesses has been pro-ven through modern laboratory analysis and clinical obser-vation. Combined treatment with Tibetan and Westem medi-cine has produced cures in 73 percent of chronic atrophic gastritis cases.

To summarize, traditional Tibetan medicine, originally unique to Tibet and born out of centuries of battling nature, has become an important part of Chinese medicine. As it integrates with advanced modern science, Tibetan medicine better serves Tibetans and people from all over the world. And the best of it has been inherited for further development.

Traditional Tibetan medicine draws followers

Thursday was a red-letter day for Purbu Cering, a graduate student with the Tibet College of Tibetan Medicine, as he passed his dissertation for a master's degree.

The young man from Xigaze, a small city with 85,300 people to the west of the regional capital Lhasa, is one of the 12 candidates to pursue the degree this year, according to the schoolboard.
As the only higher learning institution for Tibetan medicine studies, the Tibet College of Tibetan Medicine has trained more than 1,000 senior professionals, including 10 master's degree holders, for the southwest region, including Chongqing municipality, the provinces of Sichuan, Yunnan and Guizhou and theTibet Autonomous Region.

Over 400 students are presently studying for a bachelor's degree or a diploma at the college.
"The school is quite successful in carrying forward traditional Tibetan medicine," said Yangga, a graduate student who lectured onTibetan medicine at Harvard University for three months in 2002.

According to Yangga, Tibet has mobilized a large group of seasoned Tibetan doctors to train young followers since the 1980s."Today, many of these young followers have established themselves as the backbone in teaching and research."

With a history of some 1,300 years, the Tibetan medicine has won itself a reputation for strong traditional characteristics in its understanding of physiology, diagnosis and treatment, especially its effectiveness for arthritis, gastric ulcers and altitude sickness as well as tumors, diabetes, blood diseases and other diseases which Western medicine is unable to deal with.

The discipline was developed over a long period by the Tibetan people based on their experiences in life and production, absorbing the strong points of traditional Chinese medicine and ancient Indian and Arabic medicines.

Tibetan medicine to benefit more

A medical treatment centre was jointly opened by the China-Japan Friendship Hospital and Beijing Tibetan Medicine Hospital. The centre is expected to better introduce Tibetan medicines and contribute more to people's health.

Taking a bath in Tibetan medicinal water

　　　　　　　　
Lighting incense in a room and planting oneself into the environment scented by the smoke is one of the ways Tibetans keep fit. And they say they are taking a bath when doing so.
According to the Tibetan medical code, the Tibetans had long produced many ways for “taking baths” to cleanse themselves, build up their physique and prolong life. Most popular ones include taking baths in rivers or in medicated water, or by exposing themselves to steam or sunshine, plus the above-mentioned method.
The seventh Tibetan month is the best season for taking baths. The rainy season has ended, and river water temperature begins to pick up. Most of the plants have ripened. Tibetans believe the deity in charge of medicine will descend to the earth to gather medicinal herbs at this time.
Manager of the China Tibetan Medicinal Water Bathing Center in Beijing explaining the history of Tibetans taking baths in medicinal water to Wang Zhaoguo and other State leaders.
A bright star called Garma Duiba is the incarnation of the deity, who appears for seven days in early autumn. All water receiving his light becomes dew. Taking a dip in the dew will help build up one’s health and remove one’s sins. This marks the Bathing Festival, during which Tibetans rush to rivers for the purpose, especially at night when the deity star appears in the sky.
Bathing in medicated water is the continuation of the Bathing Festival. It takes in the good points of taking baths in rivers, in a smoky environment and in a house filled with steam.
What is popularly used for bathing in medicated water is “the five-taste dew”. It is actually a kind of soup prepared with cypress and azalea leaves and three kinds of medicinal herbs. Taking a bath in the soup does not mean dipping oneself in it. The soup is boiled and the steam produced provides the “smoke” for the bather. Tibetans believe such bathing is good for blood circulation and the kidney.
Through generations of research and study, more preparations have been developed to help treat internal diseases, skin diseases and those related to arthritis and nervous disability. In recent years, Tibetan medical circles have been encouraging the general public to adopt the bathing treatment.
In December 2001, the China Tibetan Medicinal Water Bathing Center, the first of its kind in China, was built in Beijing. It has since received many people from government and art circles in and outside China. The former premier of Kazakhstan took a special trip by air here for a dip in the medicated water for nine days running. He returned home lauding its magical effect.

Diagnosis In Tibetan Medicine-Like A Rich Man With One Child

By Eliot Tokar

In describing how he worked as a physician, my teacher, Dr. Trogawa Rinpoche,2 remarked: "my external activity is the practice of medicine, and in my inner thoughts I meditate on the Medicine Buddha". This comment does not simply tell us that Dr. Trogawa is a religious or pious man. Properly understood, this remark displays the first step in the process and practice of Tibetan medical diagnosis. It is an ongoing practice toward spiritual development and its resultant awareness and intention, toward which the physician continually strives. Given the differing levels of practice and development that exist among Tibetan doctors, there is no quantitatively prescribed standard for this aspect of medical practice. Still, the primary classic principle of Tibetan medical practice is that the bedrock of one's approach to diagnosis lies within the doctor's spiritual practice.

In describing the Tibetan approach to diagnosis it is vital to understand how the properly trained Tibetan doctor sees the world. After all, it is always within a doctor's subjective understanding of the nature of the phenomenal world that the relatively objective work of obtaining a diagnosis occurs. How, then, do Buddhist teachings determine the basis for making a clear diagnosis of illness?

Because the historical Buddha described his role and teaching in a fundamentally medical fashion, this connection is very direct. In fact, because the Buddha's teachings were meant to cure suffering, he was known as "The Supreme Physician".3 The Buddha is therefore a direct inspiration for Tibetan doctors, who attempt to emulate this model of a spiritually realized being who makes a conscious choice to cure others.

To appreciate how a particular medical system approaches diagnosis, one must discover how a doctor trained in that system perceives the patient. It is important to comprehend that doctor's conscious intention.

Buddhist teachings delineate Tibetan doctors' image of themselves and their patients as well as the doctor-patient relationship. Buddhism's central teachings and practices place great emphasis on (1) understanding and discovering the nature of one's mind, and thereby transcending ego; (2) developing a practice of compassion toward all other conscious beings; and (3) developing a sense of equanimity. Therefore, for the doctor of Tibetan medicine there is no psychological or professional dilemma in directly identifying with his or her patient -- as there can be, for instance, in Western medicine. In a sense, the Tibetan physician intentionally seeks to identify with the patient. It is important for us as physicians to intimately understand the basic nature of suffering -- both the patient's and the doctor's -- as well as to understand that our relationship to the patient has both a professional and spiritual significance.

Through spiritual practice the Tibetan doctor is trained to emulate a highly spiritually evolved person. A direct connection develops between the doctor's perception of the patient and a Bodhisattva's perception of all beings. The term "Bodhisattva" literally means "hero of enlightenment". Bodhisattvas are spiritual trainees who strive to generate an altruistic mind of love and compassion.4 They are basically Buddhas in the making who have dedicated their pursuit of spiritual awareness to the single goal of bringing about the welfare of all.

We can get a glimpse of the professional ethic Dr. Trogawa endeavors to practice in an instruction from the Buddhist sage Vimalakirti:

...I am ill because all sentient beings are ill. If the illness of all sentient beings were to come to an end, then my illness would be ended. Why is this so? Because when the Bodhisattva enters into the realm of birth and death for the sake of beings, he becomes subject to the laws of this realm and thereupon becomes ill. If all sentient beings were to be cured of their diseases, then the Bodhisattva would never be ill again.

It is like the rich man who only has one child. When his child becomes ill, his parents become ill. If the son is cured of disease, so also are the parents. It is the same for the Bodhisattva: he loves all beings as if each of them were his child. When all beings are cured, then the Bodhisattva will be cured.... 3

Before seeing their first patient, Tibetan doctors practice an archetypal diagnosis that becomes a basis for all the diagnoses they will perform throughout life. This diagnosis is visualized in a meditation practice used by traditionally trained Tibetan doctors.

In this meditation physicians visualize the Buddha Of Medicine, seeing all beings before him, with their particular suffering and all of the innumerable diseases they may have. The Medicine Buddha feels anguish for them and wishes them freedom from suffering. Through the power of his realized mind, this Medicine Buddha diagnoses the illnesses as symptomatic of fundamental spiritual disharmony caused by ignorance. This ignorance is a lack of understanding of the basic nature of reality, as understood from the Buddhist perspective.

The resultant confusion leads to activities of our body and mind which directly or indirectly lead to suffering and illness. Given this diagnosis, the Medicine Buddha understands the temporary, illusory nature of illness. Pushing through his sense of anguish, he delves deeper into this and sees that within every atom of every being who appears as suffering, there exists a Medicine Buddha. He experiences inner joy in the knowledge that despite suffering, there is the potential for boundless happiness. Having completed his diagnosis, the Medicine Buddha projects a purifying energy from himself to those before him that reveals their inherently healthy state.5

At this point in the meditation, practitioners merge their own selves with the being of the Medicine Buddha and become indistinguishable from him. They then proceed to a state of meditative emptiness derived from the understanding of the Buddhist teachings. In relation to this emptiness, all the forms and concepts we occupy in life -- including illness -- are understood as illusory, dream-like and therefore highly changeable. Thus, it follows that illness is made worse or better by changes in the mental perception we give it.

The Medicine Buddha's profound diagnostic skills are derived from wisdom based on deep awareness and perception. These qualities, along with his resultant capacity to heal, makes him the role model for the physician of Tibetan medicine By visualizing themselves as Medicine Buddha, doctors of Tibetan medicine pursue an aspiration to develop the same capacity for compassion, awareness and skillfulness. This process is the root from which diagnostic skill develops. It is established even before the first patient walks in the door.

Diagnosis In Tibetan Medicine -Learning To See

By Eliot Tokar

In the teachings of Tibetan medicine there is a metaphor that refers to the stages of development of the diagnostician. At the first level a student of medicine is likened to a person standing on a mountain top who is unable to perceive what is on the top of the opposite peak. At the next level the student can see that something is there. At a higher level the student can perceive that someone is standing on the opposite peak but he or she still lacks the ability to perceive anything about that person. At many succeeding levels, more and more can be perceived about this person until, ultimately, at the most advanced degree of ability, the student recognizes precisely who is there.

This metaphor describes the evolution of perceptive abilities in learning Tibetan medical diagnosis. Its meaning can also apply to the gradual process that practitioners of different medical systems must be undergo to truly perceive what a doctor from another scientific world view sees. Performing a medical diagnosis requires an understanding of the technique and language of the system within which one is operating. The foundation of diagnostic skill, however, is the development of a capacity of awareness that leads to clear and precise perception.

The following article will explain the basic tools and language of Tibetan diagnosis and begin to clear the mist that stands between the peak of Tibetan medicine and that of other medical traditions. To begin establishing a truly complementary approach to medicine, there must be a common language created through which traditional and allopathic doctors can effectively communicate about their disciplines. Medical traditions are not the sum total of their diagnostic or treatment techniques; instead, they are the result of the scientific, cultural, and spiritual knowledge that gave rise to those therapeutic applications. To establish a common language of communication, we must begin by seeing clearly.

This point is demonstrated in the book Mortal Lessons by the surgeon and Yale professor, Richard Selzer, MD.1 In this book Dr. Selzer recounts a diagnostic session performed by my first teacher, Dr. Yeshi Donden. The session was part of a demonstration conducted at an American hospital. Dr. Donden was shown a patient about whom he was told nothing. Before an audience of skeptical Western physicians, Dr. Donden performed the Tibetan pulse diagnosis and urinalysis. To the amazement of his audience he was able to accurately diagnose that the patient had a chronic heart problem. He diagnosed an imbalance in the basic circulatory principle of the body as it relates to blood and heart function. This disorder had progressed to a stage in which it affected the patients pre-existing heart irregularity, which had developed during a specific stage of embryological development. Dr. Selzer1 recounted the diagnosis in this manner: "

[Dr. Donden] speaks of winds coursing through the body of the woman, currents that break against barriers, eddying. These vortices are in her blood, he says. The last spendings of an imperfect heart. Between the chambers of her heart, long, long before she was born, a wind had come and blown open a deep gate that must never be opened. Through it charge the full waters of her river, as the mountain stream cascades in the springtime, battering, knocking loose the land and flooding her breath."

The allopathic diagnosis had been "congenital heart disease", an "interventricular septal defect, with resultant heart failure". To Dr. Selzer, who was used to the worldview, technique, and jargon of his profession, the Tibetan diagnosis seemed remarkably poetic. Dr. Selzer described this diagnosis as a largely divine mystical experience accessible to priests but not to mere doctors.1 Interest, fascination, and perhaps even respect were engendered, but little understanding between the doctors seems to develop. In fact, what Dr. Donden was doing was not magic. He was doing what is expected of a properly trained Tibetan physician, albeit at its highest level.

Diagnosis In Tibetan Medicine- Introduction

By Eliot Tokar
When most patients seek a doctor for a medical diagnosis, they generally assume that the process will clearly and directly reveal the truth about their condition. Their assumption is that the diagnostic procedure will reveal their illness in much the same way that cutting open an apple bears its core. In most cases, however, nothing could be further from the truth.

In examining the nature of diagnostic procedures, it is worthwhile to recall the Indian tale of the blind men who encountered an elephant. In this story each man, feeling only one part of the elephant, draws a completely different and erroneous conclusion about what he holds in his hands. None of them perceives that he is touching an elephant. Instead, judging from limited experience, each decides that the part he is experiencing must equal the whole: the leg is thought to be a tree trunk, the tail a rope, the trunk a snake, and so on.

In medical diagnosis we healthcare practitioners begin with our biases, based on our personal, cultural, and professional world view, thus forming the basis either for our blindness or our insight. We obtain a limited set of information that is derived from tests and/or other techniques defined by our tradition's medical science. Through this analysis, which is based on our understanding, experience, and awareness, we then attempt to comprehend the truth of the condition.

If we are to succeed we must do better than the blind men of the tale. By experiencing the trunk, leg, or tusk, we must be able finally to perceive the whole. We must ultimately have the insight and skill to see the entire elephant. However, and because of the blindness inherent in the prejudices and limitations of any world view, we inevitably see a slightly or even radically different elephant.