Tibetan medicine is a science, art and philosophy that provides a holistic approach to health care. It is a science because its principles are enumerated in a systematic and logical framework based on an understanding of the body and its relationship to the environment. It is an art because it uses diagnostic techniques based on the creativity, insight, subtlety and compassion of the medical practitioner. And it is a philosophy because it embraces the key Buddhist principles of altruism, karma and ethics.
Buddhist philosophy states that everything in the universe is in a constant state of flux – that all phenomenon are characterised by impermanence, and that the only permanent feature is impermanence itself. As Buddha said, “No matter whether perfect beings arise or not, it remains a fact, and a hard necessity of existence, that all creations are transitory.” It is this impermanence that causes each and every being to suffer at one stage or another. Suffering is thus not accidental but springs from a specific cause, whether from this life or a previous life. Only through proper learning and the genuine practice of Dharma can liberate from the vicious cycle of suffering.
Tibetan medical theory states that everything in the universe is made up of the five proto-elements:
1. sa ( Earth )
2. chu ( Water )
3. me ( Fire )
4. rLung ( Wind )
5. Nam-mkha ( Space )
Although all five proto-elements are responsible for the formation of each tissue cell, each element has a specific influence:
1. sa exerts a greater influence over the formation of muscle cells, bones, the nose and the sense of smell
2. chu is responsible for the formation of blood, body fluids, tongue and the sense of taste
3. me is responsible for body temperature, complexion, the eyes and the sense of sight
4. rLung is responsible for breathing, skin and the sense of touch and
5. nam-mkha is responsible for body cavities, the ears and the sense of hearing
The Three Principle Energy
1. rLung (wind) is one of the three principle energies of the body which manifests the the nature of Air element. It is characterised by rough, light, cold, subtle, hard and mobile. It is responsible for the physical and mental activities, respiration, expulsion of urine, faces, fetus, menstruation, spitting, burping, speech, gives clarity to sense organs, sustains life by means of acting as a medium between mind and body.
2. mKhris-pa (Bile)basically has the nature of fire. It is characterised by oily, sharp, hot, light, fetid, purgative and fluidity. mKhris-pa is responsible for hunger, thirst, digestion and assimilation, promotes bodily heat, gives lustre to body complexion and provides courage and determination.
3. Bad-kan (Phlegm) is cold in nature and is characterised by oily, cool, heavy, blunt, smCTAh, firm and sticky. Bad-kan is responsible for firmness of the body, stability of mind, induces sleep, connects bodily joints, generates tolerance and lubricates the body.
A Healthy Body:
gSowa rigpa (the art and science of healing or traditional Tibetan medicine, astronomy and astrology) involves the proper alignment of these divisions i.e. the 3 humors, 7 bodily constituents and 3 excretions, into a state of equilibrium. If this is accomplished, then the body is said to be in a state of health or free from psycho-physiological disorders; whereas a disequilibrium in any of these energies constitutes a state of disorder or ill-health.
Diagnosis in Tibetan Medicine
The diagnostic techniques include visual observation, touch and interrogation.
This involves checking a patient’s skin complexion, the colour and texture of his/her blood, nails, sputum, faeces, and other general conditions. Special attention is paid to the condition of the patient’s tongue and urine.
i. Disorders of Tongue:
In wind disorder, the tongue will red, dry and rough. In bile disorder, the tongue will be covered by a thick, pale yellow coating of phlegm. In phlegm disorder, the tongue will have a pale, thick coating of phlegm and dull, smCTAh and moist texture.
ii. Urine Disorder:
The doctor advises the patient, how and when to collect the urine sample. It is essential that patient avoid taking too much of tea, buttermilk or wine etc. which otherwise would cause discoloration of the urine sample. They are also suggested to have a sound and sufficient sleep, refrain from mental and emotional stress and desist irregular activities. It is best to satisfy these conditions a night before the examination. The urine in Wind disorder looks like water and has large bubbles when stirred. In Bile, the urine is reddish yellow and malodorous with much steam. In Phlegm, the urine is whitish with little odour or steam.
|The first urine passed at dawn is suitable for examination, since its colour is not affected by digestion and by the colour the doctor can detect diseases. The colour, steam and sediment should be tested. The urine should be kept in a plain container, so that the colour is not affected, and either a stick or straw of white colour must be used for stirring it during examination.|
Pulse reading forms the most important touching method employed in Tibetan medicine. Only after ensuring an important set of preconditions, the physician proceeds with a pulse diagnosis.
This involves placing the index finger, middle finger and ring finger of a doctor at patient’s radial arteries. The fingers must be held in a line close to one another yet not touching each other. The index finger must not put too much pressure on the skin; more pressure should be applied by the middle and ring fingers.
Left hand of patient examined by the right hand of the doctor
|a. the tip of the index finger on the right side detects heart diseases and on the left intestinal diseases|
b. the tip of the middle finger on the right side detects diseases affecting the spleen, and on the left stomach diseases
c. the tip of the ring finger on the right side detects kidney diseases and on the left diseases affecting the seminal vessel
Right hand of patient examined by the left hand of the doctor
|d. the right tip of the index finger detects lung diseases, the left tip diseases affecting the guts|
e. the right tip of the middle finger detects liver diseases, the left tip diseases due to unbalanced bile
f. the right tip of the ring finger detects kidney diseases, and the left tip diseases affecting the urinary bladder
The right hand pulse should be examined first in the case of female patients, and the left hand one in the case of males. The reason for this is that the tip of the female heart is tilted towards the right and vice versa with males.
Interrogation forms the most important clinical aspect of the diagnosis. There are three main elements to a medical interrogation:
g. determining the causative factors
h. determining the site of the illness
i. studying the signs and symptoms – this involves the doctor asking the patient about the sort of food and drink s/he has been consuming, and what kind of physical and mental behaviour s/he has been experiencing
Traditional Tibetan Medical Treatments
Dietary and Lifestyle Factors
At an immediate level, a disorder is primarily caused by an improper diet and/or lifestyle. In fact, a majority of health problems, both in developing and developed countries, can be either directly or indirectly traced to poor diet or lifestyle. Examples of this include alcoholism, hypertension and heart disease. The first form of treatment in Tibetan medicine is thus not medicines but changing a patient’s diet and/or lifestyle. Only if this fails to remedy an ailment is the use of medicines considered.
Tibetan medicines take various forms, from decoctions, powders, general pills, precious pills, and syrups, and are prescribed in small doses — a fact that reflects the emphasis Tibetan medicine places on gentle treatment.
Moxibustion and Other Treatments
Many disorders, caused by proliferation of bad blood and mKhris-pa are also treated by blood-letting at one of the body’s seventy seven blood-letting points. For cold disorders, nerve malfunction and non-malignant tumors, moxibustion, golden-needle therapy may be used to stimulate the energy channels of the body. Many diseases of the nerves and muscles, as well as pain and insomnia related to rLung, are treated with gentle massage using various medicinal oils. Medicinal bath and natural spring baths are used to treat an assortment of skin disorders as well as chronic arthritis, gout and cold types of rheumatism, and rigid and stiffness of the extremities.