Details of Tibetan Medicine: 4 Treatment of Disease

General Approach to Treatment

We have now covered the classification of disease and its diagnosis. Let us talk next about its treatment. Treatment is made by suggesting the patient modify his or her diet and behavior, and then prescribing herbal medicines, as well as sometimes acupuncture, moxabustion or other external proce­dures.

It should be noted that although there are certain standard treat­ments for specific diseases, these are always modified according to the basic bodily constitution of the patient, as well as the season of the year. During the course of a treat­ment, the medicines are often changed, for instance from weak­er to stronger. Sometimes the approach is to collect and con­centrate the disease in one part of the body with one set of medicines, and then afterwards to eliminate the sickness from its root with either another set of medi­cines, moxabustion or whatever. This is why it often appears that at first a Tibetan treatment makes the symptoms of a sickness worse.

This is the oppo­site of what is sometimes found in an allo­pathic approach, which may just dilute and dis­perse a disease throughout the body in an at­tempt to suppress the symp­toms. In this way, Tibetan medicine agrees with the approach found in the homeopathic system. Thus, it is necessary for a Tibetan doctor to monitor the course of a treatment. Also, it should be noted that Tibetan medicinal ingredi­ents are detoxified during their preparation and so do not have any adverse side-effects.

Medicine and Diet

To discuss how diet is modified and medicine prescribed, it is necessary to introduce the Tibetan Buddhist system of classification of tastes. Foods and herbs are not classified according to the three qualities of rajas, sattva and tamas as is found in the Hindu Ayurvedic system. Nor are they clas­sified accor­ding to the five Chinese elements or yin and yang as in Chinese medicine or Japanese macrobiotics. Rather, foods and medicinal ingredients are clas­sified according to six tastes and six post-digestive tastes, as well as eight inher­ent quali­ties and seventeen secondary qualities. This is also found in the Ayurvedic system, with some minor differences, but there it is secondary to the classification scheme of rajas, sattva and tamas. 

Thus, the environment a particular food is grown in affects its qualities. Sometimes, however, in the Tibetan system the six tastes are analyzed in terms of the five Indian elements. 

  • Sweet foods are a combina­tion of earth and water
  • Sour – fire and earth
  • Salty – water and fire
  • Bitter – water and air
  • Acrid – fire and air
  • Astrin­gent – earth and air. 

The space element is common to all tastes.

Tibetan medicine is prepared from different herbs and flow­ers, as well as dried fruit products, nuts, roots, the bark of trees, various animal pro­ducts, metallic and mineral substan­ces, precious gems and so on. Each medicine is composed of many different ingredients, sometimes thirty-five or more, none of which may be omitted. The ingredients are combined and ground up after each has been individually cleaned and dried in a manner fitting with its proper­ties.

The ingredients of the medicines, as well as the dietary recommendations, are chosen in terms of their tastes and qual­ities. Certain tastes and quali­ties will cause an excess in a specific humor to decrease. The same principle is involved in determining which foods and drinks may cause a disorder of the humors to manifest or get worse. Some of the speci­fics with respect to diet have already been mentioned earlier in this lecture series. There is no need to repeat them.

Tibetan doctors, then, are trained in pharmacology as well. They learn to identify the various medicinal raw materials, and how to make the medicines. They go on expeditions to the mountains to gather medicinal herbal plants. The most skill­ful can identify them blindfolded, simply by the smell and taste. The optimal location for finding the plants used in Tibetan medicine is on the slopes of high snow mountains, above the tree line, at the point where vegeta­tion just begins to grow right below the portion of the mountain that is only rock, and the ground is a mixture of rocks and slight growth. Different por­tions of the same plant have different tastes and are often used for treating different disorders. 

The combined, ground-up ingredients of a medicine can be either brewed as a tea, taken as a powder or made into small pills, usually about one centimeter in diame­ter, although sometimes about one-fifth of that size. Teas act more imme­diate­ly, like for a sore throat or asthma; powders are for rapid, deeper effects, as in the case of giving a diuretic. But pills are usually favored for long-term, deepest cures. Pills concentrate the essence of the medicines and main­tain their freshness longer.

The present-day Mongolian treatment follows the older Tibe­tan custom of pre­paring powders of only the individual medici­nal ingredi­ents and then mixing these powders together for each patient at the time of pre­scription. Since the destruc­tion of the medical monasteries in the late 1930’s, pills have not been prepared, since the whole system had to go under­ground. But the tradition of making pills will most likely soon be revived.

At present, three grades of fineness of powdered medicine are prepared in Mongolia: 

  • The coarsest grade is used for making teas. Among the Tibetans, medici­nal teas are prepared only by boiling the powdered medicine with water. In Mongolia, some are brewed this way but, for certain diseases, the medi­cinal powders can also be boiled with black tea, milk tea, milk and butter tea, or with just milk, for instance for in­somnia. 
  • The middle grade powdered medicine is swal­lowed with hot, boiled water. 
  • The finest grade is swallowed either also with hot, boiled water, or with a mixture of fermented sheep and cow whey, or even with vodka. The Four Medical Tantras do speak of taking medi­cines with alcohol for certain wind disor­ders. Although the Mongols prac­tice this, the Tibe­tans do not do so at present since so many Tibetans have taken vows not to drink alcohol.

The Mongols also take some pow­dered medi­cines with horse milk, and horse milk itself is drunk in huge quan­tities medi­cinally, especially for tuberculo­sis and other lung diseases, and for general purifica­tion of the body. In fact, it is com­mon for Mongols to follow a diet of only horse milk for one month each summer as a general puri­fying tonic­. It is not the Tibe­tan custom to collect or drink horse milk, and so it is not used therapeutically among them.

In Chinese medicine, most often the various medicinal in­gre­dients are not ground up and combined, but rather brewed whole, all together, with water as a tea.

Tibetan medicine is taken at least a half hour before or after meals, not with food, and if it is in powder or pill form, it is taken in the Tibetan tradition only with a glass of very hot, boiled water to help digest it. The pills must be crushed or chewed well before swal­lowing. Precious pills made from pulverized precious gems combined with other ingredients are light sensi­tive. They are wrapped in silk and must be prepared and taken in the dark, with a special diet to be followed that day. Medicinal butters are prepared by boiling butter, milk, honey and various combinations of herbs. These are then consumed and are helpful for such things as rejuvena­tion.

Occasionally, pow­ders are taken as snuff, for instance for sinus problems or hay fever. Also, they may be mixed with vari­ous oils or butter, and rubbed on as ointments for skin di­seases. Some powders are used dry as well, in the manner of a talcum powder.

The tim­ings for taking the medicines are speci­fic, since certain humors are more dominant at certain times of the day. Wind is most strong at dawn and the early evening, bile at noon and midnight, and phlegm during the morning. Also, two, three or even four medicines are prescribed at a time, to be taken at different hours of the day for one illness. In pre­sent-day Mongolia, howev­er, usually only one medicine is pre­scribed.

Astrological Considerations for the Timings of Medicine

In the yellow calculation system used in Tibetan astrology, there is a chart telling which of the twelve two-hour periods of the day is the most auspi­cious or inauspicious for taking medicine for people born in each of the twelve possible ani­mal-sign years. Thus, for persons born in the year of the mon­key, for instance, certain two-hour periods of the morning, afternoon and night will be more effective than others, where­as for persons born in the year of the dragon or snake, etc., these sets will be different.

Also, there is a specific two-hour period of the day when medi­cines for each of the major organs will be most effective. One would try to take the medicine for that specific organ one hour before this period so that it will work the strongest then. If the two-hour period that is the best for one’s affec­ted organ happens to be inauspicious for persons born in one’s animal-sign, one would choose the auspicious period for those of one’s birth-sign that is the closest to the period for this organ. Although these points from medical astrology are found in the Tibetan tradition, they are more prominent in Mongolia, but even there they are at present rarely followed.

In the Chinese system of acupuncture, as taught in the Chinese hospital in Ulaan Baatar, a much more modified proce­dure is followed for determining the time of treat­ment. The best hour is chosen by considering whether the patient is male or female; if female, whether she has had children or not; whether the patient is less than twenty years of age, or be­tween twenty and forty-eight, or older than this; and whether the disease is a yin or yang one, in other words, a cold or hot disorder. If treatment cannot be done at this hour, then the length of time the needles are left in and the amount they are twisted during the ses­sion will be modified.

Tastes and Qualities of Medicines and Foods

One part of the theory of the treatment of disease, then, concerns the tastes of the medicines. This, plus the post-digestive taste, will often stimu­late the body to react, for instance by secreting certain substances. Thus, it is important actually to taste the medicine, and not to hide its taste with more pleasant foods or drink. Furthermore, dif­ferent tastes have differ­ent effects when they are taken in moderation or in excess.

The six tastes are:  

  • Sweet – like honey
  • Sour – like lemon 
  • Salty – like salt 
  • Bitter  – like quinine  
  • Acrid or spicey hot – like pepper  
  • Astringent – makes mouth pucker like betel nut.  

The six post-digestive tastes and their effects are: 

  • Sweet – harms phlegm, pacifies wind and bile  
  • Sour – harms bile, pacifies wind and phlegm
  • Salty – harms bile, pacifies wind and phlegm  
  • Bitter – harms wind and phlegm, pacifies bile  
  • Acrid – harms bile, pacifies wind and phlegm  
  • Astringent – harms wind and phlegm, pacifies bile. 

Foods and medicines also have inherent and secondary quali­ties. These too affect imbalances in the body. The eight in­herent qualities are being heavy or light, rough or soft, oily, acrid and either heat­ing or cooling. Hot and cold foods, then, do not refer to tempera­ture, or to their level of spi­ciness, but to their ability to have a heating or cooling effect on the body. For example, cauli­flower and cabbage are cool­ing foods and they would be very damag­ing and difficult to digest if one has low diges­tive heat. 

Here is a full list of the eight inherent qualities of foods and examples are: 

  • Heaviness or weighty –potato, corn, wheat  
  • Oiliness – eggs, fish, mango, banana, pomegranate; 
  • Coolness – cauliflower, cabbage, pork 
  • Soothing or softening – spinach
  • Lightness – poultry
  • Roughness – coffee, rabbit meat, carnivorous animals  
  • Heat – buffalo meat, pomegranate
  • Acridity – hot chilies.  

The secondary qualities also include being heavy or light, rough or gentle, oily or dry, heating or cooling, etc. But these are deter­mined by the climate and location where the food or medici­nal plant grows. For instance, food grown in a moist, windy environment will be gentle, but in a dry, windy one, rough. If it is grown in a cold, windy environment in general, it will be cooling, while in a hot, dry place, heat­ing. This is why medicinal plants grown artifi­cial­ly in an environ­ment differ­ent from their natural one will not have the same healing proper­ties as those found in their native place. Refrigeration, freezing, reheating and preserving also seem to change the secondary qualities of foods.

The full list of the seventeen secondary qualities of foods, with examples, is as follows:  

  • Gentleness – food grown in moist windy environment 
  • Heaviness – marrow, potato, cabbage
  • Warmth – chili peppers, pomegranate  
  • Oiliness – sesame and grain oils, yak meat  
  • Firmness – rabbit brain and other foods that counter diarrhea  
  • Coldness – food grown in a windy environment
  • Softening – spinach and other foods grown in environments with strong element of earth  
  • Coolness – orange, vegetables in general
  • Pliability – foods grown in water
  • Thinness (of fluids) – foods grown in water  
  • Dryness – food grown in hot, dry places
  • Fatlessness – pulses, etc. with no fat
  • Heat – grown in sunny, hot places  
  • Lightness – grown in cool, windy places; 
  • Acridity – grown in sunny dry places
  • Roughness – grown in dry windy places 
  • Motility – grown in windy places.  

When treating a particular sickness, then, Tibetan doctors will recommend certain foods and drinks that will be helpful and others that should be avoid­ed. Although this has been discussed already, one further point needs to be mentioned. One of the most general dietary rules is not to mix foods or li­quids cold in temperature with those that are hot. To drink ice cold water with a hot meal destroys the diges­tive heat and may lead to digestive pro­blems.      

Modifica­tions of behavior are also suggested. The types of ac­tions that ag­grav­ate and alleviate the general disorders of the three humors have already been mentioned. Thus. for bile, one should stay out of the sun and so on. There is no need to repeat.

Current American Research in Behavioral Medicine

A new field of medicine has been evolving in the United States, called behavioral medicine. This involves the use of mindfulness meditation in stress-reduction clinics as an ad­junct to medication in promoting healing and coping with pain.

In the Tibetan tradition, the medical texts do not specifi­cally and expli­citly prescribe meditation for improving health. But implicit in the discus­sion of the deepest cause of disease being confusion about reality and the disturbing emotions, is the medical benefit of meditation techniques to eliminate these causes.

With mindfulness meditation, one focuses on the sensations in the body by scanning each part of the body very slowly. One sees how pain is not something solid, permanent and always the same, but is changing. In this way, one does not become so frightened of the pain, and with a drop in anxiety, patients are much better able to reduce or even eliminate their pain. One can also focus on how the thoughts arise and fall, so that one does not necessarily have to believe the negative thoughts that arise, such as “This pain is killing me,” “I can’t take it anymore,” “I’m going to get a headache,” and so on. These techniques have been very successful with patients suffering from chronic pain, headaches, asthma, arthritis, cancer, high blood pressure, AIDS and so on. Mindfulness meditation might not cure a person of cancer or AIDS but seems to prolong their lives and improve their quality of life so that they are better able to cope with their sickness.  

Moxabustion

There are further types of treatments besides changes of diet, behavior and taking medicines. The foremost is moxa­bustion, which is the application of various degrees of heat at specific energy points along the channels of the body’s subtle energy system. The word “moxa” common­ly used in English and other languages derives from the Tibetan word “metsa” (me-btsa’), meaning to apply heat. It is a technique developed in Tibet and Cen­tral Asia which then spread to other medical systems such as the Chinese.

In the Tibetan presentation of physiolo­gy, there is a detailed description of subtle energy chan­nels, through which the various types of winds or subtle energies flow. These non-material chan­nels, which cannot be found under dissection, have specific points at which blockages can occur and at which both moxabus­tion and acupunc­ture can be done. These chan­nels and points are differ­ent from the sub­tle energy meridians and acupuncture points used in Chinese medicine. ­More­over, the channels are slightly different as well from those specified in the Bud­dhist tantras and used in advanced meditation practice to gain control over the subtle energies and states of consciousness associa­ted with them. There is no contradiction here, since many levels of subtle systems may coexist within each person.

The least severe type of moxabustion is done with either a piece of sandalwood or, more commonly, a special type of onyx stone found only in Tibet and Cen­tral Asia, called the “zebra stone”, in Tibetan “zi” (gzi), which is moun­ted into a wooden handle. The zebra stone or sandalwood is heated by friction, rubbing it back and forth with great force along a groove on a wooden board. It is then applied to the appropriate moxa points, often located by making precise mea­surements on the body in accordance with the bodily proportions. The burn usu­ally produces a blister, which is no more severe than a ciga­rette burn.

I have had personal experience with this type of zebra stone moxabustion, having had it done to myself perhaps more than a hundred times. It was ex­tremely effective for a joint disorder I had. I had a syndrome that the Tibe­tan doctor told me was going to develop into either arthritis or rheumatism. I do not know the exact European medical explanation, so please forgive my ignor­ance and naivety. I was experiencing stiffness in my shoulder and hip joints, and there were soft lumps be­neath the skin at the joints that were painful when pressed. Perhaps they were inflamed lymph nodes or something like that. I do not really know. The burning was done exactly on the spot of those lumps and it would form a blister there. The way I conceptualized about it, and I may be totally wrong, is that whatever fluid was causing the difficulty in the lymph area around the joint would drain out of the lump and fill the blister that formed with the burning. Whether this is medical­ly correct or not, I do not know. But, in any case, the burn­ing instantly alleviated the pressure and got rid of the lumps at my joints. By having this treatment done repeatedly over seve­ral years, combined with taking herbal medicine, the lumps eventually stop­ped forming and now I no longer experience any difficulties with my joint­s. The moxabustion, I feel, was very effective and successful.

On another occasion, I had a case of ilio-tibial syndrome in which the ten­don, I believe, at my knee was rubbing against the bone so that it was very painful to walk down hills or for long distances. Living in the mountains, as I do, this is a great inconvenience. I was out of India when this happened, and I tried massage, Chinese acupuncture and so on, but recei­ved no relief. The Western allopathic doctors had no remedy and simply recommended I wear an elastic bandage around my knee when hiking and learn to live with it. Once I returned to India, however, I had moxabustion performed with the zebra stone, and was completely cured. I was very impressed.

The next more severe type of moxabustion is done with a small-headed ham­mer-shaped instrument made of either iron, copper, silver or gold, the tip of which is heated in a coal fire and then applied at the various moxa points. It can be very effective, for instance, for correcting a curvature of the spine or a disc problem when done at several points along the vertebrae.

The most severe form is done by slowly burning a small cone of herbal moxa paste on a point directly on the skin, which takes about ten minutes. A varia­tion on this is done in combi­na­tion with a gold needle in­serted into a point, most fre­quently into the soft carti­lage on the top of the cranium. The cone of moxa paste is burned on the out­side tip of the gold needle so that the heat is transferred to the point. These more severe types of moxa are most frequently done for paraly­sis, espe­cially in associa­tion with a stroke, as well as for epilepsy, migraine head­aches, severe depre­s­sion and various other intense wind disorders. In all cases, the effect is to remove blockages in the subtle energy channels and stimulate the flow of energy.

In the Kala­chakra texts there is a discussion of “life-spir­it,” in Tibe­tan, “la” (bla).  This is the type of energy that allows one to organize and sustain one’s life. In a heal­thy person, the point where this life-spirit energy can be most activated ro­tates around the body once every lunar month, paral­lel to the moon’s phase­s, so that on each lunar date it is located at a specific spot on the body. For instance, on the full moon day it is located at the top of the head. In medi­cal astrol­ogy, this is some­times taken into account when de­termining the best day to perform moxabus­tion on a specific point in the body.

In the Chinese tradition of moxabustion, herbal moxa paste is burned at the end of either a steel or silver needle in­serted into one of the Chinese, not Tibetan, acupuncture points, or it is done by holding the burn­ing paste with some instrument near the skin. It is not usually placed on the skin it­self, and there is no use of gold needles, hammers or zebra stones.

Modern American medical research, although still controver­sial, seems to indicate the existence of an energy-signaling, rapid information relay system, especially in the skin, which sends messages throug­h­out the body, much faster than through neural or chemical transmission, to ac­tivate and regulate the immune system. Although differences in tissue and cells cannot be detected under a microscope, never­theless, there are cer­tain cells in the skin that have higher concentrations of certain supercon­ductive chemicals that would allow for high-speed flow of energy. It is unclear yet exactly what form of energy is transmitted, but these areas of higher concentration seem to correspond to moxabustion and acupuncture points. This re­search is still in its infancy stage.

Acupuncture, Acupressure and Massage

Acupuncture is also practiced on the moxa points. The nee­dles are left in often for a half hour, which is generally longer than the technique used in the Chinese system. Further­more, also unlike the Chinese form, iron, copper, sil­ver or gold needles are used by the Tibetans for different disor­ders. The Chinese, in general, use only steel. Further­more, the Tibetan needles are thicker than the Chinese ones. According to the Tibetan ac­count, acupuncture was intro­duced from Tibet into Mongolia starting in the mid-thirteenth cen­tury at the time of Khubilai Khan. From Mongolia, it went to China, where it augmented the already existing Chinese form of acupuncture which had greatly declined. More research must be done to determine just what the Tibetan influence was.

Acupressure, as a form of massage, is also done. The moxa points are usual­ly stimu­lated with the flat tip of the thumb and rubbed with clock­wise mo­tion; although at certain spots, for certain disorders, vertical or horizontal motion is need­ed. Sometimes other fingers, or several fingers together are used, or even the palm. Depending on the illness and its cause, some acupres­sure is done dry, while others with some type of oil or butter. Chinese acu­pressure does not seem to have all these variants, and both clockwise and counterclock­wise motions are used.

At pre­sent, except for massaging certain vertebrae for easing and speeding childbirth, and for certain nerve disor­ders, the Tibetan tradi­tion of acupres­sure is not prac­ticed so extensively by the Tibe­tan doctors themselves. A vari­ant of it is more widely found in Mongolia, where it is known simply as Mongo­lian massage. With the M­ongolian techni­que, the pulse is taken several times during a session of treatment to check the energy flow. Certain points of the body, sometimes, but not always corresponding to the Tibetan moxa points, are pres­sed inwards with steady pressure. There is no rotation of the spot in the manner of either Tibetan or Chinese acupressure. Lines of flow of the winds and blood, from the center of the body outwards, are followed in the sequence of spots pressed.

Massage, although not practiced so frequently these days, is also done in the Tibetan system. Various types of oil are used for specific types of disor­ders. Sesame oil, for in­stance, massaged over the entire body, is helpful for wind diseases. Furthermore, it opens the pores, which can then be combined with rubbing in chick-pea flour. This is particularly effective for absorbing phlegm and fatty deposits for reducing weight. Massage is generally not used for bile imbalances.

The Tibetan medical texts do not have any type of massage analogous to the Japanese “reiki” technique of working with energy fields and auras by passing the hands over the body without ac­tually touching it. In the Mongolian massage techni­que used with Tibetan medicin­e, there is sometimes, however, the pla­cing of the doctor’s hand sligh­tly above the sick area on the patient. With mantra repetition and certain visualiza­tions, healing energy in the form of heat is sent to the area and the doctor takes on the pain of the disorder, often feel­ing it in his arms or el­sewhere. Some Mongolian doctors locate the area of the sick­ness in this manner, by passing their palm over the general area and feel­ing for heat. The Tibetan doc­tors do not prac­tice such techni­ques.

There is a Tibetan Bud­dhist medita­tion practice, however, called “giving and taking” (gtong-len, tonglen) in which one takes on the sickness of another person and gives him or her good health, but this is done solely by visu­alization and imagination. It only works if there is a special karmic rela­tion with the patient, and if there is, there is no need for any ges­tures of the hands. It is not working on the basis of the energy of the healer’s body affecting the energy of the pa­tient’s. In the Tibetan Buddhist tradition, spiritual methods involve most­ly mental practi­ces, and very few phy­sical ones. Thus, the powers of visualiza­tion, imag­ina­tion and pray­er are used for spiritual healing, rather than anything physi­cal such as the laying on of hands.

Other Treatments

There is also a tradition of using herbal enemas, emetics and purga­tives. Various oils with herbal mixtures are either inserted into the rectum as an enema or swallowed to produce vomiting or diarrhea to cleanse the bowels. Bathing in various types of natural hot mineral springs is nowa­days used as a substitute for specially prepared herbal baths, although both can be taken. Cupping with a metal cup in which a fire has been made to produce the suction or by sucking through a hol­lowed goat horn, combined with blood-letting and lymph-let­ting, is some­times also per­formed, for instance in some cases of high choleste­rol, high blood pres­sure and ar­thritis. It is only done, how­ever, when the bodily con­stitution and diet is very strong. For this rea­son, it is not per­formed so frequent­ly by the Tibetan doctors in India these days. It is quite common in Mongolia, although the goat horn technique is not used.

In the ancient texts there is mention of a system of sur­gery. But at the time of Emperor Tri Songdetsen, in the late eighth century, a heart operation was per­formed on a queen, which failed, and she died. After that, surgery was prohi­bited. All sicknesses and disorders are treated by medicines and the other procedures just mentioned, like acupuncture, moxabustion and so on. For in­stance, there is very good herbal medicine for appendicitis, tonsillitis, goi­ter and other thyroid disor­ders, and for kidney and gall stones so that in those cases an operation is unneces­sary.

Furthermore, sometimes special water, butter or even tiny pills are pre­pared, over which a great spiritual master, or some­times even hundreds of monks, have recited millions of mantras and then blown their breath. These substances are sometimes taken by patients for helping in cer­tain very diffi­cult situations. I have seen such conse­crated butter taken by a woman during a particularly long period of labor during childbirth, and it facilitated the birth. I have seen such water taken by someone paralyzed with a stroke and it seemed to be effec­tive. Certain pills of this type are even helpful for the common cold. There are many such instances.

Treatment of Insanity and Mental Disease

Insanity can be described in various ways. It is most­ly con­sidered an imbalance of the humors, particularly of wind. In such cases, it is treated with herbal medicines to bring the humors back into balance. Mental disease can also be caused by harm­ful spirits. Whether these are understood as actual spir­its causing harm or possessing someone, or simply as beings in general who are doing much mischief to make some­one crazy, the approach is similar. Such harm is seen as the result of one’s own previous destructive, cruel actions. One would have monks perform certain rituals aimed at appeasing and driving away these spirits, with the power of love and com­passion for them and sympathy for their own misera­ble state. Such rituals are often done as an adjunct to the medi­cal treatment of even purely physical sicknesses. The patient, if receptive, would also be advised to be­come more loving and compassionate, and if possible, to engage in spiritual prac­tices, such as mantra repetition, with this altruistic motiva­tion.

Insanity can also be due to the loss of one’s life-spirit energy (bla), mentioned before, which is like an organizing energy of life. For in­stance, people who wit­ness terrible figh­ting and carnage in batt­le, with many people being mutilated and killed, or some awful natural or social disaster with much loss of life, may lose this or­ganizing energy that would keep their life to­gether. They simply give up trying to cope with their life­, and do not do any­thing. This is a com­monly noted syndrome among soldiers, known as “shell-shock” or post-traumatic stress disorder, PTSD, and those who have a nervous breakdown and some concentration camp sur­vivors. I think it has something to do with the autoimmune sys­tem but taken more on a psycholo­gical level. So, when someone cannot cope with life’s situa­tions, the Tibetans would diagnose this as their having lost their life-spirit. In the Tibetan medical system, various rituals can be performed, known as “hooking back the life-spirit energy (bla-‘gugs). Moxa­bustion can be also be applied and medi­tation techni­ques be en­gaged in by the patient.

Thus, there can be many different causes for mental diffi­culties and many different treatments. But the deepest level of treatment is to try to see reality to overcome confusion.

I have not come across a specific medical treatment for alcohol or drug abuse. Mostly, patients would be advised to try to modify their be­havior by considering how it negatively affects others and how it severely limits them from being able to realize their pot­en­tials and help others. Ultimately, they would be led to see through the confu­sion that is causing the problem. Once they have stopped drinking or taking drugs, there is Tibetan medic­ine for detoxifying the body, particu­larly for purifying the blood.

Bon Treatment of Disease

I have unable to get any information yet about the Bon tradi­tion of medicine studied in the born monasteries today. There are certain elements from the ancient Bon medical tradition, however, that carry over into the present Tibetan system and that basi­cally is referring to certain terminology that survives in the modern texts.

There is, however, a Bon approach to sick­ness within its own ritual framework. One of the basic princi­ples of Bon is that in order to bring about a balance within the body, one must bring into balance the environment and elemental forces around one. By healing the envi­ronment, one can heal the pati­ent.

This can be done in various ways, with rituals of appease­ment of nature spir­its and so on. But one of the most common techniques is in association with astrology. Certain elements, usually the Chinese set of earth, water, fire, wood and iron, are associated with every­one’s astrological chart. Each ele­ment has a color. Strings of these colors are woven together to form a type of so-called “space-harmonizing web,” the pat­tern and choice of colors of which is calcu­lated from the patient’s chart. When such a web is hung outside the patient’s house, it acts to bring back into harmony the elemental forces around the patient. In so doing, it brings about the more conducive ex­ternal condition that will help in the patient’s recovery. Such methods, however, are never a substitute for the use of medicine.

Summary

Tibetan medicine, especially its herbal remedies, moxabus­tion and acupuncture, is very effective for many diseases that are very diffi­cult to cure with European allopathic means, such as hepati­tis, rheumatism, arthritis, sciatica, high blood pressure, diabetes, multiple sclerosis, asth­ma, allergies and so on. Nevertheless, if these are present in the form of thor­oughly established diseases, such as when inherited or gene­tic, then even Tibetan medicine will not always be successful.

Tibetan medicine has been effective with many types of cancer, and even when it cannot cure the cancer, it often diminishes the pain, prolongs the life and keeps the mind and senses clear up to death. At the time of the toxic chemi­cal poi­soning disaster in Bhopal, India, Tibetan medicine was extremely effec­tive in countering the ef­fects and preventing deaths. There is even quite good medicine for the common cold, with which one seems to go through the cycle of the cold very quickly and then is done with it.

No system of medicine can claim a perfect record of cures for any disease, and this is especially true in terms of the Tibetan approach in which each patie­nt, being treated holisti­cally, is an individual case and is given indi­vidual medica­tion. But still people’s experience with Tibetan treat­ment is very impressive. One should not expect, however, mira­cle cures for everything. For some sicknesses, there are bet­ter allo­pathic medi­cines and pre­ventives, such as for small­pox. But, even in the case of acci­dents, there is a Tibetan tradition of setting bones and giving medicines helpful for speeding the healing process and eliminating or preventing shock. Moreover, the Tibetan doctors treat animals as well, such as setting the broken leg of a horse. In Tibet and Mongo­lia, people do not shoot horses that break their legs!

Thus, it can be seen that the training of a Tibetan doctor is very broad and extensive. It is based on a strong moral ethic of benefiting the patients and never charging for exami­nations, only for medicines. Not only does it include human and veterinary medicine, and pharmacology, but Tibetan astro­logy as well. Tibetan medical schools always include an astro­logy division that trains not only astrologers, but also teaches specialized courses for the doc­tors. For instance, depending on the animal-sign of someone’s year of birth, there are certain days of the week that are conducive for life-force and life-ener­gy, and others that are disastrous. A doctor would take these into considera­tion when choosing a day of the week to perform moxabustion and so forth on a speci­fic pa­tient.

In summary, the Tibetan Buddhist medical system has a long tra­dition of practice not only in Tibet, but also Mongolia, the Mongol and Turkic Buddhist regions of the Soviet Union and China, and in portions of Nepal and the vari­ous Hima­layan areas. It has a great deal to offer and share with the Euro­pean allopa­thic, alternative and other traditional forms of medicine. There are various programs being conducted these days at medical universities and clin­ics, parti­cularly in the United States and Western Europe, to test certain Tibetan medi­cines, such as for cancer and AIDS. The Tibetans, on their side, are interes­ted in learning medical techniques from the allopathic system, such as for smallpox prevention, first aid and so on. Thus, with mutual research, respect and sharing of resources, everyone can be benefited.

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