Can you speak a little bit about healing rituals?
The discussion of healing rituals is similar to what we discussed with respect to karma. Imaginary or psychosomatic diseases, which are caused by harmful forces, are usually treated with rituals and prayers. Often Tibetans will have pujas or prayers done as a supplement to medical treatment. One does not just have the puja done without taking medicine. To do so would be like the following joke.
A man was praying to God to help him. God finally said, "What do you want?" The man said, "I would like to win the lottery." "Okay." So the man waited and waited and nothing happened. Then the fellow started praying again: "God, why have you abandoned me?" God answered, "Idiot, buy a lottery ticket!"
The rituals are not going to be effective until we buy the lottery ticket, until we take the medicine. Then they can be of some help, but they are not going to bring about miracles. They will only help if we have the karmic potential to be helped by this type of ritual. One needs to approach these rituals in a realistic fashion. They can help boost our confidence but they are really only to be done as a supplement to medical treatment. They are not magical or miraculous.
Can you talk a little bit about medicines made with precious gems?
Tibetan medicine has what are called "precious pills," which are usually made with detoxified mercury and some precious gems and metals. I know that they use diamond dust, gold and silver. Certain minerals are used, though I do not know the specifics. These precious pills are used for detoxification and so on. They usually come wrapped in colored silk with a wax seal because they are light sensitive. We need to try to not expose them to light. Sometimes, we have to soak them in water, so we get a porcelain cup and put a top on it. Or we just cut the silk off and pop it into our mouth right away.
When you were being cured of wind disorders, did the doctors tell you to bathe in hot or cold water?
No, they did not say anything specific about bathing. Some wind disorders are classified as hot and some as cold. For some, keeping warm is helpful, so a hot bath may be helpful, but not a sauna. We can see that if we go to a sauna, for instance, it is not very good for wind and increases the blood pressure. Heat is quite harmful for bile disorders. For phlegm disorders it is very helpful to sweat because it gets the excess phlegm out, so a sauna would be very good for that.
Is it possible to detect sicknesses that have not yet been manifest as symptoms?
Tibetans certainly can treat diseases that are just in a potential form. I am taking Tibetan medicine now for that reason for my eyes, which are getting weaker. I am noticing that I have not had any trouble with my eyes. But that type of treatment is usually long-term.
If we do not have the opportunity to see a Tibetan doctor, what is available in our culture that is most similar, especially if we are taking Tibetan medicine and it runs out?
It is hard to say which system in the West is most similar. Outside of Western treatments, however, probably either Chinese or Ayurvedic medicine is the closest. Sometimes in the Tibetan tradition, we are given a powder that is made into a type of tea, but it is not like the teas in the Chinese system. In the Chinese system, they do not mix the ingredients; they just give four or five loose ingredients and then we have to make the tea ourselves. In modern times, the Chinese have made pills, but traditionally they did not.
If we find that the Tibetan medicine is effective, we can get more. If we have a prescription, we can send a photocopy and a urine sample of the first urine of the day in a little unbreakable plastic bottle. For customs officials we can just write "urine sample."
What sanitary measures are taken in the fabrication of these medicines?
The medicinal plants are washed and dried in the sun, but I don't think they would stand up to Western standards of sanitation. However, I have not heard of anyone getting stomach problems from them. I only know of one example of an old man in the West with advanced cancer who got diarrhea from the medicine.
Wouldn't the urine be contaminated in the little plastic bottle?
Well, hopefully we would wash out the shampoo first! Plastic does not react very much to urine.
Can one combine treatment by Tibetan medicine with Western medicine?
That is done sometimes. It is recommended that we do not take the medicines at the same time, but that there be a couple of hours between them. Sometimes strong vitamin pills color our urine, so it is best not to take vitamins the day before we see a Tibetan doctor, particularly vitamin B.
If the patient that is not curable, does the Tibetan doctor ever perform euthanasia?
No, they don't. They try to minimize the pain and make the patient as comfortable as possible. The Buddhist attitude is to let the karma finish itself out naturally. And, of course, they did not have machines that would artificially extend life.
For example, dogs are often put to sleep in the West. Would they do that?
From a Buddhist point of view, that is not advisable. Of course, it depends on the situation. We have to judge in each case. His Holiness the Dalai Lama has said the same. If we are in a situation where there are limited medicines and we have a choice of spending an enormous amount of resources to artificially prolong the life of someone who is going to die anyway, and there are others with the possibility of recovering who could benefit from those resources, then one has to make tough choices.
Is there a time limit associated with the treatment of different diseases?
I don't know. Tibetans will often ask a lama for a divination either before they start treatment or if a treatment has been ineffective. The lama will then recommend that a certain ritual or puja be done to supplement the treatment. In India, they will often ask which medical system they should use, Western or Tibetan, and within the Tibetan system, which doctor would be best to consult. Certain people might have more of a karmic connection with one doctor than another, or one doctor might be better than another for a certain type of disease.
In the West, it is difficult to have that type of prognostication. Tibetan medicine does not give instant cures for most things. If we have an asthma attack, Tibetan medicine will not automatically open up our lungs like a spray. But once I had hepatitis in India and after a day and half of Tibetan medicine, I could get up out of bed, which would have been impossible in the West.
Is there a mixture of Tibetan medicine and the shamanism of the Bon religion?
The whole system of prognostication to see what ritual would be appropriate or inappropriate and what spirits might be involved is the aspect that comes from Bon. Astrology was in the Bon system as well.
How does Tibetan medicine deal with teeth?
As I said in the beginning, I am not a doctor so I cannot answer specific technical questions. I am sorry. I do know, however, that dental problems are usually looked at as being caused by microbes, which is how we would look at cavities as well. They don't have a sophisticated system of dentistry. I have never seen them do any sort of dental work. There is "removing the worm from the tooth," which I think means pulling out the nerve. Besides just pulling out a rotten tooth, I do not think dentistry is emphasized. As a race, Tibetans have remarkably excellent teeth. I think that could be attributed to dairy products being a primary element of their diets for so many generations.
Dr. Choedak has said that certain sicknesses were caused by spirits. Could you talk more about that?
That is what I was referring to as the class of imaginary sicknesses. I think a lot of our understanding depends on how we understand spirits, whether that means a ghost wearing a white sheet and saying boo or whether we take it a little more metaphorically, as in the harmful forces of a war freaking somebody out. The circumstantial causes of a nervous breakdown or environmental factors could be looked at as harmful spirits. Often Tibetans speak of diseases caused by nagas. Nagas are a type of spirit associated with lakes, trees, and forests and when we pollute their territory, they cause problems. That is a way of viewing diseases that come from ecological devastation.
How about diseases that are caused by black magic or witchcraft?
There are rituals that Tibetans use for overcoming such things. Tibetans take all of that very seriously. They would be in the category of the imaginary diseases. "Imaginary" is not the best way of translating the word but that is literally what it means.
Are there specific meditations one can do for specific types of sicknesses?
I don't know of meditations for a cold as opposed to meditations for an upset stomach, but there are certainly healing meditations that can be used for any type of disease. They are usually done with visualizations of specific Buddha-figures like Tara, Medicine Buddha, or Amitayus. They are usually done in terms of the five elements that we discussed in the beginning, so they involve imagining each of the elements being healed in turn. We can also imagine that another person who is sick is in our hearts and we do the same type of healing visualizations. Then there is the healing meditation called "giving and taking" which, again, is done with the imagination. In Tibetan medicine or meditation, there is nothing like the laying on of hands. We become an absolute fool if it doesn't work – and in many cases it is not going to work, so it is dangerous to pretend that we can do it. Visualizations of taking on other people's sicknesses and giving them good health are common.
There are, of course, non-Tibetan systems, such as Reiki and so on, that involve curing with the hands. From the Tibetan Buddhist point of view, these types of healings are not accomplished simply by a physical manipulation, like a physical laying on of hands, but through a mental action of healing.
No matter what system we use, there will be cases where it does not work. It depends on how we present it. If we present something as a method that will work and it does not, we become fools. In any medical system, it is best to say that it may work; we will try it and see.
Are exorcisms a part of Tibetan medicine?
Not in Tibetan medicine itself, but in the rituals that can be done to supplement the treatment.