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Research by Region
Tibet
A brief history of Tibetan Medicine
Controversies on the origin
of the Gyushi
Since
the Gyushi has, till date, remained the main study compendium
for Tibetan physicians, it is important to look at its controversial
history. The mythical legend on the origin of the Gyushi was aptly
summarised by Karmay (1981) and Taube (1981). Most Tibetan authors
consider the Gyushi a Terma (gTer ma; concealed teaching). The
date of a Terma "rediscovery" is often the historical
date of compilation, which is retrospectively attributed to the
authorship of great masters, according the text authority and
sacredness, along with age. From a historical scientific perspective
it is understood that the Terma traditions bear to the much older
mainstream Indian scriptural traditions, which has lived on in
Tibet (Mayer 1994: 543).
Here
is one of the legends of the Terma traditions on the Gyushi in
summary:
The
Gyushi was first explained by the Buddha Rigpai Yeshe (Rig pa'i
ye shes, i.e. Chandrananda = Vidyajnana) in Oddiyana. The Kashmiri
Pandit Dawa Gawa (Zla ba dga' ba) also known as Chandranandana
transmitted the teachings of the Gyushi to Vairocana (the first
Buddhist monks in Tibet, and a main disciple of Padmasambhava).
Vairocana gave them to Yuthog the Elder. The Gyushi were then
concealed as a "treasure" (gTer ma) inside a pillar
on the second floor of the main temple in Samye monastery. Most
publications mention a monk called Trapa Ngonshe (Grwa pa mngon
shes; 1012-1090) and date the rediscovery of the Gyushi at 1038.
Trapa Ngonshe handed it over to his disciple Upa Dardag (dBus
pa dar grags), who in turn entrusted it to Tsoyed Kongyab ('Tsho
byed dkon skyabs). The latter finally gave it to Yuthog Yontan
Gonpo the Younger (summarised from Karmay 1981 and Taube 1981).
The
emergence of divergent accounts on the origin of the Gyushi goes
back to the 14th century AD. It seems to have led to the formation
of two separate groups, each determined to uphold its own tradition.
The contest between the two groups hinged on the question of whether
the Gyushi is a translation of an Indian work or was simply written
by Yuthog the Younger (Karmay 1981). The argument has lived on
till the present: some scholars, like Vaidya Bhagwan Dash, believe
in the existence of a lost Sanskrit original and work on the reconstruction
of the Gyushi back into Sanskrit (1994-1998). Emmerick (1977:
1136) concluded that the present version of the Gyushi is based
on Indian sources, mainly the Astangahridayasamhita by Vagbhata,
and must have been considerably elaborated and re-edited by Yuthog
the Younger under the influence of Chinese medical texts, such
as the Somaraja (Tib. Zla ba'i rgyal po) and his own experiences
based on indigenous Tibetan medical knowledge. The Astangahridayasamhita
was translated into Tibetan by the translator Rinchen Zangpo (Rin
chen bzang po; 958-1055) (The romanised Sanskrit version was edited
by Emmerick and Das: 1998). The translation has been dated between
AD 1012 and 1039/40 (Taube 1981: 21) but could be even earlier
(Emmerick 1977: 1141). Meyer holds the Gyushi to be a "magnificent
work, highly structured, of a Tibetan author of creative and original
intelligence." (Meyer 1992:4).
Only
parts of the Gyushi have been translated into English (e.g. Donden
1986, Clark 1995) and only selected chapters have been studied
and analysed in detail (e.g. Emmerick 1975, Finckh 1978, Clifford
1984, Jäger 1996, Jacobson 2001).
Medical
Education and Commentaries on the Gyushi
Over the centuries the transmission of the Gyushi took place from
teacher to disciple, or from father to son in family lineages.
From the 15th to 17th centuries, two prominent medical schools
developed and co-exited in Tibet. They were known as the Northern
School, or Janglug (Byang lugs) and the Southern School, or Zurlug
(Zur lugs). Both schools were united by the Minister of the Vth
Dalai Lama, Desi Sangye Gyatso (1653-1705), at the end of the
17th century.
Over
the centuries, the corpus of Tibetan medical literature was enriched
by numerous commentaries on the Gyushi and textbooks for compounding
medicines, which adopted the materia medica of the flora and fauna
in Tibet. The most famous commentaries on the Gyushi, which are
still studied today, are the "Oral Instruction of the Ancestor"
(Mes po'i zhal lung) by Zurkha Lodo Gyalpo (1509 - 1579), the
"Blue Lapislazuli" (Vaidurya sngon po), completed in
1688 by Desi Sangye Gyatso, and the "Amplifications"
(Lhan thabs), completed in 1691 by the same author. A series of
medical paintings were created in Lhasa between 1687 and 1703
under the aegis of Sangye Gyatso as a visual aid for the study
of the "Blue Lapislazuli" commentary of the Gyushi.
The series, through its scope and the originality of its conception,
constitutes an exceptionally rich document, not only for Tibet,
but for the history of medicine in general (Meyer 1992: 12).
Following
the wish of the Vth Dalai Lama, the regent also founded a new
medical school, called "Iron Mountain" or Chagpori (lCag
po ri) in Lhasa, which became a stronghold of Tibetan medical
education and exited till 1959, when it was destroyed during the
Lhasa uprising. In 1992, the Chagpori Medical Institute was established
in Darjeeling, West Bengal, India, by the Ven. Trogawa Rinpoche
in commemoration of Chagpori in Lhasa
The
early 20th century saw the beginnings of a movement to modernise
health care in Tibet, presumably partly inspired by the thirteenth
Dalai Lama's encounter with British public health measures during
his exile in India, which lead to the foundation of Men-Tsee-Khang
(sMan rtsis khang) in Lhasa in 1916 (Samuel 2001: 262). Its director,
Khenrab Norbu (mKhyen rab nor bu; 1883-1962), published numerous
medical text books to adapt Sorig to the contemporary health care
needs of Tibetans. This trend of adaptation partly continued in
Indian exile with new publications, for example, the three volume
"Textbook of Tibetan Medicine" (Bod kyi gso rig slob
dpe) by Men-Tsee-Khang in Dharamsala, aiming at easier comprehension
of the Gyushi for modern students.
Modern
History (since 1959)
The modern history of Tibetan medicine is characterised by the
emergence of complex and new issues. Since 1959, Tibetan medicine
has encountered increasingly cultural dominance by Western biomedicine
in exile and at home. Consequently, the theoretical, institutional
and clinical practice of Tibetan medicine has undergone great
transformations linked to its confrontation with modernity and
secularism. Its introduction to the West, attempts at preserving
the tradition in the Tibetan exile community in India and Nepal,
and the institutionalisation of education and clinical practice
in the Tibet Autonomous Region (TAR) are main areas where such
key transformations have taken place.
Some
research works have appeared on the problems of these transitions.
Craig R. Janes wrote about the transformation of Tibetan Health
care system under Chinese rule (1995) and analysed the political
and economic forces that have transformed both the role of Tibetan
medicine in the primary health care system of the TAR, as well
as the perspectives and behaviours of the users of Tibetan medicine
(1999a, 2001). Vincanne Adams analysed Tibetan medical theories
on women's health in Lhasa (1998, 2001a), ambiguous practices
of science in Tibetan medicine (2001b) and the interrelationship
of science and the State in contemporary Tibetan medical practice
in Lhasa (2002a). One of her recent papers (2002b) investigates
the criminalisation of Tibetan medicine and medical practitioners
as part of the global pharmaceutical pursuit of new medical products.
Medical anthropological research by Sienna Craig focuses on professionalisation,
identity and efficacy among Tibetan medical practitioners in Nepal
(forthcoming, 2003). Audrey Prost explores how the changing lifestyles
of Tibetan refugees in Dharamsala and the emerging medical pluralism
of exile affects local perceptions of health and therapeutic strategies
(2004).
Several
doctoral theses have appeared on Tibetan medicine since the 1980s
(see separate list).
One
of the unique features of the Tibetan medical tradition in comparison
with Western, Chinese and Ayurvedic medical traditions, is the
premise that "mental" factors are accepted as causes
of diseases (Jäger 1999: 22). To a large extent it is the
combination of Buddhist philosophy with humoural medicine that
has made Tibetan medicine attractive to the West. Unfortunately,
it also has led to its exploitation and criminalisation in the
context of 'medical facts' versus 'magical beliefs' (Adams 2002b:1).
The
current discrepancies between the theory of the respected Gyushi
and the more pragmatic medical practices in Tibetan clinics in
Northern India, reflect the medical pluralism that Tibetan doctors
face in their daily practice; by now sphygmomanometers are more
often employed than the traditional urine analysis (Samuel 2001:
261). This exposes the contemporary tension between traditional
ethical medical values and modern pragmatic clinical situations.
How much of the tradition will get lost, transformed, re-discovered,
neglected or changed remains to be seen.
Acknowledgement:
Thanks to Mona Schrempf and Alex McKay for their helpful comments
on this paper.
Text supplied by Barbara
Gerke
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