Approximately ten years ago, a team of scholars published an outline of desiderata in the field of Tibetan medicine. Although the European-language study of Tibetan medicine had already persisted for decades (or even centuries if we consider the pioneering work of Alexander Csoma de Kőrös [1784–1842]),1 as late as 1988 R. E. Emmerick commented that the Four Tantras (rgyud bzhi), the seminal work of the Tibetan medical tradition, “was for a long time difficult of access but it is now readily available.”2 Here Emmerick refers to the modern-book edition of the Four Tantras that was published in Lhasa in 1982 based on the Degé xylographic edition,3 as well as two facsimile editions that had been published in Leh in 1975 and 1978.4 Indeed, without access to such editions, what work could have been done?
Around the same time that new editions of the Four Tantras were being published, several encyclopedic volumes introduced the central tenets, instructions, and histories of the Tibetan medical tradition to readers of European languages for the first time. A complete list of such works would be far too long to delineate here, but it would certainly have to include Rechung Rinpoche’s Tibetan Medicine (1973), Manfred Taube’s Beiträge zur Geschichte der medizinischen Literatur Tibets (1981), and Fernand Meyer’s Gso-ba rig-pa: Le système médical (1982), among others. Explanations and translations of the Four Tantras and its associated medical thangkas have continued to be published down to the present, culminating in relatively comprehensive overviews of orthodox Tibetan medicine in several European languages,5 as well as the modern Tibetan, Chinese, Japanese, and Mongolian languages, among others. It is perhaps this abundance, or even excess, of introductory and orthodox materials that caused the aforementioned team of scholars to lament the “lack of detailed analytical (rather than encyclopaedic) knowledge” and the need to “reveal the composite, variegated and dynamic nature of Tibetan medical traditions.”6 The present volume, Knowledge and Context in Tibetan Medicine, seeks to answer this call.
Since the early 2000s, a veritable deluge of Tibetan medical resources has been published for the first time. With collections like the Arura Group’s “Ancient Literature of Tibetan Medicine Series” (bod kyi gso ba rig pa’i gna’ dpe phyogs bsgrigs dpe tshogs), currently boasting well over one hundred volumes, and the nearly one thousand unique medical and astrological manuscripts that are held at the Potala Palace,7 the academic study of Tibetan medicine must now widen its focus to a textual corpus that is much larger than the Four Tantras and its exegetical literature. Grappling with such an abundance of literature may feel overwhelming, but we are not the only scholars to have felt this way.
In an apocryphal story the ancestor of the Drangti clan, Gyelnyé Kharbu (brang ti rgyal mnyes mkhar bu), is said to have been frustrated by the abundance of medical texts and commentaries that were available during the Tibetan imperial period (ca. 600–850). How could he possibly learn and practice such an excess of instructions, especially without an experienced teacher? Seeing no other alternative, he is said to have supplicated the Tibetan emperor, Jé Tri Dhé Aktsom (rje khri dhe ag tsom), also known as Tri Detsuktsen (khri lde gtsug brtsan, ca. 704–754): “My Lord, these instructions that we have are profound, but they still require that one seek out a master. Do you have any treasure texts or instructions that do not require a teacher?”8 After years of effort and service to the emperor, Gyelnyé Kharbu was finally awarded with the Lamp That Illuminates the Red Register (byang khog dmar byang gsal ba’i sgron me), a work that is both “small in size and great in reasoning” (bungs su chung la tshigs su che ba), which “does not require a teacher” (bla ma mi dgos pa). Legend holds that this practical manual was transmitted among the Drangti family for half a millennium, until it was redacted at the end of the thirteenth century, and finally published by Arura for the first time in 2014.
In addition to the uncanny familiarity of Gyelnyé Kharbu’s frustrations, I also relate this story because it highlights a central tension within medical traditions, Tibetan and otherwise—a tension between complexity and practicality, diversity and centralization, the subaltern and the orthodox. The story of Gyelnyé Kharbu, probably composed in the thirteenth century and projected back to the time of the Tibetan empire, reflects a period of great intercultural exchange. The medical traditions of South, East, and Central Asia were all coming into communication under the aegis of the Yuan dynasty (ca. 1250–1350), and the available methods for the diagnosis and treatment of disease had reached an unprecedented level of diversity and complexity. Was a patient’s fever caused by a humoral imbalance or a thermal imbalance? By karmic transgression or spirit possession? Should it be treated by medicinal compounds, external therapies, or ritual interventions? A similar degree of pluralism also characterizes the etiological and therapeutic choices of the present day, reminiscent of the unresolved controversies fossilized in the medical traditions that have been transmitted over the past millennium.
If one goal of this study is to reconcile the dichotomies of unity and diversity, another is to also explore a related dichotomy of disciplinary approaches: philology and ethnography. This divide has helped to organize the academic study of Tibetan medicine down to the present—allowing one group to discuss textual developments and prescriptive instructions, and the other to describe practical methods and lived realities. This divide between history and anthropology even served to bifurcate the panels on Tibetan medicine at the Fourteenth Seminar of the International Association for Tibetan Studies in Bergen (2016), from which the current volume derives.9 Despite the potential advantages of such a divide, the reification of disciplinary boundaries also sometimes entails unanticipated risks, emphasizing approach at the expense of context, distinction at the expense of continuity. Indeed, ethnography without philology or archeology is the description of a lived reality that is bereft of history, and philology without ethnography is an isolated truth without obvious relevance for the present day.10 Challenging the entrenched boundaries of history and anthropology, the present volume focuses upon context—historical and contemporary—in order to explore the vicissitudes of semantics and the complex relationship between medicine and religion in Tibet. By combining both historical and anthropological perspectives, we seek to fuse the horizon of each discipline, allowing meaning and healing to shift across temporal, spatial, and social contexts.
Each part of this volume has been divided into five chapters. Part One, “The Vicissitudes of Meaning in Context,” is concerned with both semantic and historical meaning in the Tibetan medical tradition. It begins with Henk W. A. Blezer’s chapter on “brown phlegm” in early Tibetan medical sources, focusing on potential intersections with the Greco-Arab notions of black bile and melancholia. In the following chapter, Yang Ga attempts not to define a word, but a person. “Who was Yutok the Elder?” he asks, “And how do we know?” Although he refrains from definitively answering this question, he incontrovertibly challenges naïve interpretations of Yutok’s biography. In Chapter Three, Tony Chui analyzes “secret medicine” in the writings of Desi Sanggyé Gyatso (1653–1705), particularly in relation to the healing of life-wind illnesses. By exploring the processes of encryption in secret medicine, Chui effectively brings Tibetan medical literature into the theoretical debates of Tantric studies. Katharina Sabernig also takes up several cryptic terms depicted on the seventeenth-century Tibetan medical paintings, and examines their transformations in later illustrations as they came into contact with biomedical conceptions and anatomical terminology. Finally, Part One concludes with Tawni Tidwell’s ambitious exploration of cancer and its correlates in the Tibetan language. Like Sabernig, Tidwell combines philological and biomedical approaches to understanding medical realities, illuminating the purview of each perspective in the process.
Part Two, “Medicine and Religion in Context,” takes up yet another disciplinary divide, exploring the relationship between medical and religious healing in Tibet. In Chapter Six, Tsering Samdrup examines the relationship between medical and ritual modes of healing in an early wartime medical manual, the Nine-fold Magical Cord (twelfth-century?). In the next chapter Carmen Simioli similarly juxtaposes empirical and ritual approaches to contagious disease in the medical treasure text cycle, the Vase of the Amṛta of Immortality. Like many of the works examined in Part Two, Simioli describes an uneasy compromise between humoral and demonic understandings of disease. My own work follows that of Simioli, examining the historical integration of prasenā divination and channel examination in the Four Tantras and the Drangti lineage of Tibetan medicine. In Chapter Nine, Susannah Deane relates two tales of spirit possession that she encountered while doing fieldwork in Darjeeling, reconsidering the relationship between textual knowledge and practical application in medically and religiously pluralistic communities. In the final chapter of Part Two, Barbara Gerke represents the transformation of the Tibetan medical tradition in the People’s Republic of China through the example of a single precious pill: Jikmé’s Old Turquoise-70. Shedding the contexts of demonic etiology, ritual empowerment, and religious integration explored in the other chapters of Part Two, Gerke explores the processes of rebranding Tibetan precious pills for cross-cultural consumption.
Despite differences in temporal context, Chapter One begins and Chapter Ten concludes with the very same subject: the transformation of medical concepts across traditions. As the present age of medical pluralism continues, we need not look further than the historical intersections of diverse medical traditions to find precedents and pathways for present exchanges. Indeed, such is the dual-task of the medical historian, in the words of the Swiss historian of medicine, Henry E. Sigerist (1891–1957): to both “light up the darkness of the past” and “[render] it fruitful for a better future.”
The history of medicine has entered upon a decisive phase. Summoned to cooperation by the living healing art, it will have to show whether it is able to follow this summons, whether it is able to participate in the solution of the great problems which today occupy the physicians’ world. But the history of medicine has a Janus-head. One face looks to the future with the eyes of the physician, and the other one is turned backward. With the eyes of the historian it tries to light up the darkness of the past. Here too the history of medicine will have to prove itself. Here too it will have to show whether the rebirth of spirit which today we experience in all spheres has passed it by, whether in purely positivistic fashion it wishes to add facts to facts, or whether it is capable of interpreting the past, of enlivening it, and of rendering it fruitful for a better future.11
The double face of Janus (limestone; Burgundy, France; 1250–1275)
Used with permission from the Philadelphia Museum of Art.Purchased with Museum funds from the George Grey Barnard Collection, 1945 (1945-25-74).
Avalokiteśvara with eleven faces and eight hands (metal; Tibet; 16th c.)
Used with permission from W. Arader. Arader Collection (Himalayan Art Resources #66738).
If the task for the biomedical historian is Janus-faced—to light up the singular past for the unified future—then the historian of Asian medicines surely needs all eleven faces of Avalokiteśvara. Even the seemingly unified tradition of Sowa Rigpa and the Four Tantras must be understood not only in the contexts of past and future times, but also those of diverse spaces—from Central Tibet to Ngari, Amdo, and Kham, as well as the rest of the PRC, Bhutan, Mongolia, Nepal, India, Europe, the Americas, and beyond—not to mention the countless lineages and schools of Tibetan medicine that are just beginning to be understood. There is still much work that needs to be done.
Despite the overwhelming number of texts and instructions that are now known in the Tibetan medical tradition, reminiscent of the textual diversity lamented by Drangti Gyelnyé Kharbu centuries ago, let us seek to do more than just “add facts to facts.” Inspired by Sigerist, let us seek to “participate in the solution of the great problems which today occupy the physicians’ world,” recognizing that the problems of health and disease, of life and death, will undoubtedly involve a multifaceted (or multifaced!) solution. As indicated one decade ago in the precursor to this volume, it is with the “composite, variegated and dynamic nature of Tibetan medical traditions”—the many contexts of Tibetan medicine—that we may light up the past. By reveling in complexity, looking with many faces, reaching with many hands, and seeing with many eyes, we might continue to render diverse pasts fruitful for better futures.
Bibliography
A ru ra, ed. Byang khog dmar byang gsal ba’i sgron me. Bod kyi gso ba rig pa’i gna’ dpe phyogs bsgrigs dpe tshogs, vol. 101. Beijing: Mi rigs dpe skrun khang, 2014.
Blezer, Henk, et al. “Brief Outlook: Desiderata in the Study of the History of Tibetan Medicine.” In Soundings in Tibetan Medicine: Anthropological and Historical Perspectives. PIATS 2003: Proceedings of the Tenth Seminar of the International Association for Tibetan Studies, Oxford, 2003, edited by Mona Schrempf, 427–38. Leiden: Brill, 2007.
Blo bzang tshe ring, ed. Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud. Lhasa: Bod ljongs mi dmangs dpe skrun khang, 1982.
Bod ljongs bod lugs gso rig slob grwa chen mo, ed. Krung go’i bod lugs gso rig rtsa che’i dpe rnying kun btus: Pho brang po ta la’i gsung rab gter mdzod las btus [Zhongguo yiyao yingyin guji zhenben 中国藏医药影印古籍珍本; China’s Traditional Tibetan Medical Texts: A Treasury of Scriptures from the Potala Palace]. Lhasa: Bod ljongs mi dmangs dpe skrun khang, 2014.
Csoma de Kőrös, Alexander. “Analysis of a Tibetan Medical Work.” Journal of the Asiatic Society 37 (1835): 1–20.
Emmerick, Ronald E. “Tibetan nor-ra-re.” Bulletin of the School of Oriental and African Studies 51, no. 3 (1988): 537–539.
Parfionovitch, Yuri, Fernand Meyer, and Gyurme Dorje, eds. Tibetan Medical Paintings: Illustrations to the Blue Beryl Treatise of Sangye Gyamtso (1653–1705). New York, NY: Harry N. Abrams, 1992.
Pollock, Sheldon. “Philology in Three Dimensions.” Postmedieval: A Journal of Medieval Cultural Studies 5, no. 4 (2014): 398–413.
Rgyud bźi: A Reproduction of a Set of Prints from the 18th Century Zuṅ-cu Ze Blocks from the Collections of Raghu Vira. Smanrtsis Shesrig Spendzod Series, vol. 68. Leh: S. W. Tashigangpa, 1975.
Rgyud Bźi: A Reproduction of a Set of Prints from the 1988 Lha-sa Lcags-po-ri Blocks. Smanrtsis Shesrig Spendzod Series, vol. 87. Leh: T. S. Tashigangpa, 1978.
Sigerist, Henry E. Kyklos: Jahrbuch des Instituts für Geschichte der Medizin an der Universität Leipzig. Leipzig: Georg Thieme, 1932.
Temkin, Owsei. The Double Face of Janus and Other Essays in the History of Medicine. Baltimore, MD: The Johns Hopkins University Press, 1977.
Alexander Csoma de Kőrös, “Analysis of a Tibetan Medical Work,” Journal of the Asiatic Society 37 (1835): 1–20.
Ronald E. Emmerick, “Tibetan nor-ra-re,” Bulletin of the School of Oriental and African Studies 51, no. 3 (1988): 537.
Blo bzang tshe ring, ed. Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud (Lhasa: Bod ljongs mi dmangs dpe skrun khang, 1982).
Rgyud bźi: A Reproduction of a Set of Prints from the 18th Century Zuṅ-cu Ze Blocks from the Collections of Raghu Vira, Smanrtsis Shesrig Spendzod Series, vol. 68 (Leh: S. W. Tashigangpa, 1975); and Rgyud Bźi: A Reproduction of a Set of Prints from the 1988 Lha-sa Lcags-po-ri Blocks, Smanrtsis Shesrig Spendzod Series, vol. 87 (Leh: T. S. Tashigangpa, 1978).
For what is perhaps the best single overview of this material, see Yuri Parfionovitch, Fernand Meyer, and Gyurme Dorje, eds., Tibetan Medical Paintings: Illustrations to the Blue Beryl Treatise of Sangye Gyamtso (1653–1705) (New York, NY: Harry N. Abrams, 1992).
Henk Blezer et al., “Brief Outlook: Desiderata in the Study of the History of Tibetan Medicine,” in Soundings in Tibetan Medicine: Anthropological and Historical Perspectives, ed. Mona Schrempf (Leiden: Brill, 2007), 428–29.
Bod ljongs bod lugs gso rig slob grwa chen mo, ed., Krung go’i bod lugs gso rig rtsa che’i dpe rnying kun btus: Pho brang po ta la’i gsung rab gter mdzod las btus (Lhasa: Bod ljongs mi dmangs dpe skrun khang, 2014), 30 vols.
Byang khog dmar byang gsal ba’i sgron me, Bod kyi gso ba rig pa’i gna’ dpe phyogs bsgrigs dpe tshogs, vol. 101 (Beijing: Mi rigs dpe skrun khang, 2014), 205: des kyang rgyal mnyes kho thag ma chod nas/ rje lags ’di rnams pas kyang zab pa cig bdog ste mchi bas/ ’di rnams la slob dpon ’tshal bar gda’ ba/ gter ma lags par gda’ ba dang / bla ma mi dgos pa’i man ngag cig bdog ste mchi bas/ de thugs la rtags par zhu byas pas/.
The panels focused on Tibetan medicine at IATS 14 were divided into two, Panel 15: “Knowledge and Context in the History of Tibetan Medicine,” convened by Olaf Czaja and myself; and Panel 25: “Sowa Rigpa (Tibetan Medicine): Contemporary and Anthropological Studies,” convened by Geoffrey Samuel and Mingji Cuomu. Despite this formal separation, most members of each panel attended the presentations of the other.
For further reflections on the future of philology, see the work of Sheldon Pollock, such as his “Philology in Three Dimensions,” Postmedieval: A Journal of Medieval Cultural Studies 5, no. 4 (2014): 398–413.
Henry E. Sigerist, Kyklos: Jahrbuch des Instituts für Geschichte der Medizin an der Universität Leipzig (Leipzig: Georg Thieme, 1932), vol. 1, 5; cited and translated in Owsei Temkin, The Double Face of Janus and Other Essays in the History of Medicine (Baltimore, MD: The Johns Hopkins University Press, 1977), 9.