Traditional Tibetan medicine

Tibetan medicine has very ancient origins. It developed on the basis of the autochthonous traditions of Tibet and thanks to the influence of the other Asian medicines, such as ayurveda and Chinese medicine. It is based on the idea that man, just like the universe, is made up of 5 elements: air, water, fire and earth, which continuously interact with one another. The fifth element, space, is considered the basis of the others. This medicine works on three levels: somatic, energetic and spiritual. These three levels are in turn based on the essential aspects of the human condition: body, energy and mind. It is therefore a holistic medicine, through which “one does not only mean a set of medicines prepared with some medicinal herbs and a few minerals, nor even a simple medical therapy. By medicine is meant a spiritual teaching”. Its aim is to restore the balance between body, mind and energy.

Health is born from the balance between the three energetic systems or Humours: Wind, Bile and Phlegm.

These are closely related to the three main passions: desire, aversion and ignorance, the latter understood as the inability to understand the real nature of phenomena. In particular, desire affects the Wind; aversion the Bile and ignorance the Phlegm. Each Humour is distinguished into five aspects with different characteristics, seats and functions.

The five Winds control breathing, blood circulation and body movements, they regulate concentration. The Wind humour is also the one most responsible for psychic processes.

The second humour, the Bile, is closely connected with digestive processes, with sight and with the colour of the skin. Many of its functions are connected with bodily heat.

The last humour, the Phlegm, in its five aspects, refers to the wet components of the organism and to their functions; it is also correlated with the immune system. The balance of these fifteen factors generates the state of good health; when a condition of imbalance occurs, they become a cause of disease.

Tibetan medicine classifies diseases into 4 categories:

1. karmic diseases;
2. diseases arising from provocations of energy (Dön);
3. natural diseases;
4. accidental diseases.

There are also the so-called mental diseases.
As regards karmic diseases, the causes can be found in the previous lives of the patient, in karma indeed, and therefore it will be necessary to act on it to heal, through purification, the transformation of karma, the blocking of the concomitant causes that favour the onset of the disease.
When we talk about Dön (lit. “provocations of energy”) we refer to non-human beings that have the ability to influence the spheres of energy of a person. In the ancient Tibetan medical tradition, connected to the pre-Buddhist religion of Bön, there existed a great variety of rituals to face the diseases that arose from contact with a Dön. All this does not mean that the person is healed by the rite alone: the ritual action is considered complementary to medicines and to the other therapies. The therapy is therefore perfect from the medical point of view when it knows how to coordinate all the types of intervention.

The natural diseases, on their part, can be caused by errors in diet and behaviour that produce an imbalance of the 3 humours. The factors that can induce the pathological states are climate, spirits, diet and behaviour.

Finally, accidental diseases can be caused by sudden events outside our control such as poisonings, traumas, demonic influences. However, it must be remembered that all those described so far are only the proximate causes of diseases. In the Tibetan medical view the primary cause of suffering, and therefore also of disease, is considered to be ignorance of the real nature of the human being. As long as man has not deeply known his own nature, he will never be able to be free from suffering.

How is a diagnosis made in Tibetan medicine?

1. General anamnesis of the patient and of the environment in which they live;
2. Reading of the pulses;
3. Examination of the urine.

As far as the general anamnesis is concerned, one must look for the origin of the disease by asking the patient what they eat and what their daily activities are, in order to understand what determined the imbalance. Then the 5 sense organs are examined: eyes, nose, skin, tongue and ears. Moreover, the doctor takes into account other factors such as the environment in which the patient lives, the season and the climate, age and gender, the phase of life they are in. When instead we talk about the pulse analysis, we refer to a very precise technique that requires experience and sensitivity. This analysis consists in feeling the pulses with the index, middle and ring fingers so as to obtain information on the organs and on the viscera. Finally the analysis of the urine, which consists in observing their appearance, colour, smell etc. in order to understand the state of the patient. Diagnosis is therefore based on the lifestyle of the patient and is necessary to understand the causes of the imbalance.

In Tibetan medicine there are 4 main types of treatment: diet, behaviour, medicines and external interventions.

The first two elements, diet and behaviour, are the basis of health; if, however, they should not be sufficient, medicines are used. The Tibetan pharmacopoeia is very rich and counts a great many remedies. The ingredients are of plant and animal origin and minerals are often used. These medicines are administered in pill form, as decoctions or as powders to be taken orally. The external interventions, on their part, can be divided into three categories: soft, rough and hard. By soft interventions are meant compresses (applications made on the skin), baths and massages. The rough applications refer to bloodletting and treatments with needles and are performed only if the condition of the patient allows it. The hard applications, on their part, are the surgical ones, which are generally little practised in traditional Tibetan medicine. These include wound care, amputations etc. This happens not only because of the limitedness of the technical means, but also as an effect of a vision of the human body as a field of energy crossed by channels that cannot be injured or interrupted without consequences.

Sources

Norbu, N., Samphel, T. R. La grande guarigione, Ubaldini Editore, Rome, 2002.

Vitiello, L., Medicina Tibetana: modernità di un antico sistema medico.