Sowa Rigpa

Origins of the Tibetan Medical System

Tibetan medicine is closely connected with Tibetan Buddhism, but its roots may predate the arrival of the Buddhadharma in Tibet in the seventh and eighth centuries. Some commentators mention the existence of a system of medicine-crediting it with varying degrees of sophistication-within the indigenous Bön or pre-Buddhist culture that flourished in Tibet. Some Bön documents say that their founder, Tönpa Shenrap, who was contemporaneous with the Buddha, preached thirteen volumes of medical teachings. One work on Bön history claims his son Chebu Trishé memorized 21,000 medical works.

TIn Darmo Menrampa’s (1638-1710) Brilliant Jewel Treasury, in answer to a question from an Indian doctor on the kinds of medical practice in Tibet, the eighth-century medical scholar Yuthok mentions medical texts on purgatives, fomentation, balneology, and ointments found in the Shangshung Bön and Yungdrung Bön traditions. Also, Four Tantras, the principal medical reference and subject of study in Tibetan medical training up to the present day, contains a few names of medicines, medical compounds, and illnesses that are said to be from the ancient Shangshung language. The concluding chapter of Four Tantras lists mantras that come from Bön religious practice. Some commentators have even suggested that Four Tantras itself is of Bön origin, and that the translator Vairocana, rather than translating it from Indian sources as other have suggested, took it from Bön medical literature.

From the seventh century onward, evidence suggests that Tibetan medicine developed from three distinct non-indigenous sources. A passage from a work called Weapons of Fearlessness, cited in Mirror of Beryl, talks of three great medical systems, and the great physicians.

The fourth tantra, the Last Tantra, is comprised of 27 chapters, which deal with diagnosis (such as urine analysis and pulse reading), medicinal ingredients and their preparations (pills, powders, syrops, medicinal butters, etc.), pacifying medication (purgatives and emetics) and addi;tional treatments (moxibustion, golden-needle therapy) which are applied when all other medicinal preparations have failed to cure the patient.

The passage continues by naming the purveyors of these systems in Tibet as Bharadhaja, Galenos, and Hsüan Yüan Huang. These three physicians, says Desi Sangyé Gyatso, came respectively from India, ‘’Trom (khrom or phrom)’’, and China. India, as is clear from the extensive accounts of Āyurvedic medical literature and practices, as easily identifiable as the Indian subcontinent. China during the seventh century, when these physicians were in Tibet, was under the Tang dynasty with its capital at Chang-an (Xian). The third locale is harder to identify. Geographically, it seems to refer to the Central Asian lands west of Tibet whose inroads into Tibet were via the Silk Route. Culturally, it seems to refer to the Greek or Persian culture that had permeated so far east by the eighth century. Trom in the west, personified by the physician Galenos, brought much anatomical knowledge to Tibet during those early times, in the form of medical works on dissection. Galenos himself stayed on in Tibet and composed several medical works.

This medical influence from the west seems to have been predominant around the times of Songtsen Gampo, as evidenced by the fact that Galenos and another physician, Tsenpashilaha, also from Trom, were rewarded with titles and commendations from the king. Tsenpashilaha was also known as Biji, and the lineage of Galenos was known as the Biji lineage. In the succeeding centuries, the Trom influence seems to have waned. The influence of China in medical matters also appears to have dominant in the seventh and eighth centuries in Tibet and may have lasted longer than the Trom influence. The Chinese bride of Songtsen Gampo brought an extensive medical text with her from China as a gift for the king. This was translated into Tibetan by Hvashang Mahādeva and Dharmakośa. Later, in the eighth century, the Chinese queen of of Jantsa Lhabön brought many medical and astrological works to Tibet. The Chinese translators Hvashang Mahāyāna, Hvashang Mahākyinda, Hsüan Yüan Huang, and Hvashang Penatseta compiled and translated many medical texts in to Tibetan. These include the renowned Somarāja, whose influence was still evident in the seventeenth century, when Desi Sangyé Gyatso included its teachings on diagnoses from urine and cauterization points in his famous collections of medical paintings.

The influence of the Indian or Āyurveda medical system in Tibet was more extensive. From the eighth century onward, inspired by the aspirations of King Trisong Detsen, Tibetan translators and scholars visited India regularly in pursuit of Buddhist literature and teachings. In doing so they brought back compositions on medicine by great practitioners of Āyurveda. Therefore, the principal origins of the medical system in Tibet were those of the indigenous Bön culture, the Greco-Arab cultures to the west, China, and India. Tibetan sources talk of the ‘’nine royal physicians from surrounding countries.’’ Alongside Trom, China, and India, these surrounding countries include Kashmir,Drugu, Dolpo, and Nepal. Other sources talk of ten medical traditions, listing Khotan, Minyak, Hor or Mongolia, and Oddiyāna in addition to the above.