Preservation and Transfer of the Knowledge of Tibetan Medicine
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Concepts of disease

Central position of the three factors: wind (rlung, Skt. vāyu) - bile (mkhris pa, Skt. pitta) - phlegm (bad kan, Skt. kapha)

"humours are biological manifestations of the five elements and are responsible for all the psychological and physiological functions of the body."
in Drungtso T. T. und Drungtso T. D. (2005: 157). Tibetan-English Dictionary of Tibetan Medicine and Astrology. Archana: Drungtso Publications.

The three factors are said to be closely associated to the three basic complexes of emotions that are: attachment  ('dod chags, Skt. rāga), aversion (zhe sdang, Skt. dveṣa) and ignorance (gti mug, Skt. moha).

The connection between the three (damaging) factors and the three emotional complexes is established as follows:

Wind (rlung, Skt. vāyu) - attachment ('dod chags, Skt. rāga)

bile (mkhris pa, Skt. pitta) - aversion (zhe sdang, Skt. dveṣa)

phlegm (bad kan, Skt. kapha) - ignorance (gti mug, Skt. moha)

In this way, the concepts underlying Tibetan medicine are closely interconnected with the concepts of Buddhist philosophy.

Body Concept of damaged and damaging factors

"lus kyi mtshan nyid basic physiology of the body; it explains the spheres which are the objects of harm (7 bodily constituents and 3 excretions) and the humours (15 humours) which are the harmers."in Drungtso T. T. und Drungtso T. D. (2005: 472). Tibetan-English Dictionary of Tibetan Medicine and Astrology.

Central position of the three factors: wind (rlung, Skt. vāyu) - bile (mkhris pa, Skt. pitta) - phlegm (bad kan, Skt. kapha)

This approach to the body is very closely linked to the anatomical description of the body of Nāḍīs (rtsa, Skt. nāḍī), Chakras (rtsa 'khor, Skt. chakra) und Bindus (thig le, Skt. bindu) that are also visualized or applied in the context of Vajrayāna practice.

Disease regarded as an imbalance of three factors

"nad illness, sickness, diseases, disorders; according to the theory of Tibetan medicine "the disease" is viewed as the result of improper proportion of the three humours - rlung (wind), mkhris pa (bile), and bad kan (phlegm) both in qualitative and quantitative aspects."
in Drungtso, T. T., Drungtso, T. D. (2005: 227). Tibetan-English Dictionary of Tibetan Medicine and Astrology. Archana: Drungtso Publications.

This approach to the body is very closely linked to the anatomical description of the body.
Model of a body consisting of different channels (rtsa, Skt. nāḍī) anlong which five winds (rtsa ba'i rlung lnga) are moved.

The model of a body consisting of different channels (rtsa, Skt. nāḍī) which are used by five winds to transport energies (rtsa ba'i rlung lnga)

"rtsa channels: this term refers to the nerves, veins and arteries. There are three types of major channels or rtsa: 1. the white one (rtsa dkar) is related to the nerves and leads to the brain, 2. the black one (rtsa nag) refers to the veins and leads to the livers and the gall bladder, 3. the red one (rtsa dmar) refers to the arteries and leads to the heart."
in Drungtso, T. T., Drungtso, T. D. (2005: 359). Tibetan-English Dictionary of Tibetan Medicine and Astrology. Archana: Drungtso Publications.

Conceptualization of disease as an imbalance of the three factors

"nad illness, sickness, diseases, disorders; according to the theory of Tibetan medicine "the disease" is viewed as the result of improper proportion of the three humours - rlung (wind), mkhris pa (bile), and bad kan (phlegm) both in qualitative and quantitative aspects."
siehe Drungtso, T. T., Drungtso, T. D. (2005: 227). Tibetan-English Dictionary of Tibetan Medicine and Astrology. Archana: Drungtso Publications.

Models of the causes of disease

1. distant causes of diseases (ring rgyu)
refer to ignorance (ma rig pa, Skt. avidyā)

2. close causes of diseases (nye rgyu)
refer to the concept of the three basic, crucial emotional complexes (dug gsum) that are attachment ('dod chags, Skt rāga), aversion (zhe sdang, Skt. dveṣa) and ignorance (gti mug, Skt. moha)

3. specific causes of diseases (khyad par rgyu)
refer to the three factors  (nyes pa, Skt. doṣa) that are
wind (rlung, Skt. vāyu),
bile (mkhris pa, Skt. pitta)
phlegm (bad kan, Skt. kapha)

see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

Karma within the causes of disease

Karma (Skt.) refers to the law of cause and effect. This law of cause and effect (las, Skt. karma) is incorporated into Tibetan medicine in terms of possible causes of disease.

Implication: Thus, even effects caused by one's own unvirtuous actions (mi dge ba bcu, Skt. daśākuśala) in this or a previous life are regarded as possible causes of diseases.
This has many implications: for example in terms of degradation of oneself and stigmatisation of others.
see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

Diagnosis

Diagnosis of diseases in Tibetan medicine from the emic perspective:

1. Methods (brtag tshul) of investigation (blta ba): Interrogation of the patient (ngag gis dri ba) based on the three factors (nyes pa gsum)  1.1 type analysis 1.2 face analysis
3. methods of pulse diagnosis (rtsa brtag)
4. urine diagnosis (chu brtag)
5. tongue diagnosis (lce brtag)
see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

"In order to impart accurate diagnosis and to prescribe correct remedies, the diagnostic principle that reveal the actual manifesting nyepa should be employed. In order to earn public admiration and popularity, diagnostic techniques based on indirect skillful means should be employed. In order to determine whether to accept or to refuse a patient during the course of treatment, four diagnostic criteria of a patient´s condition should be employed."
in Men Tsee Khang (transl.) (2015: 241). bod kyi gso ba rig pa'i rgyud bzhi las rtsa ba'i rgyud dang bshad pa´i rgyud tses bya ba bzhugs so The root tantra and the explanatory tantra from the Four Tantras of Tibetan medicine. Dharamsala: Men-Tsee-Khang.

"Methods of examination involve visual examination, palpation and interrogation"
in Men Tsee Khang (transl.) (2015: 243). bod kyi gso ba rig pa'i rgyud bzhi las rtsa ba'i rgyud dang bshad pa´i rgyud tses bya ba bzhugs so The root tantra and the explanatory tantra from the Four Tantras of Tibetan medicine. Dharamsala: Men-Tsee-Khang.

"Diagnosis through indirect skillful means involves understanding characteristics of a disorders [disorder], digging up information, taking one´s time, investigating prior treatments, voluntary disclosure, restricting the patient from speaking, declaration and taking cover in an excuse." in Men Tsee Khang (transl.) (2015: 246). bod kyi gso ba rig pa'i rgyud bzhi las rtsa ba'i rgyud dang bshad pa´i rgyud tses bya ba bzhugs so The root tantra and the explanatory tantra from the Four Tantras of Tibetan medicine. Dharamsala: Men-Tsee-Khang

Therapeutic measures

The imbalance of the three factors (nyes pa gsum) is considered to be the specific cause of disease (khyad par rgyu) see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

It is balanced by a variety of measures, such as
1. life style (spyod lam) and
2. food (zas)
(both of which are important for the prevention of diseases)
3. herbal medicines
4. acupuncture
see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

Therapy (nad phan bcos thabs) of an imbalance of the above three factors (nyes pa, Skt. doṣa) - wind (rlung, Skt. vāyu), bile (mkhris pa, Skt. pitta) and phlegm (bad kan, Skt. kapha):

1. astology (nad rtsis) is used according to the process of recovery or illness
2. counselling concering
2.1 life style (spyod lam)
2.2 food (zas)
3. currently mainly herbal medicine (bod sman)

see Köttl, M. (2009). Heilung aus der Perspektive Tibetischer Medizin. Aachen: Shaker.

External Therapies

"To eliminate or pacify a disorder by means of any external intervention is known as an external therapy. It constitutes three different types of methods: mild, rough and drastic. The three mild therapies include compresses, medicinal baths and oil massage. Three rough therapies include venesection, moxibustion and surgical therapy. The four drastic therapies include incision, amputation, extraction and expulsion."
in Men Tsee Khang (transl.) (2015: 227). bod kyi gso ba rig pa'i rgyud bzhi las rtsa ba'i rgyud dang bshad pa´i rgyud tses bya ba bzhugs so The root tantra and the explanatory tantra from the Four Tantras of Tibetan medicine. Dharamsala: Men-Tsee-Khang.