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Wind (rlung) disorders

Diagnosis of wind disorder (rlung)

In interviews with doctors of tibetan medicine in Nepal (2018) all mental disease was related to rlung disorders. In the  elaboration of the symptoms in the oral instruction tantra "mental instability", "hallucinations", "loss of sleep", in terms of ascending rlung symptoms of "giddiness, mental instability" as well as "excessive crying or laughing" that are said to be caused by "forcing out the natural urges", in terms of pervasive rlung symptoms such as "fear, depression [...] and talkativeness, restlessness, fear and panic" are mentioned, besides the "general symptoms" of rlung disorders in case of general infiltration of the whole body by rlung: "Infiltration into the heart causes exertion of pressure in the upper back, sighing, and mental instability [sic. Anders] [...] Infiltration into the whole body shows general symptoms of all loong disorders [...] Loong disorders of the heart cause body tremor, pressure on the upper body, hallucinations [sic. Anders], indulgence in inconsequential talking, giddiness loss of sleep, and sighing. Loong disorders of the lungs cause loss of sleep."
in Men Tsee Khang (transl.) (2017: 16, 17, 18). bod kyi gso ba rig pa'i rgyud bzhi las man ngag rgyud tses bya ba bzhugs so The oral instruction tantra from the secret quintessential instructions on the eight branches of the ambrosia essence tantra. Dharamsala: Men-Tsee-Khang.

"mental stress" is mentioned in the context or affirming the diagnosis or rlung disorder where mental stress is the factor which is worsening the condition. 
see Men Tsee Khang (transl.) (2017: 18). bod kyi gso ba rig pa'i rgyud bzhi las man ngag rgyud tses bya ba bzhugs so The oral instruction tantra from the secret quintessential instructions on the eight branches of the ambrosia essence tantra. Dharamsala: Men-Tsee-Khang.

Five types of rlung disorders

Oral instrution tantra: "The signs and symptoms of loong disorders based on location are as follows: Dispersion of loong disorder in the skin causes roughness, irritation, and a sensation that the skin is cracked. Infiltration of loong disorder into the muscle tissues causes swelling, roughness, discoloration, and pimples. Infiltration into the fat tissues leads to anorexia, swelling of the body, and nodular growth. Infiltration into the channels makes them empty and dilated. Infiltration into the blood causes excessive sleep, reddening of the blood vessels, and an unpleasant appearance. Infiltration into the ligaments causes lameness, stiffness, and limping. Infiltration into the bones causes severe pain, weight loss, and weakening of the body strength. Infiltration into the joints causes a sense of hollowness and inflated swelling of the joints, and leads to abnormal curvature of the spine. Infiltration into the bone marrow causes insomnia and a tethering sensation, with relief when pressure is applied. Infiltration into the reproductive fluid causes depletion, color changes, and excessive discharge. Infiltration into the heart causes exertion of pressure in the upper back, sighing, and mental instability. Infiltration into the lungs causes facial swelling, difficult expectoration, and drooling of frothy sputum. Infiltration into the liver causes excessive yawning when hungry and pain as if the liver were sagging. Infiltration into the spleen causes swelling of the body, abdominal distension and rumbling, and pain in the spleen. Infiltration into the kidneys causes pain in the kidney and waist region, and deafness. Infiltration into food in the stomach causes pain after food intake. Infiltration into the undigested site causes eructation, vomiting, anorexia, abdominal distension and rumbling, extreme thirst, and breathing difficulties. Infiltration into the digested site causes sharp pain, abdominal distension and rumbling, constipation, scanty urination, and pain at the waist and coccyx. Infiltration into the gallbladder causes abdominal distension, sharp pain, weak digestion, and yellow sclera. Infiltration into the feces causes whirling of loong, and constipation or noisy diarrhea. Infiltration into the urine causes a cold and bloated bladder, and scanty or frequent urination, Infiltration into the uterus causes menstrual blood clots, and amenorrhea or menorrhagia. Infiltration into the head causes dizziness, vertigo, and loss of balance. Infiltration into the eyes causes bloodshot eyes, sensation of the eyeballs protruding, and exacerbation on exposure to breeze. Infiltration into the ears causes tinnitus, a sensation of emptiness and earache. Infiltration into the nose causes nasal congestion, runny nose, and loss of the sense of smell. Infiltration into the teeth causes numbness, pain, and swelling. Infiltration into the whole body shows general symptoms of all loong disorders."
in Men Tsee Khang (transl.) (2017: 16, 17). bod kyi gso ba rig pa'i rgyud bzhi las man ngag rgyud tses bya ba bzhugs so The oral instruction tantra from the secret quintessential instructions on the eight branches of the ambrosia essence tantra. Dharamsala: Men-Tsee-Khang.

"Life-sustaining loong, which is disturbed by a diet having a rough potency, fasting, strenous activities, and suppressing or forcing out the natural urges, shows symptoms such as giddiness, mental instability, and difficult inhalation and swallowing. [...] Ascending loong, which is disturbed by suppressing eructation and vomiting, excessive crying  or laughing, and lifting heavy loads, shows symptoms such as stuttering, dumbness, difficulty speaking, a weak body, facial paralysis, and a weak memory. [...] Pervasive loong, which is disturbed by excessive walking or sitting, strenous sports activities, fear, depression, and a diet having a rough potency, shows symptoms such as a sensation of the heart being twisted, fainting, talkativeness, restlessness, fear and panic, and is exacerbated upon hearing unpleasant words [...] Fire-accompanying loong, which is disturbed by intake of indigestible food and daytime sleep, shows symptoms such as a cold stomach, loss of appetite, vomiting, indigestion, and a amalgamation of blood and food particles in the stomach due to blockage of the gastric channels [...] Descending loong, which is disturubed by forceful suppression or expelling of fecal matter, urine, flatus, and reproductive substances, shows symptoms such as unlocalized pain in the joints of the lower body, loos joints lameness, and obstruction of the flatus, feces, and urine. [...] Any of these loong disorders, when combined with tripa, increase the body heat and cause yellowing of the eyes and urine, and when combined with baekan, case a heavy, cool body and mental dullness. [...] The diagnosis based on assessing the beneficial and harmful effects of diet or lifestyle confirms loong disorder when there is a feeling of well-being on taking warm and nutritious foods such as meat, chhang, jaggery, and butter, administering oil massage, keeping warm with a fire or the sun, and on a full stomach; or when there is worsening of the condition on taking cold water, cow buttermilk, stale leafy vegetables, guinea pepper, teach, and in the state of hunger, thirst, cold, excessive talking and sexual intercourse, lack of sleep, and mental stress."
in Men Tsee Khang (transl.) (2017: 18, 19). bod kyi gso ba rig pa'i rgyud bzhi las man ngag rgyud tses bya ba bzhugs so The oral instruction tantra from the secret quintessential instructions on the eight branches of the ambrosia essence tantra. Dharamsala: Men-Tsee-Khang.

The following symptoms of rlung diseases are described in the oral instruction tantra

Briefly, loong disorders of the head cause dizziness, tinnitus, vomiting, fainting, and experiencing vertigo while standing up. Loong disorders of the heart cause body tremor, pressure on the upper body, hallucinations, indulgence in inconsequential talking, giddiness loss of sleep, and sighing. Loong disorders of the lungs cause loss of sleep, difficult expectoration, drooling of foamy sputum, exertion of pressure on the upper body, nausea, puffy eyes, and frequent coughing at night. Loong disorders of the livers cause eructation, sharp pain in the upper back and shulsha, loss of appetite, blurred vision, and the sensation of sagging of the liver at dawn and dusk. Loong disorders of the stomach cause breathlessness, distension, empty eructation, a pricking sensation, and relief after food intake. Loong disorders of the large intestine cause abdominal distension and rumbling, diarrhea, and excessive flatulence. Loong disorders of the kidneys cause pain at the kidneys and waist, and tinnitus.
in Men Tsee Khang (transl.) (2017: 17). bod kyi gso ba rig pa'i rgyud bzhi las man ngag rgyud tses bya ba bzhugs so The oral instruction tantra from the secret quintessential instructions on the eight branches of the ambrosia essence tantra. Dharamsala: Men-Tsee-Khang.

rlung disorder as explained in the quintessence tantra

"In wind (disorders) the tongue will be red, dry and rough, (whilst) in a bile disorder the tongue will be covered by a thick, pale yellow coating of phlegm. In a phlegm disorder the tongue will have a pale, thick coating of phlegm and be dull, smooth and moist. Urine in wind disorders looks like water and has large bubbles. In a bile disorder the urine is reddish yellow and malodourous, with much steam. Urine (reflecting a) phlegm disorder is whitish with little odor or steam. The wind pulse is floating, empty and halting, the bile pulse has a rapid, prominent taut beat, whilst the phlegm pulse is sunken, weak and ponderous."
in  Clark, B. (transl.) (1995). The Quintessence Tantras of Tibetan Medicine. Ithaca: Snow Lion.

Classification of rlung disorders in the root tantra

The classification is given in the root tantra: "The classifications of disorders on the basis of nyepa are loong, tripa and baekan. [...] Loong disorders are classified into two main categories: general and specific. The general category is further classified into two subcategories: type and location. There are twenty different loong disorders according to type. The classification according to location includes each of the six entrances of disorders [6] and one classification associated with the five sense organs, totalling seven. The specific category is comprised of the five imbalanced states of the five subtypes of loong disorders and ten disorders that are combinations of each of the five types of tripa and baekan disorders. These forty-two categories are loong disorders."

in Men Tsee Khang (transl.) (2015: 120, 121). 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.
[pg. 136: 6 "The six entrance of disorders are the skin, muscle tissue, blood vessels and nerves, bone, vital organs and vessel organs."]

Treatment of wind disorders (rlung disorders)

1. from interviews (in the year 2018): sending the person to a „meditation master“ to ask for his prayers

2. from texts:
„The elderly, children, and those suffering from loong and tripa disorders should avoid excess physical exercises.“
in Men Tsee Khang (transl.) (2015: 120, 121). 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.

"Laetae, Kanta kari, Agaru, Go nyoe, Ruta, Gugul and Gokya are the group of medicines that cure hot disorder associated with loong.[...] Men ga, Gakya, Shingkun, Kharu tsha, onion and garlic are the group of medicines that cure combined disorders of baekan and loong."
in Men Tsee Khang (transl.) (2015: 221). 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.

"Zati, jaggery and various bones are the group of medicines that cure loong disorders"
in Men Tsee Khang (transl.) (2015: 222). 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.

"The specific therapeutic methods for treating each of the three principal energies are as follows: Sesame oil is the supreme medicine for loong disorders, associated with both hot and cold disorders. A diet including jaggery, chhang, aged butter, dried mutton, meat of marmot, horse, donkey and human, garlic and onion which are heavy oily, smooth and warm in qualities should be consumed to treat loong. Lifestyle such as staying in a dim and warm place, enjoying the companionship of loved ones, listening to pleasant words, sleeping comfortably and wearing warm clothes are recommended. The medications include the three nutritious bones soup [1], concentrated soup made from aged head of a lamb, decotion of the four essence [2], decotions of Shingkun sumpa, powdered compounds of Zati or Shingkun as the main component, dairy compound, broth compound, garlic compound and chhang compound, and medicinal butter compound of Zati, Gokya, Tsendhug, Mirue, three myrobyalan fruits and the five roots. In short, loong disorders should be treated with sweet, sour, and salty taste, and oily and warm qualities. Mild enemas with aged butter and warm quality medicines are especially recommended. External therapies include performing massage with aged butter, compresses of oil on the site of pain and performing moxibustion on specific loong points such as the crown of the head, etc."
n Men Tsee Khang (transl.) (2015: 277). 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.

[pg. 280: 1 "The three nutritious bones soup are prepared from ankle, cocyx and ednd part of scapula"; 2 "The four essences are meat, butter, jaggery and chhang."

Mental diseases and WHO standards

With regard to mental diseases, the categories and diagnostics of mental diseases defined by WHO, according to ICD-10 resp. ICD-11 and DSM V, seem to be largely unknown to physicians of Tibetan medicine (according to the current status of the interviews conducted with doctors of Tibetan medicine in Nepal, 1.8.2019)