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What is Tibetan Medicine?

In the Tibetan language Traditional Tibetan Medicine is called Sowa Rigpa (གསོ་བ་རིག་པ) which literally means “knowledge of healing”. It is a holistic healing system that integrates native Tibetan healing traditions with theories and practice from Buddhism, Bön, and ancient Indian, Greek, Chinese, and Persian traditions.  Holistic is a term applied to many things so it seems important to ask: “What does holistic mean here?” The answer to this question serves as a key for understanding the entire theory and practice of Tibetan Medicine.

In Tibetan Medicine, everything internal and external is considered to be formed through the action of the four great elements earth, water, fire, wind (Tib: ས་ཆུ་མེ་རླུང་། sa, chu, me, rlung) and space (Tib: ནམ་མཁའ། namkha).  Each of these elements contributes to the formation of the world and our bodies.  According to the second of the Four Tantras, the Explanatory Tantra (བཤད་རྒྱུད bshad rgyud):

ས་ཡིས་གཞི་རྟེན་ཆུས་རླན་མེ་ཡིས་དྲོད།། རླུང་གིས་བསྐྱོད་བྱེད་ནམ་མཁས་གོ་ཕྱེ་བས།།
Earth supports, water moistens, fire warms, wind moves, [and] space [provides] room [to] spread.

Internally, these elements are found together in different combinations as the three nyepas (Tib: ཉེས་པ་གསུམ): Wind, Bile, and Phlegm (Tib: རླུང་མཁྲིས་པ་བད་ཀན)1.

The nyepa Wind is composed of the wind element, Bile is composed of the fire element, and phlegm is composed of earth and water.  The space element pervades everything.  When these nyepas are balanced and remain in their own locations in the body there is health.  When they become unbalanced they are the cause of illness.

Externally, the elements are active in the substances we consume: food, drink, medicines; as well as in the movement of time throughout the day, the seasons, and so on.  These, along with our behavior (Tib: སྤྱོད spyod) are referred to as conditions (Tib: སྐྱེན skyen).  When the cause (Tib: རྒྱུ rgyu), our nyepas, come into contact with these conditions they are either increased or decreased.  When one or more nyepa is increased or decreased too much there is an imbalance and the result is disease as  the nyepas either perform their functions deficiently or in excess.

This understanding of the relationship between our personal experience and the outside world does not end at the level of the body.  Our mental states are also linked to the operations of the three nyepas in a two way relationship.  Through the increase or decrease in the nyepas we can experience stronger emotions, be less focused, less courageous, more absent minded, have unclear memory, and so on.  Likewise,  if we allow stress, excess mental activity, laziness, depression, anger, etc, to proliferate unchecked, we can increase and decrease the nyepas.

It is through the lens of this elemental perspective that Doctors of Tibetan Medicine understand and treat the myriad diseases afflicting us.  Looking to the conditions, locations, and causes of specific diseases they prescribe treatments that include herbal and mineral based medicines, dietary advice, external therapies, and changes in behavior to help alleviate the suffering of disease, both physical and mental.  It is in this way that Tibetan Medicine can be understood to be a truly holistic system.

1 Those familiar with Āyurveda will recognize this as a foundational theory shared by both traditions, although there are differences in the combinations of elements.  In Āyurveda these three, known as the tridośa (त्रिदोश),  are called vāta (वात), pitta (पित्त), and kapha (कफ).