"gSoba Rig-pa" Tibetan Medicine: A Healing Science

Training of Tibetan Physicians

Introduction 

The training of a Tibetan doctor covers all aspects of the arts of healing, from the identification and processing of medicinal plants to the meditative empathy essential for successful diagnosis. A major component of training physicians is memorizing the Four Tantras.

Tibetan physicians are trained at Men-Tsee-Khang, the Tibetan Medical and Astrological College (T.M.A.C.), founded in Dharmasala , India by His Holiness the 14 th Dalai Lama on June 2, 1961. (The college's predecessor, Mendzekhang, was in Lhasa , Tibet .) Its primary goal is to preserve the rich and ancient tradition of Tibetan medicine and astrological science and to impart this knowledge to the younger generations. Degrees offered include the Tsipa Kachupa or Bachelor of Traditional Tibetan Astronomy and Astrology, and the Menpa Kachupa or Bachelor of Traditional Tibetan Medicine and Surgery.

T.M.A.C. Medical Curriculum offers admission based on merit to interested candidates who wish to study either medicine or astrology. New students are selected every five years. Most students are sponsored by individuals or Tibet support groups, as well as by the Tibetan government. In 2006, the college admitted 26 new students to begin their studies in Tibetan medicine.

Candidates to the program are tested in several areas including: language, essay writing, general knowledge, and an interview portion.

Course work at Men-Tsee-Khang takes five-years. Upon completion of the program students are awarded the Menpa Kachupa degree.

After completing coursework, students begin their practical training, for 1 - 3 years, under the tutelage of a master physician. After this internship is completed the students being to practice in Men-Tsee-Khang's clinics.

Four Tantras

The fundamental medical treatise, the rgyud-bzhi , is comprised of four sections, usually known as the Four Tantras:

1. RCTA Tantra: Explains the human organism and its functioning, including the healthy and the sick body.

2. Explanatory Tantra: Concerned with the life cycle (conception, childbirth, functioning of the three humors, and signs of death) and the causes, conditions, and classification of the diseases. It specifies the properties of medicinal ingredients and explains in detail diet, behavior, and the rules for maintaining health, etc. It also contains a code of professional conduct for the physician.

3. Oral Tradition Tantra: Teaches the 101 disorders of the three humors indicating their causes, conditions, symptoms and methods of therapy.

4. Last Tantra: Explains diagnosis (such as urine analysis and pulse reading), medicinal ingredients and their preparations (pills, powders, syrups, medicinal butters, etc.) pacifying medication (purgatives and emetics) and additional treatments (moxibustion, golden-needle therapy) which are applied when all other medicinal preparations have failed to effect a cure.

The complete text encompasses 5,900 verses which are grouped in 156 chapters.

Illustrated Tree of Medicine

Students learn the Tantras by using a tree structure. For example, the RCTA Tantra sprouts into nine stems, which branch out into 47 branches bearing 224 leaves. The trees represent the human organism and its functioning, diagnosis, and treatment.

Inner Qualities

In Tibetan medicine a doctor's inner qualities are considered just as important as his academic expertise. For the Tibetan physician, the Buddhist ideals of wisdom and compassion which are essential elements in his training further aid him in attending to the physical, emotional and spiritual needs of his patients.

Pulse Diagnosis

A key element to Tibetan medicine is pulse diagnosis. Students begin learning pulse diagnosis in their fifth year. It can take a decade to truly master the technique, and practice stations such as the one below are used as adjuncts to the real thing.

Tools for Pulse Diagnosis
(source: http://familymed.stanford.edu/Tibet/)

According to the text, the doctor is instructed to take the left arm first if the patient is male; the right arm if the patient is female. Both arms will be examined. In each case, he uses the three middle fingers of either hand spaced apart the width “of a grain.” Each of the six fingers is divided into an “inner” and “outer” half. These 12 positions monitor the organs. For example, the outside of the physician's index finger reads the heart; the inside, the small intestine; the outside of his middle finger, the spleen; the inside, the stomach.

The text advises the doctor to keep his fingertips “smooth, sensitive, without scars, and pliable.”

Anatomy

Autopsies are only performed when attending physicians disagree on the cause of death. Therefore, students learn anatomy by using detailed charts.

References

Avedon, John F. In Exile from the Land of Snows. New York . Knopf, 1984.

Shrestha, Romio and Baker, Ian. The Tibetan Art of Healing London, Thames and Hudson, 1997.

Stanford University School of Medicine, Center for Education in Family & Community Medicine (CEFCM), Medical Student Summer Elective in Lhasa, Tibet to Study Traditional Tibetan Medicine.