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Short history of the Tibetan medical system by Dr. Pasang Y. Arya

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I shall briefly explain the history of the Oriental Tibetan medical system. There are various conflicting accounts of its origin; some scholars say that it originated in India, other say it came from China, and some others who are very patriotic, say that it originated in Tibet itself. I would like to present my own views, avoiding the controversy concerning the spherical world and its evolution and destruction particularly with reference to the land of Tibet.

During the Neolithic age human beings lived on raw meat, fruits, plants and so on. They then domesticated the wild yak and developed the art of making dairy products; milk, butter and so forth; along with this, the art of healing severed blood vessels with molten butter and healing boils with the residual barley from making chang (beer) arose. Such techniques are known to have developed even in prehistoric times, indeed prehistoric people were knowledgeable about deitry disciplines which can be seen as the basis of the development of the art of healing.

At this point in the legend, there are accounts in the Bon texts that in Zhang Zhung, situated to the north of Mount Kailash near lake Manasrovar, which is the confluence of four great rivers, at 'Olmo-Iung, the Lord Shenrab[1] is said to have taught his son dPyad-bu khri-shes the medical text known as sMan-'bum dkarnag khra-gsum and others[2].

At the time of the first Tibetan king Nyatri Tsenpo's (b.237 B.C./Baid'urya dkar-po) enthronement, he presented 'six points of doubt' in which it says: "ln the human realm below there are poisons, spirits, interfering spirits, mountain dweIIing spirits, divisive spells and wild yaks." Bonpo Tsiblha Karma Yode replied- "theft must be repayed, there is medicine in poison, there is truth against falsity and so forth"[3]. Moreover the Elder Yuthok's biography mentions that when Bi-Ji-Ga-Je questioned a Tibetan lady she replied, "According to the healing system there is need for a balanced diet, molten butter can repair wounds in the blood vessels and parents acts as physicians treating their children's ailments and so on"[4]. It seems clear therefore that a medical system existed in Tibet from very early times.

ln the past Tibet had trade connections via silk route with its western neighbours Afghanistan, Iraq and Persia. During the reign of king Song Tsan Gampo three medical systems were introduced from the direction, which I shall explain in detail later. That the Tibetan or Bon medical system had a strong connection with the Greek medical system is evident from the fact that the Galen(ic) system of medicine was known in Tibet by the name "The Upper or Western Tibetan Medical System". ln addition the theories concerned with the four elements, the four humours, rheumatism and so forth in the two systems are very similar[5]. Since the time of Song Tsan Gampo there were accounts in many medical texts of how various scholars were invited to Tibet from Persia. And just as Taxila used to be a great city of learning in India during the 7th century, Jundi Shahpur was a great city of learning near the border in Persia in those days[6]. ln Baghdad (Iraq) and Syria the Unani system of medicine (Greek medicine) developed and became a prominent science. The Tibetan king Song Tsan Gampo could, therefore, have invited Galen (a follower of the Galen tradition) from either of these two places.

The different medical systems in Asia, the lndian Ayurvedic system, the Siddhi system[7], the Chinese system, the Muslim or Unani system, the Greek system and the Tibetan systems were clearly closely related. Whilst they aIl had minor differences in terms of practice and in social and religious bias, they aIl seems similar as water poured into water. Due to the influences of the individual cultures and religious in their practice they came to be known as different systems.

From the time of Nyatri Tsanpo until the 28th sovereign king Lha Tho Tho Ri Nyan Tsan, the religion and culture of Tibet was one, therefore the medical system was also the same. During the reign of Lha Tho Tho Ri Nyan Tsan, two lndian physicians Bi-Ji-Ga-Je and Bi-La-Ga-Ze-Ma came to Tibet. The king offered Yid-kyi RoI-cha to Bi-Ji-Ga-Je as a bride and a hundred thousand gold coins. Yid-kyi RoI-cha gave birth to a son, Dungi Thorchuk, one with a conch on the crown. He learned the science of medicine at the feet of his father and is regarded as the first Tibetan physician.[8] His sons in due course were traditionaIly the successive chief physicians to the king[9]. The lndian science of medicine was thus introduced, though this introduction does not refer to a first time introduction without there being any existent medical basis but to the first introduction of a medical system from lndia. I think later on this was known as 'introduction' (dbu brnyes pa). When the son of king Drong Nyen De'u (5th century) was born blind, at his father's suggestion the physician caIled Ha-Zha Je was invited from the land of Ha-Zha (a small ancient country between Tibet and China) who successfully operated on his eyes[10]. From this, we can infer that even in such a small principality in Tibet the level of medical practice was quite high.

There are various accounts[11] of how the astro and medical systems were brought from China during the reign of Namri Song Tsan (early 7th century). However, these all fail to mention the names of the texts, which were translated at that time. During the reign of Song Tsan Gampo (617-650) Tibet was militarily strong and unified into one nation. He conquered the bordering regions and was known for his honest code of law for which he was named Lha Tsan Po (celestial stringent king). Intending to spread the science of medicine, he invited the three physicians: Bharadvaja from India, Hen Weng Han from China, and Galen from rTarzig[12] as his personal physicians. The Indian physician translated 'Bu zhags ma bu che chung and sByar ba mar gsar, the Chinese translated rGya dpyad thor bu che chung and the rTarzig physician translated mGo sngon bsdus pa, De pho, rMa bya dang Ne tso gsum gyi dpyad[13] and the three together composed a volume called Mi 'iigs pa'i mtshon cha which they offered to the king. He praised them with the stanza[14].

"If you do not understand the three great traditions,
You cannot be counted amongst the great physicians.
Because you will be of no benefit to yourself or others,
It will be as if you were grasping at air.
Bharadavaja the great sage,
Galen the strong regent,
Han Wen Han the court physician,
To you three marvellous ones,
I praise your skill as physicians."

The king ordered that these three medical systems: the Indian, Chinese and Upper Tibetan systems be studied. He sent the physicians of China and India home with rewards but kept Galen as his court physician who composed many treatises and the Bi-Ji and Lhorong physician lineages developed from his descendants. At the order of the king he taught medicine to the four lower casts: Tuk, Jang, Nig and Mong without any discrimination and treated them equally. He was given the title, "Tshoje Menpa" - the healer physician and was rewarded with nine great and three small gifts[15]. In this way he gave great benefits.

Concerning the three traditions there is a crucial point to be considered: the Chinese and Indian systems were named as they were, whereas the rTazig system was called the Upper Tibetan system or Galen(ic) system, which is very significant. To be more specific, before Song Tsen Gampo the only culture prevalent in Tibet was the Bon culture and these medical traditions developed quite early. ln gSo ri rgyud 'bum bye ba'i yang snying and in bShad mdzod yid bzhin nor bu, Khyungtul Jigmed Namkha'i Dorje (1897-1956) says: "The Bodhisattva Chad Bu Tri Shes was born to Desang Gyalmed on the auspicious day of the 15th in the Autumn of the Wood-Monkey year, the 26th year (called) Jungden. At that time in the centre of the Tagzig 'Olmo Ling surrounding the nine leveled Pagoda of Yung Drung Bon was the forest of Jambutrika, the best of all woods and Makudara, the best of all plants. ln such a beautiful environment abides the Omniscient Lord Shenrab..." It goes on to say, "The great Chad Bu Tri Shes who possessed knowledge of the medical tantras arose..."[16] Thus Chad Bu Tri Shes and the eight rishis requested the Lord Shenrab to expound the Bon medical Tantra called rGyud 'bum and at the conclusion of his teachings he gave responsibility for them to Chad Bu Tri Shes.

We can conclude that Tibet's trade, religious and cultural relations with Persia introduced the Greek medical system into Tibet at the time of Song Tsan Gampo when he invited Galen to Tibet. That Bon medicine existed even earlier than the introduction of the Greek system into Tibetan is further substantiated by Lopon Tenzing Namdak in his work Sangs rgyas kyi bstan rtlis nga mtsar nor bu'i phreng ba in which he says that until 1987, 16483 human years have passed since the birth of Chad Bu Tri Shes. Therefore, bon medicine existed before 14,000 B.C. The theories on which the system are based are similar. For example, the Greek medical system describes the four principle elements as the causes of yellow bile, black bile, phlegm and blood disorders. Likewise a Bon sutra says[17]:

"The five poisonous delusions,
Arise from the three poisons
Which themselves give rise
To the four causes of illnesses:
Wind, bile, phelgm and blood disorders"

Moreover, in both systems pulse and urine diagnosis and blood letting are explained extensively[18]. ln short because of the similarity both in practice and theory of the Greek and the Bon medical systems, the Galenic System appears to have been named the Upper Tibetan system.

Galen, according to western medical history, was a great physician who lived from 129 to 199 A.D. He was a highly exalted and incomparable scholar, and was the court physician of the Roman King Marcus Aurelius and subsequent Roman kings. He was thoroughly acquainted with all the aspects of medical practice, especially in anatomy and in performing operations. ln the science of physiology and anatomy his discoveries and works were used even until the 16th century[19]. Rechung Rinpoche's book[20] Tibetan Medicine mentions both Galeno and Galen; his contention being that Galeno was either a translator of Galen's medical texts into the Persian language or a scholar who adopted his name. But I wonder what could be Rinpoche's source for it is not mentioned. However, there is no evidence to disprove it and it is not unusual for a master physician to be accorded the name Tshoje Zhonu/Jivaka (5th century). There is certainly room for further research into the relationship between the ancient Tibetan medical system and the Greek system.

According to bShad mdzod yid bzhin nor bu[21], the Indian physician Bhardavaja and the Nepalese physician Balaha translated the Indian treaties on medicinal butter, medicinal chang, (medicinal wines), extracting the essence on the nectar of immortality, the tantra on Somaraja for curing leprosy and the hundred thousand verses on the science of healing. These were the first translations. Because of the extent of Song Tsan Gampo's military might the Nepalese king Odzer Gocha (Acshu Verman) and the Chinese emperor Tang Tai Chung had to offer him their princesses Khri Tsun (Brikuti) and Kongjo respectively in order to safeguard themselves. The Chinese princess brought with her Chinese physicians and their system in its entirety. Later Hashang Mahadeva and Tibetan translator Dharmakosa translated the Chinese texts into Tibetan. During the time of the Tibetan king Me-Ag-Tsom (8th century) the five texts: the Four Tantras and the concluding chapter were translated, which marked the second phase of translation[22]. This was the time when the Elder Yuthok (708-833) was in his prime and it seems very likely that he studied the Indian texts in India as well as the early Tibetan translations of the Four Tantras. ln 710 when the Chinese princess Kim Shing Kong Jo came as a bride to Tibet, she brought with her the text called sMan dpyad zia ba'i rgyal po which had 115 chapters. This was translated by Hashang Mahakinda and the Tibetan master physicians Gyatuk Garkhan, Khyungpo Tze-Tze, Khyungpo Namtsuk and Chokla Monbar. Further, Trisong Deutsan sent messengers to Tibet's neighbours and invited several great physicians such as Shantigarbha from India; Ha Shang Baia, Tongsum Gangwa and Hangti Pata from China; Guyu Vajra from Kashmir; Hala Shinti from Turkistan; Sengdo Odchen from Dru-gu (Amdo); Kyolma Rutzo from Dolpo (Mustang) and Dharmasala from Nepal[23]. Each of them not only practised their own systems but translated their texts. Their works were compiled into a system called Bla dpyad po ti smug po. The king was very pleased with them and issued the following edict:

"All these physicians
Must be honoured by the black-haired Tibetans
Because they protect life.
The King is the lord of all the black-haired,
One honoured by him is the Lord of beings,
So place them in the front raw.
Lay a tiger skin and silken brocade on his seat,
Receive and see off them with gold coins to his horsemen,
Obey their advice and do not go against his words.
ln this (my) kingdom life is precious,
Do not offer rewards for that which is stolen from you;
But be ready to pay gold for even powder medicines.
Refresh the physicians with food and drink,
And in order to retain them for a long time
Avoid insincerity and talking behind their back.
Offer them silk robes and woollen boots,
Use honorific language and pay them respect.
Think of their kindness and repay it in their life.
These are the 13 codes of conduct I offer,
Whosoever transgresses them will be punished."

These are the 13 codes of conduct he declared to maintain good relations between the people and the physicians. He concluded his code by saying,

"The physicians are like fathers,
The sick are to be pitied.
They are the sons,
Do not declare their faults."

The principal court physician Shantigarba translated sN go 'bum le'u brgya dang nyi shu, a text on herbs which contained 120 chapters and a text on botany called Rin chen sgron me which had three chapters. A few of these chapters still exist[24].

The Elder Yuthok (708-833) was born to Khyungpo Dorje and Gyasa Choedon in the Earth-Male-Monkey year. He possessed super human qualities and was expert in performing miracles. At the age of 10 he was invited to Samye by king MeAg-Tsom. At the age of 20, in 728, he went on a tour and participated in a scholarly debate on the science of healing at Samye, in which he eamed a reputation and the respect of Tibetan physicians. He travelled to India on three occasions and in Tibet he propagated the science of medicine and taught many students. He lived for 120 years and passed away into the field of the Medicine Buddha.

According to the Tibetan medical system the Elder Yuthok and king Trisong Deutsan (742-798) were born in the same year during the early part of Song Tsen Gampo's reign. According the Kongtrul Yonten Gyatso (1813-1899) "the visit of the court physicians from the four bordering regions appears to have been during the early part of the reign of Tri Song and during the later part of his life nine physicians arrived." Some say that this is a baseless assertion but I have my own reservations about it[25]. After the arrival of Shantarakshita and Padmasambhava in Tibet, the translator Vairocana went to India. It was during this period that many Buddhist texts, including the Four Glorious Tantras of medicine were translated into Tibetan. When Yuthok was twenty-five, Acharya Padmasambhava and Trisong concealed the medicine Tantras in treasure houses[26]. Other Tibetan master physicians such as the court physician Drangti Gyalnye Kharbug and Nyapa Choesang extensively spread the science of medicine. These were famous physicians during the early propagation of Buddhism and were responsible for translating the medical texts from the bordering regions.

The Dark Period of Tibetan History

After 842, when Lang Darma was assassinated, Tibet was divided into many small principalities. At the same time the early system of Tibetan medicine also suffered a decline. At the beginning of the later propagation of Buddhism, at the instigation of the Lha Lama Yeshi 'Gd, the great translator Rinchen Zangpo (958-1055) was sent to India at the age of seventeen. He became proficient in the sutras, tantras and all aspects of learning. He made an offering of a hundred gold coins to the Kashmiri Panddit Jnanada and with him translated the texts Yan lag brgyad pa'i snying po bsdus pa (astanga hrdaya samhita) and 'Grel pa zIa zer le'u bco Inga pa (Chandrika, the commentary on Astanga hrdaya samhita) and rta dpyad (shalihotra) into Tibetan. He taught many disciples among whom the four physicians of Purang are well known. His fame spread not only throughout Tibet but also into China and Mongolia. He thus laid the foundation of Tibetan medicine and came to be known as the only pandit of the later propagation.

Because his lineage continued unbroken the later Yuthok lineage of practice and theory spread widely. ln 1040, Atisha Dipamkara came to Tibet and translated sMan dpyad sha sbyor dar ya kan and mGo dpyad dra ba sdom pa. The Indian abbot pandit Krishna and the translator Bende Choerab translated the Somaraja text. This text and the one translated by Vairocana (8th century) and the Chinese Ha-Shang which was also known as Somaraja are, according to Desi, similar in both content and number of chapters. ln all there were four translated texts known as Somaraja in Tibet. According to Desi's work Khog 'bugs drang srong dgyes pa'i dg'a ston this Somaraja as mentioned in treasury text BIon po bk'a thang which says, "The Somaraja composed by Nagarjuna and …" is said to be a corrupt text.

However, the content and the names of the medicines mentioned in these treatises can be found to be the same; so one can claim that the Somaraja is either a translation from India or a Chinese translation from India[27].

According to Baid'urya gy'a sel p.303/13 this treatise (Somaraja) travelled from China to India[28]. It is also possible that it could be a compilation by a group of physicians such as the great astrologer Khyungpo Ngamtshuk of Tibet and physicians who arrived from the bordering regions. However there is still room for futher research. Zhang Zijidbar who lived around 1090 travelled to India[29] with a huge amount of gold after being unsatisfied by his studies under nine scholars in Tibet. He studied the eight branches of Indian science of medicine at the feet of Rishi Canbhi after making a golden mandala offering to him. On his return from India he propagated the science of medicine in Tibet.

The Treasure master Drapa Ngon Shes (1012-1090) was prophesied in a text called Thang-yig Shel brag ma:

"At the time when one is worse than others
and Jang and Chinese quarrellike ants,
The medical text treasures at U-tse
And the treasures hidden at the three Jomo Ling sites
Will no longer remain but be revealed when
One, bearing the marks of a treasurer,
Known as Drapa Ngon Shes appears."

As prophesied, he extracted the Four Glorious Medicine Tantras, which are the essence of the whole science of healing from beneath the vase shaped pillar in Samye U-Tse. It is said in Tangyig that this occurred in 883. He later wrote a summary of the Four Tantras and passed the lineage to U-Pa Dardak[30] who passed it onto Tshalung-pa Rogton Kunchog Kyab[31] who later composed the text rTsod ldog gegs sel and gave it to the new Yonten Gonpo.

Dark period

The dark period of Tibetan History took place after the monarchy collapsed in 842, and lasted about four centuries. Then Sakyapas, Nyedongpas, Rinpungpas and Tsangtod Depas ruled Tibet. The Tibetan political, religious and secular life suffered considerably from neglect, and went down. It is evident from Zurkhar Lodroe GyaIpo's biography that for the science of medicine, the later Yuthok lineage and the Drangti, Jang, Zur, and Gongmen traditions were like rainbows in a stormy sky. Priceless texts perished, teachings surviving only through oral transmission.

Renaissance period

During this dark period of revolutions, civil war, gangs and of war lords ruling Tibet, like the lotus flower growing from the mud, the great master Lotsawa Rinchen Zangpo (958-1055) was born in Guge country, in the upper part of Tibet. Chosen by Guge king Lha Lama Yeshe Od and Jangchub Od, the descendents of Tibetan kings, he was sent to Kashmir to study Buddhism, and became a master in sutra and tantra. He then came back to Tibet and translated many sutras and tantras. From his works, a new Buddhism wave began and developed in Tibet, especially the tantric tradition. He also translated the 120 chapters of the Indian Ayurvedic text Vagbhata’s Astangahrdaya, its commentary, Chandrika from Chandranandana, and also translated Shalihotra Asvayur samhita nama for horse treatment. He translated and taught medicine to many disciples and four of them became eminent scholars physicians in this tradition. The science of medicine again resurrected and spread for the health of snow land people. From him, the upper part of the medical tradition rooted and Indian Ayurveda developed once again in this land. In the later part in his life, he met Atisha Dipamkara shrijyana and according to his advice, he went in retreat for twelve years and left for parinirvana.

Atisha Dipamkara Shrjyana (892-1055), invited into Tibet by Guge king Lha Lama Yeshe Od and Jangchub Od, arrived in the country in 1038. He brought back Dharma light and propagated love, compassion and karma-dharma to the Tibetan people. People got a chance to breathe freely after the civil war, frustration and suffering. He was venerated by Tibetan people and lived there over 17 years. His teachings of sutra and tantra founded the kadampa tradition of Buddhism and made great contribution to the renaissance of religion, philosophy, art, medicine and way of life of the people. As a man who had a good heart and courage, he went to India to study and become a master on Dharma. He came back home like a hero and became a model for Tibetan people. Through the collective interest and hunger for peace and Dharma, people brought the light, art and religion that made the foundation of present Tibetan culture, art, medicine and Buddhism.

The Age of the New Yuthok

According to Yuthok’s biography (gDung rabs) concerning nectar pills:

"To spread the knowledge

Of the medicine mala and pills
Produced through meditation,
Five sublime beings will incarnate:
Dreje Vajra, Khyungpa Dorje, Yonten Gonpo,

Bumseng and Yuthok Salu Dorje Drag
They will spread the knowledge of these pills.
I bow down to these five stainless lineage holders
Of the later period of propagation "[32]

ln accordance to the prophecy, the younger Yuthok Yonten Gonpo was intentionally born to his father Khyungpo Dorje and mother Padma 'Oden in 1126, the Fire-Male-Horse year, at Nyangtod Gozhi Retang, at a distance of approximately 20 km from Gyangtse city (upper part of Tibet).

He learned medicine from his father, and started practicing it when he was only eight years old. He also went to the lineages of all the nine physicians called experts in the art of healing (gSowa Rigpa) that were directly coming from 8th century, for further study on rGyud-bzhi and other systems existing in that time in Tibet. However, he was not satisfied with the existing knowledge and traveled to India via Nepal. To discover the rGyud-bzhi and its related branches of the medicine and medical spiritual studies he went to India six times. Details of his travels and his superhuman powers and ability to perform miracles can be found in his biography. For instance he returned to Tibet from India within half a day and brought fresh Arura leaves (Terminalia chebula Retz) to show his disciples. He brought many essential medical treatises like essence out of the ocean of the Indo-Tibetan medical science. He composed synthesis works such as rGyadpa-chechungi-snyingpo-bsduspa on Vagbhata’s Astanghrdaya, Pawoe snyingpo-sduspai mdo-gnaskyi-‘grelpa-mthongwaimelong, “Clear mirror commentary”, on Vagbhata’s “Five self clearing pulsology”, Laglen-podchung “Minor pratical book”, Mengag-shoggril-skorgsum, “three oral transmission bundles”, rGyudchungwa “Minor tantra”, and Nyamsyig-budonma “Practical experience written for sons”. Especially he finalized the rGyud-bzhi and edited the ”Four Glorious medical Tantras, the king of medical science which contains 156 chapters[33]. He wrote two different annotated texts of the rGyud-bzhi, one with golden ink for his sons, and another one in black ink for his disciples. He also composed the Chalag-bchorgyad, “eighteen supplements” of the rGyud-bzhi and gave it to his heart disciple Sumton Yeshe Zung. lorgyus-ngeshes-‘drenpai-lchagsrgyu, the medical spiritual history chapter of the Yuthok sNyingthik said: “after the completion of the rGyud-bzhi text, which is not different than the highest secret tantric tradition, Buddhas and Bodhisatvas of the ten directions visited in the sky and said “ALALA HO! Well done, son. Your work will be of great benefit to the sentient beings in the future”. With intention Yuthokpa made the rGyud-bzhi as spoken by Medicine Buddha Bedurya. Zurkhar Lodroe Gyalpo said that Yuthok’s motivation of hiring the name of the composer to Buddha Bedurya was to convince the Tibetan people that the text was equal and as highly valuable as Buddha’s words. Actually Desid Sangye Gyatsho said that Yuthokpa was a fully enlightened yogi physician and an emanation of Medicine Buddha, therefore there was no reason to doubt his works. Yuthokpa put the five Dhyani Buddhas as Yidle-kye the questioner and the four preachers of the rGyud-bzhi, Yuthok’s disciples were the four schools of medicine and the four medicine mountains were the four directions of his Goshi-Rethang school. Yuthok portayed himself as a medicine Buddha Bedurya od kyi Gyalpo. For this reason number of Tibetan scholars of past and present explain that rGyud-bzhi is a ”Bod-rtsom”, Tibetan composed, and that Yuthok the younger was its author.

According to the teaching tradition, Yuthokpa advised Sumton Yeshe-Zung to teach and propagate the rGyu-bzhi as a Medicine Buddha’s teaching. His thought and vision worked exactly during all these centuries as through Tibetan people‘s faith and belief, they have better served many people. According to this point of view and reason, followers of rGyud-bzhi then officially explain that it was preached by Medicine Buddha, and so the tradition has come until this century.

Could we say then that the rGyud-bzhi is a work not based on Buddhist medicine, invented by Yuthokpa and presented as a Buddhist medicine?

In my opinion, it is a Buddhist medicine tradition, because according to Yuthokpa’s biography, he received many teachings on Buddhist medicine and he especially received tantric healing teachings at various times in India. He himself became an enlightened person. As a Buddhist and a being that became realized through this religion, he then composed the rGyud-bzhi based on Buddhist concept, philosophy, ethics and practice.

Some facts could be considered in this matter.

1. He based the concept of rGyud-bzhi on Buddha’s teachings on religious ethics of love, compassion, nonviolence and Vinaya sutra.
2. The internal framework of rGyud-bzhi was composed on the tantric concept of Medicine Buddha Bedurya Od kyi Gyalpo and the five Dhyani Buddhas.
3. Externally, rGyud-bzhi refers to the eight Medicine Buddha’s sutra.
4. The rGyud-bzhi history shows two main sources of the tradition: In the first chapter of the first tantra, the origin of the rGyud-bzhi is based on Ayurveda, while in the history of rGyud-bzhi begins at Tanadug city, Mengyi-drongkhyer, and is based on Medicine Buddha sutra.
5. Yuthokpa added many tantric and subtle physiology concepts and practices based on Buddhist tantra and his visions.
6. He also integrated concepts coming from other medical systems and brought a number of practical techniques and methods from neighboring countries like India, Nepal, Kashmir, Mustang, China, and some other traditions.

In the later part of his life, he completed the rGyud-bzhi and passed it to Sumton Yeshe Zung and his own son Bumseng. According to his biography, Yuthok and around three hundred disciples left for Kyirong (Happy Valley) and performed a great offering puja to Jowo Rangjungwati zangpo, the famous Awalokiteshwara statue that came from Nepal during the King Songtsen Gampo’s reign. One day, while Yuthokpa was sitting in front of the statue, a bright light came out of it accompanied by sounds of Awalokitshwara’s and Medicine Buddha’s mantras, and the statue spoke to Yuthokpa about his future.

Yuthokpa taught the “Yuthok sNyingthik cycle of teachings” in the later part of his life and especially to both the physicians and the sick persons who wished to gain liberation in one lifetime. He passed on his lineage to his fortunate disciple Sumton Yeshi Zung, who himself was an emanation of Avalokiteshvara. He gave a lot of advice to his sons, daughters and disciples and soon later passed away into the realm of the Medicine Buddha at the age of seventy-six (1202). His disciples, the great Sumton and the scholar Bumseng, Yuthok’s own son, passed to other disciples his lineage of the Four Tantras teaching, which has become the still living tradition of Tibetan Medicine. Sumton Yeshe Zung held the main medical transmission as well as Yuthok sNying-thik, the spiritual tantric practice, while Yuthok’s son, Bumseng, carried his fatherly tradition at home, holding the seat of the Goshi-rethang house, teaching and propagating the rGyud-bzhi to his children and disciples. However, Sumton Yeshe Zung’s lineage became the main holder of the medical and spiritual Yuthok’s tradition and his propagation spread like a Banyan tree and pervaded the Tibetan medical system like perfume in sandalwood. Throughout generations, Tibetan people have payed respect and love to Yuthok for his kindness and believe him to be an emanation of Medicine Buddha and father of Tibetan Medicine.

The medical system has become a powerful practice in the Tibetan culture as the Medical spiritual concept, and its practice joined with loving kindness, is an essential medicine for the patient. But it is also fundamental for the physician himself, especially in Tibetan Buddhism, as a branch of the bodhisatva way of life.

The Jangpa Tradition

More than one and half century after Yuthokpa’s death, Jangdak Namgyal Dragzang (1375-1475) founded the Jangpa tradition. He was a great pandit proficient in the sutra and tantra and highly skilled in the science of medicine. He left more than thirty treatises, the most well known being Yanlag brgyadpa thamscad kyi snying po yid-bzhin norbu rinpoche, containing 120 chapters, which is a commentary and works on Astanghrdaya. He also made a commentary on the Four tantras: rGyud-dongsalbyed-sgronma on the first tantra, bDudrtsi-churgyun on second tantra, Tigchungdongsal on the third tantra and dkah’grel-dgos’dod’byungwa, Yonggtadkyi-‘grelwa-tsigdonrnampar-gsalwa and sMangzhungrinchensgrombu, commentaries on the last tantra etc and many other works. He passed on his lineage of practice, transmission and instruction to Thongwa Dondhen, the one who was “like the sun among the northerners” (Jangpa) and made him the chief physician of the Jangdak Namgyal Dakzang tradition. Thongwa Dondhen wrote extensive outer, inner and secret commentaries on the Four Glorious Tantras and established the presentation of their themes by logical means [34]. Later many successive lineage holders of the great Vidhyadhara upheld and carried out his practice. This is known as the Northern Tradition because of the place where it flourished.

The Zurkhar Tradition

Zurkhar Nyam Nyid Dorje (1439-1475) was, from his childhood years, outstanding in his studies of the sutras and tantras and other sciences and was particularly talented in medicine. He wrote Man ngag bye ba'i ring bsrel on pharmacy and pathology, and also composed a commentary on rGyud-bzhi, Podshel-phramo, as well as many other works. He taught the science of medicine to the physicians of Nyal, Lor, Byang and those from E-ha, Nyang and Kongpo locality. He died at the early age of thirty-seven. Among the many disciples he had, the following four were the most famous: Mingyur Tseten, Khragpon Sonam Tashi, Tsebum Dotje and Lichung Pema Kyab. This tradition came to be known as Zurlug, named after the area where it flourished. Kyempa Tsewang and others propagated it.

Zurkhar Lodroe Gyalpo

Zurkhar Lodroe Gyalpo (1509-1572), the nephew of Zurkhar Nyam Nyid Dorje was a great pandit learned in the sutra and tantra. His work towards the propagation of the science of medicine was even more extensive than those of the great Yuthok. He studied extensively at the feet of many tutors such as Langbu Choeje. During this period the science of medicine was at its lowest ebb primarily because the Four Tantras had become so corrupt. This situation dismayed Zurkhar Lodroe Gyalpo and stimulated him to search for the original Four Tantras of Yuthok in order to make an authentic revised edition. ln the Earth-Male-Tiger, of 1543 he discovered Yuthok's own volume of the Four Tantras with the great man's thumb prints and annotations on the pages, which he used to make the revised rGyud-bzhi edition. This work took him four years under the patronage of Rinpungpa Ngawang Dakpa during which he aIso composed the famous commentary of rGyud-bzhi Mes po'i zhal lung. Depa Yargyabpa patronized the xylography of the text in 1566, and was printed in 1573 as the Drathang edition. This became the first authoritative medical text. He also wrote seventeen works including Dri ba tsu ta'i khri shing and Mun sel sgron me, which clarifies the aspects of the tantras to be regarded as spoken by the Buddha and those which are not. ln this way his period saw the firm establishment of the tantras.

Gongmen Tradition 
Gongmen Kunchog Deleg became a master scholar under his teacher Drangti Choegyal Tashi and composed the texts Brang ti'i pod khra, Pod dmar and Pod nag. His son, Kunchog Phandar also extensively studied the science of medicine then prevalent in Tibet and wrote the extensive, medium and small gSo rig dgos 'dod kun 'byung. He had disciples who were known as the Four Pillars and Eight Beams who held the tradition. The tradition comes to be known as the Gongmen tradition and is widely respected by scholars and common people.

The Propagation of Tibetan Medicine Under the Ganden Phodrang Government

The Fifth Dalai Lama, Ngawang Lobsang Gyatsho, who took charge of the Tibetan government (Gaden Phodrang) in 1642, patronized the establishment of three medical schools such as:

1. Sorig Drophen Ling College under the supervision of Nyithang Zhabdrung Lobsang Gyatsho and Jang Ngos Nangso Dargye;
2. Drang Song Duspai Ling college at Zhika Samdup-Tse under the patronage of the Tsharong family
3. School at Lhawang-Chok (inside the Potala) under the supervision of Nangso Dargye and the Darmo physician Lobsang Choedrak.

The 5th Dalai Lama generously funded the printing of several texts including sMan bzhung cha lag bco brgyad, Mes po'i zhallung and dpalldan rgyud bzhi. He also encouraged the practice of making precious pills, commissioned the translation of the Tshe'i rig byed mth'a dag gi snying po bsdus pa text by the Indian Brahmin Sanyasi Godra Ranchi from Moharila in south India with the great translator Dharpa Ngawang Phuntsog Lhundrup (1623-?) and ordered seventy two yantra wheels to be made in accordance with the tradition of the Indian physician from Faha'i called Danadawa.

He further asked the Tibetan translator Darpa to undertake the translation of Tshangs pa tshe'i rig byed rgya mtso'i yan lag 'dzin pa gyo ba can and Phan byed man ngag lag len thor bu by Ragunatha, a physician of the Kshatriya caste from Mathura in India as weIl as Mig 'byed mthong ba dan ldan, written by Shah Jahan's court physician Manaho. These still exist in the Tengyur collection of the Tibetan canon today. He deputed Darmo Menrampa and Lhagsam to be trained in performing eye operations. He also wished to preserve the practice of using mercury in medicines in accordance with the tradition of the Mahasiddha U-gyan as prevalent in Nyanang. He supported the Namling Panchen and Darmo Menrampa Lobsang Choedak completed the remaining works on Mes po'i zhal lung by Zunkhar Lodroe Gyalpo. Further, His Holiness the Fifth Dalai Lama patronized the work of bK'a 'grel man rgyud gser rgyan by Darmo, Mermoba and Larawa and the printing of the elder and younger Yuthok's biographies. During this period there were many writers such as Nyithang Zhabdrung Ngawang Zhonu (17th century) who wrote rGyud gsum 'grel pa, Mipham Gelek Namgyal who wrote Byang khog yul thig and, sMan gyi ro nus and Lhunding Namgyal Dorji who wrote rD o ring rgyan mchog.

Desid Sangye Gyatsho and the Chakpori Medical Institute

Desid Sangye Gyatsho (1653-1705), was a reincarnated high Lama who, from his childhood, was brought up under the special care of the 5th Dalai Lama, in such special way to acquire a full knowledge on sutra, tantra and secular sciences including ethics. On Iron hill of Lhasa, he founded the Chakpori Bedurya Drophan Tana Ngo Tshar Rigjed Ling Institute in 1696 in accordance to the wishes of the Fifth Dalai Lama. He became an authoritative great scholar in Tibetan medicine, Astrology and other traditional Tibetan sciences as well as an excellent teacher, writer and debater. At his time, no one from any school of Buddhism would challenge him in any secular sciences. He studied medicine at the feet of many teachers including Lhunding Namgyal Dorje and completed his famous commentary on rGyud-bzhi, the Four Tantras, called Baid'urya sngon po, the Blue Beryl treatise, which contains more than 1,200 folios, in 1686. He also wrote a treatise called Man ngag lhan thabs as a supplement to the third tantra. Both of these works became the syllabus for the Chakpori college and gradually in all of Tibet. ln order that the meaning of the Four Tantras should not be misinterpreted in the future, he illustrated them in seventy-nine medical thangka paintings. Such beautiful thangkas and detailled works on medical field had never been done in the world. The Root Tantra is illustrated by four thangkas, the Explanatory Tantra by thirty-five, the Oral Tantra by sixteen and the Later Tantra by twenty-four thangkas - a total of seventy-nine thangkas with one more of the Guru lineage, making a total of eighty thangkas. He completed this historic work in the Water-Sheep year (1703) of the 12th sexagenary and offered them to the Chakpori institute. This was indeed an extremely rare and priceless treasure. The original thangkas were preserved at the Lhasa Mentseekhang and a copy of them was offered to the tsar Nicholaus II by the thirteenth Dalai Lama. Copies of these tangkhas are now widely published in different languages and praised by scholars and common people. Furthermore, in order to present a thorough view of the evolution of Tibetan medicine, he wrote a history text on Tibetan medicine called gSo rig khog 'bugs drang srong dgyes pa'i dg'a ston. Unfortunately, Desi Sangye Gyatsho was assassinated in 1705 by Tsering Tashi, queen of Lhasang Khan, following a political upheaval. There are as many as twenty different works done by Desid Sangye Gyatsho on medicine, philosophy, history etc., which are not mentioned here. He would personally teach the students in Chakpori and would check and guide the pharmacists preparing pills. He was able to unify the Jangpa, Zurpa and Gongmen traditions into one Tibetan medical system, which not only spread throughout Tibet but also in Bhutan, China, India, Mongolia, Nepal, and Sikkim (now in India). His contemporaries include Nyithang Zhabdrung, Darmo Lobsang Choedrak (17th century), Lhunding Namgyal Dorje, Jang Ngos Nangso Dargye, Namling Panchen, Mipham Gelek Namgyal, Chagpa Choephel, Lhagsam or Sumga and Larawa who were responsible for propagating his works. Since the 18th century there have been a succession of master-scholar-physicians such as, Deumar Geshe Tenzing Phuntsog, Karma Theckchog Dorje, Palpung Situ Rinpoche Choekyi Jugnye (1699-1744), Daphon Karma Ngeleg Tenzin, Karma Ngedon Tenzin, Jamyang Khyentze Wangpo (1882-1892), Kongtul Rinpoche Yonten Gyatsho (1813-1899), Jamgon JuMipham Namgyal Gyatsho (1846-1912), the Mongolian Upasaka Jampel Dorje, the Mongolian physician Lungrig Tendar (18th century) and others who established the reputation of Tibetan medicine in the land of snow.

Lhasa Medical & Astro. Institute/Mentseekhang

ln accordance to the wishes of the great 13th Dalai Lama, the Lhasa Medical & Astro. Institute was established in 1916. His Holiness personal physician Jampa Thubwang (b?1922) was appointed chief medical officer whose direct disciple, the Drepung physician Khyenrab Norbu (1883-1962) was appointed the principal of the institute. ln 1918, when Jabhugpa Damchoe Paljor, one of His Holiness' personal physicians retired, Khyenrab Norbu was appointed junior personal physician. He wrote many works on Tibetan medicine but his principal activity was training over a hundred students in medicine, astrology and literature. He wrote the prayers and a supplementary of medical Tantras, which were recited daily in the institute for its successful development. The physician Rigzin Lhundrup who studied at the feet of Jampa Thubwang, became a master scholar and trained many students. He was known as the Nyagrong Shar physician or Lekhung physician throughout U-Tsang, and his private institute became one of the three colleges in U-Tsang. ln 1959 the Chinese invaded Tibet, and soon engaged in the wholesale destruction of the Tibetan religion, culture and way of life. However, the destruction was not total because Chinese themselves recognised the benefits of medicine, and also because His Holiness the Dalai Lama has rekindled the religion and culture of Tibet in exile. The Chinese have made use of the Tibetan medical system and liberally financed the publication of many medical texts and thangkas. ln addition they have started convening international seminars and conferences. Lhasa mentseekhang is largely developed with many department medicine production, inpatients department, Astrology department etc. There are many Mentseekhangs in Tibet like Shigatse, Nagchu, Lokha, Ngari, Chamdo, etc. as well as many Mentseekhangs in other Chinese Tibetan ethnic group of Sichuan and Yunnan provinces.

Tibetan Medical & Astro. Institute, Dharamshala, India

ln 1959, after His Holiness the Dalai Lama escaped to India, thousands of people were able to see His Holiness and receive his teachings and advice, thus inspiring the re-establishment of Tibetan culture, religion and medicine in India to preserve the huge destruction taking place in Tibet. ln 1961, His Holiness started Kunphan Menjin Khang, a small dispensary at Chopra house in Dharamshala and, at the same time, an astrology school supervised by the Department of Culture and Religion began. The first batch of students included some monks from Namgyal monastery such as Ven. Jampa Sonam graduated under the tutorship of Dr. Yeshi Dhonden and Ven. Lhundrup Gyathso (1910-1985). Medicines were dispensed free since most of the refugees were very poor. ln 1967, The Medical Institute and the Astrology School were combined under the direct supervision of the late Ngawang NamgyaI. Many students were trained under the tutorship of the late Pandita Barshi Phuntsok Wangyal (1914-1983). Later Dr. Tenzin Chodrak, Dr. Lobsang Wangyal and others joined the Tibetan medical Institute and began to develop it widely. At present, the institute has an administration department, a pharmacy, an astrology department, a research department, two colleges, a museum and a clinic with more than forty branch clinics throughout India and Nepal. It participates in many national and international seminars and conferences and propagates Tibetan medicine all over the world.

Private Institutions

There are numerous private and governmental Institutes giving a full training on Tibetan medicine, such as the Chokpuri medical Institute, founded by Dr. Trogawa Rimpoche and graduating Tibetan young physicians.

The Central Institute of Higher Tibetan Studies in Varanasi as well as the Buddhist philosophy school in Ladakh, both under the aegis of the Indian government, give a full training on Tibetan medicine.

Tibetan medicine in other countries

1. Tibetan medicine is known in Bhutan as “Bhutanese medicine”. There is a clinic and a training center in Thimbu, Bhutan.
2. Tibetan medicine is known as “Amchi system of medicine” in Indian Himalayan kingdoms such as Ladakh, Himachal Pradesh where this system is widely used.
3. Tibetan medicine is known in Nepal as “Himalayan medicine” and is widely practiced there.
4. Tibetan medicine is known in Mongolia as “Mongolian medicine” and practiced influentially in Mongolia, Russia republics such Khalmik, Buryatia and Siberia.
5. Several western countries in Europe and America have now institutes giving information and teachings course and conferences on Tibetan medicine.

Central council of Tibetan medicine

Some years ago, the Tibetan government in exile of H. H. the Dalai Lama set up an umbrella main office of Tibetan medicine for physicians of the government in exile and those with a private practice. The office has taken the responsibility of structuring the present Tibetan medicine status, working for its preservation and development in the future. The council especially holds the great task of legalizing Tibetan medicine in India and uniting the various Tibetan medicine practitioners. So far they have organized several national conferences, seminar-cum workshops, education programs for undergraduates and Tibetan physicians, and are undertaking a registration process for Tibetan doctors and institutes.


  1. Ven. Tenzin Namdak's Sangs rgyas kyi bstan rtis ngo mtsar norbu 'phreng wa. Kalimpong edition 1962? Shenrab Miboche is the founder of Bon religion in Tibet and probably appeared in 18003. B.C.
  2. Also see: Bod kyi gso ba rig pa'i thog ma'i 'byung khungs rags tsam glengwa dpyod Idan dgyes pa'i roi mthso by Lokha physician Samlen, Lhasa Mentzikhang edition p3 L21.
  3. Khyung sprul 'jig med nam mkha'i rdo rje, gSo rig rgyud 'bum bye ba'i yang snying 'gro kun 'byung 'phrugs nad kyi zug rngu'i gdung sel sam sbyor stong rta phan bde dpyad kyi db'a sIOn roi pa'i rgyan zhes bya ba commonly known as gSo rig rgyud 'bum bye ba'i yang snying published by Ven. Tenzin Namdak:, Solan, RP. (India), 1972. P6 LI.
  4. Jo-oo Lhun-grub bkra-shis (ed. Dar-mo Smen-ram-pa Lob-zang chosgrags) rie btzun gyu-thog yon tan mgon-po'i rnyingma'i rnam thar bk'a rgyama gzi brjid rinpo che'i gter mzod ces bya lxi commonly known as gsung rnam bka' rgyama. Beijing People's Publication House 1982. P62 LlO.
  5. Singer, Charles, A Short History of Anatomy and Physiology From the Greeks to Harvey. Dover Publicalion, USA 1957, PlO L3 & P27 LlO.
  6. Jaggi, Dr. O.P. All about Allopathy, Homeopathy, Ayurvedic, Unani and Nature Cures published by Orient Paper Racks. A Division of Vision Books, Privale Lid. Madarsa Road, Kashmere Gate, N.Delhi-6, P94 Ll4.
  7. This could be the non-Buddhist tradition being one of the four traditions according to the introductory history of Root Tantra.
  8. Byam-pa 'phrin-Ies, Bod kyi gso ba rig pa'i 'byung tshul dang 'phel rgyas skor gyi ngo sprod rags bdus. Lhasa Mentzi-khang edition 1986. P2.
  9. According to the medical history, the tradition of the appointment of the king's personal physician began in the time of Dungi Thorchok. It seems that Tibet adopted this traditions from Greece or India unless this system existed in the Bon period before King Lha Tho Tho Ri Nyen Tzen.
  10. bDud-Joms Rinpoche, Rgyal rabs dvang she! 'khrul gyi me long. Council for ReIigious Affairs, Dharamshala 1978 P23 LIO.
  11. Saskya Je btzun bSod nams rgyal mtzan, Rgyal rabs gsal ba'i me long. Peking edition 1981 P61 LI7.
  12. The Tibetan word rta zig could be a corrupt use of Tazixtan or Persia.
  13. See Dr. I.C. Beckwith’s Introduction of Greek medicine into Tibet in the seventh and eighth century.
  14. sDe-srid sangs-rgyas rgya-mtshos, gsorig khog 'bugs legs bshad baid'urya'i melong drang srong dgyes pa'i dg'a ston, Kansu edition 1982 P150 LI 5.
  15. I could not locate the names of all the gifts.
  16. Ven. Tenzin Namdak, Sangs rgyas kyi bstan rtis nga mtsar nor bu'i phreng ba zhes byawa 1987, According to the author Bon radical system existed at least 14496 B.C ago.
  17. Khyung-po blo Idan sNying-po, Duspa Rinpo che'i rgyud drima med pa gzi brjid rab tu 'bar ba'i mdo. Tibetan Bon Monastery, Solan, H.P. (India) 1969 P27 L2.
  18. Nurse E. Alan, edi. by the editors of Life; The body, life Science Library, New York 1964, P.P. 24-31.
  19. Singer, Charles, A Short History of Anatomy and Physiology from the Greek to Harvey. Dover Publication, USA P46.
  20. Rechung Rinpoche Jampal Kunsang, Tibetan Medicine. Wellcome Institute of the History of Medicine, London 1973, P.5 LI4.
  21. sDe-srid Sangs rgyas rgya-mtsho, khong 'bugs PI 50 L8-16.
  22. Dondam sma wa'i senge, bShad mzod yid bzhin norbu, Dr. Lokesh Chandra, Delhi edition P292 LI.
  23. Kong sprul, sHes bya kun khyab, Lokesh Chandra, Delhi edition P215.
  24. Lung rig bstan dar, rGyud bzhi'i mtha' dpyod, P66 L6.
  25. A) sDe-srid Sangs rgyas rgya-mtsho, Phyi rghud baid'urya sngon po, Tashi Yangphel, Delhi edition 1973 P245LA.
    B) Sngo sbyor 'khrungs dpe man ngag rin chen, Library of Tibetan works and Archives, Dharamshala 1980 P233 L6.
  26. These are undoubtedly very ancient and rare texts and I feel they should be regarded as authentic. The colophon of the text says that it was translated by the great Indian master Shantigharba and seven court physicians.
  27. Sangs rgyas rgya mtsho, Khog 'bugs drang srong dgyes pa'i dg'a ston. Kansu edition, 1982 P152.
  28. According to Baid'urya gy'a sel P303 L3 this text originated in China and came to India, which was later translated into Tibetan by the translator Bende Chos Kyi Yeshi with the Indian Pandita Krishna.
  29. He left for India to study medicine because even the most famous physician among the nine traditions of Tibet could not satisfy him.
  30. The dates of the hiding and discovery of this treasure text are controversial. The above text says that when the Elder Yuthok was 25 years old, the King and Acharya hid a store of texts for three days in the desire realm that is for 150 years. However, Yuthok Yonten Gonpo was born in Earth-Male year in 708. If he hid the texts when he was 25 years old, that would have been in 733 A.D. Therefore the treasure master Drapa Ngon Shes must have found the texts in 883. This leaves a discrepancy of nearly three sexagenaries between this date and birth of Drapa Ngon Shes as recorded in the standard historical chronology.
  31. He is also called Rogton Kunchog Kyab or Tonchen Kunchog Kyab.
  32. See; Biography of Elder Yuthok Yonten Gonpo, 'bKa' rgya P320 L5.
  33. See; Conceming Elder Yonten Gonpo, Lo rgyus nges shes 'dren pa'i lcags kyu, Chagpori edition, P7 LI.
  34. Lungrig, Tendar, rGyud bzhi'i mtha' dpyod, P24 L2.