Tibet has long been placed in a unique position in this world both geographically and spiritually. Known for its remoteness, spiritual advancement and esoteric knowledge, Tibet has also developed a unique and fascinating understanding of the human body, health and disease. Tibet’s medicine developed through a combination of traditional Bon shamanism with influence from the surrounding Indian, Chinese, Nepalese, Persian and Greek cultures and medical knowledge. Furthermore, Tibetan medicine is heavily influenced by Buddhist philosophy and through it has gained the understanding of how mind affects disease (Sharma, 2019).
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Ignorance, which clouds the mind and obstructs clear understanding of the “Law of Causality and Reality of Phenomena” is understood to be the root of all disease and suffering. Due to this ignorance, an incorrect view of life is formed and this leads to development of the three mental poisons (Sharma, 2019). These poisons are:
- Attachment/desire
- Hatred; and
- Delusion.
The Humours in Tibetan Medicine
Each of these three mental poisons is connected to a bodily humour – the development of a mental poison subsequently gives rise to its corresponding humour. Attachment is thought to be the first of the mental poisons to form and to be the principle cause of unhappiness in life. This poison is directly related to the Wind humour. Hatred or anger is related to the Bile humour due to its hot nature and connection with the liver and gall bladder, per Chinese medicine. The third mental poison, delusion can develop from anger which gets in the way of clear thinking. This poison is linked to the Phlegm humour (Sharma, 2019).
The Wind humour (rLung), which corresponds to the Vata dosha in Ayurveda, is connected to the Air element and develops from the mental poison of attachment or desire. Wind is classified as rough, light, cold, subtle, hard and mobile. Thus, similar conditions in the environment, lifestyle or diet (like cold wind, bitter or raw foods, disturbed sleep or excessive activity) can aggravate it, triggering the disease process. Wind resides in the lower part of the body and especially affects the intestines, lungs, heart and nervous system (Gyatso, 2010, Sharma, 2019).
The Bile humour (mKhris-pa), which corresponds to the Pitta dosha in Ayurveda, is connected to the Fire element and develops from the mental poison of anger or hatred. Bile is classified as oily, sharp, hot, light, foul-smelling, purgative and liquid. Bile is aggravated by excesses of similar conditions in the environment, diet and lifestyle such as spicy foods, hot weather and excessive physical activity. Bile resides in the middle part of the body and especially affects the liver, gall bladder, circulation and perspiration (Gyatso, 2010, Sharma, 2019).
The Phlegm humour (Bad-kan), which corresponds to the Kapha dosha in Ayurveda, is connected to the Water and Earth elements and develops from the mental poison of delusion. Phlegm is classified as unctuous, cold, heavy, dull, smooth, stable and sticky. Again, excesses of these attributes whether they be through diet, lifestyle or the environment can lead to imbalances of this humour and the development of disease. Examples include cold, damp, salty food, like dairy products, living in a damp environment and over-sleeping. Phlegm resides in the upper part of the body and especially affects the kidney and bladder and the movement and regulation of fluids in the body. Phlegm is further sub-divided into yellow and black phlegm. Yellow phlegm is developed from an overflow of the Bile humour while black phlegm can develop from a chronic presence of yellow phlegm and is linked to impurities in the blood and Ama in Ayurveda (Sharma, 2019).
How Disease Spreads
The humours of Tibetan medicine are a similar concept to the dosha of Ayurveda. Known as “faults”, the humours refer to three types of energy that can keep the body in balance or, when imbalanced, cause the development of disease. Each of these humours is divided into five sub-humours which describe the different types of each humour. These are identical to the sub-dosha of Ayurveda. When one or more of the humours or sub-humours become imbalanced, this begins to adversely affect the 7 bodily constituents (plasma, blood, muscle, fat, bone, bone marrow and reproductive tissue) and the 3 excretory functions (sweat, stools and urine) (Sharma, 2019). The humour then spreads through the body in four stages, similar to the six stages described in Ayurveda (Samprapti). These stages are:
- Accumulation, where the humour accumulates due to changes in diet, season, environment or lifestyle. This is a natural process that occurs throughout the year and with correct living can be contained in this stage as natural cycles accumulate and drain each humour in turn.
- Aggravation, where the humour begins to accumulate to a dangerous extent. Here, subtle symptoms of ill-health will begin to be manifest in the location of each humour.
- Spreading, where the aggravated humour beings to move from its natural location to start affecting other parts of the body.
- Localisation, where the aggravated humour settles in a weak part of the body and starts to cause more obvious physical symptoms.
Diagnosis in Tibetan Medicine
Diagnosis in Tibetan medicine is a complex procedure, but the assessment of pulse, urine and stool is the focus. Several types of pulse can be identified and analysed by the skilled practitioner and much can be perceived about the current condition of the body and mind through this technique. Diseases are then classified into hot or cold conditions, the offending humour identified and treatment begun accordingly.
Treatment in Tibetan Medicine
Treatment strategies in Tibetan medicine are categorised into those which work on a spiritual and those on a physical level. Spiritual level treatments include the Buddha’s three cures for the three mental poisons (wisdom, virtue and compassion) (Dummer, 1988) and spiritual guidance for dealing with evil spirits and emotional issues. Physical level treatments are further categorised into gentle therapeutics and drastic measures. Gentle methods are most suitable for conditions where the humour has not spread to other parts of the body and these include massages, hot spring therapy and steam baths (Tsarong, 2003). Drastic measures are used for more serious conditions and include cupping, golden needle therapy (acupuncture), and (as a last resort only) surgery.
Dietary and lifestyle adjustments are an important part of treatment and are designed to rebalance the humour that is out of balance as well as to cool a hot condition or heat a cool condition. This is achieved through the pre and post-digestive tastes of the food and their correspondences with the humours in a similar way to Ayurveda. Medicines are produced from herbs, gems, minerals and even trees. These are collected and prepared carefully, in tune with the cycles of energy and often combined with spiritual ritual into medical pills (Sharma, 2019).
Imbalanced humours are best treated early, before spreading and also during the season of their accumulation. This is covered in a future article regarding the seasons of Tibetan medicine and corresponding dietary methods of treatment.
Are you interested in a holistic approach to nutrition that incorporates Chinese and Ayurvedic knowledge? Read about my programs here.
References
Dummer, T, 1988, Tibetan Medicine and Other Holistic Health Care Systems, page 105, Routledge
Gyatso, T, Hakim, C, 2010, Essentials of Tibetan Traditional Medicine, page 21, 35, 47, 106, North Atlantic Books, USA Tsarong, TJ, 2003, Fundamentals of Tibetan medicine, page 62, 73 Men-Tsee-Khang Publications.
Sharma, M, 2019, School of Health Naturopathy Course Notes, Tibetan Medicine Module, page 1415, 16-19, 28-29, 40, The School of Health, Stroud, UK
