How Tibetan Medicine in Exile Became a “Medical System”

Abstract

Tibetan medicine or Sowa Rigpa was largely ignored in classic publications on “Asian medical systems.” This article contends that one important reason for this oversight was that Tibetan medicine had not yet managed to establish itself as a recognizable medical system at that time. This has changed only recently with ongoing political and economic processes through which Tibetan medicine in exile has been transformed, since the 1990s, from a regional health tradition into a globally recognizable and clearly defined and delimited medical system. After some reflection on the notion of medical systems, this article focuses on the events and interests that led to the establishment of the Central Council of Tibetan Medicine in early 2004, which can be regarded as the official establishment of Sowa Rigpa as a medical system. The discussion then moves on to the consequences of this development for Tibetan medicine in exile at large, and for its most powerful institution, the Men-Tsee-Khang, in particular. The outcome of wider exile Tibetan political aspirations, Sowa Rigpa's “embodiment” as a medical system also has direct medical and pharmaceutical dimensions, manifesting most importantly in efforts to regulate and standardize its syllabi, clinical practice, and pharmaceutical production. The article gives in-depth insights into some of the most important recent developments in Tibetan medicine in exile, its economic and political organization, and the role of its main institutions.

Keywords:

• Tibetan medicine
• Sowa Rigpa
• Tibetan exile
• Asian medical systems

Acknowledgments

The research and writing of this article was funded, at different stages, by a Wenner Gren dissertation fieldwork grant, the Austrian Science Fund (FWF project P20589-G15), and a Marie Curie International Incoming Fellowship (PIIF-GA-2010-275832). I am grateful to the Body, Health and Religion Research Group (BAHAR) for enabling me to participate on its international workshop on Tibetan medicine in Cardiff. Special thanks are due to Geoffrey Samuel, Elisabeth Hsu, Mona Schrempf, Barbara Gerke, Colin Millard, and the other workshop participants, as well as Mélanie Vandenhelsken and two anonymous reviewers, for their insightful comments and suggestions. Finally, I am indebted to the CCTM, its executive members, and staff for their collaboration and support over the years, without which this research would not have been possible.

Notes

1 This framework reflects the discourses of nationalist movements in India, China, and elsewhere since the nineteenth century, which used medical traditions as a means to legitimate their political claims for independence (see Prakash 1999; Chatterjee 1993; Langford 2002; Kloos 2010).

2 The only indirect reference to Tibet in Leslie 1976 occurs on page 3, in the introduction to Asian medical systems, where Leslie mentions Ayurveda's “marked influence in Tibet” and other areas.

3 Robert Redfield, from whose writings Leslie et al. borrow, uses the term civilization as a synonym for “great traditions,” in order to point to the complexity, historicity, and larger connections between what was previously studied as bounded local cultures or “small traditions.” In light of its modern connotation as the opposite of barbarism (the existence of one assuming and necessitating the other), its use as an ideological justification of colonialism and Samuel Huntington's (1996) thesis of a “clash of civilizations,” the term is deeply problematic (hence the use of quotation marks in this article). In the exile Tibetan case, however, both meanings of the term—as synonymous with culture and as the opposite of barbarism—conveniently converge in the fight for cultural survival, political sovereignty, and resistance to common Chinese claims that Tibetans were “barbaric.”

4 Later, yoga and naturopathy were added, as well as homeopathy (the latter indicated by the “H” in ISM-H).

5 AYUSH stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. In Sanskrit, āyus (commonly pronounced “ayush”) means “health” or “long life.”

6 Bon is usually considered to refer to pre-Buddhist religious traditions of Tibet, which are still practiced by a part of the Tibetan population and recognized by the fourteenth Dalai Lama as one of six Tibetan religious schools (Kvaerne 1995). The historic competition between Bon and Buddhism extends to contemporary Tibetan medicine in the form of debates over its origins, which are located either in the Buddha's teachings or in the Bon tradition. See also Colin Millard's contribution to this issue.

7 The CCTM distinguishes between two kinds of registration: “qualified medical practitioners,” who possess graduation certificates from Tibetan medical colleges recognized by the CCTM; and “registered medical practitioners,” who are mostly Himalayan amchi trained in the traditional teacher-apprentice system (and thus lacking any official certificates).

8 These approximate figures were gathered in July 2013 and refer to the period between 2011 and 2013. At the time of the original research in 2008, the CCTM had only two permanent staff members and a total budget of between 500,000 and 600,000 INR, of which around 100,000 INR were acquired through membership fees. Although still operating on very limited funds, the CCTM has thus grown considerably in the last five years.

9 At the time of writing this article, both the medical university and the new pharmaceutical factory have remained in the planning stage for several years, mainly due to a lack of funds.