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Abstract
Despite the recent growth of social science literature concerning the traditional medicine industry in Asia, insights into the contemporary dynamics of so-called ‘classical formulae’ remain relatively scant, as do studies of small-scale, less capitally intensive and technologically advanced modes of production. This paper seeks to address these gaps by considering a single Sowa Rigpa (Tibetan medicine) formula known as Samphel Norbu, or ‘wish-fulfilling jewel’, which appears in numerous texts and is today among the most popular Tibetan medicines in the world. Drawing primarily upon long-term fieldwork in Himalayan India, the paper follows Samphel Norbu's rise from exclusivity to popularity and examines the ways it has been transformed in the process, both materially and in its economic, social and clinical significance. The paper shows how Samphel Norbu acts as a marker of inequality between different groups of healers, and examines the role the medicine played in the development of commercial pharmacy and the proliferation of complex medicines. Tracing out wide variations in the medicine's formulation, composition, mode of production and pattern of circulation places the issue of multiplicity at the centre of analysis, and leads to a questioning of the assumptions that underpin the category ‘classical formula’. The paper reflects upon the repositioning of such formulae within emergent configurations of knowledge, power, industry and market, and on their transformations and transformative effects both over time and in the present moment.
Acknowledgements
Although they are too numerous to name, the author wishes to thank all the Sowa Rigpa practitioners he has met from Ladakh, Dharamsala, Nepal and the Tibetan areas of China for their invaluable help and insights during the researching of this paper. Any mistakes or misinterpretations are entirely the author's own. Thanks go to Laurent Pordié and Anita Hardon for organizing the conference panel for which this paper was originally prepared, and for their diligence in turning that panel into this special issue. The author also expresses his gratitude to those who accompanied and advised him during the research phase, or commented on earlier drafts of this paper, namely Barbara Gerke, Sienna Craig, Theresia Hofer, Maarten Bode, Mingji Cuomo and Stephan Kloos.
This work was supported by the Economic and Social Research Council of Great Britain under Grant PTA-1031-2006-00452; the French National Research Agency under Grant ANR-09-SSOC-019-02; and the European Research Council under Grant ERC 336932.
This research was conducted according to the ethical guidelines of the French National Research Agency, the European Research Council and the Austrian Academy of Sciences.
Conflicts of interest: None.
Notes
1. Sowa Rigpa is the Anglicized rendering of the Tibetan gso ba rig pa (‘science of healing’), which is the vernacular term for the tradition best known worldwide as ‘Tibetan medicine’.
2. Tibetan terms are rendered in simplified phonetic form throughout the text, with transliterations according to the Wylie (Citation1959) system given in parentheses after the first usage.
3. For detailed discussion of ‘channels’ in Sowa Rigpa theory and practice, see Garrett and Adams (Citation2008); and Gerke (Citation2013).
4. See: Emmerick (Citation1977); Martin (Citation2007); and Meyer ([1981] 2002).
5. Terminalia chebula, Terminalia belerica and Emblica officinalis are crucial components in many Ayurvedic and Sowa Rigpa remedies, implying a very long history of trade in the region.
6. For example, cloves and nutmeg came only from the Moluccas until the eighteenth century, but had been in global trade for at least 2000 years prior to that (Ellen Citation2003, 4).
7. There is some confusion over the identification of the material known in Tibetan as gi wang. As Sabernig (Citation2011, 89) explains, different texts refer to it as elephant's bezoar, enterolith, intestinal calculi, gallstone or bile.
8. Despite centuries of involvement in overland trade routes linking China, Tibet, the Indian subcontinent and Central Asia (Rizvi Citation1999), Ladakh did not have a reliable road link to the outside world until well into the 1970s (Demenge Citation2010). Prior to that, it took several weeks of trekking to reach any major settlements, rendering small-scale trade extremely limited.
9. These figures are based on interviews with more than 20 amchi who were active during the period in question.
10. This sample comprised roughly equal numbers of older and younger practitioners, of those trained within and outside of formal institutions, and of those working in rural and urban settings. Notably, Samnor ranked higher for urban and formally trained practitioners than for their rural counterparts.
11. Interview 3, 8 December 2011.
12. Interview 1, 9 December 2011.
13. Several providers of Tibetan medicines on a global scale (such as the Dharamsala Men-Tsee-Khang) require consultation with a recognized physician prior to supplying medicines over the internet. However, there are websites through which Samnor and other complex medicines can be sourced without a prescription, for example: http://kunphen.tripod.com/catalogue.html
15. Traditional medicines marketed as tonics or dietary supplements are in many ways the perfect herbal pharmaceutical commodity for industrial firms due to their recurrent demand and non-specific effects, as well as their ability to side-step more stringent drug legislation (Bode Citation2008, this volume; Nichter Citation[1989] 1996).
16. The Dutsi Bumzang (Bdud rtsi'i bum bzang - ‘Excellent Vase of Elixirs’) is a compilation of 125 formulae first published in Lhasa in 1959 by the renowned Tibetan practitioner, scholar and teacher Khyenrab Norbu. It was widely reprinted across the region (for example, Norbu Citation1968) and was often copied out by hand by Ladakhis unable to purchase a printed copy. The book remains well known in the present day and is a commonly referred to benchmark for classical formulations across the Tibetan cultural area (Hofer Citation2014, 56).
17. In Ladakh, a 3 g dose of ‘ordinary’ Samnor costs around five rupees (US$15 cents).
18. Substitutes for elephant bezoar, for example, can be obtained from cows and several other animals, from minerals, from an algae that grows in certain fresh water springs, and from a common Himalayan plant.
20. In Ladakh this is particularly true for the younger generation and for poorer rural practitioners.
21. For a detailed discussion of mendrup see Garrett (Citation2009) and Craig (Citation2011).
22. The Dharamsala Men-Tsee-Khang has developed a range of herbal teas, supplements and cosmetics known as ‘Sorig Products’. While this move does echo developments in the Ayurvedic industry in certain ways, Sorig Products are entirely separate from the mainstream of medicine production, and show no sign of replacing clinical supply as the institute's main industrial focus.