Currents of Tradition in Sowa Rigpa Pharmacy

Abstract

This article traces patterns of continuity and transformation shaping Sowa Rigpa (Tibetan medicine) pharmacy in contemporary Ladakh, Himalayan India. It examines interlinked changes in the way medicines are being formulated, manufactured, assessed, and positioned in relation to wider social, economic, and political processes. The focus is on two practitioners who share a great deal, including medical lineage, training, and ritual connection, but whose pharmacy practices diverge in several crucial ways. The article compares the institutional contexts within which they make medicine, examines their interactions with technology and labor, and considers the dynamics of authority, power, and agency influencing their activities. Engaging the concept of “currents of tradition” and elements of assemblage theory, the author shows how changes in pharmacy practice relate to changes in the values assigned to Tibetan medicines, in their distribution patterns, and in the effects they have in the social world. In the period of flux and accelerating medical modernization that has followed the official recognition of Sowa Rigpa in 2010, pharmaceutical practice appears as an important field in which traditional medicine is at once expressed, maintained, and transformed.

Keywords:

• Traditional medicine
• Sowa Rigpa
• Tibetan medicine
• currents of tradition
• pharmaceuticalization

Acknowledgments

This article was prepared within the Pharmasud project (2009–13), funded by the French National Research Agency.

Notes

1 In the absence of universally accepted nomenclature for this medical tradition, I use the simplified phonetic form of the Tibetan term gso ba rig ba (the science or knowledge of healing), capitalized as it has entered the English lexicon (Craig 2012: 11). Sowa Rigpa is the most widely used vernacular referent in the textual canon and in ordinary speech, although the tradition has adopted numerous local names across its geographical range and is better known worldwide as “Tibetan medicine.”

2 Ladakh is a semiautonomous region of Jammu and Kashmir State in northwestern India, bordering Pakistan to the west and China to the north and east. It is a mountainous, cold desert region with a small population of 250,000 people scattered over a vast area. The Ladakhi people comprise a rich ethnic and cultural amalgam, with deep connections to Tibet but also strong influences from other historical, cultural and social configurations (Rizvi 1996). The Ladakhi language is derived from an early form of Old Tibetan (Zeisler 2005). Today, although virtually identical to Tibetan in choskat (high literary form), spoken Ladakhi is pronounced very differently, incorporates many words of non-Tibetan origin, and itself comprises numerous dialects, rendering it only partially comprehensible to Tibetan speakers (Bray 2005). For ease and accuracy of reading by nonspecialists, I render Ladakhi words phonetically and according to local pronunciation.

3 See Adams 2002, 2007; Adams et al. 2010; Alter 2005; Attewell 2007; Bode 2008; Craig and Adams 2008; Banerjee 2008, 2009; Kuo 2009; Ma 2010; Obringer 2001; Sujatha 2011; and Taylor 2005.

4 The article also draws upon research conducted in India and Nepal during the winter of 2011.

5 The Department for Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH) is the main body of the government of India responsible for traditional medicine.

6 Sowa Rigpa has a long history in what is today the Indian Himalayas. There are established medical lineages based in areas stretching from Ladakh and Himachal Pradesh in the west to Arunachal Pradesh in the east. A particularly influential branch of the tradition is that of the India-based Tibetan exile practitioners and institutions, most notably the Men-Tsee-Khang medical institute and college, which was established in Dharamsala in the 1960s under the patronage of the Dalai Lama (Kloos 2010).

7 See De Landa 2006, Deleuze and Guattari 1987, Ong and Collier 2005, and Serres and Latour 1995.

8 It is difficult to establish the value of the Tibetan medicine industry in China with any degree of confidence, although it is safe to say that it generates more than US$50 million per year and probably considerably more (Craig 2012; Saxer 2010: 80).

9 The Amchi Research Unit was established in 1976 as a branch of the Indian government's Central Council for Research in Ayurvedic Science. Although its budget and activities were limited, it was the only centrally funded institute of its kind and carried out documentary studies, research into materia medica, and simple clinical trials. It was renamed the Sowa Rigpa Research Centre in 2004 and then upgraded in 2008 to become the National Research Institute for Sowa Rigpa.

10 Out of the fifty-eight amchi I interviewed, thirty-two made the majority of the medicines they prescribed themselves.

11 “Literally, men [pronounced sman in Ladakh] means ‘medicine’ or ‘remedy’; the word refers to medical treatments or therapies on the one hand, and to materia medica of all sorts on the other.…The Tibetan word drup (grub) possesses a similar multivalence: as a verb, it means to accomplish, establish, or achieve, to make ready or perfect, to form; as a noun, it means affirmation, attainment, and established existence. When combined, mendrup thus describes the process by which a medicine is completed, activated, made ready to heal” (Craig 2006: 213).

12 Forms of smandrup have a long history in the texts and practices of several Tibetan Buddhist traditions and although it is not exclusively medical, versions of it have been practiced by amchi since the twelfth century (Garrett 2009).

13 Ladakhis may be primarily referred to by either of their two given names. In this case, Nawang Tsering is widely known as Nawang, whereas Padma Tsetar is commonly called by his second name.

14 Marietta Kind (2002) and Krystyna Cech (1987) have described smandrup in Nepal and India, respectively, highlighting its role in binding communities together in times of upheaval. This form of ritual cohesion is materially expressed through the distribution of empowered medicines such as smandrup dudsi chos sman to members, associates, and sponsors (Pordié 2008a).

15 All the core members are natives of the Changthang region of eastern Ladakh and this connection is an important contributor to collective identity.

16 A valuable preparation made from purified mercury and precious materials (including gold and silver), ngul chu rinchen tsho thal requires intensive pharmaceutical, ritual, and spiritual practices to produce. It is a crucial ingredient in many of the most powerful Sowa Rigpa medicines, including smandrup dudsi chos sman and rinchen rilbu (precious pills). For further details, see Craig 2012 and Saxer 2010: 114–17.

17 Samphel Norboo Trogawa Rinpoche was a renowned lama (Tibetan Buddhist monk), amchi, and scholar and a holder of the famous Chagpori medical lineage teachings. Trogawa Rinpoche fled Tibet in the 1960s and worked initially at the nascent Men-Tsee-Khang medical college in Dharamsala (India). He established the Chagpori Tibetan Medical Institute in Darjeeling (West Bengal) in 1992, from where he continued to study, practice, and teach Sowa Rigpa, to widespread acclaim, until his death in 2005. For further details, see chagpori-tibetan-medical-institute.com/drtrogawarinpoche.htm.

18 Dzongsar Jamyang Khyentse was a renowned Tibetan rime lama (nonsectarian monk) and Trogawa Rinpoche's main spiritual teacher.

19 Trogawa Rinpoche visited Nyi for this purpose in 1987, 1992, 1994, and 2002.

20 Without mentioning it by name, Stephan Kloos (2010: 115–16) refers to this practice taking place at the Men-Tsee-Khang medical college run by Tibetan exiles in Dharamsala. For more detailed discussion of phabs rgyun in Ladakh, see Blaikie 2013.

21 See Blaikie 2009 for a fuller discussion of shifting medicine production and procurement patterns in Ladakh.

22 For example, chapter 31 of the second treatise of gyu zhi mentions, among the prerequisites of the healer-physician: “One should entrust oneself (to one's teacher) without harbouring doubts about him, perform one's tasks without being two-faced, make all one's actions accord with his will and always maintain awareness of his kindness” (Clark 1995: 227).

23 See Craig 2012; Craig and Adams 2008; Kloos 2010; Millard 2008; Samuel 2001; and Saxer 2010.

24 The Men-Tsee-Khang pharmacy run by Tibetan exiles in Dharamsala is by far the largest and best-known producer of Sowa Rigpa medicines in India (Kloos 2010).

25 See Banerjee 2009, Bode 2008, Craig and Adams 2008, Kloos 2010 and Saxer 2010.

26 Electricity supplies are erratic in Leh, and there are frequent shortages during spring and summer, when the majority of LAS medicines are made.

27 Vincanne Adams (2007: 39) notes similar questions being raised during the early days of mechanization at the Lhasa Mentsikhang medicine factory.

28 Medicinal powders can be easily kept in perfect condition for over a year in the dry and cold climate of Ladakh but turn to what one amchi described as “soup” in a matter of days in the damp air of the foothills, destroying their potency and rendering them impossible to dispense.

29 Widely translated as “efficacy,” phan nus combines phantoks (benefit) with nus pa (potency), or “that which is useful with that which is powerful” (Craig 2012: 6).