Author: Lisa Tsering
Publication: www.indiawest.com
Date: April 16, 2001
India - A 30-minute hike up from
the onion sellers and smoke-spewing busses of Kotwali Bazaar, and midway
to the yupscale cybercafes and video parlors of McLeod Ganj a pricey Rs.
100 taxi ride away, the Tibetan Medical and Astrological Institute maintains
its quiet, industrial facade while giving little idea of the riches within.
More than the bitter, spherical
brown pills, and more than the golden hammers, cups and tubes used for
surgery; beyond the complex astrological calculations that accompany each
diagnosis and the array of minerals and herbs awaiting the key to release
their medicinal powers, within Tibetan medicine lies a component not found
in any other of the world's medical traditions.
The "secret ingredient" in the Tibetan
doctor's arsenal is spirituality.
"His Holiness the Dalai Lama has
said that monks and nuns make better doctors," Pema Dadhul Arya, the director
of the Tibetan Medical and Astrological Institute, told India-West recently.
Courses in Buddhism and astrology are an important facet of the medical
curriculum, and professors continually stress the importance of empathy
and kindness.
"It may be the chemical that cures
the disease, but it's the power of compassion that helps the patient heal,"
said Arya.
The institute, founded by the 14th
Dalai Lama, Tenzin Gyatso, in 1961, is considered the most highly respected
source for Tibetan medicine and medical training outside of Tibet.
Situated on the side of a mountain
with breathtaking views of the Kangra valley below and the sharp, snowy
peaks of the Dauladhar range behind it, the TMAI complex of buildings is
located below the Dalai Lama's monastery and downhill from the tourist
hot-spot McLeod Ganj.
The Dalai Lama founded TMAI, known
locally by its Tibetan name, Men-Tsee Khang, as part of his effort to keep
Tibetan cultural traditions alive in exile in India, after he escaped from
Tibet in 1959 to avoid persecution by the Chinese.
Besides administering to the thousands
of Tibetan refugees who continue to arrive in Dharamsala from China-occupied
Tibet each year, TMAI has also become a vital health resource for Indians
across the country, whether at its headquarters here in Himachal Pradesh,
in big cities like New Delhi or in rural locations from Karnataka to Leh.
Through its network of 37 branch
clinics throughout India, TMAI provides free or low-cost medical care to
more than half a million Indians each year, and provides more than Rs.
5 million worth of free or subsidized medicine. Ninety percent of its patients
are Indian, said Arya.
Tibetan medicine's connection to
India goes back centuries. The first text book of Tibetan medicine, the
rGud-bzhi (pronounced gyu-shee), written during the fourth century A.D.
and expressing the wisdom of the Medicine Buddha, was actually in Sanskrit
instead of Tibetan, because Sanskrit was the language of sacred texts in
Tibet at that time.
Today, Tibetan medicine is often
compared to Ayurveda, since Tibetan medicine classifies individuals within
three categories, or humors, and uses herbal medicine and diet in its treatment.
The three doshas of Ayurveda are
roughly parallel with the humors of Tibetan medicine: Ayurveda's vata,
or air, is closest to rLung (prounced loong); pitta, or fire, is called
mKhris-pa (tee-pah); and kapha, symbolizing the equilibrium of water and
earth, is close to the Tibetan humor Bad-kan.
The two medical systems may be similar
in many ways, said Dr. Tenzin Choedrak, the senior personal physician to
the Dalai Lama, but there are other aspects of Tibetan medicine that set
it apart from any other.
Tibetan medicine relies on astrology,
including the twelve animal signs of the Chinese zodiac and five elements
of air, water, wood, fire and earth, as an important tool to understand
the movement of fluids in the body. And the formulation of medicines, including
rare and expensive "precious pills," which may contain gold, silver and
even trace amounts of poisons such as mercury, are dependent on the phases
of the moon.
In addition, the spiritual aspect
of Tibetan medicine - expressed in prayers to the Medicine Buddha and carefully
worded mantras - is a vital part of treatment. To the Tibetan doctor, disease
is a sign of imbalance between the spirit, mind and body. "Mental poisons"
such as attachment, hatred or delusion, can play as important a role in
disease as physical factors.
Yet at its core, "Tibetan medicine
is a science. It's not shamanism," Dr. Tashi Rabten, founder of the International
Tibetan Medical Association in Rye, NY, told India-West by phone. Prayer
and astrology may play an important part, but "people get the wrong idea
that Tibetan medicine is all about spirituality," he said.
Nevertheless, the two most famous
Tibetan doctors, Dr. Tenzin Choedrak and Dr. Yeshi Dhonden, a former physician
to the Dalai Lama who is now part of a landmark study on breast cancer
at the University of California at San Francisco (I-W, Feb. 2), were both
Buddhist monks before they became doctors.
According to Arya, Indians most
often turn to Tibetan medicine for chronic ailments, such as rheumatism,
arthritis, sinus problems and diabetes, rather than for emergency treatment
(for which Western medicine is best, say Tibetan doctors). For others,
Tibetan medicine provides relief from the pain of the late stages of cancer
and AIDS.
Recently, research in collaboration
with the All India Institute of Medical Science's department of Diabetes
and Endo- crinology has shown a 17 percent decrease in blood glucose levels
in some patients with Type 2 diabetes mellitus, and an 18-month study on
arthritis in collaboration with Oxford University showed marked improvement
in mobility and pain relief.
Dhonden is currently conducting
research on metastatic breast cancer with Dr. Debashish Tripathy of UCSF
and Dr. Fredi Kronenberg, a consultant from Columbia University.
Some of its formulations have been
shown to effectively prevent disease as well: after the Jan. 26 earthquake
in Bhuj, Gujarat, TMAI sent a doctor and a pharmacist there for 15 days
to combat infectious disease, and doctors sent large shipments of "plague
pills" with a pungent scent of Valerian (in Hindi, jalakan) to help curb
the outbreak of pneumonic plague in Surat, India in 1994.
Since the fourth century, Tibetan
medicine has continued to evolve. "Tibetan medicine is the first integrated
system of medicine which incorporates various aspects of Ayurveda, Chinese
and Greek medicine and presents the concepts underlying these practices
from a Buddhist perspective," explains Dr. Lobsang Rapgay, a trained Tibetan
physician who now works as a licensed clinical psychologist on the faculty
of UCLA and directs UCLA's Behavioral Medicine Clinic. And since 1990,
TMAI has incorporated modern biology and other mainstream sciences into
its course work as well.
Most Westerners who make the 13-hour
bus ride from Delhi up to Dharamsala overlook TMAI. The more spiritually
minded ones spend time at the Library of Tibetan Works and Archives, a
ten-minute walk uphill from the institute; while the bhang-and-yoga crowd
stays close to bustling McLeod Ganj. The institute does offer limited training
in Tibetan medical principles to licensed doctors from India and the West,
but discourages the weekend visitor looking for a "Learning Annex" approach
to its highly specialized and complex theories.
But the clinic, and a recently opened
museum of Tibetan medicine, are open to all. Inside the new museum are
brilliantly colored thangka paintings, surgical tools, herbs and minerals.
It's a fascinating side trip for visitors to Dharamsala, once they know
where to look.
Tibetan medicine's journey to the
American mainstream has been slow going. A Jan. 1, 2001 broadcast on Dateline
NBC on cancer treatments being developed by Dhonden and Tripathy sparked
interest, as did the First International Congress on Tibetan Medicine held
in Washington, D.C., in 1998.
But there is a shortage of doctors
and astrologers. The rigorous, five year long training program is given
only in the Tibetan language, and the discipline doesn't pay as well as
allopathic, or mainstream medicine, explained Arya. Medicine, too, is facing
a shortage as Indian herbal suppliers face growing demand, and prices have
increased as much as tenfold for certain Himalayan ingredients over the
past five years, he said. The population boom in the Dharamsala region
has also meant power and water shortages (the local government turns off
the electricity district-wide for up to two hours per day), which affects
TMAI's ability to produce enough product to supply its branch clinics and
doctors stationed in India, Mongolia, Nepal, Bhutan and countries in Europe.
And TMAI is not yet recognized by the World Health Organization, said Rapten.
But there are a number of Tibetan
practitioners established in the United States, and doctors from TMAI do
make the occasional American tour: in January, a TMAI doctor lectured at
San Francisco State University and later this year, several doctors will
visit Minneapolis from May 6-18 and Chicago from May 21 to June 10. Even
more encouraging, TMAI is now raising funds to build its first full-fledged
branch clinic in America, the Medicine Buddha Healing Center, near Spring
Green, WI.
The progress of Tibetan medicine
in the West continues, and if its success in India is any indication, it
could one day be as familiar as Chinese and Ayurvedic medicine here. For
now, though, its "jewels of wisdom" remain obscure. Says a spokesman for
the Spring Green project, "In America, most people don't know anything
about it."