Buddhism and Medicine in Tibet: Origins, Ethics, and Tradition

Buddhism and Medicine in Tibet: Origins, Ethics, and Tradition William A. McGrath Herndon, Virginia B.Sc., University of Virginia, 2007 M.A., University of Virginia, 2015 A Dissertation presented to the Graduate Faculty of the University of Virginia in Candidacy for the Degree of Doctor of Philosophy Department of Religious Studies University of Virginia May, 2017 Abstract This dissertation claims that the turn of the fourteenth century marks a previously unrecognized period of intellectual unification and standardization in the Tibetan medical tradition. Prior to this time, approaches to healing in Tibet were fragmented, variegated, and incommensurable—an intellectual environment in which lineages of tantric diviners and scholarly literati came to both influence and compete with the schools of clinical physicians. Careful engagement with recently published manuscripts reveals that centuries of translation, assimilation, and intellectual development culminated in the unification of these lineages in the seminal work of the Tibetan tradition, the Four Tantras, by the end of the thirteenth century. The Drangti family of physicians—having adopted the Four Tantras and its corpus of supplementary literature from the Yutok school—established a curriculum for their dissemination at Sakya monastery, redacting the Four Tantras as a scripture distinct from the Eighteen Partial Branches addenda. Primarily focusing on the literary contributions made by the Drangti family at the Sakya Medical House, the present dissertation demonstrates the process in which the Tibetan medical tradition transitioned from controversy, competition, and change, to a narratively unified set of theories and practices that came to be taught at Buddhist institutions throughout the Tibetan plateau. From the fourteenth century onward, sharing an established Buddhist origin, bodhisattva code of ethics, and monastic institutional center, the theories and practical instructions of the Tibetan medical tradition continued to be transmitted and diffused throughout the Buddhist networks of Asia, from the center of the Tibetan plateau to the periphery of the Mongolian steppe and beyond. Keywords: Buddhism, medicine, Tibet, narrative, history, transmission, practice, tradition W. A. McGrath | Buddhism and Medicine in Tibet | ii Table of Contents INTRODUCTION: ON THE VERY IDEA OF BUDDHIST MEDICINE IN TIBET ................... 1 CHAPTER ONE: DIVINATION AND DIAGNOSIS IN THE EARLY TIBETAN MEDICAL TRADITION ........................................................................................................................................... 10 The Social Context of the Medical Tradition in Twelfth-century Tibet ................................... 11 Mirror Divination, Child Mediums, and Oracular Revelation: The Tibetan Assimilation of Prasenā Divination ................................................................................................................................ 14 On the Meaning of the Word Prasenā ..................................................................................................... 15 Child Mediums, Prasenā Revelation, and Possession ......................................................................... 18 Prasenā Divination in Tibetan Literature ............................................................................................... 23 Channel Examination and Prasenā Divination .............................................................................. 25 Channel Examination as Prasenā Divination ....................................................................................... 29 Prasenā Divination as Channel Examination ........................................................................................ 32 The Indispensable Channel Prasenā Rituals ........................................................................................ 32 The Wonder Channels and the Subsequent Tantra ...................................................................... 41 Conclusion: Observation and Revelation in the Tibetan Medical Tradition ......................... 48 CHAPTER TWO: ADAPTATION AND INNOVATION IN TIBETAN MEDICAL SCHOLASTICISM ................................................................................................................................ 50 Medicine as a Scholastic Field of Knowledge ................................................................................ 54 Practical Scholasticism in the Tibetan Medical Tradition .......................................................... 63 The Small Practical Manual ................................................................................................................ 67 The Account of Transmission .................................................................................................................. 68 Diagnostics in the Small Practical Manual ............................................................................................ 74 The Five Classifications of Medicine ....................................................................................................... 79 The Closing Section ............................................................................................................................. 87 CHAPTER THREE: ORIGIN MYTHS AND THE BUDDHIST NARRATION OF MEDICINE ............................................................................................................................................. 94 Narrative and Polemics in the Tibetan Medical Tradition .......................................................... 97 The Collection of Medicine .............................................................................................................. 105 Precedents for the Mythology of the Four Tantras ...................................................................... 112 W. A. McGrath | Buddhism and Medicine in Tibet | iii Narrative Echoes from Mt. Wutai ..................................................................................................... 117 The Great Tantra, the Lesser Tantra, the King of Tantras, and the Four Tantras ................ 124 The Expanded Elucidation of Knowledge and the Reconciling of Narratives ....................... 131 CHAPTER FOUR: THE YUTOK STUDENT AND FAMILIAL LINEAGES AT THE SAKYA MEDICAL HOUSE .............................................................................................................................. 141 The Mongols, the Drangti Clan, and the Sakya Medical House ............................................... 142 The Drangti and the Yutok Familial Lineage ............................................................................... 146 The Yutok Student Lineage ............................................................................................................... 152 The Later Layers of the Indispensable Account ..................................................................................... 163 Canonization and Curriculum in the Tibetan Medical Tradition ........................................... 170 Conclusions: Education, Standardization, and Unification ...................................................... 178 CHAPTER FIVE: IMPERIAL LEGENDS AND THE ESTABLISHMENT OF PROFESSIONAL ETHICS IN THE TIBETAN MEDICAL TRADITION ................................. 180 The Expanded Elucidation of Knowledge in the Tibetan Tradition of Buddhist Historiography ..................................................................................................................................... 182 The Escape of Minister Gar ............................................................................................................... 186 Foreign Physicians and the Tibetan Assimilation of Medicine ................................................ 192 The Early Propagation: The Inception of Medical Lineages .......................................................... 193 The Middle Propagation: The Translation of Medical Texts ......................................................... 194 Geographical Precedents in Tibetan Medical Literature ........................................................... 199 Geography in the Four Tantras ............................................................................................................... 200 Geography in the Gold Measure Collection ......................................................................................... 203 Geography in Khokbuk Literature .......................................................................................................... 205 The Establishment of Professional Ethics in the Tibetan Medical Tradition ........................ 211 Galen in Tibet ............................................................................................................................................... 212 Professional Ethics in the Tibetan Medical Tradition ..................................................................... 213 Precedents and Interpretations of Professional Ethics in the Tibetan Medical Tradition ... 220 Summary and Conclusions: A Tradition of Historiographical Creativity at the Sakya Medical House ...................................................................................................................................... 222 CONCLUSIONS: DIAGNOSIS AND PRESCRIPTION, HISTORY AND PROPHESY .......... 225 BIBLIOGRAPHY .................................................................................................................................

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