MEDICINE AND MEMORY IN TIBET Studies on Ethnic Groups in China Stevan Harrell, Editor MEDICINE AND MEMORY IN TIBET Amchi Physicians in an Age of Reform Theresia hofer UniversiTy of WashingTon Press Seattle Copyright © 2018 by the University of Washington Press Printed and bound in the United States of America Composed in Minion, typeface designed by Robert Slimbach Cover photograph: Moxibustion applied to a patient’s head. Photo by Meinrad Hofer. 22 21 20 19 18 5 4 3 2 1 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage or retrieval system, without permission in writing from the publisher. University of Washington Press www.washington.edu/uwpress Library of Congress Cataloging-in-Publication Data Names: Hofer, Theresia, author. Title: Medicine and memory in Tibet : Amchi physicians in an age of reform / Theresia Hofer. Description: Seattle : University of Washington Press, 2018. | Series: Studies on ethnic groups in China | Includes bibliographical references and index. Identifiers: lccn 2017029406 (print) | lccn 2017028012 (ebook) | isbn 9780295742984 (hardcover : acid-free paper) | isbn 9780295742991 (paperback : acid-free paper) | isbn 9780295743004 (ebook) Subjects: lcsh: Medicine, Tibetan—History—20th century. | Medicine, Tibetan—History—21st century. | Physicians—China—Tibet Autonomous Region—History. | Memory—Social aspects—China—Tibet Autonomous Region—History. | Social networks—China—Tibet Autonomous Region— History. | Ethnicity—China—Tibet Autonomous Region—History. | Social change—China—Tibet Autonomous Region—History. | Tibet Autonomous Region (China)—Social conditions. | Tibet Autonomous Region (China)— Relations—China. | China—Relations—China—Tibet Autonomous Region. Classification: lcc R603.T5 H65 2018 (ebook) | lcc R603.T5 (print) | ddc 610.951/5-dc23 lc record available at https://lccn.loc.gov/2017029406 CONTENTS Foreword by Stevan Harrell vii Acknowledgments ix Note on Terminology and Romanization xiii List of Abbreviations xv Maps xvi Introduction 1 Chapter 1 The Tibetan Medical House 29 Chapter 2 Medicine and Religion in the Politics and Public Health of the Tibetan State 59 Chapter 3 Narrative, Time, and Reform 89 Chapter 4 The Medico-cultural Revolution 116 Chapter 5 Reviving Tibetan Medicine, Integrating Biomedicine 152 Chapter 6 Looking at Illness 185 Conclusion 214 Notes 227 Glossary 239 Bibliography 249 Index 273 FOREWORD Research conducted in Tibet is precious in any age, since that land is not easily accessible even in the best of times. Today, as access becomes ever more difficult—especially for foreign researchers—analysis based on research on the ground is invaluable. Theresia Hofer had both the enter- prising spirit and good fortune to be able to conduct “officially official” research in 2003 and “officially unofficial” research in 2006–7 while study- ing Tibetan language at Tibet University and serving as a consultant with a medical project conducted by the Swiss Red Cross. Research carried out in areas of the Tibet Autonomous Region remote from the capital city of Lhasa is doubly precious, partly because rural areas are difficult to reach and partly because there is little material avail- able on many areas. Hofer has the linguistic skills and deep cultural knowl- edge to be able to interview and collect documents in Shigatse Town and in Ngamring and Lhatse Counties, and her personal acquaintance with several rural, urban, and monastic physicians gave her entry to observe how they cared for their patients. Research on medicine in Tibet is rare, since Tibetan medicine is less familiar to outsiders than the Chinese or Ayurvedic systems. Research on medicine as it is practiced among the common people is especially valua- ble, since there is almost no documentation in languages other than Tibetan and since age-old practices passed down within local family tra- ditions are in danger of disappearing, even as the Chinese regime gov- erning Tibet promotes preservation and “modernization” of the traditions of the Mentsikhang (Institute of Medicine and Astrology) and Tibetan medicine hospitals. vii viii Foreword The Medical Houses explored in this book are houses both in the physical sense of structures where a doctor holds consultations and pre- scribes and prepares medications and in the metaphorical sense of endur- ing social groups, based primarily on kinship ties, that pass on the texts and clinical expertise on which diagnosis and treatment are based. Hofer became acquainted with the members of several of these houses, located mostly in rural areas, listened to their house histories and personal stories, examined their treasured medical texts with them, and sat in on their consultations. And what a story these houses have to tell! Like so many stories about Tibet and Tibetans, it begins with an idealized past before the 1959 revolt against Chinese rule, when the doctors practiced their art without politi- cal interference; then moves to their suppression and personal suffering in the early years of the Cultural Revolution beginning in 1966; continues to their cautious revival beginning in the 1970s, even before Chinese Communist Party leader Hu Yaobang’s famous visit to Tibet in 1980; and finally brings us to their immersion in the whirlwind of modernization that began to overtake the region after the turn of the millennium. We are not sure just what has happened to western Tibet’s Medical Houses since the Lhasa demonstrations of 2008. The Chinese regime has continually tightened policies, increased surveillance and “patriotic edu- cation,” and reduced opportunities for Tibetan-language learning, while at the same time pursuing reckless economic development, developing hydro electric power and mining, promoting immigration (though mostly to Lhasa) by the Han (China’s ethnic majority), and encouraging tourism not just to see the breathtaking scenery but to learn an official, bowd- lerized version of Tibetan culture minus the “problematic” parts of the religion—that is, the connection between religion and the state. Will the children of the Medical Houses carry on their knowledge and practice? Whatever the future holds, Theresia Hofer has given us an insightful account of what they were like and how they endured through years of revolution and reform, hinting that they may well adapt and flourish in the current age of renewed repression. —Stevan Harrell Summer solstice, 2017 ACKNOWLEDGMENTS My most heartfelt thanks go to the Tibetan research participants in Tsang for so willingly and generously sharing their lives, medical work, and memories with me, jointly seeking clarity, and providing their hospitality. Although many names used in this book are pseudonyms, my apprecia- tion and respect for each individual remains the same. I am particularly grate ful to the late Yonten Tsering and his wife Yeshe Lhamo in Shigatse, and to Ngawang Dorjé and his family in Lhasa, for letting me become a part of their families and for teaching me so much. All interpretations and conclusions drawn from the research are solely my own, as are any errors. In Lhasa, Shigatse Town, and Beijing, too, I received indispensable help with my research and enjoyed the friendship of many people who influ- enced this book in subtle but important ways, and to whom I am deeply grateful. They include Rinzin, the late Tsering Gyalpo, Nyima Tsering, Nyima Lhamo, Penpa Tsering, Tashi Norbu, Tsering Dikey, Jigmé, Dawa, Leigh Miller, Jason Sangster, Kabir Heimsath, Maria Luisa Nodari, Ruth and Flaviu Huber, Ursula Rechberg, Dawn Collins, and Mingji Cuomo in Lhasa; Thomas Aebi, Leo Näscher, Lobsang, Jake, Adrun, Mike, Sabriye and Paul, and Putri and Yulha in Shigatse; and Professor Thubten Phun- tsog, Wang Liu, and Zhen Yan in Beijing. I would also like to acknowledge my hosts and teachers at Tibet University for providing me with a long- term visa and residence permit and for allowing me to progress as a stu- dent of the Tibetan language, while continuing to be a researcher. The fieldwork and visits since 2006 would not have been the same without the friendship and intermittent translation assistance of Peyang, whom I ix x Acknowledgments admire for her strength of character and for inspiring hope when hope seems impossible. Over the past decade I have been blessed to meet and work with a remarkable group of colleagues and friends who share a passion for and deep commitment to the study of Tibetan medicine in the contemporary world: Vincanne Adams, Calum Blaikie, Alessandro Boesi, Sienna R. Craig, Frances Garrett, Barbara Gerke, Denise Glover, Janet Gyatso, Stephan Kloos, Alex McKay, Colin Millard, Nianggajia, Audrey Prost, Geoffrey Samuel, Mona Schrempf, Katharina Sabernig, Martin Saxer, Herbert Schwabl, Tawni Tidwell, Stacey Van Vleet and Ronit Yoeli-Tlalim, among others. I have also benefited greatly from colleagues working in social anthropology and modern history of the greater Himalayan and Tibetan region, and here my thanks go in particular to Robbie Barnett, Hildegard Diemberger, Françoise Robin, Isabelle Henrion-Dourcy, Ken Bauer, Mark Turin, and Sara Shneiderman. Hildegard Diemberger, Guntram Hazod, Andre Gingrich, Ernst Steinkellner, and Charles Ramble were early sup- porters, and I am especially grateful for their guidance with my first research and language efforts in the region. Many people along the way have helped me sharpen my argument and clarify the presentation of materials.