“Sowa - Rigpa” : Himalayan Art of Healing

Indian Journal of Traditional Knowledge Vol.3(2), April 2004, pp. 212-218

“Sowa - Rigpa” : Himalayan art of healing

Padma Gurmet Amchi Medicine Research Unit (CCRAS), Ministry of Health and Family Welfare Govt. of India, Leh, Ladakh, J. & K. [email protected] Received 1 September 2003

Sowa-Rigpa commonly known as Tibetan or Amchi medicine is among the oldest surviv- ing well-documented medical traditions of the world. With the living history of more than 2500 years it has been popularly practiced in Himalayan regions throughout central Asia. In India it has been popularly practiced in Ladakh, Himachal Pradesh, Arunachal Pradesh, Sikkim, Darjee- ling and now in Tibetan settlements all over India. Originated from India Sowa-Rigpa is based on Jung-wa-lna (Panch Mahabhuta /five elements) and Nespa gSum (Tri-dosh/ three humours) theories. According to these all animate and inanimate phenomena of this universe are com- posed of Jung-wa-lna (five elements). It is on the theory of five basic elements that the science of physiology, pathology and pharmacology is established. This paper gives an introductory note on history, theory and practice of Sowa-Rigpa (Science of healing) in India.

Keywords: Sowa-Rigpa, Amchi, Tibetan medicine.

IPC Int. Cl.7 :A61K 35/78; A61K 35/12; A61K 35/56.

Historical background folk medicine was prevalent in Tibet, but Sowa-Rigpa commonly known as Am- if we give a close look, the majority of chi or Tibetan medicine is one of the old- theory and practice of Sowa-Rigpa are est surviving and well-documented medi- similar to Indian medical system Ay- cal traditions of the world. It has been urveda, followed by few Chinese princi- popularly practiced in Tibet, Mangolia, pals and then prevailing Tibetan folklore. Bhutan, some parts of China, Nepal, Hi- The first Ayurvedic influence was ob- malayan regions of India and few parts of served in Tibet during 3rd century AD but former Soviet Union. There is a conflict- it became popular only after 7th century ing account about the origin of this medi- with the advent of Buddhism in Tibet. cal tradition. Some scholars believe that it Thereafter this trend of exportation of has originated from India; some say Indian medical literature, along with China and others consider it to be of Ti- Buddhism and other Indian art and sci- betan origin. However, before introduc- ences was continued till early 19th cen- tion of present medical system a kind of tury. India being the birthplace of Buddha Bon (pre-Buddhism religion of Tibet) and Buddhism has always been a favorite GURMET: “SOWA - RIGPA” : HIMALAYAN ART OF HEALING 213

place for learning Buddhist art and cul- medicine used to be the only health care ture for Tibetan students, many Indian facility for the people of these regions scholars were also invited to Tibet for and even after the introduction of modern propagation of Buddhism and other In- medicine with all government support, dian art and sciences. This long associa- the latter could not replace Amchi system tion with India had resulted in translation in many parts of Himalayn Buddhist and preservation of thousands of Indian society due to its strong socio-cultural literature on various subjects like religion, background. Amchis have not only social sciences, arts, culture and language, etc. respect but also spiritual respect as the in Tibetan language. Out of these about representatives of Sangyas-smanla twenty-five texts related to medicine are (Medicine Buddha) and their services for also preserved in both canonical and non- ailing beings are priceless. Every major canonical forms of Tibetan literature. village and hamlet has been having an Much of this knowledge was further en- Amchi of its own since ages. Besides riched in Tibet with the knowledge and treating the patients as doctor of the skills of neighboring countries and their village Amchis are most learned and own ethnic knowledge. resourceful persons of the village. It was Present Tibetan medical system Sowa- therefore being an Amchi has been a Rigpa (Science of healing) is one of the matter of great dignity in the Ladakhi classic examples of it. Rgyud-bzi the fun- society. It takes several years to become a damental textbook of this medicine was skillful Amchi; which requires hard first translated from India and enriched in theoretical and practical training. In most Tibet with its own folklore and other of Himalayan regions Amchis are trained medical traditions like Greek and Persian. through rgudpa (lineage) system in After Tibet the impact of Sowa-Rigpa families (Father to son). After finishing along with Buddhism and other Tibetan their training the new Amchi has to give art and sciences was felt in neighboring an examination in front of entire Himalayan regions. In India this system is community in presence of few expert practiced in Sikkim, Arunachal Pradesh, Amchis in a ceremony to enroll himself as Darjeeling (West Bengal), Lahoul & Spiti an Amchi of the village. But for further (Himachal Pradesh) and Ladakh region of study many Amchis used to go to Tibet. Jammu & Kashmir. The relation between Amchi and patients is always cordial due to strong religious Sowa-Rigpa : an important socio- background and social systems. Amchis cultural part of Himalayas never ask for cost of their medicine and Sowa-Rigpa is popularly known as services; whatever the patients wish or Amchi medicine in most part of Indian afford they can offer and most of the time Himalayas. Derived from the Mangolian the treatment is given free. The villagers word “Am-rjay” it means superior to all. offer crops during harvesting time and The practitioners of this medicine are free labour every year to the Amchi known as Amchis. Till early 1960s Amchi family for their services. With time and 214 INDIAN J TRADITIONAL KNOWLEDGE, VOL. 3, NO. 2, APRIL 2004

modernity things are rapidly changing i.e. Gods, Rishis, Buddhist and non- and the ancient way of practicing Amchi Buddhist and all of them understood his medicine is replaced with modern formal teachings as their own system. Another text clinics and professional training (Six year mentions that when Bhrahma remembered BTMS degree course). medical science for the first time, he re- called the medical teachings of Buddha Ka- Philosophical background shyapa in an earlier aeon, thus it seems that The fundamental textbook rgyud-bzi of Buddha Kashyapa is the medical teacher of Sowa-Rigpa is believed to be taught by Bhrahma. Buddha; therefore it is closely linked with Buddhist philosophy. The followers be- lieve that whether they are physically The basic theory healthy or not, all of us are sick till we Sowa-Rigpa is based on the principles of attain Nirvana. Even though disease Jung-wa-lna (English ─ five elements, San- might not be manifested, it is always pre- skrit ─ Panch-mahabhuta) and Nespa gsum sent in dormant form until we give up (English ─ three humours, Sanskrit ─ Tri- root cause of sickness i.e. ignorance. Ig- dosh). All animate and inanimate phenom- norance gives rise to three basic root of ena of this universe are composed of Jung- sickness Nespa-gsum (Tri-dosha) i.e wa-lna; namely sa, Chu, Mai, rlung and Dod-chags (desire/lust) root cause of Nam mkha (Roughly translated as earth, rlung (Air, Vata), Zes sdang (anger) root water, fire, air and space, Sanskrit ─ Dharti, cause of mkris-pa (Bile, Pitta) and Ti-mug Jal, Agni, Vayu and Akash). The science of (mental darkness) root cause of pad-kan physiology, pathology and pharmacology of (Phlegm, Kapha). Due to presence of this system is established on these theories. 84000 afflictive emotions in mind it gives Which means our body is composed of rise to the same number of diseases. Thus these five cosmo-physical elements of Jung- Bhagwan Buddha preached 84000 kinds wa-lna; when the ratio of these elements of teachings. The animate and inanimate becomes imbalanced in our body, disorders phenomena of the universe are composed result. The medicine and diet used for the of same material basis of Jung-wa-lna treatment of disorders are also composed of (five elements) due to the Karma of all the same five basic elements. In the body the living beings. The behavior and con- these elements are present in the form of duct of physician and patient are also Nespa gsum (Three humours) Luszung- largely based on Buddhist principles. A Ldun (English ─ seven physical constitu- Buddhist tantra and mantra ritual plays a ents, Sanskrit ─ Sapt Dhatu) and Tema very important role in the treatment of gsum (English ─ three excretion, Sanskrit ─ patients. Tri mala). In drugs, diet and drinks they It is mentioned in rgyud-bzi that when exist in the form of Ro-tug (Six tastes), Buddha taught this text as manifestation of Nuspa (potencies), Yontan (quality) and Zu- Tang srong-rigpai-yeshes, physicians of rjes (post digestive taste). It is in context of four different medical systems were present; this theory that a physician would use his GURMET: “SOWA - RIGPA” : HIMALAYAN ART OF HEALING 215

knowledge, skills and experience in treating three mental poisons namely anger, desire a patient, using the theory of similarity and and mental darkness are born within us, dissimilarity of five elements. which act as basic origin of illness and give birth to three humours. When the ratio of Healthy and unhealthy body three humours i.e. air, bile and phlegm is out A healthy body is typified as a state of of balance due to circumstantial conditions balance of three humours (Nespa-gsum), such as diet, lifestyle, seasonal and mental seven physical constituents (Luszungs- conditions gives rise to different kinds of ldun) and three excretions (Tema-gsum) in disorders. Diseases can be classified in the body with complete harmony of five terms of different methods such as location aggregates (five senses). The three humours in the body, type, etc. Due to presence of are air (rlung), bile (mkris-pa) and phlegm 84000 different types of afflictive emotions (pad-kan), which are further divided into in the mind the number of disorder also goes fifteen types of humours. Seven physical up to 84000. These can be condensed into constituents are nutritional essence, blood, 1016 types, further 404 types, 101 types, muscle tissue, fat tissue, bone tissue, bone three humours and finally into two types i.e. marrow and regenerative fluid; the three hot and cold disorders. The outline of excretions are stool, urine and sweat. Hu- disorder is explained in detail with complete mours are the biological representative of note on initiation of disease, location, five elements; physical constituents are the pathways, time of arising, fatal effect, side basic tissue elements of the body and excre- effects, etc. tions are the waste product of the body whose proper elimination is essential for Diagnosis good health. Healthy and unhealthy state of A physician of Sowa-Rigpa employs body is largely dependent on the balance three main tools for diagnosing a patient i.e. and imbalance of these twenty-five elements visual diagnosis, diagnosis by touch and due to proper diet and behavioral patterns. diagnosis by questioning. Visual diagnosis The subject of human body is finely ex- comprises of two main methods of tongue plained in Sowa-Rigpa with different chap- examination and Urine analysis. Various ters on embryology, anatomy, physiology diseases can be diagnosed by checking the and neurology in an appropriate manner nature, color and smoothness etc. of the with functions of each and every part of the tongue; urine can be analyzed on three dif- body. ferent stages of fresh urine, while it is cool- ing down and when it is cold by looking at Outline of disease its color, speed of discoloring, vapor, odor, It has already been mentioned that the bubbles, sediments, etc. science of Sowa-Rigpa is closely linked Diagnosis by touch is represented by the with Buddhist philosophy, where it is advanced technique of pulse examination believed that all the breathing creatures on followed by touching the body for tempera- the earth are sick till they don’t give up the ture and smoothness, etc. Pulse is the most root cause i.e. ignorance. Due to ignorance important and major diagnostic tool in 216 INDIAN J TRADITIONAL KNOWLEDGE, VOL. 3, NO. 2, APRIL 2004

Sowa-Rigpa, which is explained under thir- on the earth has medicinal value and teen general topics like preparatory conduct, therapeutic efficacy. Medicinal sub- proper time for examination, place, pressure stances are classified into eight major of physician’s finger, technique, constitu- categories i.e. Rinpoche sman (prized tional pulse, astonishing pulse, general and metal and stone), sa sman (drugs from specific pulse, death pulse, etc. Questioning mud and earth), rdo sman (stones), shing is another mode of diagnosing a patient; sman (drugs from trees), rtsi sman (es- history of case, present condition, family sence and exudates medicines), thang background and changes in body, etc. are sman (plant ingredient for decoction/ main questions asked. shrub), sno sman (herb) and srog chags sman (animal parts). The ingredients of Treatment medicine are used in both single and The treatment has four major sections ─ compound forms; compound medicine is diet, behaviour, medicine and acces- based on two major permutation and sory/external therapies. Right administration combination that is ro (taste) based com- of these four sections is very important for bination and nus pa (potencies)-based treating a patient in an appropriate manner. combination. There are about seventeen Minor ailments can be treated with proper different categories of medicinal prepara- regulation of diet and behavior only; a pa- tion out of which some important prepa- tient with medium state of condition can be rations are decoction, powder, pills, linc- treated with medicine like decoction, pow- tus, medicated ghee, Bhasmas, medicated der, pills, purgatives, emetics, etc. and in wine, paste, medicated bath. advanced stages disease can be cured by application of accessory/external therapies The elemental composition of a drug is like moxabustion, venesection, fomentation, determined on the basis of the six major massage, surgery, etc. As mentioned above tastes i.e. sweet, sour, saline, pungent, in the outline of disease all disorders can be astringent and bitter. Elemental condensed into three humours, accordingly composition of sweet taste is the treatment of disease is also possible un- predominated by sa (earth) and chu der three-humour basis. Buddhist rituals and (water) elements; sour taste is mantra also play a very important role in the predominated by mai (fire) and sa (earth); treatment of disease and in pharmaceutical saline is predominated by chu (water) and process, etc. mai (fire); bitter is predominated by chu It is a known fact that role of a physician (water) and rlung (air); pungent taste is is very important in treatment of a patient; predominated by mai (fire) and rlung therefore special emphasis is given on this (air); astringent taste is dominated by sa aspect in this system of medicine. (earth) and rlung (air) element. Sweet, sour, saline and pungent taste alleviates Pharmacology rlung nespa (Air humour), which is Based on the theory of Jung-wa-lna, dominated by rlung (air) element. Bitter, Sowa-Rigpa believes that every substance sweet and astringent taste alleviates nespa GURMET: “SOWA - RIGPA” : HIMALAYAN ART OF HEALING 217

mkris-pa (bile humour), which is decline in these regions due to lack of dominated by mai (fire) elements. support from Government, national and Pungent sour and saline taste alleviates international organizations. Although little nespa pad kan (phlegm humour) which is development can be seen in shape of few dominated by sa (earth) and chu (water) formal Amchi clinics and Institutional elements. Other important factors for training facilities, etc, but the biggest set understanding drugs composition and back for the survival of this tradition in the action are Zu zes sum (three post coming generations is the lack of interest digestive taste) nuspa-rgyad (eight among young educated people in absence of potency) and no bo (specific action) of good Government job opportunities. Most particular drugs. The therapeutic efficacy of the ancient Amchi families have already of drugs is also dependent on the above lost their family tradition and are only left factors. with their family names. Therefore an appropriate action from Government, Conclusion national and international organizations is Sowa-Rigpa is a rich accumulation of required to save this age-old healing system science, art and philosophy with history for the next generation. of more than 2500 years. It is based on holistic approach of body and mind for Suggested further reading leading a healthy way of life with com- 1 Buddha.rgyud-bzi.Leh: Tashigang, 1970. plete harmony with nature. It is a science 2 Dash, Vaidya Bhagwan. Tibetan medicine because it is based on a systematic and with special reference to Yoga Shataka, (Li- logical framework of understanding the brary of Tibetan works & Archives Mcleod- body, disease and its relationship to the ganj, Dharamsala, Himachal Pradesh). environment. The correlations between 3 Dorjai Gawai, Thungs-Pai Drimed Shail Gi body, disease and its treatments are well Melong, (Meregs Pai Tun Khang, Lhasa Ti- explained under the theory of Jung-wa- bet), 1995. lna. It is an art because its diagnostic 4 Phuntsog, Dilmar Dgeshes bStanzin, Dri Med Sel Gong & Sel-Phring. Leh: Tashigang, techniques and composition of medicine, 1983. etc. are based on the creativity and com- 5 Gurmet Padma, Ayurveda in Tibet, in: Com- passion of the medical practitioner. And it pendium of Invited Lectures, World Ayurveda is a philosophy because it follows the key Congress 2002, pp 117-122. Kochi, Kerala Buddhist principles of self-sacrifice, (Swadeshi Science Movement), 2002. karma and ethics. Therefore Sowa-Rigpa 6 Gurmet Padma, An Introduction to Ayurvedic is a complete guide for leading a healthy Text in Tibetan Buddhist Canon Stan Gyur, way of life with balanced body and mind. in: Proceeding Seminar on Literary Research, Delhi, (Central Council for Research in Ay- Till now the practice of this ancient art of urveda and Siddha), 2000. sDi-sRid Sans- healing has been sustained due to its rGyas rGya mTso. efficacy and strong socio-cultural basis in 7 Gurmet Padma, Fundamental principles of most part of Indian Himalayas. But since Amchi medicine, Souvenir: Asian Seminar on last two three decades the system is on Indigenous System of medicine, Bhartiya 218 INDIAN J TRADITIONAL KNOWLEDGE, VOL. 3, NO. 2, APRIL 2004

Chikitsa Aevam Shodh Sansthan, Opp. Sta- 9 Gyatso, Desrid Sangyas. RGyud-bzi Gril pa dium, Rajendra Nagar, Patna 800016. Vaidurya Snonpo. Leh: Tashigang, 1969. 8 Gurmet Padma, Amchi Chikitsa Ekk Pare- 10 Men-Tsee-Khang, Fundamentals of Tibetan chaya, Sindu Darshan. Vol-2 FRL (DRDO) medicine, Mcleodganj, Dharamsala, Himachal C/O 56 APO. Pradesh.