The Painted Mirror
The Painted Mirror
Interactions between Science and Mythogenesis in Tibetan Medical Historiography
Introduction
The Four Tantras (Tib. Rgyud bzhi), composed in the 12th century by Tibetan polymath Yuthok Yönten Gönpo (1126-1202), has formed the theoretical and practical basis of the Tibetan medical tradition for over 800 years.[1] The scientific history of this corpus is itself a topic of significant interest, as its author managed to compile and synthesise knowledge from across Eurasia into a cohesive medical system, illuminating the highly cosmopolitan scientific and technological environment of the Silk Roads. But equally interesting is the evolution of Tibetan medical historiography itself, and the ways in which doctors, historians, and religious systematisers crafted and presented the history of medicine in Tibet. While an interdisciplinary spirit led many generations of medical theorists to reach across cultural boundaries to establish a robust and reliable ‘Science of Healing’ (Gso ba rig pa) for all, this was carefully emplotted through myth and historical revisionism to serve political, social, and indeed scientific aims. I argue that these explicit historiographic choices were instrumental in establishing Tibetan medicine as an enduring medical modality, which continues to flourish and transcend cultural and scientific boundaries in the 21st century.
With increased academic interest in Tibetan medicine and a growing body of Tibetan-led scholarship in the field over the past twenty years, some of the most tenacious riddles surrounding Tibetan medical history – namely the provenance of the Four Tantras – have been largely resolved, opening up new avenues of inquiry for critical historical analysis. It is evident that many important figures in Tibetan medical historiography, including the author of the Four Tantras himself, were involved in processes of careful mythogenesis, bending historical truths and ontological paradigms to ultimately serve the interests of medicine itself. This gives rise to important questions about the relationships between scientific ‘truth’ and historical ‘truth,’ and illuminates the crucial role of historiography in the processes of scientific innovation.
I will present some of the main themes in Tibetan medical historiography over four key periods: the Tibetan imperial age (7th-9th centuries CE), the cultural renaissance (11th-13th centuries), the early modern period (16th-17thcentury), and the present era (20th-21st centuries). In each period, we can see how shifting politics and paradigms of authority gave rise to distinct themes in Tibetan medical historiography, including their romantic emplotment in an ever-expanding tapestry of living myth.[2] As our understanding of the scientific history of Tibetan Medicine grows, opportunities arise to critically examine the intentional historiographic approaches taken by systematisers in service to their fields of knowledge, and the effects of these decisions on the fields themselves.
Syncretism in Imperial-Era Tibet
The imperial era of Tibet spanned from the 7th-9th centuries CE, marked by the unification and expansion of the Tibetan empire under King Songtsen Gampo (r. 618-650) and his successors. While the pre-imperial Yarlung dynasty was largely unknown in Central Asian politics,[3] this new era century saw significant cultural developments including the adoption of a common script (based on Sanskrit), the conversion to Buddhism, and increased trade of knowledge and physical goods with neighbouring states including China, India, and the Abbasid caliphate to the west. Tibet’s increasing military strength made the empire a formidable contender to Tang China, and they engaged in numerous territorial raids including a short but significant occupation of the Tang capital of Chang’an in 763. In 786 they expanded their control of the kingdoms of Khotan to capture the key intellectual hub of Dunhuang, which they ruled for 60 years, though Tibetan influence persisted long after its return to Chinese rule in 848.[4]
By the 7th century, Buddhism had already become a powerful unifying force in Asia. Mahāyāna Buddhism had spread out of India into the ancient kingdoms of the Tarim Basin, and further to China, Korea, and Japan. In joining the Buddhist cultural and religious landscape, including the enthusiastic adoption of written texts, Tibet was able to forge productive relations with its neighbours. Tibet established itself as a key player in global politics and trade – not just of material goods, but also of technologies, skills, beliefs, beings, and knowledge.[5]
According to traditional accounts, Songtsen Gampo formalised Tibet’s cultural transformation through marriages to Buddhist aristocrats from China and Nepal. While the earliest extant accounts of the Tibetan imperial age – a pair of manuscripts from Dunhuang known as the Old Tibetan Annals – bear no mention of Buddhism being introduced during Gampo’s reign, cultural exchanges between Tibet and China, including Gampo’s marriage to the Chinese ‘princess’ Wencheng, are corroborated, and independent Chinese accounts confirm that envoys were sent between Tibet and China in the early 7th century.[6] These exchanges are largely remembered for their transmission of Sino-Tibetan astrological and geomantic frameworks, but both traditional histories and textual analysis mark this era as a key period of medical development, as well, with an import of foreign knowledge through the translation of medical texts as well as the specialist expertise of travelling doctors.
Early medical historians of the 13th-14th century provide extensive lists of physicians, texts, and traditions that came to Tibet in the imperial era, a recurring theme that speaks both to the scientific history of imperial medicine and the apparent appeal of an interdisciplinary approach to medical science.[7] This ethic of interdisciplinarity is also reflected in some of the far earlier Dunhuang materials, particularly Pelliot Tibétain 127, which states, "This text (yig) on medical practice (dpyad) is not even [to be found] at the archives (? phyag sbal). It is a compilation of all traditions of medical practice (dpyad yig thams cad), in addition to being compiled according to the indigenous (phugs pa) medical practice of Zhang zhung."[8]
Over time, this interdisciplinary legacy became emplotted in progressively mythic and fantastical accounts, and by the 16th century the affairs of the Tibetan empire came to involve such illustrious figures as the Vedic sage Bharadvāja, Hsüan Yüan Huang (the ‘Yellow Emperor’ of China), and Galenos of Rome.[9] While Galen is an attested historical figure from the 2nd-3rd century CE, the other two visiting doctors are primarily legendary figures conventionally placed in the 2-3rd millennium BCE. None of the three could have conceivably visited Tibet during the 7th century, thoughcomponents of their associated medical systems did in fact make it to Tibet during the imperial age. But rather than assert these traditions as sources of Tibetan medical knowledge, later histories frame them as precursory influences that set the stage for the fated establishment of the superlative Four Tantras.
Unfortunately, none of the original medical texts from Gampo’s time have survived, but several key redactions of materials from the later imperial age are extant and have been published.[10] In addition to imperial orthographic features, the dating of these texts is confirmed by the absence of any influence from the Aṣṭāṅgahṛdayasaṃhitā, the 7thcentury Ayurvedic classic, which was translated into Tibetan in the 11th century and immediately dominated Tibetan medical theory.[11] Among the most important of these pre-Aṣṭāṅga works are the Explicit Treatise (Dmar byang)[12],the Lunar King (Zla ba’i rgyal po), and the Yellow-Covered Volume of the Biji (Bi ci’i po ti kha ser).[13] The Explicit Treatise was only discovered in the early 2000s, and internally dates itself to the reign of King Tridé Tsugten (704-755 CE), a highly important period of development which, according to later historians, resulted in the translation of numerous foreign medical texts.[14]
The Lunar King (popularly known as the Somarāja) is perhaps the most famous of the pre-Aṣṭāṅga medical works. Despite its attributed Sanskrit title, no Indian original has ever been identified, and while the text features distinctly Indic elements like Ayurvedic humoural theory, there are many other elements (including pulse and urine analysis) which have clear non-Indic origins. The primary section on uroscopy appears to be modelled after the same source text consulted by the Persian theorist Ibn Sīnā (980-1037) for his Canon of Medicine (al-Qanun fi al-tibb).[15]This text was just one of many points of entry for foreign medical principles in Tibet, and the Lunar King seems torepresent one of the earliest attempts at a distinctly ‘Tibetan’ synthesis of popular Eurasian medical knowledge.[16]
The peak of the empire came in the 9th century under the reign of King Ralpachen (r. 815-838), as did itssubsequent dissolution when he was assassinated by his brother Langdarma, the latter remembered as a villainous anti-Buddhist oppressor who was himself assassinated by the Buddhist monk Lhalung Palkyi Dorje around 842.[17]Controversy surrounding royal succession after this string of scandals ultimately led to civil war in Tibet, and the empire fell into an ‘era of fragmentation’ lasting around a century and a half, though political disunity persisted until the Mongols seized control of Tibet in the 13th century. As a result of this tumultuous turn of events, many documents and materials from the imperial era were lost, with most surviving fragments coming from Dunhuang and heavily-redacted manuscripts like our pre-Aṣṭāṅga texts.
The Tibetan Renaissance and Development of the Four Tantras
By the 11th century, a fractured Tibet had begun to replace its political might with another kind of social power – Buddhism. In neighbouring India, tantric Buddhist movements were slowly fading amidst a rapidly shifting social and political environment, and many Indian Buddhist masters made their way across the Himalayas to propagate their traditions on the Tibetan plateau.[18] This initiated a Buddhist cultural renaissance in Tibet known as the ‘latter dissemination’ (phyi dar) period. In addition to new translations of Indian Buddhist texts, Tibetan visionaries began producing their own bodies of work, instigating reformation and innovation in Tibetan Buddhist paradigms of authority.
It was primarily in the Tibetan renaissance that historical perspectives of the imperial era were retroactively formulated, particularly surrounding the establishment of Buddhism in Tibet. Works like the Mani Kabum (Ma ṇi bka’ ‘bum) and the Copper Palace (bka' thang zangs gling ma), both composed by Nyangral Nyima Özer (ca. 1124–1192), established many of the core charter myths of Tibetan Buddhism, including the establishment of Avalokiteśvara as the patron deity of Tibet and the miraculous affairs of the imperial Vajrayāna patriarch from Oḍḍiyāna, Padmasambhava.[19]While Tibet’s political and military dominance dissolved in the era of fragmentation, Tibetan religious innovators helped to secure its position as a Buddhist intellectual powerhouse with enduring influence on neighbouring societies.
While unifying national narratives became much more prominent, the intellectual landscape of renaissance Tibet was deeply Indo-centric, and Sanskrit texts and their propagators were central to the codification of official Tibetan philosophical, ritual, and intellectual paradigms. It was generally accepted that all authentic Buddhist teachings (and their ancillary sciences) must have an Indian provenance.[20] In the field of medicine, Rinchen Zangpo (985-1055) coordinated the Tibetan translation of the Aṣṭāṅgahṛdayasaṃhitā, which Yang ga describes as a “milestone” achievement in Tibetan medical history.[21]
The Aṣṭāṅgahṛdayasaṃhitā quickly came to dominate the Tibetan medical world, and in the 12th century it was transmitted to one Yuthok Yönten Gönpo, whose grandfather had been an early recipient of the tradition. Yuthok is regarded as the father of Tibetan medicine, and the ‘codifier’ behind the Four Tantras, his medical magnum opus,comprised of an amalgamation of Indian, Greco-Arabic, Chinese, and indigenous Tibetan medical knowledge carefully developed over a lifetime of research and clinical practice. But according to conservative historians (and Yuthok’s own writings), the Four Tantras were in fact an original teaching of the historical Buddha held by a secret Indian lineagebefore its import into imperial Tibet.[22] Responding to a need to appeal to Indo-centric Buddhist authority, Yuthok made the bold decision to disguise his original texts as a Sanskrit translation, a move that ensured his manifesto’s influence for many centuries to come.[23] His own established charter myth for the collection, featuring the Medicine Buddha as the original source of the teachings, begins with a Sanskrit title and a classic nidāna formula (“Thus I have heard at one time…”), itself perceived as a reliable seal of authenticity for Indian Buddhist texts. While modern versions of the Four Tantras feature a posthumous edit to the nidāna, earlier accounts attest that the original work once opened like any other Indian Buddhist classic.[24]
This narrative of an Indian transmission lineage coming to Tibet in the 8th century has always had its sceptics, however, provoking generations of criticism and apologist defences over the text’s canonical status. By the 13th century, the rising gter ma (revealed treasure)[25] tradition and its formalised framework for spiritual revelation provided a useful paradigm for establishing the work as scripturally authentic, ultimately leading to an institutional designation of the Four Tantras as one of the first gter ma revelations in Tibet.[26] According to this version of accounts, the texts were brought to Tibet in the imperial age and concealed in a pillar at Samye monastery, to be discovered in the 11th century by the monk-physician Traba Ngönshe (1012-1090), after which they passed through two hands before landing in Yuthok’s hands for mere revisions.[27]
History shows that Yuthok was an acclaimed scholar and eminently well-travelled researcher, and he claims to have travelled to India six times in order to study with the great masters of the subcontinent.[28] According to his own accounts, he travelled not only to India but also to Sri Lanka, Oḍḍiyāna, Nepal, and Persia in pursuit of medical knowledge, and didn’t settle down to teach until returning to Tibet at the age of 34.[29] His curriculum was principally based on the Aṣṭāṅgahṛdayasaṃhitā,[30] and while he began to supplement it with his own commentaries and compositions over time, his students principally dedicated themselves to Ayurveda and took great pride in their tradition’s authentic Indian provenance.[31]
The only student to receive both the Four Tantras and the associated tantric practice cycle known as Yuthok’s Heart Essence (G.yu thog snying thig) was Sumtön Yeshe Zung, who studied with Yuthok for the last 12 years of the patriarch’s life and career. Yuthok spent many years refining his great work and left it unpublished at his death, with Sumtön alone tasked with disseminating it in the years to come. Rather than pursuing fame, it seemed far more important for Yuthok that his life’s work would outlive him and take root as a reliable system of medicine in Tibet. Sumtön Yeshe Zung played a critical role in early debates regarding the Four Tantras, helping to fortify the charter myth against an onslaught of criticisms by Yuthok’s own senior students. Sumtön was a relatively junior disciple, and the rest of Yuthok’s pupils saw the Ayurvedic classics as the gold standard of medical authority. This made Sumtön’s claims to a secret ‘essential’ collection from Yuthok rather destabilising. Some dismissed the Four Tantras as nothing more than a remedial training manual for Sumtön, who failed to grasp the meaning of the original Indian authorities.[32]
While these debates began in Sumtön’s time, they came to a head between the fourteenth and sixteenth centuries with the formation of the rival Jang (Wyl. Byang) and Zur schools of Tibetan medicine.[33] While the former maintained that the Four Tantras were canonical buddhavacana (‘buddha-word’) with multiple streams of transmission dating back to the 8th century, the latter believed the treatises to be Yuthok’s own novel composition. By the 16th century there were a wide array of theories circulating on the origins of this important text collection. Besides those who deemed it to be an original teaching of the Buddha, many others asserted that the treatise was composed in Tibet in the 8th century,[34] orthat it was Sumtön’s attempt to hitch his own original work to his master’s rising star. Some historians, like Sokdokpa Lodrö Gyeltsen (1508/9-1579) and Zurkhar Lodrö Gyelpo (1509-1579), asserted Yuthok to be the sole author.[35]
While many of these positions ran contrary to the pro-canonical stance of the Jang school, they did not always disagree with the fundamental assertion that the Four Tantras was technically buddhavacana. According to Sokdokpa, Yuthok’s legacy as an enlightened master was enough to establish his original works as formal Buddhist doctrine.[36] In numerous schools of Tibetan Buddhism, similar forms of original material became classifiable as dag snang, or ‘pure vision’ revelations.[37] Through this epistemological framework, an author can rely on visionary experiences of insight, often involving enlightened beings and non-human wisdom holders, as a reliable source of canonical doctrine, thus avoiding accusations of ‘making things up’ without proper authority. While the scientific orientation of Tibetan medical systematisers like Yuthok was no less robust than in the imperial era, politics and paradigms of authority shifted dramatically after the Era of Fragmentation. To ensure the success of his work, which Yuthok undoubtedly perceived to be the best-available medical science of his time, he evidently made a conscious decision to engage in creative mythogenesis, as many other ambitious systematisers did during the Tibetan renaissance.
Institutionalisation and Establishment of an Orthodox History of Medicine
Tibet fell under Mongol rule in the 13th century, and it wasn’t until the 17th century that governmental authority in Tibet was granted to the Fifth Dalai Lama, whose endorsement by the Khoshut lord Güshi Khan established him as the religious and temporal leader of Tibet.[38] He operated closely with his second regent, Desi Sangye Gyatso, a highly influential politician and polymath who ruled following the Dalai Lama’s death (unbeknownst to the public) for a decade and a half. They established Chagpori University (Lcags po ri sman rtsis khang) in Lhasa, which featured the Regent’s own commentaries as core textbooks alongside the Four Tantras, and their political and academic institutions remained in place until the 20th century. For the Fifth Dalai Lama and his ambitious regent, the driving ethic of historiography was not to uncover historical ‘facts,’ but to frame the history of knowledge in such a way that it could become standardised,universally adopted, and moderated by a centralised body.
Gyatso was famously critical of any who doubted the canonical nature of the Four Tantras, and his opinions on the matter became formally accepted as an orthodox position. While his medical history, known as the Mirror of Beryl(Bai DU+rya sngon po), relied heavily on the medical knowledge of his forebears, he was unrestrained in his attacks on rivals who attributed the Four Tantras to Yuthok Yönten Gönpo.[39] Though Yuthok’s influence on Tibetan Medicine was universally acknowledged, state-sponsored institutions needed to find a way to honour his contributions without handing over the reins of medical orthodoxy to a problematic figure who challenged the very foundation upon which the Buddhist authority of the Four Tantras was established.
In an appeal to ecumenicalism, the Fifth Dalai Lama extended state sponsorship to rival Zur-affiliated institutions like the Tsarong (Tsha rong) family’s Sanctuary of Assembled Sages (Drang srong ‘dus pa’i gling), so long as they agreed to adopt a state-sponsored curriculum under a prescribed set of ‘guidelines’ (bca’ yig) and ended the promulgation of heterodox views (log rtog).[40] He also composed various ritual manuals and prayers for Yuthok’s Heart Essence, in the spirit of “healing the trauma of the recent war.”[41] The formulation of a new ecumenical ritual paradigm that reinforced the authority of the central government was an important component of medical institutionalisation. According to Stacey Van Vleet, this process involved a “revision of tantric medical practices in order to create a unified doctrinal framework for medical study,” which “sought to create a new state medical orthodoxy by reconciling the tantric practices associated with different Tibetan Buddhist traditions.”[42] Three years into these institutionalisation efforts, the Fifth Dalai Lama composed a ritual manual on the Medicine Buddha Sūtra, which was to be performed thrice monthly within the reformed Tsarong school.[43] While practices associated with Yuthok’s Heart Essence were still permitted, the overall focus was altered to de-emphasise the cult of Yuthok entirely. This shift purportedly helped to facilitate non-sectarian engagement between traditions, but importantly also discouraged any circulating notions that Yuthok was the true author of the Four Tantras.
Along with new ritual paradigms, there was also a need for new mythic histories to support the establishment of the state medical system. Conveniently, a new hagiography of ‘Yuthok Yönten Gönpo’ was purportedly discovered at this time,[44] but the subject was not the familiar 12th century Tibetan patriarch that we know but an entirely different figure,placed in the imperial court of King Trisong Detsen in the 8th century. While completely unknown to earlier medical historians, this ‘Elder Yuthok’ was envisaged as an ancient propagator and overseer of an imperial-era Four Tantras translation project. The 12th century Yuthok (later known as ‘Yuthok the Younger’) is retroactively identified as both a descendant and reincarnation of the imperial figure, despite never having mentioned him in his own writings. Most modern scholars identify this hagiography as a fundamentally ahistorical and mythic composition written sometime after the 14th century,[45] but the proliferation of the account both in Tibet and in the west have afforded it a lasting influence in perceptions of Tibetan medical history.[46]
According to the new account, Yuthok the Elder was the court physician of King Trisong Detsen who presided over a great medical conference held at Samye Monastery. After defeating an assembly of foreign physicians in debate, he instructed Vairocana the translator to retrieve the Four Tantras from India, which were then translated, edited, and concealed for future times. This story quickly became integrated into the authoritative history of Tibetan Medicine through Sangye Gyatso’s works, further supporting the claim that the Four Tantras were at once an original Sanskrit work and a gter ma revelation connected to the Tibetan empire, and most importantly not an original work of Yuthok.
The systematisation and institutionalisation of Tibetan Medicine was directly facilitated through a careful recrafting of medical history which, along with educational regulation and ritual systematisation, allowed the state government to control and propagate their medical tradition. Advancements during the early modern era reflect a distinctly pragmatic aim to unify medical scholarship in Tibet under the Ganden[47] government’s authority, which could only be accomplished by definitively ending the debates surrounding their established locus classicus. While it’s possible that Sangye Gyatso genuinely believed the story of Yuthok the Elder to be authentic, it’s clear that the overarching intent of his approach to historiography was not to present an objective view of history, but to tell a compelling story that would bolster the reception and adherence to a centralised Tibetan medical institution.
Responding to Colonisation and the Challenges of Modernity
In the 20th century, the Tibetan state faced a new challenge – Chinese colonisation. The cultural revolution left Tibetan medicine in a highly vulnerable position, and doctors were faced with securing the future of their medical tradition or risking its complete loss. Many important texts and doctors went to Dharamsala, India, where the 14th Dalai Lama established the Tibetan Government-in-Exile, while other figures like Dr. Jampa Trinlé (1928-1990) worked to ensure that the medical tradition could survive inside Tibet.[48] But Mao Zedong, who had a keen interest in traditional medicine, ended up taking a relatively permissive stance on Tibetan medicine, leading to a modern Chinese policy which identifies Tibetan medicine within the umbrella of the Chinese medical tradition.[49]
Debates on the origin of the Four Tantras again flared up amid these circumstances, as well as expanding integration with global scholarship in the history of medicine. Khenpo Troru Tsenam Rinpoche (1928-2004), one of the most acclaimed doctors of the last generation, proclaimed that the Four Tantras were originally composed by Yuthok the Elder, but that Yuthok the Younger also had a hand in their codification, inspired by visionary experiences of the Medicine Buddha.[50] Others adopted a narrative devised by adherents of the Tibetan Bön tradition, who have their own redaction of the Rgyud bzhi known as the Four Vases (‘Bum bzhi), and who assert that the Four Tantras was actually based on a prehistoric Tibetan collection from the legendary Bön patriarch Tönpa Shenrab Miwoche.[51] As expressed by Yang Ga, there is a strong sense of Tibetan identity wrapped up in the assertion that the Four Tantras is a Tibetan text, and as it became clear that no Indian source could be found, many sought instead to push the Tibetan origins of the collection back in time as far as possible.[52]
In expanding beyond Asia, Tibetan medicine has also been forced to contend with the scientific empiricism of global biomedicine, as well as shifting standards of cultural identity and ‘ownership.’ Many Tibetan doctors have sought to integrate with biomedical paradigms on a scientific level, but medical historiography has remained a more fluid and creative space. Modern scholars like Yang Ga have shifted the field quite substantially, however, supporting a new approach to Tibetan medical history both inside the tradition and in global scholarship. In his doctoral dissertation, Yang Ga found that about fifteen percent of the Four Tantras collection is directly based on the Aṣṭāṅgahṛdayasaṃhitā of Vāgbhata, with the rest derived from ‘pre-Aṣṭāṅga’ works like the Lunar King and the Explicit Treatise,[53] Yuthok’s earlier writings,[54] and a minority comprised of novel content not found elsewhere. This evidence precludes any attribution of the Four Tantras to an imperial-era source, and reliably places its composition in Yuthok’s hands in the 12thcentury.
In reconsidering the history of the Four Tantras, we must consider the role of Tibetan systematisers in bringing together disparate medical traditions and technologies into a unifying framework. This seems to be a common thread among Buddhist doctors in Tibet, guided by the foundational Buddhist ethic of benefitting sentient beings, which forced efficacy and accuracy to be favoured over rote adherence to traditional authorities. Reason and receptivity are key components of the Tibetan medical tradition, but the actual narrativization of Tibetan medical history (beginning with Yuthok and his followers) did not serve the same empirical aims. Rather, Tibetan medical historiography was, and still is, used to secure the cultural and religious footing of traditional medicine in a volatile world.
Conclusion
The evolution of Tibetan medical historiography begins with an imperial legacy of scientific openness and interdisciplinarity. But as medical practice in Tibet evolved to reflect progressive scientific theories and innovations, medical historiography became significantly more conservative with time. In each major phase of medical development (imperial, renaissance, early modern, and modern), new historiographic approaches emerged to emplot and contextualise the advancements of Tibetan medicine. In each of these crucial periods of development, medical innovations were carefully contextualised within a broader historiographic framework reflecting contemporary political aims, religious values, and paradigms of authority.
From its inception, Tibetan medicine has made good use of mythogenesis to create sacred lineages and legendary journeys for its most important medical works. Many of these myths are grounded in actual developments in Tibetan history, including the influences of foreign physicians and disciplines in the imperial era, but they are crafted to inspire a sense of reverence and gravity. The Four Tantras are conventionally treated like any sacred Buddhist text. They are carefully wrapped and placed on shrines, prostrated to, and studied as an authentic tantra. This deep appreciation of healing knowledge is very much in line with Buddhist orientations towards medicine, which approach healing as a sacred and direct process of alleviating suffering. But institutionalised myth has also obscured some of the most fascinating elements of Tibetan medicine’s scientific history, including its interdisciplinary legacy and the remarkable contributions of brilliant scholars like Yuthok.
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[1] For a translation of the first two tantras, which are of principal interest here, see: Yuthok Yönten Gönpo, The Root Tantra and The Explanatory Tantra from the Secret Quintessential Instructions on the Eight Branches of the Ambrosia Essence Tantra (Dharamsala: Men-Tsee-Khang, 2008).
[2] See Hayden White, Metahistory: The Historical Imagination in Nineteenth-century Europe (Baltimore: Johns Hopkins University Press, 1973).
[3] Valerie Hansen, The Silk Road: A New History with Documents (New York: Oxford University Press, 2017), 306.
[4] Ibid, 307-9.
[5] Ronit Yoeli-Tlalim, ReOrienting Histories of Medicine (London: Bloomsbury, 2021), 18. Also see Hansen, The Silk Road, 307-8, 320-1.
[6] Yang Ga, Sources for the Writing of the Rgyud bzhi, 34-5.
[7] See Dan Yerushalmi, “Foreign Doctors in Tibet? An Old Zhijé Source Shows Up,” Tibeto-Logic, 16 December 2017, https://tibeto-logic.blogspot.com/2017/12/foreign-doctors-in-tibet-old-zhije.html.
[8] Ronit Yoeli-Tlalim, “Central Asian Mélange,” in Scribes, Texts, and Rituals in Early Tibet and Dunhuang, ed. Brandon Dotson, Kazushi Iwao, Tsuguhito Takeuchi (Wiesbaden: Reichert Verlag, 2013), 56. This text was sealed in Dunhuang’s ‘Library Cave’ in the 11th century.
[9] Desi Sangye Gyatso, Mirror of Beryl: A Historical Introduction to Tibetan Medicine, transl. Gavin Kilty (Somerville: Wisdom Publications, 2010), 148. Also see Ronit Yoeli-Tlalim, “Re-visiting ‘Galen in Tibet’”, Medical History 56, 3 (2012), 355-65. https://doi.org/10.1017/mdh.2012.21.
[10] Yang Ga, Sources for the Writing of the Rgyud bzhi, 43. According to Yang Ga, at least three of these early texts are from as early as the reigns of Tride Tsugten (r. 705-755) and Trisong Detsen (r. 755-797).
[11] Ibid, 76-80. Yang Ga refers to these early texts as “pre-Aṣṭāṅga” works, a convention which I have adopted here.
[12] Ibid, 44. The full title of this text is the Byang khog dmar byang gsal ba’i sgron me.
[13] Ibid, 44-88.
[14] Ibid, 44-9.
[15] Ronit Yoeli-Tlalim, “On Urine Analysis and Tibetan Medicine’s Connections with the West,” in Studies of Medical Pluralism in Tibetan History and Society, ed. Sienna Craig, Mingji Cuomu, Frances Garrett and Mona Schrempf (Halle: International Institute for Tibetan and Buddhist Studies GmbH, 2010), 195-211.
[16] Yang Ga, “Origins of the Four Tantras and an Account of its Author,” in Bodies in Balance: The Art of Tibetan Medicine (New York: Rubin Museum of Art, 2014), 163-4.
[17] See Samten Karmay, “King Lang Darma and His Rule,” in Tibet and Her Neighbours: A History, ed. Alex McKay. (London: Hansjörg Mayer, 2003), 57-66. Also see Sam Van Schaik, “The Decline of Buddhism I: Was Lang Darma a Buddhist?,” Early Tibet, 28 February 2008, https://earlytibet.com/2008/02/28/lang-darma/.
[18] Jens Braarvig, “The Spread of Buddhism as Globalization of Knowledge,” in The Globalization of Knowledge in History, ed. Jürgen Renn (Edition Open Access, 2012), 254.
[19] Daniel Hirshberg, "Nyangrel Nyima Wozer," Treasury of Lives, April 2013, http://treasuryoflives.org/biographies/view/Nyangrel-Nyima-Ozer/5999.
[20] This tension is illustrated quite aptly in the hagiography of Machig Labdrön (Ma gcig lab sgron, 1055-1154). See Sarah Harding (transl.), Machik’s Complete Explanation: Clarifying the Meaning of Chöd (Ithaca: Snow Lion Publications, 2013), 93-4.
[21] Yang Ga, Sources for the Writing of the Rgyud bzhi, 76.
[22] Gyatso, Mirror of Beryl, 152-8.
[23] This title is the Amṛta Hṛdaya Aṅga Aṣṭā Guhya Upadeśa Tantra.
[24] Janet Gyatso, Being Human in a Buddhist World: An Intellectual History of Medicine in Early Modern Tibet (New York: Columbia University Press, 2015), 148-51.
[25] See John Powers, Introduction to Tibetan Buddhism (Ithaca: Snow Lion Publications, 2007), 378-83.
[26] Yang Ga, Sources for the writing of the Rgyud bzhi, 8-9.
[27] Ibid, 155. This story is not recounted anywhere in Traba Ngönshe’s own biography, and seems to have been first recorded in an anonymous visionary account known as the brGyud Pa’i rNam Thar Med Thabs Med Pa (The Indispensable Liberation Account of the Lineage) See Malcolm Smith, “Bön Origins of Tibetan Medicine,” http://www.bhaisajya.net/2008_09_01_archive.html.
[28] Yang Ga, “Origins of the Four Tantras,” 155-75.
[29] Jaakko Takkinen, “Yutok Yonten Gonpo”, Treasury of Lives, June 2020, https://treasuryoflives.org/biographies/view/Yutok-Yonten-Gonpo/P3005.
[30] Yang Ga, Sources for the Writing of the Rgyud bzhi, 83.
[31] Ibid, 6-7.
[32] Yang Ga, Sources for the Writing of the Rgyud bzhi, 7.
[33] Ibid, 155-6.
[34] Ibid, 157.
[35] Ibid, 9-15.
[36] Ibid, 157-8. Also see James Duncan Gentry, “Arguing over the Buddhist Pedigree of Tibetan Medicine: A Case Study of Empirical Observation and Traditional Learning in 16th- and 17th-Century Tibet,” Religions 10, 530 (2019). 10.3390/rel10090530.
[37] Gentry, “Buddhist Pedigree of Tibetan Medicine,” 16.
[38] Samten Karmay, “The 5th Dalai Lama and His Reunification of Tibet,” in The Arrow and Spindle: Studies in History, Myths, Rituals and Beliefs in Tibet, (Kathmandu: Mandala Book Point, 2009), 504-517.
[39] Gyatso, Being Human in a Buddhist World, 83-93. Also see Stacey Van Vleet, “Medicine as Impartial Knowledge: The Fifth Dalai Lama, the Tsarong School, and Debates of Tibetan Medical Orthodoxy,” in The Tenth Karmapa & Tibet's Turbulent Seventeenth Century (Chicago: Serindia Publications, 2016), 263-91.
[40] Ngawang Lobsang Gyatso (Ngag dbang blo bzang rgya mtsho), “Drang srong ‘dus pa’i gling gi bca’ yig,” 110-121, 83 ff.
[41] Van Vleet, “Medicine as Impartial Knowledge,” 264.
[42] Ibid, 269.
[43] Ibid, 277.
[44] Yang Ga, Sources for the Writing of the Rgyud bzhi, 174.
[45] Ibid, 96.
[46] See Rechung Rinpoche, Tibetan Medicine Illustrated in Original Texts (Berkeley: University of California Press, 1976).
[47] The Ganden Phodrang (Dga’ ldan pho brang) was the theocratic political institution established around the authority of the Dalai Lama, which , beginning with the Fifth Dalai Lama in 1642 and continuing until the Chinese occupation in the 1950s.
[48] (Men-Tsee-Khang n.d.) Men-Tsee-Khang, “Tibetan Medicine History,” Men-Tsee-Khang (Sowa-Rigpa) Tibetan Medical & Astro-science Institute, n.d., https://www.men-tsee-khang.org/tibmed/tibhistory.html. More than 6,000 monasteries were destroyed in the Cultural Revolution, and according to most Tibetan estimates more than 1.2 million Tibetans died as a direct consequence of the Chinese invasion.
[49] Mike Ives, “China and India File Rival Claims Over Tibetan Medicine,” The New York Times, 27 July 2017, https://www.nytimes.com/2017/07/27/world/asia/unesco-tibetan-medicine-india-china.html.
[50] Yang Ga, Sources for the Writing of the Rgyud bzhi, 17-8.
[51] Ibid, 159.
[52] Yang Ga, Sources for the Writing of the Rgyud bzhi, 20-1.
[53] Yang Ga, Origins of the Four Tantras, 165.
[54] These include the Small Tantra (Rgyud chung), the Jewel Garland (Nor bu’i ‘phreng ba), and the Writing for Sons (Bu don ma). See Yang Ga, Origins of the Four Tantras, 165-7.