by Bob Flaws

My read this weekend was Desi Sangye Gyatso's Mirror of Beryl: A Historical Introduction to Tibetan Medicine. Desi Sangye Gyatso was the regent for the Fifth Dalai Lama, a.k.a. the Great Fifth. So this book was written during the seventeenth century, However, it has only recently been translated into English by Gavin Kilty. Of particular interest to readers of this blog, the book devotes quite a bit of space and attention to discussing the impact of Chinese medicine on the development of Tibetan medicine. According to Desi Sangye Gyatso, the three main things taken from Chinese medicine were pulse diagnosis, urine diagnosis, and astrology.

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If one looks at Tibetan pulse examination, the over-riding Chinese influence is immediately apparent. The viscera and bowel correspondences for the three positions are essentially those of first millenium Chinese medicine. Even the names of the three positions are Tibetan phoneticizations of the Chinese cun, guan, and chi. However, Tibetan medicine has maintained a lot of esoteric pulse lore lost within Chinese medicine. In addition, pulse diagnosis enjoys a preeminent status within Tibetan medicine that it has not had in China since at least the late Ming dynasty. Thus Chinese medical practitioners interested in a more elaborate and profound use of pulse examination may want to look at Tibetan pulse diagnosis.

As for urine diagnosis, I find it very interesting that Desi Sangye Gyatso identifies this as basically Chinese in origin. I say this because I know of no Chinese medical sources on urine diagnosis. If Tibetan urine diagnosis was borrowed from China, I would think there would be references to this method of diagnosis in Chinese medical sources at least up to through the Tang dynasty, if not later. In Tibetan medicine, urine diagnosis is second only to pulse diagnosis and is a very highly developed technique going far beyond such rudimentary Chinese observations of whether the urine is dark, light, or cloudy. Either Desi Sangye Gyatso was wrong about the Chinese source of urine diagnosis or, perhaps, this was a regional technique from one of the areas of China bordering Tibet but not practiced in the heart of China itself. In any case, I find this discrepancy intriguing and will be keeping my eyes peeled for any further information on this subject.

In Tibet, two types of astrology were practiced side by side. Kar-tsi means astrology from India, while nag-tsi means astrology from China. In terms of medicine, nag-tsi, Chinese astrology, plays the dominant role. Interestingly, nag-tsi as practiced in Tibet is largely based on the Chinese five phases and their various interrelationships. However, Tibetan doctors also made use of the cycle of the 60 stems and branches, the eight trigrams, and the nine stars. "Chinese" astrology was used by Tibetan doctors to aid in diagnosis and prognosis and, very importantly, in the timing of the manufacture of medicines and the administration of therapies.

A great deal of the Mirror of Beryl is devoted to discussing the ethical, intellectual, and spiritual requirements of medical students, teachers, and practitioners. Personally, I found this material very inspiring. Desi Sangye Gyatso makes it extremely clear that the superior practitioner should practice from a sense of universal love and compassion. He also spends a good bit of time discussing the importance of spiritual practice, not only to develop such love and compassion, but to gain the power to bless medicines, gain super-normal insight and intelligence, and to teach one's patients about the spiritual causes and cures of disease. If pulse diagnosis, urine analysis, and astrology traveled from China to Tibet, I believe it would be fitting for the spiritual aspects of Tibetan medicine to have an effect on contemporary Chinese medicine. While this is highly unlikely in China itself (due to political reasons), the adoption of Tibetan spiritual insights and practices could dovetail nicely with the spiritual concerns and yearnings of Western practitioners of Chinese medicine. Western practitioners interested in reading an account of such spiritual guidelines and trainings may want to take a look at Desi Sangye Gyatso's Mirror of Beryl.

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