To put theory into practice we have specific diagnostic tools. As taught to me by my
teacher Dr. Trogawa Rinpoche, we should first speak to the patient and find out
their medical history as well as pertinent aspects of their personal
We then look at a
urine sample. In the urinalysis we observe such things as the color of
the specimen and its odor and then after vigorous stirring the size,
color, amount, and persistence of bubbles, and any deposits. From this we
can begin to confirm the nature of the illness, the presence of infection
and the localization of the illness among other things.
Next we feel the twelve
pulses. There are six distinct pulses at the radial artery of each wrist.
We feel for such things as the width, depth, strength, speed and quality
of the pulse. Each of those factors when understood properly allow us to
clearly define the illness, its location, hidden complications and its
Additional Diagnostic Techniques
To further confirm the
diagnosis we can look at the color, shape and coatings of the tongue, the
sclera of the eye and we may look for sensitivity at certain pressure
points on the body.
Treatment is specific to each of the four diagnostic
categories. The first consideration in treatment is the principle that
all illness ultimately originates in the mind. This does not mean that
all illness is psychological or psychosomatic.
Rather, it means that due to ignorance
we misperceive the nature of reality and act in ways which create
suffering such as illness. Given this basic principle, when treating an
illness physicians first begin by recommending specific behavioral and
lifestyle modifications. If this is not sufficient, then physicians work
at the level of dietary therapy. If these are not enough to cure the
problem, physicians employ herbal medicines or, if needed, physical t
herapies such as acupuncture. As stated by Dr. Trogawa Rinpoche, the
treatment ultimately must fit the patient; that is, treatment must be
formulated in a manner which can and will be effective for that
Behavioral modification can include
meditation instruction, spiritual advice, counseling, exercise, or the
reorganization of habitual patterns such as sleep habits and eating
Initial stages of meditation generally
include simple breathing practice and working with one's thoughts in a
manner which calms the mind. Meditation then evolves beyond that point to
include specific contemplations and visualizations which begin a process
leading to a new understanding and perception of the world.
This aspect of the treatment may vary
slightly with the diagnosis. For example, in the case of
Lüng disorders, meditation may be specifically directed
toward understanding the impermanent nature of physical phenomena as a
cure for materialism and attachment. In the case of Tripa
disorders, emphasis may be placed on generating a deep feeling of love
and compassion as a cure for aggression and anger. In
Bädkën disorders, meditation will focus more on
developing wisdom as a cure for ignorance.
Physical activity, lifestyle, exercise
and habits are also considered. For example, patients with
Lüng disorders are told to pay special attention to
regularity of lifestyle (eg. eating, sleeping and excretory
function), find time for calm activities and socializing, and exercise in
ways that promote good overall circulation, using techniques such as
yoga. Individuals suffering from a Tripa disorder should
avoid situations causing conflict. They should avoid direct, excessive
exposure to the sun and engage in physical activities which relax them.
Patients with Bädkën disorders should keep warm
and perform vigorous exercise such as running or dancing. Swimming is not
appropriate if it involves immersion in cold water. In the case of a
combined disorder such as Mukpo , behavioral modification is
tailored to the particular form the illness takes.
In recommending an appropriate diet,
Tibetan physicians consider which types of food are harmful and which
might be beneficial, the amount of food to be eaten, the number of meals
per day and the proper meal times. Food is analyzed based on its
qualities and nature as defined by a five element theory. The
characteristics and therefore the nature of all matter then result from
the qualities of these elements individually or in combination. Specific
arrangements of the five elements which occur during embryological
development form the three basic principles of physical function
(Wind, Bile, Phlegm). This is important because the
taste of different foods, their resulting natures, and therefore their
effects on the human organism are also dictated by the specific
arrangements of elements which make up the food. This principle enables
practitioners to think intelligently about diet and health relative to
each individual patient's lifestyle, environment and health
If the above approaches are not
sufficient in relieving the condition, herbal medicines are prescribed.
In Tibetan medicine, herbal treatments range from simple to very complex,
in a using approx. 3 to 150 herbs per formula. Each formula or set of
formulas is prescribed to fit the manifestation of the disease and the
evolving condition of the individual patient. As a result, herbal
medicines often need to be modified at each visit.
Typically, two to four formulas are
prescribed, to be taken each day at specific times. Morning remedies
commonly include those for Bädkën disorders or
digestive disorders. Afternoon remedies are typically used to treat
Tripa disorders. Remedies given in the late afternoon or evening
are usually given to treat Lüng disorders. Ultimately,
the organization of the prescription is based on both the doctor's
judgment and the patient's lifestyle.
If the above treatments are not sufficient to cure the
illness, physicians employ therapies such as acupuncture, moxabustion,
cupping, massage, and inhalation therapy.
But despite even the best use of
medical treatment we cannot attain good health simply by being physically
healthy. We need to have a healthy mind as well.
Based on the centuries-old Buddhist
study of the mind, Tibetan medicine gives priority to factors of
psychological and spiritual development in its definition of health. It
seeks to understand and explain the nature and reason for the suffering
we experience in our lives.
It teaches acceptance of and gives
meaning to the cycle of birth, sickness, old age, and death we all
encounter. Common experiences such as not getting what we want, not
wanting what we get, being separated from whomever or whatever is dear to
us, and being joined with people and things we dislike becomes a basis of
spiritual understanding and growth.
Tibetan medicine explains how hatred,
anger and aggression, ignorance and incomprehension and a materialist
view of the world result in states of mind which are at the root of our
suffering. How our habitual patterns of thinking and behaving are the
primary cause of illness. Finally, it asserts that through study and
spiritual practice an understanding and awareness can gradually be
achieved which transcends that suffering.
In Tibetan medicine we attempt to
become aware of the process of our physiological, spiritual and
psychological evolution as it originates from what we do what we say and
what we think. Every action sows its seed in the mind and will eventually
ripen in accordance with its nature. No experience is seen as causeless.
The transient, ever-changing nature of all things is embraced. The
conclusion which is reached from this view is the interdependent nature
of all things. The highest value is placed on the attainment of
compassion and what is termed loving kindness.
For a Biography of the Author:
Copyright 1998, Eliot Tokar