Soktsang  Tibetan  Herbal  Medicine  
 
Tibetan  Medicine  Handbook  
 
The  Purpose  of  this  Handbook  is  to  provide  a  simple  summary  of  Tibetan  medical  theory,  diagnosis  
and   therapy.   The   Handbook   contains   information   that   will   allow   you   to   understand   clearly   what   is  
happening  when  you  come  to  the  clinic  and  the  kind  of  therapies  that  are  used.  
 
Soktsang   Tibetan   Herbal   Medicine   would   like   to   fully   inform   you   of   the   measures   taken   to   ensure  
your  visit  to  the  Tibetan  Doctor  adheres  to  the  highest  possible  standards.    
 
• Lobsang  Soktsang  is  educated  to  the  highest  standard.  He  graduated  with  a  First  Class  General  
Medical  Degree  in  Lhasa    He  was  awarded  his  Masters  of  Tibetan  Medicine  Degree  (The   MEN-­‐
RAMPA,   Tib.)   by   the   Institute   of   Tibetan   Medicine   at   Dharamsala,   India.     After   graduating,   he  
went   to   work   at   the   Lhasa   Mentsee   Khang   Hospital,   the   premier   centre   of   excellence   of  
Traditional  Tibetan  Medicine.  
• Soktsang   Tibetan   Herbal   Medicine   fully   complies   with   the   UK   law   and   uses   medicines   that   are  
entirely  herbal.  
• Every  effort  is  made  to  ensure  the  quality  of  the  herbs  received  from  Tibet,  which  includes  test  
carried  out  to  ensure  the  herbs  are  uncontaminated.    
• We  deal  directly  with  the  institution  in  Tibetan  that  cultivates  the  herbs.  

 
History  
 
The   Tibetan   name   of   the   main   text   of   Tibetan   medicine   is   Gyushi,   which   means   ‘The   Four  
Tantras’.     It   consists   of   four   volumes   that   each   cover   different   aspects   of   Tibetan   medical  
knowledge   and   practice.   The   first   volume,   which   is   the   shortest,   presents   the   history   of  
Tibetan  and  summarises  Tibetan  medical  knowledge  using  the  metaphor  of  tree  with  three  
roots  representing  the  condition  of  the  body,  diagnosis,  and  treatment.  The  second  volume  
covers  anatomy  and  pharmacopoeia.  The  third  volume,  which  is  by  far  the  largest,  deals  with  
Tibetan   disease   categories,   how   they   come   about,   how   they   should   be   diagnosed   and  
treated.  The  fourth  volume  gives  instructions  on  diagnosis  and  therapeutic  techniques.  
The  first  volume  of  the  Gyushi  presents  an  account  of  the  origin  of  the  Tibetan  medical  
teachings.   In   this   account   the   Medicine   Buddha   appears   in   the   mandala   or   palace   of  
medicine,  surrounded  by  many  disciples.  From  his  heart  is  emanated  the  sage  Rigpa  Yeshe,  
who  represents  the  mind  aspect  of  the  Medicine  Buddha,  and  from  his  tongue  is  emanated  
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the   sage   Yilè   kyes,   who   represents   the   speech   aspect.   The   whole   medical   teaching   then  
takes   place   as   a   dialogue   between   Yilè   Kyes   requesting   the   teachings   and   Rigpa   Yeshe   giving  
them;  each  chapter  in  the  Gyushi  begins  in  this  way,  with  Yile  Kyes  requesting  the  medical  
teachings  of  the  specific  subject  to  be  discussed.  
Tradition  holds  that  this  knowledge  was  compiled  in  a  Sanskrit  text  which  was  translated  
into  Tibetan  by  the  great  translator  Vairocana  in  the  eighth  century,  it  was  then  passed  on  to  
Padmasambhava,   who   concealed   the   text   in   a   pillar   of   Samye   monastery.   In   1098   the   text  
was   taken   from   Samye   monastery   by   Drapa   Ngön   Shé   and   passed   on   to   Yuthog   Yontan  
Gompa   who   revised   it   according   to   knowledge   he   had   gathered   after   making   several  
journeys   to   India.   A   major   turning   point   in   the   history   of   Tibetan   medicine   was   during   the  
period  of  the  fifth  Dalai  Lama  in  the  seventeenth  century.  He  attempted  to  establish  medical  
institutions  and  produce  a  new  xylographic  edition  of  the  Gyushi.  The  work  he  initiated  was  
completed   by   his   regent   Sangye   Gyamtso   (1653-­‐1705),   who   revised   the   Gyushi   and  
composed  his  famous  commentary  to  it  The  Blue  Beryl.  
The   view   that   the   Gyushi   was   translated   from   a   Sanskrit   original   brought   from   India  
represents   one   historical   tradition   in   Tibet.   There   is   another   long   standing   tradition   which  
took  another  stance,  namely  that  the  Gyushi  is  not  a  translation  of  a  Sanskrit  original  but  was  
composed   by   Yuthog   Yontan   Gompo.   Adherents   of   the   Bön   religion,   the   pre-­‐Buddhist  
religion   of   Tibet,   hold   another   view;   they   contend   that   the   Gyushi   is   a   reworking   of   their  
main  medical  text  known  as  the  Bumshi.  
During   the   period   of   the   Royal   dynasty   from   the   seventh   to   the   ninth   centuries   Tibet   was  
the   dominant   imperial   force   in   Central   Asia,   and   as   such   was   open   to   the   influence   of   the  
neighbouring  regions  of  Iran,  China,  Nepal  and  India.  Cultural  influence  also  came  from  the  
Central  Asian  Towns  along  the  Silk  Route  where  Tibet  had  a  strong  military  presence.  During  
this   period   physicians   from   different   medical   traditions   were   invited   to   Tibet   and   medical  
works  of  their  traditions  were  translated  into  Tibetan.    
In  the  eleventh  century,  during  the  period  of  the  later  propagation  of  Buddhism  in  Tibet  
numerous   Ayurvedic   texts   were   translated   into   Tibetan   including   the   famous   Collection   of  
the  Essence  of  the  Eight  Branches  by  Vagbhata.  Medicine  was  also  influenced  in  this  period  
by   the   new   influx   of   Tantric   cosmological   notions;   the   Kalachakra   tantra,   which   has   had   a  
major  influence  on  Tibetan  medicine  and  astrology  was  translated  in  1027.  Also  at  this  time  
translations   were   made   by   Orgyenpa   Rinchenpal   of   Indian   medical   texts   dealing   with  
mercury   based   medical   compounds.   Tibetan   medicine   is   thus   a   highly   integrated   system  
which  contains  elements  of  Ayurvedic,  Persian  and  Chinese  medicine  woven  together  with  
Tantric  cosmology  and  indigenous  Tibetan  material.  
 
 
An  Outline  of  Tibetan  Medical  Theory  
 
The  Five  elements  and  the  Three  Humours  in  Tibetan  Medicine  
 
One   of   the   basic   principles   of   Tibetan   medical   theory   is   that   everything   in   the  
macrocosmic   environment   and   the   microcosm   of   the   human   body   is   made   up   of   various  
combinations  of  the  five  elements  of  earth,  water,  fire,  air  and  space.  Another  fundamental  
principle   is   the   notion   that   all   psycho-­‐physical   processes   in   the   body   can   be   divided   into  
three   categories.   Each   of   these   series   of   processes   is   co-­‐ordinated   and   maintained   by   a  
certain  force,  which  drawing  on  Galenic  terminology,  is  commonly  rendered  as  a  ‘humour’.  
Though   there   is   some   justification   in   using   this   word,   the   Tibetan   word   nyépa   that   is   usually  

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translated  as  ‘humour’,  actually  means  ‘fault’  or  ‘wrong  doing’.  In  order  to  understand  why  
the   Tibetan   word   has   this   meaning   we   need   to   consider   the   relationship   between   Tibetan  
Buddhism  and  medicine.  
At   the   very   foundation   of   Tibetan   medical   notions   about   health   and   disease   lies   the  
Buddhist   concept   of   the   ‘three   mental   poisons’.   The   root   cause   that   leads   beings   to   be   born  
into  the  cycle  of  death  and  rebirth  is  a  deep  fundamental  ignorance  of  their  own  nature,  this  
leads   to   a   false   sense   of   self,   which   in   turn   leads   to   the   ‘three   mental   poisons’   of   ignorance,  
desire,   and   aggression.   According   to   Tibetan   medical   theory,   the   ‘three   mental   poisons’  
generate  the  three  humours  in  the  human  constitution:  desire  is  the  cause  of  wind  (Tibetan,  
lung),  aggression  is  the  cause  of  bile  (Tibetan,  tripa),  and  ignorance  is  the  cause  of  phlegm  
(Tibetan,  peken).  The  three  humours  have  a  dual  nature:  if  they  are  in  their  right  proportions  
and  locations,  they  generate  health  and  well  being;  but  if  by  some  means  they  are  disturbed,  
this  will  result  in  sickness.  Following  the  Buddhist  notion  that  suffering  is  innate  to  all  forms  
of   life   that   exist   within   the   cycle   of   death   and   rebirth,   the   humours   are   named   only  
according  to  their  negative  aspect  as  ‘faults’.  Following  from  this  philosophical  position,  the  
medical  text  graphically  likens  the  inherent  disposition  of  the  humours  to  generate  sickness  
to  an  insect  becoming  poisoned  as  a  consequence  of  feeding  on  a  poisoned  tree.  
Now   let   us   consider   the   characteristics   and   functions   of   the   three   humours   in   the   human  
constitution.   The   three   humours   are   related   to   the   five   elements:   wind   has   the   elemental  
nature  of  air;  bile  that  of  fire;  and  phlegm  that  of  earth  and  water.  The  humours  are  referred  
to   in   Tibetan   by   names,   which   when   translated   into   English   denote   specific   physical  
referents,  but  the  Tibetan  terms  lung,  tripa  and  peken  refer  to  much  more  than  ‘wind’,  ‘bile’  
and   ‘phlegm’.   Although   the   three   humours   permeate   the   entire   body,   each   is   associated  
with  a  certain  area  of  the  body:  wind  is  located  in  the  heart  region  and  in  the  area  below  the  
navel;  bile  is  located  in  the  region  between  the  navel  and  the  heart;  and  phlegm  is  located  in  
the  area  above  the  heart.  According  to  Tibetan  medical  theory  there  are  five  forms  of  each  
of   the   humours.   Each   of   these   subdivisions   is   responsible   for   certain   psychological   and  
physiological   functions   and   is   also   associated   with   a   specific   location   in   the   body.   The  
following  table  summarise  these  functions  and  locations.  It  can  be  seen  from  this  table  that  
the   three   humours   are   the   guiding   force   underlying   all   psychological   and   physiological  
process.  For  this  reason  at  the  Tara  Institute  of  Tibetan  Medicine,  to  avoid  confusion  as  to  
the   way   the   word   ‘humour’   has   been   used   in   other   traditions,   it   is   defined   specifically   as  
‘bio-­‐dynamic  agent’  
 
 
THE  FIVE  WINDS   LOCATION   FUNCTION  
     
Swallowing,  breathing,  shedding  tears,  
Life  Holding  Wind   Top  of  the  Head  
sneezing,  belching,  clarity  of  mind.  
Speech,  body  strength,  body  colour,  gives  
Upward  Moving  Wind   Chest  
strength  to  the  mind,  clear  memory.  
Pervading  Wind   Heart   Capacity  for  Movement  
Separates  the  nutrients  from  the  wastes  during  
Fire  Companion  Wind   Stomach   digestion  and  helps  form  the  body’s  
constituents.  
Genitals  /   Flow  of  sperm,  menstrual  blood,  urine  and  
Downward  Expeller  Wind  
Rectum   stool.  
     
THE  FIVE  BILES      
     
Digestive  Bile   Between  digested   Digest  food,  provides  body  heat  and  strength.  

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 and  undigested   Supports  of  bile  humours.  
food  
Colouring  Bile   Liver   Provides  the  colour  of  bodily  constituents.  
Body  heat,  courage,  pride,  intelligence,  will  
Accomplishing  Bile   Heart  
power.  
Eyesight  Bile   Eyes   Provides  Eyesight.  
Complexion  Clearing  Bile   Skin   Gives  a  clear  complexion.  
     
THE  FIVE  PHLEGMS      
     
Provides  body  moisture  and  supports  the  other  
Supporting  Phlegm   Chest  
phlegms.  
Decomposing  Phlegm   Stomach   Breaks  down  the  food  in  the  stomach.  
Experiencing  Phlegm   Tongue   Provides  capacity  for  tastes  
Provides  the  sensation  of  satisfaction  from  the  
Satisfying  Phlegm   Head  
senses.  
Connects  the  body’s  joints  and  enables  
Connecting  Phlegm   Articulations  
movement  of  the  limbs  
 
Table  of  the  15  humours  
 
Summary  of  the  Qualities  and  Functions  of  the  Three  Humours  
 
The   division   between   the   body   and   the   mind   that   is   prevalent   in   western   medicine   is   not  
present   in   Tibetan   medicine,   where   the   body   and   the   mind   form   part   of   a   single  
psychophysical   continuum.   From   the   table   we   can   see   that   each   of   the   three   humours   is  
responsible  for  a  range  of  psychophysical  functions.  The  qualities  of  the  humours  relate  to  
their  elemental  nature:  wind  is  related  to  the  element  of  air;  bile  is  related  to  the  element  of  
fire;   and   phlegm   is   related   to   the   elements   of   water   and   earth.   In   accordance   with   their  
elemental   nature   wind   and   phlegm   have   a   cold   nature   and   bile   has   a   hot   nature,   thus   in  
Tibetan  medicine  all  diseases  fit  into  one  of  these  two  categories.  In  what  follows  a  summary  
will   be   made   of   the   functions   and   qualities   of   each   of   the   humours.   It   is   important   to   pay  
particular   attention   to   the   qualities   of   the   humours   as   these   are   related   to   the   cause   of  
illness  and  its  treatment.  
 
The  Qualities  and  Functions  of  the  Wind  Humour  
 
Wind  in  keeping  with  it  affinity  with  the  element  of  air  is  most  prominent  in  bodily  processes  
characterised   by   flow   and   motion,   in   other   words   to   the   kinetic   elements   of   the   human  
constitution.  It  is  responsible  for  the  systems  in  the  body  that  involve  movement,  such  as  the  
nervous,  vascular,  and  muscular  systems.  It  is  also  responsible  for  breathing,  the  passage  of  
bodily  wastes,  making  the  senses  sharp,  and  vitality.  The  wind  humour  is  also  fundamentally  
related   to   mental   processes   and   our   psychological   well-­‐being.   Wind   is   primarily   located   in  
the  heart  region  and  in  the  area  below  the  navel.  The  qualities  of  wind  are:  rough,  light,  cool,  
subtle,  firm  and  mobile.  
 
The  Qualities  and  Functions  of  the  Bile  Humour  
 
Bile   in   keeping   with   its   association   with   the   element   of   fire   is   most   prominent   in   bodily  
processes  characterised  by  heat  generation  or  the  production  of  energy,  in  other  words  to  
the  thermodynamic  elements  of  the  human  constitution.  It  has  a  fundamental  role  to  play  in  
the   process   of   digestion   and   metabolism.   It   is   also   responsible   for   hunger   and   thirst,   body  
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heat,  the  clearness  of  the  complexion,  courage  and  intelligence.  Bile  is  primarily  located  in  
the  region  between  the  navel  and  the  heart.  The  qualities  of  bile  are,  oily,  sharp,  hot,  light,  
strong-­‐smelling,  purgative  and  moist.  
 
The  Qualities  and  Functions  of  the  Phlegm  Humour  
 
Phlegm   in   keeping   with   its   association   with   the   element   of   water   and   earth   is   associated  
with  the  bodily  fluids  such  as  mucus  production  and  the  synovial  fluid;  it  is  also  governs  the  
thermoregulatory   aspects   of   the   human   constitution.   Phlegm   is   responsible   for   the   firmness  
of   the   body   and   the   stability   of   the   mind;   it   enables   sleep,   allows   the   body’s   articulations,  
gives  patience,  and  makes  the  body  soft  and  lubricated.  Phlegm  is  located  primarily  in  the  
area  of  the  body  above  the  heart.  The  qualities  of  phlegm  are,  cool,  oily,  heavy,  smooth,  dull,  
firm  and  adhesive  
 
The  Cause  of  Sickness  
 
According  to  Tibetan  medical  theory,  health  is  experienced  when  the  various  components  
of  the  human  constitution,  the  three  humours,  the  seven  bodily  constituents  (the  essential  
nutriment,   blood,   flesh,   fat,   bone,   marrow,   and   regenerative   fluid)   and   the   three   forms   of  
excreta  (stool,  urine  and  sweat)  are  functioning  in  a  balanced  and  harmonious  manner.  For  
the  three  humours  this  means  that  they  remain  in  their  correct  locations  and  proportions.  In  
Tibetan  medical  theory  there  are  numerous  causative  factors  that  can  bring  about  sickness.  
General   causes   of   disease   are   related   to   such   factors   as   negative   influences   from   the  
environment   (such   as   seasonal   changes),   poisons,   incorrect   behaviour,   and   infection.  
Specific  causes  of  disease  are  related  to  the  humour’s  properties.  For  example,  wind  is  said  
to   be:   rough,   light,   cool,   subtle,   firm   and   mobile.   If   any   factor   is   present   which   has   any   of  
these  properties,  and  this  cause  is  sustained  for  a  prolonged  period  of  time,  this  will  bring  
about  pathological  conditions  in  the  wind  humour.  
Tibetan   medical   theory   lists   three   forms   of   modification   that   a   humour   goes   through  
when   it   is   disturbed.   The   first   stage   is   ‘accumulation’.   When   a   cause   is   present   that   has  
similar  properties  to  the  humour  this  will  first  lead  it  to  accumulate  in  its  own  location.  As  
the   humour   accumulates,   a   natural   process   ensues   where   one   begins   to   desire   forms   of  
behaviour  or  diet,  which  have  the  opposite  qualities  of  the  humour.  The  following  stage  is  
‘arising’,   when   the   humour   becomes   pathogenic   and   spills   over   into   the   pathways   of   the  
other  humours;  it  is  at  this  time  that  symptoms  of  the  pathological  condition  manifest  in  the  
body.   The   third   stage   is   ‘calming’;   this   refers   to   the   time   when   the   disturbed   humour   is  
returned   to   a   state   of   balance   in   its   own   location   by   appropriate   diet,   behaviour   and  
therapy.   Disorders   may   involve   a   disturbance   in   one,   two   or   all   three   of   the   humours  
combined.  
What  is  important  to  note  here  is  that  the  focus  in  Tibetan  medicine  is  not  so  much  on  
biological  substrata,  that  is  to  say  with  specific  bodily  components,  but  on  the  functioning  of  
the   system   as   a   whole,   which   is   governed   by   the   three   humours.   Organic   disorders   are  
considered  to  be  preceded  by  a  series  of  functional  disorders;  if  they  are  recognised  in  time  
they  can  be  prevented  from  reaching  the  organic  stage.  
 
Tibetan  Medical  Diagnosis  
 
Broadly   speaking   there   are   three   forms   of   diagnosis   in   Tibetan   medicine:   tactile   diagnosis,  
visual  diagnosis,  and  diagnosis  through  asking  question.  Visual  diagnosis  involves  looking  at  
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any   abnormal   features   in   the   body’s   appearance.   Of   particular   importance   here   is   the  
appearance  of  the  tongue:  a  dry,  red  and  rough  tongue  indicates  a  wind  disorder;  a  thickly  
coated   tongue   denotes   a   bile   disorder;   and   a   pale   coloured   tongue   indicates   a   phlegm  
disorder.   Tactile   diagnosis   involves   feeling   the   patient’s   body   for   any   abnormal   features   and  
taking   the   patient’s   pulse.   After   listening   to   what   the   patient   has   to   say   about   his   or   her  
condition,  and  carrying  out  visual  and  tactile  diagnosis,  the  Tibetan  doctor  will  ask  questions  
to   verify   the   nature   of   the   disorder.   The   type   of   questions   asked   usually   relate   to   the   typical  
symptoms   of   specific   humoural   disorders.   For   example   questions   related   to   aches   in   the  
region   of   the   hips,   waist   and   joints,   sharp   shifting   pains,   shivering,   and   anxiety,   could  
indicate  a  disturbance  in  the  wind  humour.  
 
Urine  Diagnosis  
 
Urine   diagnosis   is   one   of   the   main   forms   of   diagnosis   in   Tibetan   medicine.   In   Tibetan  
medicine   the   urine   is   likened   to   a   mirror   which   reflects   the   condition   of   the   body.   First   of   all  
it  is  important  that  if  the  urine  is  to  truly  reflect  the  condition  of  the  body  it  should  not  be  
contaminated   in   any   way.   For   this   reason,   on   the   night   before   the   diagnosis   the   patient  
should   avoid   foods   that   affect   the   colour   of   the   urine,   such   as   tea,   coffee,   or   alcohol.   The  
patient   should   also   avoid   sexual   intercourse   and   any   excessive   physical   or   mental   activity.  
The  urine  to  be  examined  should  be  passed  in  the  early  morning  in  order  to  avoid  any  traces  
of  food  from  the  previous  evening.  
The  characteristics  of  the  urine  are  examined  at  three  different  times.  When  the  urine  is  
hot   and   fresh   the   doctor   should   note   its   colour,   steam,   smell   and   bubbles.   When   it   is  
lukewarm,  the  sediment  and  the  surface  film  should  be  observed.  Finally,  when  the  steam  
dissipates   a   change   will   occur   to   the   colour   of   the   urine;   the   doctor   should   note   the   new  
colour   and   how   it   develops.   By   doing   this   the   doctor   can   gather   detailed   information   on   the  
humoural  condition  of  the  patient.  
 
*Please  note,  it  is  not  necessary  to  bring  a  sample  of  your  urine  to  the  clinic,  unless  you  are  
asked  to  do  so.  
 
Pulse  Diagnosis  
 
The   main   form   of   diagnosis   that   Dr   Dhonden   uses   in   the   Tara   clinics   is   pulse   diagnosis.  
Just   as   we   saw   with   urine   diagnosis   it   is   important   that   when   you   come   to   the   clinic   your  
pulse  is  not  agitated  in  any  way  that  can  confuse  the  diagnosis.  Rich  foods,  alcoholic  drinks,  
strenuous  physical  or  mental  activity  are  examples  of  behaviour  that  can  affect  the  pulse.    
The  doctor  will  take  your  pulse  by  using  the  tip  of  his  index,  middle  and  ring  fingers  on  the  
radial  artery  on  both  of  your  wrists.  Each  finger  takes  two  pulses.  These  twelve  pulses  relate  
to  the  condition  of  what  in  Tibetan  medicine  are  referred  to  as  the  five  solid  and  six  hollow  
organs.  The  correspondences  between  the  fingers  and  the  internal  organs  are  shown  in  the  
following  table.  
 
 
Finger  Position   Six  hollow  organs   Five  solid  organs  
     
Left  Hand      

6
Top  of  tip  of  first  finger   Lungs    
Bottom  of  tip  of  first  finger       Colon  
     
Top  of  tip  of  second  finger   Liver    
Bottom  of  tip  of  second  finger     Gall  Bladder  
     
Top  of  tip  of  third  finger   Right  Kidney    
Bottom  of  tip  of  third  finger     Bladder  
     
Right  Hand      
Top  of  tip  of  first  finger   Heart    
Bottom  of  tip  of  first  finger       Intestine  
     
Top  of  tip  of  second  finger   Spleen      
Bottom  of  tip  of  second  finger     Stomach  
     
Top  of  tip  of  third  finger   Left  Kidney    
Bottom  of  tip  of  third  finger     Seminal  Vessicle/Ovaries    

The  Twelve  Pulses  in  Tibetan  Medicine  

 
Pulse   diagnosis   is   a   complicated   topic   and   it   takes   years   to   master   the   technique.   Each  
person   has   a   specific   constitutional   pulse   and   the   doctor   must   ensure   that   this   is   taken   in   to  
consideration  and  not  confused  as  a  pathological  pulse.  The  three  constitutional  pulses  are:  
the  male  pulse  which  is  ‘thick’  and  ‘rough’;  the  female  pulse  which  is  ‘thin’  and  ‘fast’;  and  the  
neutral   pulse   which   is   ‘long’,   ‘smooth’,   and   ‘supple’.   In   addition   the   quality   of   the   pulse  
varies   with   the   change   of   the   seasons   and   this   must   also   be   taken   into   consideration.   The  
characteristic  pulse  of  a  wind  disorder  is  ‘empty’  and  ‘floating’,  that  of  a  bile  disorder  is  ‘fast’  
and  ‘thin’,  and  that  of  a  ‘phlegm’  disorder  is  ‘sunken’  and  ‘slow’.    The  main  Tibetan  medical  
text   gives   six   general   pulse   for   types   of   cold   disorder,   ‘weak’,   ‘deep’,   ‘impaired’,   ‘slow’,  
‘loose’,  and  ‘empty’;  and  six  for  types  of  hot  disorders,  ‘strong’    ‘prominent’,  ‘fast’,  ‘twisting’,  
‘hard’,  and  ‘taut’.  The  text  then  goes  on  to  describe  the  specific  pulses  of  forty-­‐six  different  
kinds  of  disorder.  
 
 
Treatment  
 
There  are  four  forms  of  treatment  in  Tibetan  medicine:  diet,  behaviour,  medicines,  and  
external  treatments.    
 
1.  Medicines  
 
The  Elemental  Nature  of  Medicines  
 
7
 As  we  saw  earlier,  according  to  Tibetan  medical  theory  everything  that  exists  is  made  up  
of  various  combinations  of  the  five  elements:  earth,  water,  fire,  air  and  space.  Disease  comes  
about   when   the   five   elements   that   make   up   the   human   constitution   are   disturbed.   The  
healing   properties   of   a   medicine,   according   to   Tibetan   medical   theory,   derives   from   its  
constituent   elemental   nature.   Thus   a   medicine   works   because   its   elemental   nature  
addresses  the  elemental  imbalance  caused  by  the  disease.    
If  the  element  which  predominates  in  the  medicine  is  earth,  the  medicine  will  have  heavy,  
firm,   blunt,   smooth,   oily   and   dry   properties;   it   is   used   to   cure   wind   disorders.   If   the   element  
which   predominates   is   water,   the   medicine   will   have   liquid,   cool,   heavy,   blunt,   oily   and  
pliable  properties;  it  is  used  to  cure  bile  disorders.  If  the  predominating  element  is  fire,  the  
medicine  will  have  hot,  sharp,  dry,  coarse,  light,  oily  and  mobile  properties;  it  is  used  to  cure  
phlegm  disorders.  If  the  predominating  element  is  air,  the  medicine  will  have,  light,  mobile,  
cold,  coarse,  and  dry  properties;  it  is  used  to  cure  phlegm  and  bile  disorders.  
We   saw   earlier   that   each   humour   has   certain   qualities.   For   example   wind   has   the  
characteristics   of   being:   rough,   light,   cool,   subtle,   firm   and   mobile.   We   also   saw   that   if   a  
causal   factor   is   present   with   the   same   qualities   of   the   humour   this   will   disturb   the  
functioning   of   the   humour.   The   same   logic   is   also   applicable   to   the   healing   properties   of  
medicinal  substances.  Medicines  are  effective  because  they  have  the  opposite  properties  to  
those   of   the   imbalanced   humours;   these   qualities   are   referred   to   in   Tibetan   medicine   as   the  
eight   potencies,   these   are:   heavy,   oily,   cool,   blunt,   light,   coarse,   hot   and   sharp.   Medicines  
with   heavy   and   oily   potencies   cure   wind   disorders;   cold   and   blunt   potencies   cure   bile  
disorders,  and  light,  coarse,  hot  and  sharp  potencies  cure  phlegm.  In  addition  to  this:  light,  
cold   and   cool   potencies   increase   wind;   hot,   sharp   and   oily   potencies   increase   bile;   and  
heavy,  oily,  cool,  and  blunt  potencies  increase  phlegm.  
We   also   saw   earlier   that   when   conditions   are   present   which   adversely   affect   the  
humours,   a   process   ensues   whereby   the   humour   first   accumulates   in   its   own   location   and  
then  spills  over  into  the  locations  of  the  other  humours.  If  the  disorder  is  at  the  first  phase,  
medicines   are   used,   which   pacify   the   humour   in   its   own   location.   If   the   condition   has  
reached  the  second  phase,  before  the  humour  can  be  pacified  in  its  own  location,  medicine  
is   first   given   which   gathers   the   humour   from   the   pathways   it   has   wrongly   infiltrated.   In  
certain  cases,  the  pathological  condition  may  have  to  be  ejected  from  the  body.  The  whole  
range   of   Tibetan   medicines   thus   falls   into   two   categories:   pacifying,   and   cleansing.   Thus   a  
Tibetan  medical  therapy  may  involve  various  stages  of  treatment.  
 
 
Taste  as  a  Reflection  of  the  Elemental  Nature  of  a  Medicine  
 
The  elemental  nature  of  a  medicine  is  reflected  in  its  taste.  Tibetan  medicine  identifies  six  
tastes,  which  are  produced  by  six  pairs  of  elements;  this  can  be  seen  in  the  following  table.  
 
MEDICINES  WITH  A  SWEET,  SOUR,  SALTY,  AND  HOT  TASTE  CURE  WIND  DISORDERS  
 
MEDICINES  WITH  A  BITTER,  SWEET  AND  ASTRINGENT  TASTES  CURE  BILE  DISORDERS    
 
MEDICINES  WITH  HOT,  SOUR  AND  SALTY  TASTES  CURE  PHLEGM  DISORDERS  
 
 
 
 
8
  
 
 
 
Taste   Elements  
Sweet   Earth  and  Water  
Sour   Fire  and  Earth  
Salty   Water  and  Fire  
Bitter   Water  and  Wind  
Hot   Fire  and  Wind  
Astringent   Earth  and  Wind  
The  Elemental  Nature  of  the  Six  Tastes  
 
Furthermore,   during   the   process   of   digestion,   the   tastes   of   the   medicine   are   transformed  
producing   what   in   Tibetan  medicine  are  called  the  three  ‘post  digestive  tastes’:  sweet  and  
salty   medicines   produce   a   sweet   post   digestive   taste;   sour   remains   sour;   and   bitter,   hot   and  
astringent  medicines,  in  the  post  digestive  stage,  become  bitter.  Each  of  the  post-­‐digestive  
tastes   cures   disorders   of   two   of   the   humours:   sweet   cures   wind   and   bile;   sour   cures   phlegm  
and  wind;  and  bitter  cures  phlegm  and  bile.  
In   traditional   Tibetan   medicine   there   are   eight   forms   of   medicinal   substances:   precious  
medicines   (precious   stones),   stone   medicines,   earth   medicines   (minerals),   tree   medicines,  
mucilaginous   medicines   (oils   and   fluids),   shrub   medicines,   herbal   medicines   and   animal  
medicines.   From   these   eight   classes   of   medicinal   substances   10   types   of   medicinal  
compounds  are  made:  decoctions,  pills,  powders,  pastes,  medicinal  butters,  medicinal  ashes,  
medicinal  concentrates,  medicinal  beers,  gem  medicine,  and  herbal  preparations  
 
Information  Concerning  the  Medicines  that  are  used  in  the  Soktsang  
Tibetan  Herbal  Medicine  clinics  
 
*IN   THE   CLINICS   ONLY   MEDICINAL   POWDERS   ARE   USED   CONTAINING   HERBAL  
INGREDIENTS   WHICH   SATISY   EXISTING   LEGISLATION   ON   HERBAL   MEDICINES   IN   THE  
UNITED   KINGDOM.   NO   MINERAL   OR   ANIMAL   INGREDIENTS   ARE   USED.   THE   MEDICINES  
USED   ARE   COLLECTED   AND   MANUFACTURED   IN   EAST   TIBET   ACCORDING   TO   SPECIFIC  
INSTRUCTIONS.  
 
Usually  you  will  be  given  three  medicinal  powders.  Each  of  these  medicinal  compounds  has  a  
specific  function  to  play,  but  it  is  important  to  note  that  the  three  compounds  work  together  
as   a   unit.   The   specific   action   of   each   of   the   medicines   will   be   explained   to   you.   The   morning  
medicine   should   be   taken   about   10   minutes   before   breakfast;   the   lunch   and   evening  
medicines   should   be   taken   10   minutes   after   your   lunch   and   evening   meals.   Put   half   a  
teaspoon   of   the   powder   on   your   tongue,   and   wash   it   down   with   hot   water.   If   you   are  
prescribed   a   decoction,   the   method   of   making   this   involves   putting   half   a   teaspoon   of   the  
powder   into   a   pan   containing   a   cup   (about   ½   pint)   of   water,   bring   to   boil   and   simmer   gently  
until  about  a  third  of  the  liquid  has  evaporated.  This  will  take  about  10  to  15  minutes.  Strain  
the  medicine  and  discard  the  dregs.  Drink  the  liquid  whilst  it  is  still  warm.  
 
WHEN  FIRST  TAKING  A  PRESCRIBED  COURSE  OF  TIBETAN  MEDICINE  YOU  MAY  SOMETIME  
EXPERIENCE  A  TRANSIENT  WORSENING  OF  YOUR  SYMPTOMS  WHICH  WILL  NORMALLY  
9
ONLY  LAST  FOR  A  FEW  DAYS.    THIS  IS  IN  FACT  A  POSITIVE  SIGN  WHICH  HAPPENS  WHEN  
THE  REMEDY  AND  ILLNESS  MEET.    I.E.  A  REMEDY  WELL  TARGETED  FOR  AN  ILLNESS  MAY  
PRODUCE  A  TEMPORARY  REACTION.    THIS  IS  NOTHING  TO  WORRY  ABOUT  AND  IT  SHOULD  
SOON  PASS  GIVING  WAY  TO  A  STEADY  IMPROVEMENT.    
 
2.  External  Treatments  
 
Traditionally,   Tibetan   medicine   uses   a   range   of   external   therapies   which   include:   massage,  
hot   and   cold   applications,   methods   for   inducing   sweating,   mineral   baths,   blood   letting,  
moxibustion,  acupuncture  and  surgery.  Hot  and  cold  applications,  involve  pressing  on  certain  
areas  of  the  body,  with  objects  such  as  a  warm  or  cold  stone,  or  fennel  seeds  wrapped  in  a  
cloth   and   dipped   in   hot   oil.   Bloodletting   involves   making   a   small   incision   in   a   vein   and  
allowing  pathological  blood  to  leave  the  body.  The  incision  is  made  on  one  of  seventy-­‐nine  
locations,   depending   on   the   nature   of   the   disorder.   For   several   days   before   it   is   done,   the  
patient   is   given   a   decoction,   which   serves   to   separate   the   pathological   blood   from   the  
healthy  blood.  Moxibustion  involves  the  burning  of  small  cones  of  the  herb  gerbera  on  one  
of  seventy-­‐one  locations  on  the  body  that  are  related  to  various  disorders.  Another  form  of  
heat   treatment   used   in   Tibetan   medicine   is   cauterisation   with   a   metal   instrument.   The  
Tibetan  medical  text  also  lists  numerous  types  of  medical  baths  classified  according  to  their  
mineral  content;  such  natural  hot  pools  are  commonly  found  in  the  mountains  in  Tibet  and  
throughout   the   Himalayan   region.   If   all   other   forms   of   treatments   have   been   ineffective,   for  
some   disorders   the   text   recommends   surgery.   However,   nowadays,   with   the   exception   of  
minor  problems,  surgery  is  not  practised.  
 
*In   the   clinics   the   only   forms   of   external   therapies   that   are   used   are   massage   and  
moxibustion.    
 
3.  Behaviour  modification  
 
Behaviour   can   also   affect   the   humours   in   a   positive   or   negative   way.   As   both   wind   and  
phlegm  disorders  are  by  nature  cold,  a  person  suffering  from  such  a  condition  should  stay  in  
a  warm  place.  For  people  with  bile  disorders,  due  to  its  hot  nature,  they  should  stay  in  a  cool  
place.  Certain  types  of  activity  are  appropriate  for  disorders  of  each  humour;  for  wind,  the  
Tibetan   medical   text   advises   that   the   individual   should   stay   in   pleasant   company,   calm  
activity  is  recommended  for  bile,  and  for  phlegm,  physical  exercise  is  beneficial.  The  medical  
text   also   stresses   that   the   natural   processes   and   needs   of   the   body   such   as,   vomiting,  
yawning,   sneezing,   sleeping,   hunger,   urinating,   and   so   on,   should   not   be   impeded.   If   Dr  
Dhonden   thinks   that   certain   forms   of   behaviour   are   appropriate   for   your   condition   he   will  
inform  you  during  the  consultation.  The  Following  Table  lists  the  behavioural  factors  that  are  
listed  in  the  medical  text  that  can  lead  to  pathological  conditions  in  the  three  humours.  
 
Wind   Bile     Phlegm  
Excessive  bitter,  light  and   Excessice  sharp,  hot,  oily   Excessive  bitter,  sweet,  
coarse  foods   foods.     heavy,  cool  and  oily  foods  
Exhaustion     Anger   Sleeping  in  the  daytime  
Lack  of  food   Strenuous  activity  carried   Being  Cold  
out  in  hot  conditions  
Lack  of  sleep   Carrying  heavy  loads   Eating  food  before  
previous  meal  has  been  
10
 digested  
Diarrhoea   Violent  activity    
Vomiting      
Grief      
Excessive  Mental  Activity      
Excessive  Verbal  Activity      
Forcefully  restraining  body      
functions  such  as  
sneezing,  urinating,  
defecating,  and  so  on.  
 
4.  Diet  
 
Food,  like  medicine,  has  certain  properties  that  can  affect  the  functioning  of  the  humours.  
The  same  logic  applies  as  we  saw  for  medicines:  foods  with  the  same  elemental  qualities  and  
characteristic  of  a  disorder  should  be  avoided.  As  we  saw  in  the  earlier  section  on  medicines:  
first,  the  properties  of  a  type  of  food  is  related  to  its  elemental  nature  which  is  reflected  in  
the  foods  taste;  and  second,  each  type  of  food  can  be  classified  according  to  one  or  more  of  
the   eight   potencies   which   we   discussed   earlier.   The   following   table   gives   a   list   of   types   of  
foods   and   the   corresponding   tastes   and   potencies.   Dietary   advice   in   Tibetan   medicine   is  
usually  related  to  foods  of  a  similar  taste.  Foods  with  a  sweet  taste  are  beneficial  for  wind  
and  disturb  phlegm.  Foods  which  combine  a  sour  and  sweet  taste  are  beneficial  for  wind  and  
blood  disorders.  Foods  with  a  sour  taste  are  beneficial  for  phlegm  and  wind  and  disturb  bile.  
Foods   with   a   salty   taste   are   beneficial   for   phlegm   and   wind   and   disturb   bile   and   blood  
disorders.   Foods   with   a   bitter   taste   are   beneficial   for   bile   and   disturb   wind.   Foods   with   an  
astringent   taste   are   beneficial   for   phlegm.   The   following   table   presents   the   taste   and  
potencies  of  a  selection  of  common  food  items.  
 
VEGETABLES  
  Taste     Potency  
Onion   Sweet  and  salty   Hot  and  heavy  
Potato   Sweet   Heavy  
Corn     Sweet   Heavy  
Peas   Sweet   Heavy  
Cabbage      
Red  Cabbage   Sweet     Heavy  
Aubergine   Sweet   Hot  and  Heavy  
Courgette      
Lettuce   Sweet   Heavy  
Carrots   Sweet   Heavy  
Celery   Bitter   Light  
Spinach   Bitter   Light  and  Hot  
Green  Pepper   Hot     Sharp  and  Coarse  
Red  Pepper      
Mushrooms   Astringent  and  Sweet   Hot  and  Heavy  
Sweet  Potato   Sweet   Heavy  
Chilli   Hot   Sharp  and  Coarse  
     
11
 GRAINS  
     
White  Rice   Sweet   Light  and  Cool  
Brown  Rice   Sweet   Heavier  than  white  rice  
Wheat   Sweet   Heavy  and  Cool  
Rye   Sweet   Heavy  and  Cool  
Barley      
     
MEAT  
     
Mutton   Sweet   Heavy  and  Warm  
Lamb      
Beef   Sweet   Cool  and  Light  
Chicken     Sweet   Light  
Fish   Sweet     Heavy  and  Hot  
     
DAIRY  PRODUCTS  
     
Milk   Sweet   Cool  and  Light  
Butter   Sweet   Oily,  Heavy  and  Hot  
Yoghurt   Sour   Coarse  
Cheese   Sour   Coarse  
Ice  Cream   Sweet   Cool  and  Heavy  
     
NUTS  AND  SEEDS  
     
Peanuts   Sweet   Oily,  hot  and  heavy  
Walnuts   Sweet   Oily,  hot  and  heavy  
Sesame  Seeds   Sweet   Oily,  hot  and  heavy  
Tahini   Sweet   Oily,  hot  and  heavy  
Peanut  Butter   Sweet   Oily,  hot  and  heavy  
     
FRUIT  
     
Banana   Sweet   Heavy  and  Oily  
Orange   Sour  and  Sweet   Cool  and  Light  
Grapefruit   Sour  and  Sweet   Heavy  
Grapes   Sweet   Heavy  
Apple   Sweet   Heavy  and  Cool  
Strawberry   Sour   Coarse  and  Cool  
Peach   Sweet   Heavy  
Tomato   Sour  and  Sweet   Light  and  Sour  
Watermelon   Sweet   Cool    and  Heavy  
Coconut   Sweet   Oily  and  Heavy  
Pineapple   Sweet  and  Sour   Coarse  and  Heavy  
Raisins   Sweet   Cool  and  Heavy  
Lemon     Sour   Cool  and  Coarse  

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Pear      
Apricot      
Peach      
     
CONDIMENTS  
     
Black  Pepper   Hot   Hot  and  Coarse  
Salt   Salty   Heavy  
Sugar   Sweet   Cool  and  Light  
Honey     Sweet   Light  and  Dry  
Garlic   Sweet   Hot  and  Heavy  
     
MISCELLANEOUS  
     
Alchohol   Sweet  and  bitter   Hot  and  light  
Beer   Sweet  and  Bitter   Cool  and  Light  
Tofu  (soy  bean  curd)   Sweet   Heavy  and  oily  
Eggs   Sweet   Heavy  and  Hot  
Bread      
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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