Medical tradition in Tibet not necessarily Buddhist

Medical tradition in Tibet not necessarily Buddhist

Robert Buswell, director of the UCLA Center for Buddhist Studies and distinguished professor of Buddhist Studies, and Professor Janet Gyatso of Harvard Divinity School. (Photo: Peggy McInerny/ UCLA.)

Tibetan Buddhist scholar Janet Gyatso argued that the 79-panel illustration of the Tibetan medical classic, The Four Treatises, provides ample evidence that an important sphere of Tibetan life was not primarily Buddhist.

“You have these amazing and wonderful scenes of things going on in Tibetan life [and] not a lot of religion,” observed Gyatso. “There's very little painting in Tibet that is not religious, so this is one of the very few opportunities where painters really had a chance to illustrate everyday scenes.”

UCLA International Institute, December 15, 2015 — Tibetan Buddhist expert Janet Gyatso, Hershey Professor of Buddhist Studies at the Divinity School of Harvard University, recently spoke about her new book, Being Human in a Buddhist World: An Intellectual History of Medicine in Early Modern Tibet (Columbia, 2015), at a UCLA Center for Buddhist Studies colloquium on November 6.

Gyatso’s talk explored the 79-panel illustration of the Tibetan medical text The Four Treatises created in the late 17th century and presented an argument for imagining Tibetan civilization as something beyond Buddhism alone. Specifically, she pointed to the emergence of a modernity of sorts in Tibet by the 17th century, as evidenced in a deep interest in empirical knowledge and a certain resistance to religious authority. And she argued for retaining the distinction between Buddhism and medicine, despite the prevailing trend in Buddhist Studies.

For the purposes of her analysis, Gyatso made a clear differentiation between Buddhist healing, which she defined as the rituals and meditation techniques for healing the mind delineated in Buddhist religious texts, and a separate medical tradition that focuses on the material realm. The latter includes a vast literature that addresses medical techniques, diagnoses, remedies and an extensive pharmacopeia.


Gyatso said that it has been a discovery to learn that after works of Tibetan Buddhism, the greatest volume of written literature in Tibet is on medicine. “There is a root text in Tibetan literature [on medicine] and a huge number of commentaries on this work. There’s also a huge literature on materia medica and pharmacopeia, recipes and practice manuals. A really, really large literature,” she said. “So that in itself is significant in terms of written culture.”

Many works of Buddhism were imported and translated from Sanskrit into Tibetan during the Yarlung Dynasty in Tibet (from roughly the 6th to mid-9th centuries), when Buddhism arrived in force in the country and several of the country’s great historic kings ruled. “At the very same time,” said Gyatso, “they were also bringing in medical works — not only from India, but seemingly from Western Asia and also from East Asia.”

She noted, for example, that detailed medical knowledge of the body was already evident in the Buddhist concentration practice that focuses on the impermanence of the body. Commenting on the specificity with which body parts are described in the relevant Buddhist texts, she said, “Even at the early date that this medication was devised, they were already using medical knowledge borrowed from Ayurveda.”

Gyatso also pointed out the long interconnection between medicine traditions and Buddhism in India, personified in the blue Medicine Buddha (Bhaisajyaguru). It is known, she added, that monks in early Buddhist monasteries were knowledgeable about some forms of medical treatment and that early hospitals were operated by Buddhist monks, at least for fellow monks.

The parallel traditions of Buddhism and medicine

The early Tibetan kings of the Yarlung Dynasty, considered Bodhisattvas* in Tibetan Buddhist tradition, figure prominently in the Tibetan imagination and played a large role in the conception of the Dalai Lama elaborated in the 17th century, explained Gyatso. The 5th Dalai Lama (Ngawang Lobsang Gyatso, 1617–82) was, for example, the first Buddhist figure to become the secular as well as the religious leader of Tibet (in 1642), with his regent (desi) Sangye Gyatso (1653–1705) providing the philosophical reasoning for his expanded role.

A brilliant if controversial figure, Gyatso said Desi was “one of the great intellects behind the whole concept of Tibet as a Buddhist country.” In addition to taking over the reins of the secular government when the 5th Dalai Lama died, the Desi established the School of Medicine and Astrology on Iron Mountain (Chags po ri), commissioned a series of 79 paintings to illustrate the aforementioned The Four Treatises and built the Potala Palace in Lhasa.

During this period of national consolidation, said the speaker, the 5th Dalai Lama traced his legitimacy to the early Tibetan kings through both the tradition of Tibetan Buddhism (i.e., through reincarnation) and the tradition of Tibetan medicine. The latter had never foundered since foreign medical texts were first imported under the Yarlung Dynasty, but the 5th Dalai Lama revived classical medical texts, built new medical schools and invited Asian medical practitioners to his court. A similar connection between empire (or political power) and medicine was also apparent in the Ching dynasty in China, observed Gyatso.

Illustrated medical text sidelines Buddhism

Before analyzing the illustrations commissioned by the Desi, Gyatso first discussed the text of The Four Treatises (also known as The Four Tantras). The root text of Tibetan medicine, it is believed to have been compiled in the 12th century by medical practitioner and theorist Yuthok Yontan Gompo, who was not a monk.

“This is a . . . a detailed medical work of theory and therapeutics, diagnostics, pharmacopeia and so on and so forth,” said Gyatso. “And it really represents a kind of melting pot of Asian medicine at the time.” Not only does the work show important influences from Indian Ayurvedic, Chinese and Greco-Arabic medicine, but it also appears to include Central Asian medical influences (including from the indigenous Tibetan Bön religion) that are difficult to attribute.

The text contains strikingly little Buddhist ritual, asserted Gyatso, and also fails to discuss the next life — something very rare for a Buddhist work. “We’re all going to get sick and we’re all going to die is what the text is saying,” noted Gyatso. “Certainly Buddhism talks about impermanence . . . but if you understand impermanence, somehow you can transcend it as well.”

Although the medical classic is an apocryphal sutra attributed to the Buddha himself — the only such “full-service” medical work attributed to him — the debates of Tibetan medical writers make clear that few believed the Buddha was the author. Gyatso noted that these writers rarely said so directly because of the political risks associated with denying the omniscience of the Buddha, which would have also undermined the legitimacy of the Dalai Lama.

The scholar then turned to the visual evidence of the 79 paintings created under the leadership of Desi Sangye Gyatso. She claimed that the images in the panels relativized or sidelined Buddhism in a way that created room for a broader category of “human being” that superseded Buddhism. Although no medical writer outright said “that medicine is more powerful and is of a higher order than Buddhism,” she argued that this message is apparent in the images themselves.

The few direct references to Buddhist practices in the paintings, for example, are unspecific in a way that breaks with the tradition of Buddhists texts. Advice to meditate on a deity, for example, is illustrated in a manner to suggest that any deity will do, just as an illustration about studying the Dharma implies that any Dharma text will do. In another image, a monk is included in a group of five people that a certain remedy can cure, a juxtaposition that stresses his human and not his religious identity. Another image about the need to refrain from having sex prior to a urine text implies that sex among older and younger monks was a fact of life in Tibetan monasteries. “Some of the visual effects are just jarring,” she observed, “So right away, you feel like you’re not in a Buddhist realm.”

“You have these amazing and wonderful scenes of things going on in Tibetan life [and] not a lot of religion,” observed Gyatso. “There’s very little painting in Tibet that is not religious, so this is one of the very few opportunities where painters really had a chance to illustrate everyday scenes.” The painters obviously enjoyed their task, presenting medical knowledge while “giving you a sort of grand vision of the spectrum of humankind,” she said. “And there’s a certain delight in it.”

Gyatso concluded by arguing that there was a legitimate difference between what modern historians perceive and what historical actors themselves have said when they use the term “Buddhist.” Although an analyst must take seriously what actors say, it doesn’t mean that he or she cannot take issue with their theoretical claims where the evidence merits such an argument. Regretfully, she observed, this type of analysis is not always “acceptable” in Buddhist studies today.

In the 17th century and perhaps earlier, she said, “I'm seeing on the part [of medical writers] a real urge to get out from under the complete domination of a religious viewpoint that dominates the entire way the society works. This is not to say that there is obviously huge devotion, and interest and support of Buddhism, but it's not everything. And certain intellectuals were finding it something of a limitation.”

She also urged experts on Buddhism to acknowledge the emergence of a certain kind of modernism in Tibet prior to its encounter with the West, one that emerged from the culture’s medical tradition. "[Tibetan medical experts had] an idea of what science might be, of what objective science might be. They don't articulate it fully the way that ends up happening in European theory, but they're on their way there,” she explained. “And it's important to recognize that that was happening without direct contact with European science."

* A Buddhist devoted to achieving enlightenment for the good of all sentient beings.

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Published: Tuesday, December 15, 2015