NOTE ON TERMINOLOGY AND ROMANIZATION
1 David Germano and Nicolas Tounadre, “THL’s Simplified Phonetic Transcription of Standard Tibetan,” Tibet and Himalayan Library, 2003, www.thlib.org/reference/transliteration/#essay=/thl/phonetics.
INTRODUCTION
1 Amchi, originally a Mongolian term for doctor, is used frequently, along with menpa, in contemporary Tibet. Amchi and menpa denote both medical and biomedical doctors. Although a division in clinical practice between Tibetan medicine and biomedicine can no longer be upheld, for clarity’s sake I use amchi only for those mainly trained as Tibetan medical doctors, except in chapter 4.
2 Many Tibetans consider Ü-Tsang, together with Kham and Amdo (in far eastern Tibet), as the three parts of pre-1950s Tibet. Yet, the sociocultural and political diversity and internal divisions of this region make this a difficult proposition. For clarification, see Note on Terminology and Romanization.
3 For an in-depth analysis of the terms Sowa Rigpa and Tibetan medicine in the academic literature to date, see Craig and Gerke (2016).
4 On the humors in classical and contemporary Indian, Chinese, and Greco-Arabic medicine in South Asia, see Van Alphen and Aris (1995), Attewell (2007), and Langford (2002).
5 For example, the Blue Beryl and the Supplement by Desi Sangyé Gyatso and the Transmission of the Elders by Zurkar Lodrö Gyelpo.
6 Parfionovitch, Dorje, and Meyer 1992; Trinlé and Lei 1988; Gyatso 2015.
7 For a full review, see Hofer (2011d), chapter 4.
8 Cf. Mullaney 2010.
9 For example, Millard writes that after 1955 “the following decades presented great challenges” (2013: 365). Similarly, Soktsang and Millard summarize Janes (1995): “Although in the early period of Chinese rule Tibetan medicine had been supported by the Chinese government, with the beginning of the Cultural Revolution in 1966 Tibetan medicine went into serious decline and was virtually non-existent by the mid-1970s” (Soktsang and Millard 2013: 3). Schrempf (2007), describing the transmission of medical knowledge among Bonpo practitioners in Nagchu, includes little information on the impact of the Maoist reforms on the group of practitioners with whom she worked.
10 Chatterjee 1993; Dirks 1996; Duara 1995; Prakash 1990; Spivak 1988.
11 Fjeld 2006; Jinba 2013; McGranahan 2010; Naktsang 2014; Roche 2017.
12 This research has resulted in a number of publications where the methods are discussed in more detail (Hofer 2012).
13 David Germano, discussant response on the panel “Applied Scholarship in Tibet” at the 12th International Association for Tibetan Studies Seminar, Vancouver, August 2010.
CHAPTER 1
1 Craig 2007, 2012; Garrett 2014; Hofer 2012; Schrempf 2007.
2 Attewell 2006, 2007; Barth 1990; Hsu 1999; Scheid 2007.
3 Hofer 2012: 21–25; Trinlé 2000; Kelsang Trinlé 1997; Rechung 1973; Sangyé Gyatso ([1703] 1994; 2010).
4 Aziz 1978; Childs 2004; Diemberger 1993; Levine 1981, 1988.
5 There are two Tibetan spellings: sman grong, meaning “Medical House” or “hamlet of doctors,” and sman ’khrungs, “being born into medicine.” In this context they mean more or less the same, but given the wider use of the Tibetan term trong (grong) for households with a corporate character in the Tibet kinship literature (Aziz 1978; Levine 1988) and how this term is spelled in Tibetan medical literature (for instance, the “Sakya Mentrong,” Hofer 2012: 74), the first spelling, sman grong, and its meaning of “household of doctors” are more relevant here.
6 See Hofer 2012.
7 Parfionovich, Dorje, and Meyer 1992: 156.
8 A mchi rgyud chad pa red
9 Yonten Tsering’s brother married outside as a magpa, one of his older sisters was ordained as a Buddhist nun at Jonang nunnery in the early 1950s, and another married into another taxpayer household of the village.
10 Khang dkar po (Khang Karpo).
11 None of the four thus ranked households in Gye was polyandrous, as was often the case among trelpa in other parts of Tsang, for instance Panam (Fjeld 2006).
12 As a so-called grong sgags dmag mi.
13 Taube 1981. The Gongmen continued the medical work of the nearby Sakya Medical House (Sakya Mentrong), where successive members of the Drangti medical family had played a major role up to the fifteenth century.
14 It was quite common for Buddhist monks who worked as physicians to create or propagate a lay Medical House, as in the case of Dramang Lharje, father to doctor Derge Purpa Dolma (Hofer 2015).
15 Whether members of other Medical Houses were students at the Lhünding Mentrong when the Fifth Dalai Lama sent financial allowances to Lhünding Dutsi Gyurme and his students (Hofer 2012: 108), we cannot ascertain from current records or living memory.
16 For example, in the Menghe medical currents in Jiangsu and Shanghai (Scheid 2007) and at Medical Houses in contemporary Xin’an, Anhui Province, discussed by Hsu (2010).
17 Hsu 1998; Mueggler 2001; Wellens 2010.
18 I follow the US conventions here, taking the ground floor as the first floor.
19 See Carrasco 1959; Fjeld 2005; Goldstein 1989; Petech 1973; Childs 2004.
20 In Ngamring, although all land technically belonged to the Dalai Lama and the Lhasa Tibetan government, this was locally administered by monastic estates, such as Drepung, the Panchen Lama’s Labrang, as well as other local, usually larger monasteries, or nobility from whom the trelpa families rented their land and to whose local administrators, or ponpo, they paid their taxes.
21 Chos mdzad khyim tshang
22 This tripartite social division also crops up in the history of Ngamring’s main Gelugpa Ngamring Monastery, Ngamring Choede (Sherab Dorjé 1994).
23 When members of households of these three ranks entered monastic institutions, they made a substantial donation of money or goods to the monastery (for example, tea offerings to the assembly), and subsequently were spared from manual labor within the monastery, allowing them to concentrate solely on their religious studies.
24 On these groups in Tsang, see Fjeld (2008). An occurrence during Kim Gutschow’s fieldwork in Ladakh is also interesting: she reports that some amchi, to keep the potency of medicines intact, kept their medicines away from “death pollution,” that is, a place where someone was dying (Gutschow 2011: 202).
25 For details of the exact titles and authors, see Hofer (2011d: 357).
26 For digital copies of some works in this collection, see the Tibetan Buddhist Resource Centre website, under catalog numbers W4CZ20860–W4CZ20873. For images of selected manuscripts, see Hofer (2014a: 86, 181, 182, 185, 193).
27 Gongmen Konchog Pandar (Gong sman dkon mchog phan dar) n.d. In this work we also find details on surgical techniques and practices that he was famous for; see Arya (2014: 85–86).
28 A detailed study of these medical collections would enable a better appraisal of how conditions were diagnosed and treated, what recipes were like, and the differences among Medical Houses and traditions. It would also allow us to make some judicious remarks on the scope of medicine, in particular, its intersections with Buddhism at a time when this relationship had not been troubled through the socialist materialist logic promoted by the Chinese Communist Party (CCP) in Tibet. On earlier debates over the role and place of Buddhism within medicine, see Gyatso (2015).
29 There are only few studies of the work of private amchi outside of Lhasa during the 1940s and 1950s. Snellgrove and Richardson (1968: 262) hold that although healing did not play such an important role in Tibetan Buddhism as in Christianity, one was just as likely to find a layman or a monk medical practitioner. They write that in villages and the countryside, there were “no medical practitioners available,” and “for most illnesses Tibetans put more faith in prayers, charms and amulets, than in medicine.” This representation is filtered through the common layer of British colonial perceptions of Tibet in the sphere of medicine and health care, most explicitly expressed in the memoires by a British Indian Indian Medical Services surgeon who served in Lhasa in the 1930s (Morgan 2007; cf. McKay 2007; and Hofer 2011d). Fosco Maraini, photographer on one of Guiseppe Tucci’s expeditions, reported that a physician in Gyantse “wears the hat of a scientist with a large gold frieze and turquoises.” Note in his caption to a b/w print and negative in Series T.37, No 2012, Archival Number: FFM99N551, Marini Photographic Collection, Gabinetto Scientifico Letterario G. P. Vieusseux, Palazzo Strozzi, Florence, Italy. A print of this photo can be found in Maraini (1952: plate 22).
Cassinelli and Ekvall (1969) report that at Sakya there were “at least three families of hereditary medical practitioners,” one of which provided the “official” doctors for the K’ön (Akhon) family (324). They had clinic-like establishments where people went to get “purgatives, febrifuges and remedies for headaches and indigestion, to be bled, to have sores lanced and wounds cauterized, and to have broken bones set.” The practitioners received payments for their services and gifts upon the recovery of their patients. They had the status of Jo Lags, “thus being recognized as performing government function.” In Tibetan there are more accounts, also of the practical work, of five generations of the Dopta and Surkhang amchi (Amchi Tashi Namgyal 1999) and of the Khankar medical tradition in Kyirong (Norbu Chöphel and Tashi Tsering 2008).
30 Chos sman gnyis ’brel
31 The title of the manuscript is Man ngag gyud ’bum dkar las byis pa dang mo nad gso ba’i sdeb bzhugs so.
32 For a historic photograph of an amchi reading a patient’s pulse, foregrounded by his medical bag and instruments on a low table, see Hofer (2014d: 60).
CHAPTER 2
1 The ten sciences comprised five major sciences (the inner science, nang rikpa; epistemology and logic, tentsik rikpa; grammar, tra rikpa; medicine, sowa rigpa; and the arts and crafts, zorikpa) in addition to the five minor sciences of poetry (nyenag), astrology (tsi), lexicography (debjor), the performing arts (dögar), and language (ngöndzö) (see Seyfort Ruegg 1995).
2 Bell 1925; Goldstein 1989; Kapstein 2006; McKay 2003; Shakabpa 1967; Shakabpa and Mahler 2009.
3 Byis pa nyer spyod
4 Studies of smallpox eradication in India reveal a complex mixture of decision making, unequal power relations and diverging understandings of success and acceptance of the vaccines by local people, as well as considerable local resistance (cf. McKay 2007: 134–42; Bhattacharya 2005). It is difficult to judge Cassinelli and Ekvall’s assessment that the campaign met no resistance without knowing more about its reception. Smallpox was a disease that at least some Tibetan doctors are reported to have known how to cure, including the members of the Tsarong medical lineage, who had close historical ties with the Sakya medical establishment (Trinlé 2000: 255–65; Sangyé Gyatso [1703] 2010). One cannot, therefore, assume that there was no precursor to Western medical vaccines for dealing with the disease; moreover, at least practitioners and recipients would receive the new methods used in the Sakya area.
5 Such surveys were carried out in many places in China, either during the Republican period or in the 1950s by the Communists; see Fang (2012: 21–23).
6 I interviewed them in 2003 during a two-day political meeting and followed up on these initial conversations with personal visits to many of their monasteries.
7 Kun rtags gdon kyi nad
8 Gzhan dbang sngon gyi nad
9 Yongs grub tshe gi nad
10 Lhar snang phral kyi nad
11 Gdon. These illnesses are dealt with in chapters 79–81 of the third volume of the Four Treatises and feature prominently in Tibetan medical pediatrics; see Jäger (1999).
12 These were Shershig (Sher shig dgon pa), Yartsen (Yar tzen dgon pa), Yülngön (Yul ngon dgon pa), and Ombo (’Om bo dgon pa).
13 Dpal ldan tshul khrims rin po che (1904–1972).
14 Thanks to Khyungtrul Rinpoche’s initiative, Bonpo texts, including medical texts, were reprinted in the 1950s using modern printing techniques in India (Kvaerne 1998) and brought back to Tibet as part of a brief revival of Bon and Bonpo medical scholarship in northern and western Tibet (Millard 2013).
15 I would like to thank Ravenna Michalsen for sharing her translation of this biography and her unpublished MA thesis with me.
16 Skye med Rin po che
17 In 2007 one dotsé (rdo tshad) equaled ¥2.5, bringing the cost of one rinchen rilbu to about ¥250 in today’s money.
18 A brief reference in the biography of the Lhasa-based physician Tenzin Chödrak (1924–2001) mentions that he met Ani Ngawang at the Mentsikhang after the end of the Cultural Revolution in the 1970s, having heard that she knew how to make tsotel. He and Khenpo Troru Tsenam tried to purify mercury for the first time after the reforms in Kongpo and were looking for instructions. Interestingly, no details are given on whether she gave him instructions. See Gerke 2015a.
19 On ideas about differential merit gained from offerings to Tibetan Buddhist monks and nuns in Ladakh, see Gutschow (2004) and in Tibet, see Schneider (2013).
20 This was the Sman sbyor gyi nus pa phyogs bsdus phan bde’i legs bśad, printed at the Mentsikhang in Lhasa in 1949.
21 This was also the case with the Bon lama and doctor Khyungtrul, who taught medicine to several nuns unrelated to him, including an elderly nun still resident at Gurgyam Monastery in western Tibet in 2009 (personal communication with Colin Millard in June, 2011; and Millard 2013: 13).
22 The Mentsikhang’s eye surgery division was then run by two male physicians, while the number of cataract surgeries carried out by the biomedically trained Chinese eye surgeons at People’s Hospital #1 in Lhasa increased dramatically.
23 For a history of Ngamring Chöde, see Sherab Dorjé (1994). Dowman gives a figure of four thousand monks, immediately before the start of reforms in the early 1960s (1988: 273).
24 On earlier activities and references to medical work at Tashilhunpo, see Carnahan and Rinpoche (1995: 38, 80–82), Gerke (2015b), Hofer (2012), Markham (1876), Turner (1800 [2006]), and Tsarong (2000: 87–88).
25 Skyid skyid nad ka
26 The full name of the school was Menlop Shi(ga)tse Dralhün Kyinak Drangsong Déling Menkhang (Sman slob gzhis rtze bgra lhun skyid nags drang srong bde gling sman khang) (Trinlé 2000: 557).
27 Lamenpa Kewang Solpön Dawa (Blas man Mkhan dbang gsol dpon zla ba), Tashilhunpo Dharpa Khamtsen’s monk Kachen Lobsang Tashi (Dka’ chen blo bzang bkra shis, a fifth-rank official) and Taygon Chakpo Khamchen’s Trung Penpa are named personal physicians to the Ninth Panchen Lama, Thubten Chökyi Nyima (Thub bstan chos kyi nyi ma, 1883–1937; Trinlé 2000: 558). These doctors might also be mentioned in the autobiography of the Ninth Panchen Lama (Lobsang Tupten Chökyi Nyima 1944), but I was not able to obtain a copy. See Jagou 2011. All three teachers were also remembered by the graduates of Kikinaka whom I interviewed.
28 Interestingly, the majority of students had already left in 1958, well before the March 1959 uprising in Lhasa and the subsequent start of Democratic Reforms. One reason might have been rising tensions between the Tenth Panchen Lama and the Communist administration as the former gave refuge to several monks from his home region, Amdo, where attacks on religion had already started. There was no reduction in the number of monks in central Tibet in the 1950s; the loss of economic support for monastic landholdings would start in 1960–61 with the second stage of Democratic Reforms and other campaigns. Perhaps by 1958 there were increased local counterrevolutionary incidences and the closure was a preemptive measure to minimize opposition to the Communist presence in Shigatse.
29 “After Chakpori was established, the Regent declared that every main monastery would henceforth have a lama-doctor from there. This marked the beginning of ‘public health’ in Tibet” (Clifford 1994: 61).
CHAPTER 3
1 Goldstein 1997, 2007, 2013; Shakya 1999; Shakabpa 1967; Shakabpa and Mahler 2009; Smith 1996; Yeh 2013.
2 These autobiographies were partly ghostwritten and have been translated into several languages. On Tenzin Chödrak’s biographies in the context of mercury purification, see Gerke (2015b).
3 Epa Sonam Rinchen 2009; Pasang Yonten 1987. For a fuller review of these often conflicting views, see Hofer (2011d: 101–35).
4 Makley’s informants referred to these in Tibetan as sdug ngal bshad pa/dran pa.
5 See also Su Wenming (1983) and Chang Wei (1978).
6 See Strong (1959) for photographs of Chinese medical workers tending to those wounded by rebels during the March 1959 uprising. See also Epstein (1983) and Han (1977).
7 sngon ma
8 gral rim gyi ’thab rtsod
9 gzhon nu gsang ba’i rkrig ’dzuks
10 bco brgyad drug bcu
11 lo rgyus kyu gnya’ gnon shu zhog ki bdak po
12 lo rgyus sha mo
13 mi ngan sha mo
14 The Tibetan term mangtso (the people) was coined by Tibetan translators in the 1950s to replace earlier terms such as miser (commoners, subjects) in an effort to render into Tibetan the Chinese term ren min, meaning “common folk,” equivalent to the German Volk (Willock 2010).
15 nang chen po
CHAPTER 4
1 Contrary to widespread official claims (China Tibet Information Centre 2005; Epstein 1983: 386–400; Hsi and Kao 1977) and the situation in eastern Tibet (Weiner 2012: 200–209), there were no concerted CCP efforts during the 1950s to establish a permanent health care infrastructure in villages or nomadic areas of central Tibet. Communist medical activities remained largely restricted to Lhasa and prefectural capitals. When Communist cadres arrived in the villages in 1959–60, they did not regularly bring with them medical personnel or set up government clinics. Ngamring’s first biomedical health post was established in the county seat in 1961, employing one Han doctor and two Tibetan health workers, and only occasionally treating Tibetans in nearby villages.
2 Fang 2012; Taylor 2005; Scheid 2002, 2007.
3 The ingredients listed for this medicine were various kinds of gzi, pu shel, mrgta, turquoise, and corals, which were donated to the Mentsikhang. In addition, three doctors went out to collect other ingredients, including “seven-rebirth flesh, the ststsha of the lords of the three families, sbra tshal and white mustard of rgyal ba gya’ bzang pa and chos rgyal bya pa, as well as brain pills of rgyal ba klong chen pa (Trinlé 2006: 32).
4 The Norbulinka was renamed the People’s Park, and Chakpori Hill became Victory Peak. On the Cultural Revolution in Lhasa, see Goldstein, Jiao, and Lhundrup 2009; Woeser 2006; Tubten Khétsun 2009; Barnett 2006.
5 Sbyor med rig gnas gsar brched chen po
6 It is rare that Tibetan writers describe their hardships in officially published works in the PRC. There is still pressure to present almost everything as uniformly better in the new society. The Cultural Revolution is a rare exception, the only period of modern Tibetan (or Chinese) history for which official concessions have been made to the CCP’s otherwise tight censorship. This also varies between regions and over time, however, and has to be understood in the context of post-Mao official explanations for the Cultural Revolution. The official line is that the many acts of destruction and attacks on learning, religion, and culture were misguided, the actions of “ultra-leftists” for which the Gang of Four was duly sentenced and punished in 1981 (Barnett 2009: 9–10). The subsequent leadership apologized to the nation and to the Tibetans specifically in 1980 (Wang Yao 1996). According to Barnett, “Followers of this view speak as if a new Party and next Chinese government emerged in 1979 or 1980, with no responsibility for the previous era” (2006: 9–10).
7 Note that this marked the second time since the Communist takeover that the Tibetan medicine paintings were saved just as they were about to be destroyed, most likely in both cases due to the favorable connections Jampa Trinlé had with leading CCP officials.
8 For another account of the June 7 massacre, see Goldstein, Jiao, and Lhundrup (2009: 45–58).
9 Tubten Khétsun 2009; Pema Konchok 2002; Goldstein, Jiao, and Lhundrup 2009; Woeser 2006; and others.
10 For comparison see Fjeld (2006: 74–77) and Ben Jiao (2001) for details in Panam.
11 Ngawang Dorjé was one of the bumrampa graduates from Tashilhunpo’s Kikinaka Medical School, having been sent there from the local Samdrub Ganden Monastery. He had to leave the order in the early 1960s.
12 In his words, a zing cha chen po. This uprising is discussed in oral history accounts in Goldstein, Jiao, and Lhundren (2009: 172–82). On the Cultural Revolution in nearby Phala, also see Goldstein and Beal (1990).
13 This is not to be confused with 西医, or xi yi in Pinyin, meaning “Western medicine.” Yet these two terms for biomedicine sound very similar.
14 See, for example, Yeh (2013: 60–91) for model agricultural communities that were emulated in the vicinity of Lhasa.
15 There were two main versions of The Barefoot Doctor’s Manual in China, one for southern and one for northern parts of the country. These were updated over the years, complemented by regional additions and translations, as well as journals and magazines for barefoot doctors (see Fang 2012: 58–60).
16 Sidel 1972; Sidel and Sidel 1973; Chang 1978.
17 Konchok 2002: 48–50; Shakya 1999: 316–17; Pema Bhum 2001.
18 The preface acknowledges collaboration with the Institute of Botany of the Chinese Academy of Science and the Pharmacy Research Institute of the Academy of Chinese Medicine (RCTARHB 1973a, 1973b: 3). This makes it plausible that the editors continued or even reedited the work that Jampa Trinlé and his Mentsikhang colleagues had carried out prior to their demise in 1966, in preparation for the First Study on Tibetan Medicine and Medical Materials (1965). For this work they collaborated with Shao Wanggan of the Institute of Botany at the Beijing Academy, as well as one Chinese and three Western medical doctors from the Lhasa People’s Hospital (Trinlé 2006: 35). Janes also refers to several United Front collaborations in the 1950s in the field of pharmacology, but without further details (1995: 16).
19 I found a copy of the Chinese edition in Lhasa through a book dealer, but not in Ngamring or in amchis’ homes.
20 The full title in Tibetan is Bod ljong rgyun spyo krung dbyi’i sman rigs. Tibetan for Chinese is here spelled krung dbyi.
21 sman rigs
22 On the genre of illustrated Tibetan materia medica works, see Hofer (2014c).
23 For a discussion on Tibetan terms and classification of medical simples, or trungpe, see Hofer (2014b and 2014c).
24 Gso rig dang sman rigs
25 Krung go’i gso rig dang sman rigs ni rlabs chen gi nor mdzod cig yin pas ’bad brtson chen pos sngog ’don byas te yar rgyas gtong dgos. Literal translation: “The Chinese science of healing and pharmaceuticals is a marvelous treasury, so work hard to explore and develop it further.” I follow the standard translation from Chinese, but add “pharmaceuticals” to highlight the new focus on material dimensions: “Chinese medicine and pharmaceuticals are a great treasure house, they should be diligently explored and developed.”
26 Liu Shaoqi had been a key figure during the early Cultural Revolution. He wanted to restrain the students and masses and retain a greater degree of government control in exposing counterrevolutionaries. He was later exposed as a “capitalist roader” and became one of the many official enemies and targets of the revolution. For details, see Dittmer (1998).
27 Rang bzhin: hot, cold, warming, and cooling.
28 ro lnga: sour, bitter, sweet, pungent, and salty.
29 ro ba
30 phan nus
31 ’gos nad
32 gnod ’bu
33 Srin ’bu. These are my translations from Tibetan into English, including “contagious,” “viruses,” and “bacteria,” all of which came up with a bilingual Tibetan/Chinese speaker looking at the same sections of the work in the Chinese version (1973b).
34 The concept of chuser in Tibetan medical works is otherwise intimately linked to this system’s conception of the body’s distilling and digesting of food and its transformation into the seven bodily constituents, where chuser is one of the waste products.
35 On the dire consequences of using and accessing Tibetan works, see Pema Bhum (2001).
36 This work was widely used among exiled Tibetan doctors into the 1990s (personal communications with Pasang Yonten, July 2014, and Barbara Gerke, September 2014). The copies of the work routinely circulating there had the introductory pages with Mao’s quotations ripped out. The prime role of The Sino-Tibetan Herbal was rivaled only in 1995, when Gawo Dorjé’s seminal work on Tibetan materia medica (1995), published in Beijing, was distributed in India. This work again used the Tibetan medical term trungpé for “simple” but no longer made any references to Mao.
37 cha shas
38 snying bcud
39 phyi phyogs
40 bod gso rig
41 ’phrod bsten gsar brje
42 rang mgo rang
43 rnying gtor bcud len
44 gna’ bzang deng spyod, phyi bzang krung spyod
45 Sngo sbyor. This most likely refers to the work Sman sbyor bdud rtsi’s thig le. For recent reprints in India, see Tashigang (1974: 125–200) and, in China, see Ju Mipham (2006: 357–79).
46 rang bzhin
47 The Nyer mkho’i sman sbyor ’chi med bdud rtsi’i bum bzang by Mkhyen rab nor bu (Khyenrap Norbu 1995) and the Sman sbyor gyi nus pa phyogs bsdus phan bde’i legs bshad (largely the work) of Khyenrap Norbu.
48 Men-Tsee-Khang 2008, 2011.
49 A gar go snyon, Cinchona sp.
50 Even the Buddhist scholar Ju Mipham Namgyal Gyatso’s nineteenth-century instructions on compounding medicines (Ju Mipham 2006) on average use more ingredients. This work is seen in medical circles as a collection of uniquely simplified medical compounds. It is this work that the introduction probably refers to as a source.
51 China Tibet Information Centre 2005; Epstein 1983: 386–400; Hsi and Kao 1977.
52 This mention of “no details” was probably Trinlé’s veiled way of saying that whatever was considered “religious” and “superstitious” needed to be left out.
53 Ngawang Chödrak was rehabilitated from his “crimes” and rejoined the Mentsikhang in 1980 but passed away the following year (Trinlé 2000: 456–57).
54 We lack, however, a year of publication or the publisher, and so far I have not seen a copy of this work. This work was studied as a substitute for the Four Treatises by the rural Amchi Pema in Ruthog, alongside a republished work by Kongtrul Yonten Gyatso (1976).
55 Trinlé 2000, 2004. Others, for example, were in Namling, Ali, and Gyantse.
56 For these early years we have no separate records for western and Tibetan medical treatments, but combined, the hospital is reported to have carried out between 1974 and 1992 a total of 125,038 treatments, for an average of over 10,000 patients per year.
57 The document notes that between 1974 and 1988 staff of the Ngamring’s People’s Hospital collected 21,858 half-kilos (kjama) of dried plants.
58 Especially from the early 1980s, these included the rinchen rilbu, which were never made at the county hospital due to the great expense.
59 mo rigs bya gzhag
60 The Tibetan medical revolutionary pharmacological project requires further study and should include other sources, such as a three-volume pharmacopeia from Qinghai on Tibetan plants, published in Chinese: Qinghai Sheng sheng wu yan jiu suo, The Clear Mirror of Materia Medica on the Plateau of Ching-hai and Tibet (Qing Zang gao yuan yao wu tu jian), 2 vols. (Sining: Qinghai ren min chu ban she, 1975–78).
61 Cf. Lora-Wainwright 2005.
CHAPTER 5
1 Goldstein 1997; Goldstein and Kapstein 1998; Wang Yao 1994: 287–88.
2 Trinlé 2004, 2006; Chen Hua 2008.
3 Chinese Minority Medicine Committee Secretary 2007; Huang 2007.
4 On Tibetans leading the revival and renovation of Buddhist monasteries in Tsang, see Diemberger (2010).
5 Goldstein, Jiao, and Lhundrup (2009) hold that this was simply local factional fighting and not “protests.”
6 In Panam, for example, a household received an average of 2.4 mu of farmland per person for administration and cultivation (Fjeld 2006: 85–89).
7 Gdung rgyud shul ’dzin
8 Zhing pa ’bring pa
9 Nga dag’i dug rtsa
10 Cf. Pema Bhum 2001.
11 Tang gyi rgyud bzhi
12 His dates are 1813–1899/1900.
13 The introduction to this reprint acknowledges by name classical sources (gzhung lugs) such as the Four Treatises as a basis for the reprint.
14 Some of these had been restored to the family. They regained the wooden materia medica box (which was empty) and the medical bags from fellow villagers, as well as some preserved Indian materia medica, all of which were installed in the altar room of the house.
15 For a more complete account of the Ruthog amchi’s work and history, see Hofer (2012), and on the family’s medical compounding, Hofer (2011d).
16 sger gyi A mchi
17 This was similar to the situation of the famous amchi and Rinpoche Tenzin Wangdrak of western Tibet; Trinlé 2000: 554–56; Millard 2013.
18 Spel gzhung slob gra
19 Given that the TDF was partly financed by the United Front Work Department, it might be better characterized as a nonparty, charity, or welfare organization rather than nongovernmental.
20 For a documentary film on early SRC work in Shigatse, see Neuenschwander (1989).
21 After supporting the training of seven hundred health workers, this project was discontinued in 2003. There had been long-standing discrepancies between the approaches of the SRC and the local Health Bureau to rural primary health care provision and promotion, especially regarding the use of essential drugs (see Hofer 2011a). Subsequently, SRC activities shifted toward preventive rather than curative measures. To this end, a new collaboration began with the Tibetan Women’s Federation.
The SRC also steered away from the rural health care system, moving toward a community-oriented strategy, including health promotion, the prevention of the spread of sexually transmitted diseases (STDs), and the building of green houses and distribution of solar water heaters. Only the cataract eye surgery camps remained as a curative project.
22 Personal communication with Frances Howland and Phillipe Dufourg, August 2003, and personal observations in October 2002, August 2003, and throughout 2006–7.
23 The Lus thig zla ba nor bu’i me long by Zurkar Nyamnyi Dorjé.
24 See Khyenrap Norbu 1995.
25 Moxibustion, bloodletting, cupping, and golden needle treatment.
26 In fact, some have never replenished their stocks of medicines since graduating. Similar problems are faced by graduates of the Kailash Medical Project school; personal communication with its director, Lhasa, November 2006.
27 Meyer 1998: 11.
28 Heimsath 2003: 3–5.
29 Three out of the twenty-one graduates from the first intake whom I interviewed in 2006 worked in a governmental clinic, as well as nine of the twenty-eight graduates from the second cohort whom I interviewed in 2007 (see Hofer 2007a, 2007b).
30 Shigatse Vocational Health School provides a three-year health worker training course. It includes only few Tibetan medical modules, which are insufficient to qualify anyone to practice Tibetan medicine.
31 Swiss Red Cross 2005. Note that this reflects one individual’s opinion about the reasons for the closure of the school, and not those of SRC, its International Cooperation Department, or subsequent SRC delegates to Tibet.
32 This document is based on senior doctors’ accounts, official statistics, and Health Bureau and policy documents. The text thus sheds light on how doctors negotiated and organized their work in relation to wider local, regional, and national demands highlighted here. In contrast to Jampa Trinlé (2004) and to some extent Janes (1995, 2002), who emphasize the role of the central Mentsikhang-related medical bureaucracy, the Short History focuses on local developments at the county level and was meant for consumption by Health Bureau and other government employees.
33 Ngamring was the only one of five county capitals (out of seventy-five in the TAR), to gain a full, structurally independent Tibetan medical hospital (Trinlé 2004: 138–39).
CHAPTER 6
1 October 7, 2006: 8,198 patients; August 7, 2007: 10,631 patients; September 19, 2007: 10,831 patients. In less than a year Yonten Tsering saw 2,632 patients.
2 Hofer 2007a, 2007b, 2008b.
3 Craig 2012; Adams and Craig 2008; Blaikie et al. 2015.
4 Bloom and Jing 2003; Lora-Wainwright 2005; Farquhar 1996.
5 Ngamring Health Report 2002; Hofer 2008a, 2008b.
6 Janes et al. 2006; Nguyen and Peschard 2003; Farmer 2015.
7 Adams and Craig 2008; Craig 2014; Hofer 2011a.
8 Hofer 2008a, 2008b, 2011d, 2012.
9 Janes 1999a, 2002; Craig 2012; Saxer 2013.
10 Adams 2001; Adams and Li 2008; Adams, Dhondup, and Le 2011.
11 On case record writing and keeping, see Hofer 2012.
12 khog pa, literally, “inside, the trunk of the body.”
13 Originally part of the Mentsikhang, it later became an independent institution. Its relatively short history notwithstanding, the bag attested to the factory’s history going back to 1696, the founding year of the long-destroyed Chakpori Medical College.
14 Dribgyön is a multifaceted illness category I often encountered in Ngamring. Its etiology was variously understood and addressed through different techniques that involved monks and nuns chanting and saying prayers, patients making offerings to deities, ingestion of Tibetan medicines (rinchen rilbu), and the application of golden needle therapy (ser khab), as well as oracles to suck out the disease.
15 Although I have collected and analyzed several illness narratives from Yonten Tsering’s patients, constraints of space did not permit inclusion.
16 For details of production, see Hofer 2012, 2014b.
CONCLUSION
1 Blaikie 2013a; Craig 2012; Millard 2013; Soktsang and Millard 2013; Blaikie et al. 2015.