According to the Tibetan folklore, the first disease was indigestion, and the first medicine was boiled water. In the 8th century, the Han medicine (`Complete Treatise on Medicine') was transmitted to Tibet by the two Tang Princesses Wen-Cheng and Jin-Cheng. Doctors from Tang, India and Nepal were invited to Tibet. A Tang doctor, Tashi-Donsongonwa (his Han name was lost), was invited twice to Tibet, and became famous. The Tibetan saint of medicine, Yutok Yonten Kongpo was among his pupils. The Tibetan saint traveled to Tang, Nepal, India, wrote the important `Four Part Medical Classic' which was considered to be the canon to this date. Note that this canon had been continuously edited, modified in the last thousand years, some later Buddhism influences were obvious.
During the revival of the Buddhism in Tibet, many Indian monks were fond of medicine, and transmitted Indian medicine to Tibet. The three vital activities, `lon', `qibo' and `paigen', were formulated under the influences of the Indians and the Hans.
Due to the process of cutting bodies in the `skyburials', the Tibetan Anatomy was excellent. Tibetan had a vivid picture of human body . The Tibetan doctors observed the development of fetuses, and divided the period of pregrancy into `fish period', `turtle period', `pig period'. This was a discovery in embryology.
Similar to the Han tradition, a series of `Materia Medica' (`ben cao' in Han) were compiled.
In the 17 th century, Diba Sangs-gyas Gya-tsho set up `Mendzi Khang' institute for astronomy and medicine. He wrote the volumed book `Blue Glaze' which became a classic. A collection of 79 Thangka about medicine was commisioned by him which were preserved to the present.
II: Physiology
Basically, there are three vital activities, `lon', `qibo', and `paigen', inside the human body which is built with seven components: milk, blood, meat, fat, bone, marrow and `essence' (hormone ?). There are three excreta: excrement, urine, perspiration. `Lon' is likened to the air or wind. This is in charge of blood circulation, breathing and the circulation of vital energy named `qi' by the Han and `prahna' by the Indians. `Qibo' is likened to fire. This controls metabolism, digestion and thermoregulation. `Paigen' is likened to water and earth. This is in charge of physical form, i.e. height, hereditary traits and constitution.
The correlation of the three activities is different for each individual and can serve as a basis for classifying human types, `lon' is characteristic of people who are care-free, quick to grasp and forget things. Qibo is typical of hot-templed and intolerant people and `paigen' typifies these whose natures are calm and apathetic.
III: Diagnosis
Both Tibetan and Han doctors regard illnesses as having been caused by imbalances in the biological rhythm of the human organism, i.e. in the Tibetan medicine, it means the imbalances of the three `vital activities', seven `components, and three `excreta'. They may be summarized as `cold' and `hot' diseases.
When examining a patient, a Tibetan doctor starts with a definition of his nature, that is, the correlation of the three activities. Then he searches for a reason for the imbalance and a method of restoring balance.
The main methods employed in the Tibetan medicine are: observing, inquiring, and pulse-taking . Note that they are identical with the Han medicine in principle. The most important ones are urine-observing and pulse-taking.
To observe urine, the doctor should pay attention to the colour and the vapour of the patient's urine when it is hot, warm, and cold. For instance, if the colour of the urine is yellow, then the patient has `qibo' disease, etc. If the vapour is small, then the patient has `lon' or `paigen' type cold disease.
The methods of pulse-taking are similar in the Tibetan and the Han medicine. A Tibetan doctor takes the patient pulse with his fingers, varying the amount of pressure which he applies on the specific points of the patient's wrist. Thus the doctor's left forefinger provides him with information about the patient's lungs, his middle finger about the liver and his ring finger about the kidneys. The frequency of the patient's pulse is measured in relation to the physician's own breathing: five to six beats to one breath are considered normal.
IV: Clinical Medicine
The healing arts are: food, living habit, medicine, and outside therapeutics.
Due to the shortage of fuel, sometimes the foods are uncooked in Tibet, and the digestive problems are rampant. The Tibetan doctor advises people to drink boiled water, to cook foods properly, and pay attention to the sources of water.
The Tibetan doctors will classify the living habits into: (1) daily routine, (2) seasonal routine, (3) temporary behaviour. Their advices are largely common sense nowaday.
Based on `Materia Medica' (`ben cao' in Han), thousands herb medicines are prescribed. Some of them are minerals as `Pearl 70', `Coral 25', `13 Shades of Gold'. Red pearls are held to be most effective, because they are formed in molluscs, and molluscs are transfigurations of the Bodhisattva and the Buddha.
The outside therapeutic methods are: blood-letting, moxibustion, medicine bath, external medicine, puncture. The last technology is largely lost.
V: Doctor's Training
In the `Mendzi-Khang' Institute, a doctor shall study medicine for four years and astronomy for another five years. In some other monasteries, it might be longer, twelve to fifteen years. To begin with, a student will spend years in memorizing `Four Part Medical Classic' line by line and numerous pharmaceutical charts. For the first examination, each student must recite the canon from cover to cover which lasts from dawn to midnight.
Beside receiving the medical and the astronomical trainings, a student will study fairly amount of Buddhist sutra, and practice yoga, and kung fu. The rational for Buddhism training is to strengthen the morality of the doctor. The yoga and kung fu training will help him to take pulse more reliably.
There were thirty to seventy students in `Mendzi-Khang' in the first part of 20th century. The total number of the Tibetan doctors was very limited.
VI: Remarks
There might be some hidden treasures in the herb medicines which worth further study by the scientific methods.
The Esoteric Buddhism is unnecessarily mixed with the medicine. The secretive Esoteric way of transmitting knowledge from teachers to pupils is adopted in the Tibetan medicine. Some books are openly named `secret'.
The Tibetan medicine uses the astrology and superstitions extensively, which mystifies the subject unnecessarily. For instance, the ailing person will recover if a person sent for the doctor is a sage or a monk who arrives on horseback and is well dressed. On the other hand, it forecasts ill if a person who sent for the doctor is emasculated or unclean, or has physical defects and rides an ass or yak.