Tibetan medicine (Sowa Rigpa) is often portrayed as an enduring system of therapeutic knowledge and practice, primarily and until not long ago transmitted through lineages in monastic and lay medical colleges. This book challenges the notion of Sowa Rigpa as a static, centralised knowledge system by exploring past and contemporary practices of medicine in a remote rural area in Western Tibet. Written by one of the few scholars to have undertaken long-term anthropological fieldwork in rural Tsang, it describes transformations that have taken place in the transmission and practice of Tibetan medicine in Ngamring. As the heartland of one of Tibet’s main medical traditions, the so-called Jangluk, or ‘Northern Tradition’, the site of extreme, destructive reforms during the early Communist era, and also the locus where from the 1970s onwards exceptional efforts were made to revive medical traditions, Ngamring offers a unique opportunity to study the continuity and change of Tibet’s medical heritage.
The book offers a detailed account of the previously unchronicled Jangluk medical tradition that flourished in Ngamring between the 15th and 17th centuries. As part of their efforts to construct a centralised Tibetan state at the turn of the 17th century, the rulers of Lhasa tried to unify and standardise extant medical traditions throughout the country. However, this book demonstrates that local medical traditions, with their differentiated interpretations of Sowa Rigpa’s core text, Four Tantras, persisted and continued to develop their own lineages and practices. Moving forward in time, subsequent chapters document the ways in which these local traditions struggled to survive when Communist reforms were implemented in the region. Drawing on her encounters and interviews with Tibetan amchi, or medical doctors, the author provides a textured account of how both private and government trained medical practitioners have come to learn and apply Sowa Rigpa in Tibet today. Many amchi are challenged by structural frames and keen to take into consideration patients’ demands, which necessitate provision of a so-called ‘integrated’ health care that involves extended use of Chinese-style biomedical and sometimes Traditional Chinese medical ideas and practices. The potential of ‘integrated’ health care to benefit the health of local Tibetans is demonstrated neither to be straight forward nor necessarily the preferred choice of amchi themselves.
The book argues that in tandem with the current organisation of the health care system in China, spiralling costs for Tibetan medicines due to limited raw materials and rising standards in industrialised medical production, have transformed Tibetan medicines to become entirely unaffordable for some rural populations. The study’s conclusion points to the paradoxical situation whereby Tibetan medicines have ceased to be easily available in the countryside, while at the same time they are consumed on a larger scale in urban areas of Tibet and, increasingly, in a developing Chinese market. It remains to be seen whether, with Tibetan medicine now entering a lucrative global market, it can at the same time remain a viable health resource for those who have cultivated and protected the precious art of healing and the high-altitude environment in which it developed and on which it fundamentally depends.