Traditional Tibetan Medicine གསོ་བ་རིགཔ་ From East to West
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སྨན་ཐབས་ Formulas

The perspective of Tibetan Medicine states we are a combination of elements forming from, and relating with the relationship of internal and external elemental influences.

In this way, so too should our medicine remedies be compounded keeping in mind these aspects of elemental balance. Tibetan Medicine bases its formulas on principles where we clearly understand how exactly any substances we work with are comprise not only of the 5 elements of earth, water, fire, wind and space, but also what are known as the 6 tastes, 3 post digestive tastes. The direct influence from the elements themselves upon taste is reflected in their environments, season of collection, how, when and in what way they must be processed or purified.Raw Tibetan Medicine Herbs

This is a complex practice of formula containing multiple stages and steps along the way from the plants and minerals on the mountains to our Tibetan pharmacy shelves. Deep appreciation for these factors and relating directly to the environment for what it provides us as a offering for healing is an integral aspect of producing traditional Tibetan formulas. Collecting Tibetan Medicines
Old-style Making of Tibetan MedicinesCountless formulas exist in the Sowa Rigpa system of healing. Each uniquely designed for specific humoral imbalance and distinct disorders. The Tibetan pharmacopoeia includes thousands of ingredients.

Some formulas are simple and contain a just a few of your most common cooking spices. Other spices more well known in other areas of the world have become common in the west. Cumin, caraway, coriander, turmeric, cinnamon, licorice, clove, cardamon, long pepper, pomegranate, saffron, garlic, sesame, onion seed, ginger, fenugreek and a host of others are used throughout Tibetan Medicine.

Minerals and stones such as calcite, quartz, iron, various salts, mineral pitch are commonly used. Some minerals are not digestible on their own and require proper detoxification according to ancient guidelines written in the ancient medical texts.  Multiple stage process are required for some of these materials. Tibetan pharmacists are extremely knowledgeable physicians who not only have trained in all the healing arts, but also obtain extra specific training. The Tibetan pharmacist is a true artist, understanding the variation a season of extra heavy rain or drought may affect a herb and making adjustments according to the elements and 6 tastes to balance the 21 characteristics of the three humors. Special training is begun early in their studies and continues for years after they become a physican in how to follow the exact protocols as performed for centuries in picking, processing and possible detoxification. Many common plant and mineral substances are the basic building blocks for common formulas used widely to this day. In many aspects kitchen cabinet wisdom can contain some of the most profound formulas. While it is true many herbs are found only in the Himalayan regions, many I have growing in my own garden. The place where I live, nestled at the foot of the Rocky mountains, has many important herbs. I have also seen some medicinal herbs growing all over the United States. I have been producing my own Dutsi 5 Lums, known as the Five Nectar Bath, because all the ingredients grow in the USA, 4 of them native to my area and in my garden. To learn more, please see an article on the Five Nectar Bath on my clinic website.

Tibetan herbs ready to formulate

Other special formulas named རིན་ཆེན་རིལ་བུ་ rinchen rilbu, or ‘precious pills’ are intensely potent medicines and substances used to deeply transform, enhance treatment. These can take several months to gather the ingredients, detoxify them properly and compound them into traditional supplements. Used as regenerative, preventive and restorative to general health and serious illness alike, proper guidance is required while taking these formulas and I disapprove highly of online sellers providing these without a proper pulse and urine check. This is also an issue because quality of these substances is very important and unless you have the proper training as a full Menpa or Amchi (Doctor of Tibetan Medicine) you do not know when these formulas are called for and when they are not.

Precious Tibetan Medicine Purified Mercury

Moonlight Chongzhi Calcite Medicine

It is of great importance to only use Tibetan formulas under the proper supervision of a fully trained and qualified physician of Tibetan Medicine. This ensures your care is overseen by one who has not only been certified to administer traditional supplements but spent several years in apprenticeship under highly accomplished senior doctors. This is because the subtleties of each formula can change the entire balance of the system. What works for you in winter may not work in summer; this is a system which recognizes fluctuations and changes not only in one’s internal but external environment. The formulas are very precisely made and prescribed according to the reading of the pulse, urine, tongue, signs and symptoms.

Additional consideration, no two bodies are alike. Thus two illnesses though similar may not require the same medicines. This is one reasons why great care is taken in teaching Tibetan formulas only to the proper students who can learn the entire system. Like western physicians who take a vow to do no harm, doctors in my tradition are taught the system itself is derived from the great healing Buddha. During my training, countless teachers demonstrated the need to really understand formulas, but also not to give medicine simply for money or fame. This was an integral part of Tibetan medicine in ancient times and continues today. My own experience as one of the few western people trying to study completely in my time abroad, with only very few western persons who had come before me (just enough to count on one hand), I was often put through months of observation of my character and motivation before being allowed to study. In addition only after the proper transmissions and educational foundations were obtained was I taught the deeper aspects of formulas and prescribing.

Having now seen thousands of people with various disorders I can understand how easily one with little experience of the elements morphing as illness change and recede and trying to find and maintain balance of the person’s basic nature and individual baseline of elemental harmony requires deep observation and precision for prescriptions.

In recent years, I have seen the development of Tibetan Medicine in my home country of the United States. When I began in 1999 there were only a few books in the entire English language, much less translations of herbs. Even western Buddhist centers and Buddhist practitioners had never or just vaguely heard of Tibetan Medicine. There were no practitioners or clinics and exposure was often a traveling physican coming through once or every now and again with little translation of the system. That has dramatically changed and now mail order companies supplying basic formulas and even precious pills have appeared.

My husband, Dr. Tsundu Sengye Nyinda, a native Tibetan who was trained not only as a physician but also worked the many years following his training in the pharmacy, is in agreement with me that this is a dangerous approach. People both supply and take a variety of formulas believing it to benefit by simply listing and reading a basic description. However, without the careful observation and supervision of a qualified doctor, they can cause harm if taken incorrectly, too frequently, or taken for the wrong condition, wrong season, or at the wrong stage of the illness. When people say there is no side effect this is simply not true. Even drinking too much water can kill you.

Again, go back to pondering the connection of the elements. Imagine you have what Tibetan Medicine calls a “hidden fever” and yet your basic nature is cold. The heat may be trapped, and you know you have something which is inflammatory. There may even be widespread inflammation, but it can also commonly be under a layer of heavy, damp cold. If you try and just take cooling anti-inflammatory herbs and substances, but do not understand how your basic nature of cool effects your disease, digestion and condition you’re dealing with, you can easily create a secondary discord as a result of trying to just take anti-inflammatory cooling herbs.

I have begun to see this more and more as western persons tell me they are taking this or that formula for insomnia and wind symptoms. There are many different wind formulas in Sowa Rigpa. People suffering from wind often have restlessness, depression, anxiety, fearful or intense emotions, insomnia, sleep issues or neurological and nerve system issues. Yet no single wind formula is the answer. Careful consideration must be given for the whole system, and care to not disrupt one’s natural balance. I have seen people worsen with mailorder or store bought adrenal formulas or wind herbs.

Therefore caution is advised to seek out qualified care. Just as I recommend you seek a qualified licensed acupuncturist with over 5,000 hours of training over a chiropractor who has taken a handful of courses, so too is there a difference in a well trained physican of Tibetan healing and those who have just become interested. This is not to say people who have taken the time to genuinely study are not becoming well trained. I do see the interest and study of Tibetan medicine increasing. However, check the qualifications of your practitioner carefully. Nowhere is this more vital than with the giving of precious pills, where there is a very specific protocol to follow. The three humors in Tibetan Medicine require that you always monitor the delicate balances and qualities of the patient’s food, environment and medicines.

It is our great hope that people and businesspersons will maintain respect for complete and formally trained Tibetan physicians and request that you not self-diagnose and prescribe or try to mass market Tibetan Medicine. This is in order to firstly and most importantly protect the patient. This also ensures the protection of the reputation and integrity of both the formulas and the Tibetan medical system as a whole. In centuries past and present the student of Tibetan medicine had to demonstrate their genuine compassion to help others, learn how to not harm by accurately and completely diagnosing all the subtle aspects of the body and mind as well as protect the medical system before being given secret transmissions on the medicine formulas. Many ways of administering formulas were handed down orally from master to student and are not found in the original text.

As many eastern systems of medicine are brought in translation to the west some of the pure and subtle qualities are in grave danger of being mistranslated, misinterpreted, lost or culturally appropriated. As Tibetan Medicine is so new to the USA, relative to Ayurveda and Chinese Medicine, my husband and myself as Tibetan physicians have the advantage of seeing how this has adversely affected these other medicine systems. We hope, as much as we can, to avoid some of the same pitfalls. Just as you would never ask someone other than a fully trained MD to prescribe your heart, thyroid or neurological medicines, so too are physicians of Tibetan medicine carefully instructed and guided over 4-5 years before ever being allowed to give Tibetan Medicine formulas. I myself took 10 years to be trained, largely in part to needing to learn the language and also because no schools were available when I began to study in earnest and had to live abroad. Even for those who are studying deeply now I still recommend to them and anyone who inquires about internship with me that they spend some time abroad in Asia to truly see how the daily assessment of elements, seasons and bodies functions.

Preservation of herbs is also a very important issue. Resources are becoming more scarce as the popularity of the Sowa Rigpa system is increased. This is due in large part to the exile of the Tibetan people, now spread across the world and with them Tibetan Medicine has moved out into the western world. That is why I grow some of the herbs and over the years have learned to integrate the Tibetan medicine principles of understanding potency and power of effects of western herbs into the Tibetan framework. If it is a locally grown and easily accessible herb, that is better not only for the patient, but the global carbon footprints and endangered herbs in the Himalayas.

Can you have Tibetan Medicine treatment without the formulas? YES! Within the 4 methods of treatment diet and behavior are the cornerstone. If these are not followed the medicine is not effective or greatly minimized. If you have ever met me or come to see me you know this is where I stress importance in your treatment. Food is medicine and these same principles I have discussed about taste, power of effect and the elemental influence is seen in food. Food truly is medicine, just think back to the list of spices I detailed at the beginning. Your kitchen spice cabinet should be your first resource of medicine.

While the potential side effects of Tibetan Medicine are very minimal, even with some of the stronger medicines compared to western pharmaceuticals, this is due in part to the skill of the doctor.  There is no comparison when working with a trained Tibetan doctor who is aware of how to read the internal and external signs of the body in relation to the medicine. This deep understanding of how the medicines are applied and create desired effects versus the untrained or minimally trained person who reads minor descriptions and thinks for example, ‘this is good for sleep or digestion and so forth’ lack the extensive understanding of the precise and subtle composition and balance of each formula and how they effect individual body types and disorders. Without this meticulous attention to detail it can absolutely create secondary illness, problems and negative effects. This is an example of where eastern medicine is in grave danger of being watered down, lost in translation, or simply abused. I provide this caution because that is what lead to making a bad name for a very useful system. A very basic example of this is the herb widely known as Ephedra, used in both Chinese Medicine and Tibetan Medicine and even used among Native Americans. A great herb which got a bad reputation and was banned for sport just because a western supplement group put this herb in a combination or formula it would never in a million years ever be combined with in the traditional systems for which it is used.

Both my husband and I feel very strongly about this issue because it is our job as Tibetan doctors to follow our vows to never harm and to serve and protect Tibetan Medicine. We do encourage people to get training and understand how diet and behavior are the best medicines. Once understood by  both patient and less than fully qualified practitioner of healing modalities, the basic practice and theory of correct diet can be applied and bring benefit. I love teaching practitioners of various systems the basics of diet, the elements, three humors and 6 tastes because I know it will do nothing but benefit. I teach seminars and workshops throughout the country to give the basic principles of Tibetan Medicine which are needed to apply the basics of diet and behavior towards healing. Not to be ignored, the kitchen cabinet herbs are the most simple and profound medicines that can help just about everyone. For the formulas however, please seek out qualified care.