Man, Medicine, and Society .

A talk given in 1983 at the two-week First International Conference on Tibetan Medicine held in Venice and Arcidosso organized by Professor Namkhai Norbu.

You may have noticed that on the poster for our conference there is a figure that may look like either a man or a woman. It depicts Yuthog Yönten Gönpo the Elder, one of the most famous and important Tibetan doctors of the past, who we think lived towards the end of the seventh century CE. Tibetans consider this doctor a Master. I have personally met many masters, spiritual masters, that is. For instance, I spent five or six years in a college where we studied mainly Buddhist philosophy, but the master of our college was a great doctor under whom I studied for the first time the famous Four Tantrasof Tibetan medicine.

Later on, I was on the border between China and Eastern Tibet, where I met another teacher who was very famous as a spiritual master, and not so much as a doctor, but who was, in truth, also a great doctor. I studied under him the Four Medical Tantras again. Lastly, I met the man who was for me one of the most important spiritual teachers. He was known as a doctor, and he often and mainly introduced himself as such. As a matter of fact, a teacher will manifest in different roles. At times, we can meet a teacher who will present himself as a doctor, or as a monk, or as the head of a monastery. Alternatively, we can meet doctors who are also yogis, practitioners; or doctors who will introduce themselves as normal people and live a normal lay life. The last teacher I mentioned was mostly this type of lay person, he was not a monk, but in truth he was one of the most important spiritual teachers of his time. This means that those who practice medicine must possess true knowledge.

Generally, we see human beings and medicine as subject and object, but we always need to understand the principle well. In Tibetan, the true meaning of men, medicine, is “benefit;” medicine, therefore, is something that benefits the individual. But in order to truly bring benefit, we must first of all understand the existence of individuals. Someone may have a physical problem, for example, a headache. But this headache may have a deeper cause: beyond the physical level there is always the individual’s mind. A doctor must understand this fact in order to be able to heal through medicine. When we speak of medicine usually we mainly mean material things, especially in the Western world, where technology is very developed. For example, if someone asks their doctor for medication to get rid of a headache, the doctor may offer a more complete explanation, saying that perhaps a massage may help, or they may suggest a certain kind of diet to overcome the problem. But today many people are not satisfied with these remedies and will say that they do not have time to do those things, and they beg the doctor to prescribe an effective medication to quickly get rid of the pain. This is the current situation.

Eventually the doctor ends up satisfying the patient, enabling that attitude. Society depends on economy and circulation of money. If I, as doctor, prepare a medication that cures the deep root of the illness, but that does not have an immediate result, people most likely will not be interested in it; on the other hand, a medicine that makes pain immediately go away will be very successful. Everyone works a bit in this direction, so our knowledge decreases. Going back to the earlier example, if we get a headache, there must be a very precise reason: it could be bad digestion, a liver problem, a sinus infection; it could also be nerves – there could be multiple factors. Thus, we need to know how to work concretely with the existence of the individual and to understand if the problem depends on energy, mind, or simply is at the physical level.

Perhaps many people are getting tired of hearing every day Tibetan doctors speak about the cause of an illness, that is, of the three humors, lung, tripa, and peken, or, going more in depth, of the three passions, but this is a very precise and concrete principle. Even in the West people say, “Do not get angry, or you will ruin your liver!” It is the same principle. Passion is mostly connected to mind. The endless workings of mind slowly disturb energy, which in turn triggers disease at the physical level.

By medicine, we do not even mean that the doctor will make a kind of miracle to heal the patient: rather, the doctor has a certain knowledge of the condition of the individual, but complete remission can only happen through the collaboration of the patient. The individuals themselves must be interested in gaining certain knowledge: this is what we call awareness.

For instance, healing a disease is not just about taking a medication: one of the most important medicines is diet, what we usually eat and drink. Medicinal substances have a certain power, and generally we use those as well. But in the Western world there is a specific way to see things. For example, if you ask advice about diet in general, on what is good and what is harmful, perhaps a doctor specialized in macrobiotics will tell you that eating tomatoes is not good. But for Italians not eating tomatoes is a problem, because Italy produces tons of them! That is not exactly the principle: there is no food that is always beneficial, and another that is always harmful. For this reason, yesterday and over the past few days, the doctors have spoken about many different substances, of their worth, of the energy they possess, and so on. And they have also spoken of the way in which they use decoctions. Many know a medicinal plant, and they use it to make a decoction. Thinking that perhaps it is good for the liver, they harvest it and make a tea out of it. But this is not how medicine works. At times a specific decoction can be used for a specific problem, but there is no individual whose only organ is the liver, there are other organs, other functions. Something that we think is good for the liver; if taken excessively, will damage the heart. This principle is the fundamental basis of the diet.

Therefore, the explanation Doctor Jigme gave yesterday was very important. When we speak of pharmacology, we must consider the taste, energy, and quality of a substance. To truly know which substance will benefit us, first of all we must know ourselves, our condition: only then will we be able to assess what we need most. I believe that most of you have a book I wrote, Birth, Life, and DeathIn the last pages you will find a short analysis that can serve as an example, a list of foods used on a daily basis: I am not saying that eating a specific food is beneficial; rather, next to each item you will find three kinds of numbers that refer back to earlier tables. Each number gives a precise idea of the characteristic functions of the substance. Before this list, there is also a table that explains how we accumulate lung,tripa, and peken. If we read closely what causes their imbalance, we understand that in our diet all the substances that help to decrease them are positive for the individual. But it is not only a question of diet in general, another very important factor is conduct, behavior. For example, in the West it is very common that when people are tired because of their job, they will go and rest immediately after a very large meal. This is considered a normal thing. Nowadays also Tibetans in India have taken up this habit because in a warm climate, with a full stomach, one gets sleepy easily. Why does one get sleepy? It is a manifestation of tripa. The characteristic of sleep belongs to peken.To sleep in the afternoon disturbs tripa, bile. In Tibet, we never let a sick person sleep in the afternoon. In the case of certain diseases, to sleep in the afternoon immediately causes fever. There is an illness, called nyenka, in which the influence of negative forces that disturb an individual plays a role.  One of the worst disturbances of this kind is caused by sleeping in the afternoon. One can think: “I always sleep in the afternoon, and nothing has ever happened to me.” It is not for sure that the disease will manifest immediately, but once it does, it is there, and it is not positive.

Medicine in general helps us to live well, in an aware manner. For instance, people who have a lungtendency that is particularly strong do not usually sleep well at night. But if they start walking up and down, like many do, when they cannot sleep, after a while they will exchange night with day, and this is not going to help them. On the contrary, this will develop the lungeven more. So, we have a whole series of structures and behavioral habits that can either help an illness develop or calm it down. There are many diseases, especially pekendisturbances, that necessitate open air, luminous places, like the mountainside; with other diseases, instead, it is best to stay indoors, in the dark. This means that we cannot have fixed rules for the behavior either. The best thing is for the individuals to become a little bit aware about their own existence, which includes body, speech, and mind. This is very important: any teaching you will meet will always be based on these three considerations, just like any cure for illness must be based on this knowledge.

The physical body is connected to the entirety of our material dimension. We always apply this concrete knowledge, but we then have mind. Mind is not a material object that we can see and touch; thoughts, however, arise constantly, and we tend to follow them and to fall into reasoning. If you observe well and try to understand where thoughts come from, you will find nothing. Still, they keep arising without ceasing. In Buddhist philosophy, we say: “There is, but there isn’t.” Some say that this is just dialectics, but it is not like that. It is a real and concrete experience. When we say that there is not, it means that we cannot find anything that we can establish as object. And yet, even if we find nothing, we cannot say that there is nothing either, because many strange ideas keep arising. It is very simple: mind is like this.

For example, if we have a thought of hatred, and we follow it and develop it, rage and anger grow, and from these emotions actions ensue. If we observe well, all confusion comes from mind, not from the body. But what connection exists between body and the so-called mind? The connection, in our terminology, is called energy that in yoga we call prana, vital energy, and is connected to breathing. For this reason, in yoga it is said to train in breathing, which is considered one of the most important means to coordinate energy. In Chinese medicine prana is called qi; the Japanese, in Aikido, call it ki. In any case, the true meaning is that breathing is always connected to energy.

Any teaching, no matter what, is always introduced with three principles: to apply it, we first of all explain the position for the body, then the specific way of breathing, and finally the condition for the mind. Why do we always speak about these three principles, that is, body, speech, and mind? Because this is the condition of the individual. Even in medicine we must be extremely aware of these three aspects. If we do not have this knowledge, medicine becomes like an object through which we try and do something. With medicine, we do not mean the situation in which a doctor, in their study, examines a patient, prescribes some medication, and then the patient leaves: this is relative. The most important thing is to make the individual responsible. Doctors must have this understanding because they will always have to face sick people; if they do not have it, the patient will simply ask for medications to eliminate pain.

Western doctors, in meeting Tibetan medicine, ask first of all how to learn it. This is a rather difficult enterprise because, given that this medicine is written in Tibetan language, we must first of all to have a certain understanding of that language which, unfortunately, is not as widespread as English or other languages. Not only that, but there is no organization to teach it to foreigners. So, there are obvious obstacles in this sense. It is not easy to understand Tibetan medicine, but at the same time I am not saying it is impossible.

It is necessary first of all to understand what we mean by “Tibetan medicine” and its principles. We must, in other words, acquire an understanding of the existence of individuals. When we speak of a way to heal a disease or to conduct analyses, it means that we are entering a very specific field. Specific things can be learned slowly, they are not indispensable to Western doctors because Western medicine is for sure already quite developed. I am convinced that the great benefit Western doctors can take from Tibetan medicine is its way to conceive of human beings and of medicine itself. This does not entail changing or giving up on Western medicine and embracing another. Many people immediately put limitations saying “ours” and “yours.” Others tend to build the stereotype of Tibetan medicine as spiritual, different from other medical traditions, and in so doing, they create problems between the Western tradition and the Tibetan one.

I personally do not see a conflict; rather, I believe that the fundamental point is to understand that we are all human beings and that we exist. Our being Western or Eastern people does not change a thing: a nervous Tibetan is no different from a nervous Westerner. What we need to understand is why a person is nervous, and what is the best way to overcome this nervousness. This is not so much related to nationality. Humans utilize their culture because that is the knowledge they possess. For instance, Western culture is very different from the Tibetan one. And we are not talking about the West in general: specifically, Italian culture, for example, is different from the English one. Accordingly, the knowledge of individuals depends on where they were born, how they were educated, how they grew up, and everyone finds it easier to use their own culture which they have experienced. But in order to utilize one’s own culture, one needs to enter into the principle of knowledge: we each must become a bit aware of its meaning so that we will not find conflicts between cultures; rather, our knowledge will increase.

I will give you an example. Someone suffering from appendicitis, a very painful condition, may think that they do not want to undergo surgery, preferring natural medicine, and they want to use Tibetan medicine as a cure. So, this person will perhaps have to suffer for a long time, whereas it would be much easier for them to go to the hospital and have the appendix removed with one simple surgery. But someone refuses to have the surgery saying that today, in the modern world, everyone acts as if we were machines. In my opinion, this view is not correct, because we have situations in which surgery is necessary. Considering human beings just like machines whose parts can be replaced is not correct either, however. If human beings were only physical bodies, it would be easy to take out parts and put in new ones. But in many situations, we do not know how to connect them to energy, and then we can block many things. We need therefore to acquire a principle of knowledge and apply it as much as possible. If we have a certain understanding and knowledge, both Western and Tibetan medicine can truly be helpful and important. As I always say, medicine must help those who have problems and who want to overcome them. When someone has a problem, their first wish is to overcome it in any way possible: a doctor must keep this in mind quite clearly.

In Venice, I heard some doctors say that Tibetan doctors were explaining rather complex things, and they asked how they could apply them here. It is true, it is not easy to use such things, because Tibetan doctors have been studying for years, and explaining matters in two or three days, or even in one week, can not solve everything. Other interested people asked where they could deepen their knowledge of Tibetan medicine, explaining that they could not study it at their universities, where it is not taught, and that there are no Tibetan doctors who will be constantly on the road to teach courses. It is not easy, this is true. And yet, if we understand the principles, something can develop, one way or another. Thus, it seems to me that the main point is not to enter in a very detailed fashion in specific topics. In this conference, the most important thing for us is to understand the point of view of Tibetan medicine. This is the key to know it, and it may also be a key to increase awareness in our daily life.

By medicine we mean neither a theoretical study conducted on books nor medications. As we have already said, Tibetan medicine comprises three parts: medications, behavior, and diet. Medications relate to two different issues, namely to strengthen the body in such a way that it continues to be healthy and to heal it when a physical disturbance has already occurred. The same holds true for behavior and diet: if we understand this point, we have a way to collaborate with our own selves.

This is why I think that the most important thing is to be aware. Awareness encompasses everything. I will give you an example. Usually we discuss all sorts of problems: a doctor will speak about the specific issues of a patient, or about health matters within a hospital, like the number of beds available, medications, and so on. All our efforts are directed towards the material dimension. This is the case not only with medicine, but with society in general. But the most important thing, in the end, are the individuals who make up society. What does society mean?

Society is formed by individuals. It is like when we speak about numbers. “Numbers” is a generic plural noun, but in a concrete way we must start to count from number one, and then we have two and three, and so on. If we did not have “one,” we could not have “one hundred.” It is therefore very important to understand one, rather than one hundred or one thousand. The number one is actually the awareness of the individual, otherwise all of society’s problems we constantly talk about are false. The qualification of human beings is the capacity to reason and to understand. And if this is the case, society cannot be compared to a flock led by a shepherd. This means that we are the number one, every single one of us: I am part of society, also someone else is part of society, and thus many people together are called “society.” Then I must be first of all aware of my existence, of having a physical body that is related to the entire material dimension. If I eat something that is not good, I will not feel well, and my physical body will be disturbed by it.

Reproduced from Shang Shung Publications’ recent book ‘The First International Conference of Tibetan Medicine’.

[1]Chögyal Namkhai Norbu, Birth, Life, and Death, Shang Shung Publications, 2008.