Interview with Dr. Sonam Wangdu Changbhar
Tibetan Herbal Clinic
A detailed version of this interview was prepared by Dr. Peter Fenton, a writer and educator with special interest in traditional forms of medicine and instruction, based in Sandpoint, Idaho, USA. In April 1998, he stayed at ITTM, Kalimpong, for pursuing his research for a forthcoming book on Tibetan medicine. We are thankful to Dr. Wangdu Changbhar for having replied to the questions extensively. Excerpts are published below.
Making Tibetan Medicine is a process which requires many steps. Blessing the medicine is one of them. Can you outline for us how a blessing of the medicine is conducted?
The preparation of Tibetan medicine requires many steps, like detoxification and purification of most of the ingredients. The Tibetan physicians do not treat the body as a machine but with a holistic approach, i.e. physically, mentally and spiritually. Therefore, the blessing of medicine is considered to be important. The blessing of the medicine is conducted by performing the rituals and by reciting the mantras of the eight manifestations of the Medicine Buddha, who have vowed to ease the sufferings of the sick. This supports the purification of the medicine spiritually through receiving blessings from the Medicine Buddha.
Can you explain the role of a mantra in blessing medicines or in healing?
According to the Buddhist religion, there are millions of Bodhisattvas as there are countless dust particles. They have taken a vow, each of them in different capacities and for different purposes. When we recite a mantra we are evoking a particular Bodhisattva. For instance, for longevity, Buddha Amitayus is called upon, for wisdom and knowledge, Manjushri, for alleviation of sufferings, the Medicine Buddha. In this way, both blessing and healing are accomplished.
Many people today realise the benefits of Tibetan Medicine. But it will take many generations to train Non-Tibetans in the practice and even then it may not be possible to transmit the required knowledge.
What is your opinion ?
It is true that the transmission of the required knowledge would not be possible even after generations. To be efficient in Tibetan medicine one has to first learn the Tibetan language thoroughly in order to obtain the precise medical terminology. Unfortunately, the translated medical terminology is insufficient, even today. For instance, Tibetan medicine is based on the three body humours, namely rlung (lit. air), mkhris pa (lit. bile) and bad kan (lit. phlegm). But these English equivalents are inadequate and do not correspond precisely to the Tibetan medical terms.
Can you discuss the relationship between mind and illness?
Mind and illness are interrelated. The three body humours (as mentioned earlier) are the essential components which regulate all the normal functions of the body and maintain a delicate balance, that we consider as "health". According to the tri-humoural theory, the cause of most diseases lies in the mind, for the body follows the mind. The three poisons of human mental and emotional activity - desire, anger and ignorance - disturb this delicate balance. The consequences are: Desire / attachment leads to an increase in rlung (air humour); anger/hatred leads to an increase in mkhris pa (bile humour); ignorance/ closed mindedness leads to an increase in bad kan (phlegm humour).
It is said in the Tibetan medical texts that the source of all disease is ignorance. What does this mean?
It is very true that the source of all disease and suffering is ignorance. More clearly, ignorance is the misapprehension of a phenomena as being truly existent. We are actually unaware of the Truth and the deep meaning of emptiness. Therefore, we are born in the six realms of cyclic existence. Even if we are to die tomorrow, we will still be planning so many things for our lives. Unless and until enlightened, our mind will be continuously influenced by the three poisons of human activity. This is due to our ignorance. That ignorance causes our suffering.
In recent times, certain Tibetan doctors have been recruited to go on tours. This means that they travel from city to city, from place to place, staying only a day or perhaps a week in each place before moving on. In each place, they see a great number of patients. But usually, there isn't enough time for follow up visits. This means the doctor will not be around in the future to care for his new patients. What do you think of this practice?
It is said that something is better than nothing. Keeping this saying in mind, those who cannot avail this opportunity of continuous medical care can have at least a chance to benefit from Tibetan medicine. But certainly it is very important to follow up the cases because the patient's improvement depends to a great extent on the doctor.
Moreover, Tibetan medical treatment is a slow process and must be continued for quite sometime, especially in case of chronic diseases. But often, the visiting doctor is unable to continue his practice at one place for many months, because of limitations, such as visas.
Therefore, it would be a lot easier if the WHO and the international community would recognise Tibetan medicine officially as an alternative medical system. Establishing permanent centres of Tibetan medicine in different cities would help to make available this unique natural system of treatment, to ease the suffering of people.
I, went to a Tibetan doctor in the west. He was very thorough and we got along well. However, after the diagnosis, the doctor prescribed some pills. Then, I got the bill. The secretary charged more than 3000 rupees for just a several week supply of herbal pills. I have heard of other cases where even more is charged. Many people had hoped that Tibetan medicine would become a viable alternative to the extremely costly allopathic medicine. But at prices such as these, this medicine too will be out of reach of the poor people. Can you comment?
Well, if you ask this question to the doctor himself he might give you the right answer. I think it is expensive, as compared to India. But I understand the huge expenditures a doctor has to bear: the costs of travel, carrying his stock of medicines from East to West, the expensive living, etc.
Another important aspect is the high cost of the ingredients of Tibetan medicine and the difficulty in procuring them, like musk, gall stone of elephants, bear's bile, etc. A few things are available in India and neighbouring countries, but they are very expensive. Saffron, nowadays, costs Rs. 50,000 per kilogram (approx. US$ 1250 per kg).
Medicinal plants which grow beyond 15,000 feet above sea level are very rare. They require special attention because the flowering time of these herbs is sometimes only a day or a week.
Hence, the doctor has to arrive during the right season, at the right place and right time to get the particular herb. Metals, minerals, precious and semi-precious substances, like gold, silver, diamond, sapphire, turquoise, pearl, coral, etc., are also used in some Tibetan precious pills. The poisonous part of the minerals and stones have to be eliminated by the process of precipitation and are finally burnt to ashes. For the detoxification and precipitation of mercury, which is used in certain medicines, at the least ten persons are required. Moreover, the working process will take about six months. The manufacturing of genuine Tibetan medicine is time-consuming and an expensive affair.
The question of genuineness is of prime importance. Quality control and standardisation in terms of ingredients as well as the finished product pills and price control are very important for maintaining a good service for the patients. There should also be some kind of control over practitioners. In Dharamsala, for example, the Department of Health, Central Tibetan Administration, registers genuinely qualified Tibetan doctors.
A Tibetan doctor is to treat the patients kindly and compassionately. Every qualified doctor takes an oath to serve the people in their sufferings. The doctor can charge fees, depending on the capacity of the patient. The treatment should be totally free for those who cannot afford it. In the 8th century, the Tibetan King Trisong Deutsen made it a rule to pay the doctor in gold and silver for his services, since he regarded the doctors as life-savers. Drinking and indecent behaviour were strictly prohibited for the physicians. These are two of the thirteen rules and regulations imposed by King Trisong Deutsen.
Today, many people are learning to make their own medicine, or at least they are trying to make it. There are a number of reasons for this, but the most important is that they want to try to help themselves. Can you comment ?
I think it is not advisable to prepare the medicine without thorough knowledge. This requires a rigorous training in terms of identification of the ingredients, their potential, taste, nature, quality, effects, processes like detoxification, precipitation, elimination etc.
Even though the potency and the nature of two or more ingredients may match, their effect may still be different, because the nature of the plants are also influenced by the five elements (earth, water, fire, air and space) during their period of growth. If the composition does not match, the result can be adverse and fatal. Therefore the principles of plant growth according to the elements and their effects on the quality also has to be studied.
The Tibetan medical system remained secret for well over thousand years. The physicians in Tibet kept their knowledge closely guarded. The effect of its secret existence was that the genuine, specialised and practical methods remained intact. Medicine in Tibet was a hereditary profession. The secret of medicine making was handed over from a father to son or sometimes from a teacher to a single disciple; after all, medicine is a matter of precious life and death.
Hence, before undertaking any preparations to manufacture medicine, the secret of this unique system of treatment must be known from the grass-root level. Then only it can contribute towards the betterment of mankind.
Can you offer some suggestions to the readers about taking care of their own health?
It is important to know that Tibetan medical treatment is based on three grounds: diet, appropriate behaviour and medication. In other words, diet and behavioural habits are associated with our daily lives. When there is an imbalance in these two, it may result in a disease and subsequently we would have to turn to medicines for cure. A humoural imbalance can initially be corrected without medication by consuming a balanced diet, regular exercise and appropriate behaviour, which forms the basis of good health. This would also prevent diseases.
The best health care would therefore be regular exercises, appropriate food and behavioural habits, neither excess nor deficient, in order to maintain the balance of the three humours, which are responsible for a healthy blood circulation and maintenance of the body organs and channels.
What do you feel will happen to the Medicine Buddha tradition in the future?
W. CHANGBHAR: I am optimistic about the future of the Medicine Buddha tradition. I think, in time, this unique system of treatment will be known world-wide. It will receive global recognition and acceptance. With the blessings of the Medicine Buddha less human suffering would prevail.
SONAM WANGDU CHANGBHAR
now a private practitioner in Calcutta, graduated from the Tibetan Medical and Astro Institute in Dharamsala and holds the Menrampa Degree (M.D.). He has served at TMAI branch clinic at Bylakuppe, Mysore, as a chief physician till 1988. A Gold Medallist in Tibetan Medicine, he has taught and practised in Europe and Asia. A Fellow of the International Council of Ayurveda, he is a Honorary advisor to the Indian Board of Alternative Medicines. In 1997 he was awarded D.Sc. (Honoris Causa) by the Open International University for Complementary Medicines, Colombo.
Dr. Sonam Wangdu Changbhar
Tibetan Herbal Medicine
400, Jodhpur Park,
Calcutta - 7000 68, India
Phone: 0091 - 33 - 473 6496
Fax: 0091 - 33 - 473 6797