FourTantras

ThebasictextofTibetanMedicine

TheFourTantras

ThebasictextofTibetanMedicineiscalledthe"FourTantras"andwastaughtbyBuddhahimself.AllTibetanphysiciansstudyit.Tantrameans"lineage".Itiscomposedoffourbooks:

TheFirstTantraiscalled"RootTantra"anditcontainsverybrieflyanexplanationofalldiseases.Itislikeaseed.TheSecondTantra,composedof31chapters,iscalled"ExplanatoryTantra".Itexplainsallabouttheanatomyandphysiologyofourbodytheprocessofbirthanddying.TheThirdTantra,composedof92chapters,iscalled"OralTransmissionsTantra"anddealswiththecause,thenature,thetreatmentofdiseasesandtheirclassification.TheFourthTantra,composedof25chapters,iscalled"LastTantra"anditexplainsthe18methodsofdiagnosis,pharmacologyandsupport,orexternaltreatments.

Theentiretextincludes156chapters.

BuddhagavetheteachingsoftheFourTantrasinBenares(Varanasi,India)whenhewas71yearsold.Hegavetheminordertobenefitsentientbeings,nottoallowdoctorstobecomerich.Forthisreason,TibetanMedicinestressestheattitudeaphysicianshouldhave.Inthepast,inIndiaandTibet,doctorswouldnotpresentthepatientwithafee.Patientswouldsimplygiveanofferingandiftheydidnot,thedoctorwouldnotcomplainhismaingoalwasthepractice.ThemotivationsthatbringpeopletostudytheFourTantrasarediverse:tobehealthyandlivealonglifetopracticethespiritualpathtoaccumulaterichnesstobehappy.Thosewhostudythistexttobecomerichhaveawrongmotivationandmisunderstandthemaingoal,thatis,tobenefitothers.

ThetextbeginswithaphraseinSanskrit:Amritahridayaanghaashtaguhyaupadeshatantranama.Amritahridayameans:"theessenceofimmortality".ItindicatesthattheFourTantrasareliketheamrita,thenectarofimmortality.Ifwedrinkamrita,orifwestudyandfollowtheseteachings,webecomeimmortal.InSanskritamritameans:"immortalitynectar"hridayameans:"essence".Anghameans:"branches",ashtameans:"eight"eightbranches.Guyaupadeshameans:"secretoraltransmission",anoralinstructionthatisnottaughtinpublic,instead,itistaughtonlytowhomistrulyinterestedandwishestolearn.Whoeverreceivestheseteachingshastokeepthemsecret.

ThisintroductiontoTibetanMedicinefollowsthemedicalthangka(painting)ofthemedicinetree(seepictureabove).ThefirstmedicalthangkasdatebacktothetimeoftheFifthDalaiLama.DesiSangyeGyatsowasagreatmasterandheconceived80medicalthangkasinordertooffersomeclearandimmediatelyunderstandableoutlinesof

TibetanMedicineaswellastoallowilliteratepeopletostudymedicine.

Themedicinetree

Themedicinetreehastwomainbranches:theleftoneisthebranchofhealththeright,thebranchofdisease.Atthebasisofthegeneraltheory,wecometothethreehumours:wind,bileandphlegm.Thesethreehumoursexistinallofus,whetherwebehealthyorsick.Thecauseoftheirexistencearethethreepoisons:hatred,attachmentandignorance.Thethreementalpoisonsaretherootsofthethreehumoursandthethreehumoursarethefruitofthethreementalpoisons.Inthemedicinetree,blueisthecolourforwind,yellowforbileandgreenforphlegm.Insideourbody,thereare7constituentsand3excretions.Theessenceoffood,whentransformed,producestheseconstituents.Wasteisexpelledthroughthethreeexcretions.Whenthissystemworkswell,weareingoodhealth.Thenumberofchakras,three,five,nineandsoon,variesaccordingtotheTantrathatexplainsthem:eachTantrahasadifferentchakrasystem.IntheTibetanmedicalsystemweconsiderfive5chakras:thechakraofthehead,throat,heart,navelandsecretchakra(atthegenitalorgans).Furthermore,wehave5typesofwind,5typesofbileand5typesofphlegm.Wind,Bile,Phlegm

The5windsare:

1. Thelifesustainingwindthatresidesintheheadchakra,governsthebodilyfunctionsandsustainslife.Itisthewindthatpermitsactionssuchasbreathing,swallowing,sneezingandspitting.

2. Theascendingwindthatresidesinthethroatchakra,whosefunctionistoproducesoundwhenwetalk,givesusapleasantappearance,makesusstrongand

activeandisresponsibleformemory.3. Thepervasivewindthatresidesattheheartchakra,

pervadesthewholebodyandallowsforallmovements.

4. Thefirelikewindthatresidesinthenavelchakra,allowsforthefunctioningoftheinternalorgans(heart,liver,intestines...)itsmainfunctionisthedigestion.Itdistinguishesthenutrientsfromthewastesinthefoodthatweeat.Thefinestpartofthefoodthatweeatistransformedintoblood,bones,musclesansoon(thesevenconstituents).Thiswindallowsfortheprocessoftransformation.

5. Thedescendingwindthatresidesinthesecretchakra,flowsinthebladder,intheintestinesandinthegenitalorgansitsfunctionistoexpelsperm,mensesandurine.

The5bilesare:

1. Thedigestivebile.Ifyoudividethestomachintothreeparts,thisbileresidesintheupper.Itsfunctionistorefineanddigestfoodandtostrengthenstheotherfourbiles.

2. Thecolouringbilethatresidesintheliver,whosefunctionistogivecolourtothepartsofthebody.

3. Theaccomplishingbilethatresidesintheheart,whosefunctionistobringupthoughts,worries,anxiety,angeretc.

4. Thesightbilethatresidesintheeyes,whosefunctionistoallowustosee.Ifitweakens,oursightalsoweakens.Whilethisbileishealthy,wehaveperfectsight.

5. Thepigmentingbilethatresidesintheskin,whosefunctionistocolourtheskin.Whenwehaveabilesicknessourskinchangescolourandbecomesfirstyellowthenblack.

The5phlegmsare:

1. Thesustainingphlegmthatresidesinthechest,sustainsallotherfourphlegmsitsfunctionistomoveallbodyfluids.

2. Thedecomposingphlegmthatresidesinthatpartofthestomachwherethefoodisnotyetdigested,whosefunctionistogrindallkindsoffoods.

3. Thetastingphlegmthatresidesinthetongue,helpstobeawareoftastes.

4. Thesatisfyingphlegmthatproducesthesatisfactionfeelingresultingfromwhateverisgoodinlife.

5. Theconnectivephlegmthatresidesinthejoints,allowsustomovethem.Whenitdoesnotfunctionwellweexperiencepainandjointproblems.

Tobeingoodhealthallthesehumourshavetobebalanced.Whenahumourbecomesweakortoostrongitcreatesunbalanceandtherefore,disease.

Constituentsandexcretions

Whenweeat,ourbodytransformsthefooduntilitformsthe7constituentsifweeatrichfoodthetransformationisfaster.Thefoodessencebecomesbloodfromthebloodderivesflesh,fromthefleshfat,fromthefatbones,fromthebonesmarrowandfromthemarrowspermandovum.The3mainexcretionsare:sweat,urineandfeces.Wehave15humours,7constituentsand3excretions:inall,25components.Ifthese25componentsworkwell,wearehealthyotherwise,webecomesick.Inthemedicinetreearedepictedthreeanimals:therooster,thesnakeandthepig.Thesethreeanimalssymbolicallyrepresentthethreementalpoisons:theroostersymbolisesattachment,thesnakehatredandthepigignorance.Thethreementalpoisonsarethecauseofthediseasesofthethreehumoursandofthethreehumoursthemselves.Attachmentproduceswindhatredproducesbileandignoranceproducesphlegm.Attachmentproduceswind:youwillnoticeitwhenyou

havelongsessionsofsexualactivity,withoutpausethenextdayyouwillfeelconfused,fullofairandwithaheadache.Thisisjustanexampleinfact,attachmentproducesmanytypesofwind.Hatredproducesbile:youcanclearlyseeitwhenyougetveryangry.Yourbodytemperatureincreasesandyourfacebecomesred.Doctorsadvisetodrinkwatertocalmdown.Ignoranceproducesphlegm.Whenphlegmincreaseswebecomefat,lazy,slothful.Wefeellikedoingnothing,wedon'tevenfeellikeeating.

Imbalanceandillness

Nowwearegoingtoexplaintherightsideofthemedicinetree,thepartonimbalanceandillness.Thethreementalpoisonsarethecausethatgeneratesthethreehumours,buttheyarealsotheprimarycauseofalltheillnesses.Therefore,ifwewanttohealourselvesdeeply,wehavetotreatourmentalpoisonstoo.Thisatthesubtlelevel.Atthegrosslevel,thesicknessesarecausedbymanyfactors,forexampletheclimate.Iftheclimateisunusual,iftheseasonsarenotbalanced,itiseasiertobecomesick.Forexample,coldweatherinsummerortoohotasummerortoocoldawinter.Otherfactorsofdiseasearediet,behaviourandsoon.Furthermoretherearemanymalignantspiritsthatcausehealthproblems.ManyWesternersdonotbelieveinspiritsbutinTibetanMedicinewetalkaboutthem.Wefallsickduetowrongdietforexample,whentheclimateishotthebilehumourincreases:ifweeatalotofmeatanddrinkalotofwine(warmingfoods)thebilehumourincreasesevenmoreandwebecomeeasilysick.Wefallillduetowrongbehaviour:forexample,ifwewearheavyclothesinsummerorifwestaynakedinwinter,whenitisverycold.

Localisationofthethreehumours

Phlegmdiseasesaffecttheupperpartofthebody.Bilediseases,liverandkidneys.Winddiseases,backandlowerpartofthebody.Thephlegmhumour,whichisofthenatureofignorance,residesinthebrain.Thisisthereasonwhyphlegmdiseasesaffecttheupperpartofthebody.WhenTibetansbecomeangrytheybeattheirchest,becauseangerresidesintheheartchakra.Angerisofthenatureofhatred:whenwelosetemperourtemperatureincreasesand,sinceheatisofbilenature,bileincreases.Attachmentproduceswindwindresidesinthesecretchakraandisproducedfromvariousattachments,likeattachmenttosexandsoon.Thethreehumoursmoveinspecificplaces.Eachonehitsitsownterritory:forexample,biledoesnotaffectthefeet.

Wind

Ifwehaveastrongwinddisease,thefirsttroubleweexperimentispaininthebones.Thismeansthebonesareawayofthewind.Asforthesenseorgans,thewindrunsthroughtheears:therefore,withstrongwindproblemsearswillring.Sometimesthetroubleissostrongthathearingishindered.Thewindalsogoesthroughtheskin:withstrongwindproblemstheskinflakesoff.Thefivevitalorgansare:heart,liver,kidneys,lungs,spleen.Thewindrunsthroughtheheartwithstrongwindproblemstheheartsuffersforexamplewecanhavestrongpalpitationsandsoon.Thewindrunsalsointhecentral"vital"channelofthebody.Theholloworgansare:wherethespermforms,bladder,gallbladder,intestines(both),colon,stomach.Thewindhumourrunsthroughtheholloworgans:withaseriouswinddiseasewefeelinflatedatthelevelofthenavel.Sothewindentersthebones,thentheears,theskin,theheartandtheholloworgans.

Bile

Bileenterstheblood,thereforewhenwehavebileproblemstheveinsbecomethickerbecausethebloodcirculatesveryquicklyanditgetsverywarm.Bileproblemsmakeussweatverymuchwhenwesweatalotitmeansthebilehumourisunbalanced.Amongthesenseorgansbileresidesintheeyes:ahighbilemakestheeyesyellow.Vitalorgans:liver.Holloworgans:intestines,gallbladder.Duetobileimbalancetheeyesbecomeyellowandtheliverswells.

Phlegm

Phlegmcirculatesinmeat,bones,fat,sperm.Normallyanimbalanceofthethreehumoursisdetectedinthefaecesandtheurineseriousphlegmproblemsarewelldiagnosedfromtheurine.Whenphlegmbecomesunbalanced,wehavecatarrhfromthenoseandthetonguebecomethickandswollen.Phlegmisfoundinthelungs,spleen,stomach,kidneys,bladderandfeet.Thethreehumoursdonotonlydividebodyzonesbutalsothevarioustypesofenvironmentsandlifeages.

Divisionaccordingtoage

TibetanMedicineexplainsthatfrom0to16yearsoldwearechildrenfrom16to70,youngandafter70,old.Oldageisthetimeoflifewhenwindhumourprevails.Duetothisreason,winddiseaseshappensespeciallyduringthisage.Childrenoryoungpeoplerarelysufferfromwinddisorders.Winddiseasescaughtatanoldagearedifficulttoheal.Youth:thisistheageinwhichbileprevails.Thereforebileproblemsaremoredifficulttocureandeasiertoget.Childhoodisthephlegmageoflife:atthisagephlegm

problemsarethemostdifficulttocure.

Divisionaccordingtogeographicareasandseasons

Thefirstdrawing(inthemedicinetree)representsamountainwithsnowandwind:thatmeansaverycoldandwindyplace.Thisplacehasthenatureofwind,wherewecatchwinddiseases.Theseconddrawingrepresentsahotdesert,likeRajasthaninIndia.Hotplacesfavourbiledisorders.Thethirdplaceisgreen,wetandrainy:aplaceveryconducivetophlegmdiseases.Thisistruebothforwarmandwetandcoldandwetenvironments.Whatmattersisthepresenceofmuchdampness.

Seasons

TheFourTantrasalsoexplainhowtheseasonsinfluencethehumours.Insummerwindproblemsmanifest:peoplefeelweak,especiallyinthemorningandintheevening.Bilemanifestsinautumn:itgetsworseduringthedayandintheevening.Phlegmmanifestsinspring,wheneverythingsprouts:manypeoplesufferfromheartburns,asignofaphlegmworsening.Especiallyintheeveningandatdawn.Itisveryimportant,fordiagnosisandcure,totakeintoconsiderationallthesefactors:age,geographicareaandseason.

Incurablediseasescausingdeath

Ourlifedependsonthreeconditions:vitalenergy,fortuneandkarma.Ifvitalenergy,fortuneandkarmaarenotdepletedwekeeponliving.Otherwisethereisnothingwecando,wehavetodie.Ifoneoftheseconditionscomestoanendevenpositive

things,likeappropriatetreatments,cancausedeath.Forexample,forapatientwithfeveritisnormallygoodtodrinkwater.But,ifoneofthethreelifesupportingcausesismissing,evenwatercanchangeintoapoisonandkillthepatient.Thefavourablecausebecomesunfavourableandprovokesdeath.Thepictureoftheburninghouserepresentsapoisonedpatientthatnobodycanhelp:forhimeventreatmentsbecomepoison.Anotherpictureshowsabrokencentralchannel,orshushuma.Thistooisacauseofcertaindeath:thecentralchannelcannotberepaired.Evenafevertoohighisacauseofcertaindeath.Andwindproblems,whentheybecomeveryserious.Whenweareveryweaknomedicinecanhelpourbodyisnotabletoassumemedicinesandthereforewedie.Thenwehave"changeable"incurablediseases.Forexample,thediseaseappearsasabileproblemandsoitreceivesabiletreatmentbut,duringthecureorshortlyafter,itmanifestsasawindorphlegmdiseaseandsoon.Thesearethechangeablediseases.

Diseasescausedbyspirits

Diseasesprovokedbyspiritscanmanifestindifferentwaysbuttheyhaveonethingincommon:theyarenotcurablebymedicine.WeneedtogoandseeaLamawhowillmakeamo(divination),orsomethinglikethat,todiscovertheoriginoftheproblem.Afterthathewillprescribesomeritual.Onlyaftertheritualhasbeenperformedandthespiritsexorcisedthepatientcanstarttakingmedicines.Infact,themedicinebecomeusefulonlyafterthespirithasleft.Itmayalsohappenthatasickpeoplereceivesavisitorfromfarawayandwhenthevisitordepartshegetsworse.Thismeansthatthevisitorwasfollowedbyspiritsthatdamagedthepatient.Whenweareborn5differentspiritsarebornwithus

whichwillaccompanyusthroughoutourlife.Wehavealsoathingcalledla,ourvitalenergy.Intheworldexistsomespirits,theDon,thatcanstealthelafromaveryweakperson.Fromthenonthediseasegetsworseandifthelaisnotrecovered,thepatientwilldie.Thereexistsomespecialpujas(ceremonies)torecoverthela.

Karmicdiseases

Karmicdiseasesareduetonegativeactionscommittedinourpastlives.Theyarenotcurablebymedicine.Likewiththediseasescausedbyspirits,theonlychanceistogotoaLamaandasktherightpurificationpractice,forexamplethe"100000prostrations".InTibetmanytimespeoplethatwereconsideredincurableafterthesepracticewerehealed.Unfortunately,itisnotalwayspossibletoescapetheconsequencesofaparticularlyheavykarma.Sometime,nocureexists.

Types

Aswehaveseen,inTibetanMedicinetherearethreehumours.Whenweareborn,forkarmicreasons,hereditarinessandsoon,wecanhaveaconstitutionmoreconnectedtoonehumourthantotheothers.Veryrarelywehavepuretypesorthebalancedcombinationofthethreehumours.Morefrequentlywehavethecombinationoftwohumours(oneofthetwostronger).Sowecanhavewindbiletypesorbilephlegmtypesandsoon.

Howtorecognisethetypes:

Lungtype:lean,bent,withabluish,dryskindryhairverytalkative.Itcannotbearthecold(heisalwayslookingforwarmplaces).Heisagreatwalkerbutgetseasilytired.Heisveryreactive.

Biletype:alwaysthirstyandhungrybutnotnecessarilyfat.Hairisblondeandtheskinyellowish.Veryintelligent.Heisalsoveryproudandarrogantandbecomeseasilyangry.Phlegmtype:basicallyfat,withwhitecomplexion.Hisskiniscold.Heisalwaysstickingouthischest.Hehaslittleappetite.Heisverypatientandslow.

Thephlegmtypepersonisveryluckythebiletypecomessecondandthewindtypeisthelessluckyofthethree.Alsofromthepointofviewoflifespan,thephlegmtypehasthelongestlifethebiletypecomessecondandthewindtypelast.Thisisthenatureofthethreehumours.

Howtorecognisethetypeinachild

WithsmallchildrenphlegmnatureprevailsbutagoodTibetandoctorcanstillrecognisetheirtype.

Howtoprolonglife

Thereisamethodtoprolonglife:bysavingthelifeofmanybeingsindanger.Forexample,bybuyingandtheletfreeanimalsthataregoingtobekilled.InIndiapeoplegotofishermen,buyfishesandletthemfree.Savingthelifeoflivingbeingsisthebestmethodtoprolonglife.ThisbehaviourisfollowedbothbyBuddhistsandbyHindus.AlsotheNagpoGutuppill,whichismadeof9substancesandcontainsmanyblessings,fromthepointofviewofTibetanMedicinehasthepotencyofprolonglifeandmakesusmorehappy.

(lastrevision:August2001)