Friday, January 27, 2017

Channels = Veins, Nerves & What, Sinews?

I was planning a blog about chakras, but something else came up. I was reading Janet Gyatso’s translation and discussion on the typology of bodily channels that is findable in the Explanatory Tantra* when a remarkable parallel dawned on me, slowly. I have no intention to detract the least bit from Janet’s accomplishment. Quite the contrary, it is my fondest desire to send you off to read it so you will see for yourself how amazing it is. However, she uses that particular quote from the E.T. as a springboard to go into intricately nuanced studies of the historic discussions linking medical channels with those known from canonical Buddhist tantras. This problem occupies much of the heart of her book, while I spring off in a different direction.
(*One of the famous Four [Medical] Tantras, the Rgyud-bzhi. Although they do have the word tantra in the title, they do not form a part of the canonical Buddhist tantras. Confusing? Bear with us.)
Right now my finger joints are torturing me (perhaps tendonitis?) and I hope to avoid spilling a lot of my very limited keyboard energy. Instead I’d like to stop right there with the 3rd category of veins, called connective channels, since I noticed something very interesting, strongly suggesting what many will find a surprising connection with Byzantine or Graeco-Arabic medicine of the Hippocratic school. The four major categories are 1. formative channels, 2. evolving channels, 3. connective channels, and 4. lifespan channels. 

Now for no. 3, the connective channels, I quote the passage from the Explanatory Tantra, ch. 4, according to the official Mentsikhang translation (truncated just because at this late hour I think you and I will prefer something shorter):  
“The interconnecting channels are of two: white (nerves) and black (blood vessels) channels. The blood vessels having its main trunk branch upward to form twenty-four major blood vessels. These channels are responsible for the formation and development of blood components and muscle tissues. These twenty-four channels consist of eight major deep blood vessels, which are connected to the vital and vessel organs, and sixteen superficial blood vessels that are connected externally with the head and limbs... 
“The brain, being the base of the nervous system, is like vast ocean of channels from which the spinal cord descends like a descending root. There are nineteen peripheral nerves which are responsible for all physical mobility. Out of these, thirteen concealed nerves are connected with the internal organs like suspended silk cords, whereas six visible nerves which further branch into sixteen minor nerves are connected with the outer limbs.”
To unpack a bit, here there is a concern to distinguish structures visible on the surface, as many veins are, from those that are buried in deep tissue, and normally invisible. But note right away that in place of “sixteen minor nerves” we will probably prefer to read sixteen minor water channels (chu-rtsa phran-bu bcu-drug), although I suppose we could then argue that in this medical context, chu ought mean not just water, but bodily fluids in general. I suppose...

But wait one minute. Yonten Gyatso, in his review of Barry Clark’s translation of this passage criticizes him for translating chu-rtsa as tendons or as ligaments. The reviewer finds no reason that ligaments should appear in the context of channels, and there is indeed something puzzling about this. However, I would point out, there is a word chu-ba that means ligamentand the sixteen minor chu-rtsa are really and truly explained as connective tissues for bones* in the medical dictionaries available to me.  They even enumerate them, siting them in wrists, elbows and other joints.
(*Whether these sinews be tendons or ligaments, such are liable to be confounded in any language. In my understanding rgyus-pa should mean the tendon that connects muscles to bone, while chu-ba means the ligament that joins bone to bone. I have several hefty Tibetan-Tibetan medical dictionaries, but I’m too lazy to list their titles here. In her book, at pp. 229 and 447, Gyatso puts forward the correct spelling for the word for tendon as not chu-ba, but chus-pa, throwing us ever so slightly off track. No, the correct spelling is not chus-pa, and Yes, the chu in chu-rtsa is not the chu meaning water, but the chu that is short for chu-ba, so there is really no good reason to go on using the translation water channel.)
It would seem — I claim no expertise for myself — that in the Hippocratic Corpus there are three main classes of channels: phlebes meaning mainly the blood vessels, neura, the ligaments & nerves, and poroi for the irregular on-and-off valve-like openings for draining excess fluids. On these, see Craik’s article, especially p. 107.  

Taking down my Liddell & Scott, I find that the word neura in Greek means “a string or cord of sinew, a bowstring” (in Homer, Hesiod, etc.). The Latin for neura is nervus.

I think you will remember this the next time someone says you are high-strung or about to snap. We’re all a little neurotic sometimes, although I hope you’re not thinking I am as much as I fear you are.

But seriously, in both Greek and Tibetan medicine, it looks as if we are meant to understand that [1] sinews — those most connective of connective tissues, [2] nerves, and likewise [3] blood vessels, are all about connecting things. Has this never occurred to you? 

Or, to cut this short since I’m low on energy and you have demonstrated enough patience by now, I’ll just conclude with a summation: A long-influential strain of early Greek-style medicine had in common with the official bible of traditional Tibetan medicine a tendency to classify the sinews and the nerves together, or what might be saying the same thing, they had some trouble distinguishing them. This general point, while I believe it will hold true, does require finessing, should you feel so inclined to go into it with the necessary detail and rigor. Feel free and stress-free until next time, my friends.

Notice the "suspended silk cords" or tassels
hanging directly down from the brain
(with no detour via the spinal column)

Good to read just so you’ll know:

E.M. Craik, “Hippocratic Bodily ‘Channels’ and Oriental Parallels,” Medical History, vol. 53 (2009), pp. 105-116.  Try this link.

Frances Garrett & Vincanne Adams, with assistance from Jampa Kelsang, Yumba and Renchen Dhondup, “The Three Channels in Tibetan Medicine, with a Translation of Tsultrim Gyaltsen's A Clear Explanation of the Principal Structure and Location of the Circulatory Channels as Illustrated in the Medical Paintings,” Traditional South Asian Medicine, vol. 8 (2008), pp. 86-114.

Janet Gyatso, Being Human in a Buddhist World: An Intellectual History of Medicine in Early Modern Tibet, Columbia University Press (New York 2015).

I.M. Lonie, “Medical Theory in Heraclides of Pontus,” Mnemosyne, 4th series vol. 18, no. 2 (1965), pp. 126-143. Interesting for its treatment of the poroi, Lonie takes you into a Greek medical world no less fascinating and surprising than the Tibetan.

D. Martin, “An Early Tibetan History of Indian Medicine,” contained in: Mona Schrempf, ed., Soundings in Tibetan Medicine: Anthropological and Historical Perspectives, Brill (Leiden 2007), pp. 307-325. It reveals the existence in Rome of the lost medical history by Che-rje dating to very close to the beginning of the 13th century. Neglected in this study is any notice of the closely contemporary parallel sketch of medical historical pluralism in the Four Tantras itself:  See now Janet Gyatso's book, at p. 150, and see also the Mentsikhang's edition and translation of the Subsequent Tantra, at p. 295 (listed here below ↓ under “Yuthok”). This passage, quite oddly, attributes pulse and urine diagnostics to Tibet’s own indigenous medicine, even when we now can say there are sure indications that the former was largely informed by Chinese medicine — the Four Tantras actually make use of borrowed Chinese technical terms in this context — while the latter, urinalysis, has clearly dependent connections with Graeco-Arabic sources on that subject.

Wendy McDowell, “Medicine’s Unique Ways of Knowing: An Interview with Janet Gyatso,” Harvard Divinity School Bulletin (2016), go to this link.

Plinio Prioreschi, A History of Medicine, Volume Two: Greek Medicine, Horatio Press (Omaha 1996), p. 262:
“The Hippocratic physician knew very little of the nervous system; nerves were confused with tendons and ligaments and the word neuron meant tendon or sinew.”
Yang Ga (Dbyangs-dga'), The Sources for the Writing of the Rgyud bzhi, Tibetan Medical Classic, doctoral dissertation, Harvard University (Cambridge 2010). Here a number of connections are made between Tibetan and Greek medicines in fields of wound treatment, uroscopy, and so on. I should add that he finds many connections with Chinese and Indian medical systems as well. I notice, too,  that on p. 309 he translates chu-rtsa as “tendon-like channel.” For Graeco-medical urinalysis, Yang Ga drops the name of Theophilus (7th-9th century CE sometime), but see also R. Yoeli-Tlalim, who located impressive parallels elsewhere in the literature.

Ronit Yoeli-Tlalim, “On Urine Analysis and Tibetan Medicine's Connections with the West,” contained in:  Sienna Craig, Mingji Cuomu, Frances Garrett & Mona Schrempf, eds., Studies in Medical Pluralism in Tibetan History and Society, International Institute for Tibetan and Buddhist Studies (Halle 2010), pp. 195-211. In this article Ronit discusses Isaac Israeli, aka Isaac Judaeus (ca. 850-950 CE), a Jewish Egyptian-Tunisian medical writer, who composed his works in Arabic. His work was subsequently translated into Hebrew and Latin and became among the best known works on the subject in both the Middle East and Europe. The outline he supplies for his systematic treatment of urinalysis closely matches the outline of the urinalysis section in the Tibetan medical text the So-ma-ra-dza (Tibskrit for Somarâja, “King of Sleep,” an epithet of cannabis).

Yonten Gyatso, review of Barry Clark, The Quintessence Tantras of Tibetan Medicine, Snow Lion (Ithaca 1995), contained in Tibet Journal, vol. 28, no. 3 (Autumn 2003), pp. 97-106, and particularly p. 103, where the passage on the nerves is dealt with. The author is a contemporary figure in the field of Tibetan medicine, well-known for his herbarium project.

Yuthog Yonten Gonpo, The Basic Tantra and the Explanatory Tantra from the Secret Quintessential Instructions on the Eight Branches of the Ambrosia Essence Tantra, translated into English by the Translation Department, Men-Tsee-Khang Publications (Dharamsala 2011), the 2nd edition, in 337 pages; at pp. 62-65 you will find the main discussion of the channels. I find it interesting that this official publication gives the authorship credit without comment or discussion, since this has been a point of contention for much of Tibet’s history (see chap. 3 in Janet Gyatso's book). The cover page doesn’t distinguish the Elder from the Younger Yuthog, but we may learn from the Preface (p. v) that the Elder composed, while the Younger rewrote, the Four Tantras. As of today I believe it is quite sure and well established that the Four Tantras were put together in circa 1200 CE and that there never was an Elder Yuthog. So although it no longer makes sense to call him by this name, the Younger Yuthog (perhaps with aid of his immediate students) is to be regarded as the author/compiler of all of it.

Yuthok Yonten Gonpo, The Subsequent Tantra from the Secret Quintessential Instructions on the Eight Branches of the Ambrosia Essence Tantratr. into English by the Translation Department, Men-Tsee-Khang Publications (Dharamsala 2011).

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If you want to try an experiment, go to this website and use their search-box to find “nerves” or “tendons” and see how they are seemingly identical (or confounded?) in a number of Hippocratic works.

The frontispiece, derived from the famous 17th-century medical illustrations that feature so largely in Janet Gyatso's not only well-written but beautifully produced book, is not actually meant to illustrate the channels themselves, but rather the pulses that indicate particular types of disorders. Don’t be surprised if I tell you that the Tibetan word rtsa means both channel and pulse. (Not every channel pulsates as much as the other, but well, I guess you got my point.)

From the pavement of Santa Catarina, Sinai.
We’re all interconnected, you betcha!
Look into it & you’ll start seeing things.


  1. that is fascinating Dan and certainly worth exploring further! Georgios

  2. Thank you for these thought-provoking observations, Dan. I am reminded of a review that you wrote over thirty years ago (JAOS 106, no. 2, 1986), where you discuss topics not unrelated to these, opining, “I personally tend toward the view that Indian medical knowledge was an important factor in the development of Buddhist tantra” (p. 389). This suggestion has long intrigued me, even if such originary influence can prove to be illusive.
    Some things I would suggest considering: as Yang Ga's excellent work shows, there is little to no relationship between the Explanatory Tantra and the Medicine of the Moon King (sman dpyad zla ba'i rgyal po; you're etymological discussion of Somarāja is fun, but the Tibetan title decisively interprets “soma” as “moon,” right). See Yang Ga pp. 155–188, esp. 179: “It seems that the influence of the Somarāja on the Bshad rgyud is very limited.” The Phyi rgyud, however, in which channel examination (rtsa brtag pa) is explicated, displays a great influence from the Moon King. This is also where that tricky quote about the Tibetan origins of channel examination come (in the mjug don bsdus pa, no less, which may be an even later addition to this already Subsequent Tantra).
    To me this shows a confluence and confounding of ideas in rtsa that may be even more convoluted than we have heretofore suggested. Does the rtsa of the Explanatory Tantra easily connect (pun intended) to the rtsa of the Subsequent Tantra? Can one haptically examine a tendon? Well, probably, but it would take some creative interpretation.
    Anyways, these are just a few ideas. Thank you again for opening up such discussions and I look forward to your future thoughts on the channels, wherever they make take us. Westward, Eastward, or Inward.

  3. Dear Bill,
    Thanks for your comment with so many issues to give answers for. Are those influences illusive, allusive or elusive, or both? I may take your comment as a springboard for an upcoming blog on the national origins of three-fingered pulse analysis - Greek? Chinese? Indian? Tibetan? All four? Just two? I have some ideas about that, if no clear answers, not clear to me I mean. So I thought it would be fun to put some of the materials in favor of the various possible origins into some kind of order, even if it may end up being little more than a show of hands. Anyway, I'd like to think about it some more before making the attempt.
    Also, I'm not married to the idea that So-ma-ra-dza is Cannabis, since it could be understood to be other plants in other contexts. Looking into the materia medica dictionary of Sman-pa Tshul-khrims-skal-bzang, it is So-ma Nag-po that is identified with Cannabis sativa, while there are two different identifications of So-ma-râ-dza: Hibiscus abelmoschus and Psoralea corylifolia. Barry Clark (in his translation, at p. 143), who is quite a stickler for the identification of medicinals, says So-ma-ra-dza is Cannabis medica. What do you think So-ma-ra-dza is? (I purposely spell it the Tibetan way, since I guess we are searching for a Tibetan-world significance for it rather than an Indian.)

  4. You might find interesting cautious statements about Cannabis and So-ma-ra-dza here :


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