Medicine in the Life of Atisha

Pieced fabric icon of Atisha surrounded by jewels,
from a private collection (HAR no. 9305)

Today I thought I would put on display an interesting passage that tells us what Atisha knew about the healing arts, and what impact he had on Tibetan medicine. I was alerted to its existence by a blog entitled “G.yu-thog Rnying-ma 'Khrungs Ma Myong Zer-mkhan-rnams-kyi Lan-du.” That title can be translated ‘In Response to Those Who Say the Elder Yutok Never Knew Birth.’ The title takes aim primarily at Tibetan-born skeptics about the existence of Yutok in the Tibetan imperial period.* Written by a contemporary person not previously known to me by the name of Tshangs-dbang-dge-'dun-bstan-pa, the essay is praiseworthy for making evidence-based arguments in a principled manner. My main point, if I have one today, is to say that one of his two prime pieces of evidence for casting doubt on the non-existence of the Old Tibetan Yuthok turns out not to support his case.

(*Imperial period means the period prior to the mid-9th century, stretching back to an indeterminate point in pre-history.)

Our immediate source is Helmut Eimer’s book entitled Rnam thar rgyas pa, Part 2. Only two brief bits of it are given in the just-mentioned blog as evidence to refute skeptics who have been saying that the Elder Yuthok never existed. Here we supply the complete passage in Wylie style transliteration (created on the basis of Eimer’s) with my translation. The numbers are the ones Eimer uses for his paragraphs:

088

gso ba rig pa la yang jo bo shin tu mkhas pa yin gsung / srog chags kyi gtso bo mi glang rta gsum la brten nas bcos thabs la dpag tu med pa yod de / de yang rgyal ba lhas mdzad pa'i sman yig dang / gang zag mis mdzad pa'i sman yig gnyis las /

It is said that the Jowo (Atisha) was also very learned in healing science. He had unlimited curing methods useful for the chief among living creatures: humans, cattle and horses. To say more on this, there are two types of medical documents: [1] those composed by Victors (Buddhas) and Gods and [2] those authored by human personages.

[Medical texts by Victors and Gods]

rgyal ba lhas mdzad pa'i sman yig la / rigs gsum mgon pos mdzad pa'i gso ba'i bstan bcos mang po dang / 'tsho byed kyis zhus pa zhes bya ba dang / sman dpyad gzhan la phan pa'i mdo dang / 'tsho ba zas kyi mdo dang / bde bar gshegs pas gsungs pa'i sman dpyad ma lus pa yang jo bos mkhyen /

Among the medical texts authored by Victors and Gods the Jowo was knowledgeable in many healing treatises authored by the Lords of the Three Families as well as Questions of Jīvaka, Sūtra on Benefitting Others with Medical Treatments, Sūtra on Healing Diet, and every one of the medical treatments that were taught by the Sugatas.*

(*“The Lords of the Three Families” means Mañjuśrī, Avalokiteśvara and Vajrapāṇi. Jīvaka was the famous physician in the time of the historical Buddha. Sūtra on Healing Diet is one of a set of five medical texts attributed to Nāgārjuna, although not known to be extant. Nāgārjuna being a human author, his work appears misplaced here. The other texts I haven’t successfully identified in any other source.)

[Medical texts by human beings]

gang zag mis mdzad pa la drang srong legs thos kyis mdzad pa'i sman dpyad legs thos la sogs pa dang / slob dpon klu sgrub kyis mdzad pa'i yan lag bzhi pa dang / rta dbyangs kyis mdzad pa'i yan lag brgyad pa la sogs jo bos ma lus par mkhyen pa yin / ((gser 'od dam pa dang dus bzhi nad kyi gnyen po bya ba de la brten nas /))  (Mchan-note: jo bo nyid kyis kyang 'tsho ba'i snying po zhes bya ba mdzad.)

As far as those authored by human personages are concerned, the Jowo was knowledgeable in every text including the Suśrutasaṃhitā (?) and other works composed by Suśruta, the Caturaṅga (Four Limbs) written by Teacher Nāgārjuna, and the Aṣṭāṅga (Eight Limbs) by Aśvaghoṣa [i.e. by Vāgbhaṭa]. ((Relying on the Suvarṇaprabhāsottama and what is known as the Remedies for Illnesses of the Four Seasons...)) (Note: The Jowo himself composed a work called Heart of Healing.)*

(*The Caturaṅga could not be identified any further. One might guess that it has to do with the game of the same name, the one we know about under the name of Chess. Using the name of Aśvaghoṣa we may be sure that Vāgbhaṭa was intended. His work Eight Limbs was extremely influential in Tibet, translated by the Great Translator Rinchen Zangpo. The other texts, including the title attributed to Atisha, could not be identified any further despite my efforts.)

089

jo bo bod du byon nas thugs dgongs la nga'i gso ba rig pa 'di bod du nub 'gro las che sman tsho bod na med pas snyam pa la / rje btsun ma sgrol mas g.yu bya ne tso cig tu sprul nas byon nas /

After the Jowo came to Tibet he thought to himself, ‘My healing art is bound to decline since the healing herbs do not exist here in Tibet.’ As he was thinking this, the Reverend Tārā took the form of a turquoise bird, a parrot, and came to him.

sman rgya'i la sgo 'gags gyur kyang // khyod kyi gso ba don mi rmongs // snang ba sman du shar nas yod kyis zer skad bstan par bgyi'o // gshegs par zhu'o zer bas, de'i phyir byon pas bod kyi ri klung thams cad kyi sman ma lus par bstan pas / jo bo'i zhal nas / rgya'i sman re la bod na dod po re ci nas 'dug ste / slar la bod kyi sman nus pa che tsam 'dug / khyad par du dbul phongs rnams la phan par 'dug gsung /

She said, 

“Herbs, even when the passes to India are blocked,

will not disrupt your healing aims.

The phenomenal world arises as medicine, 

so make use of what is there.”

Inviting her to come with him, he went outside, and she showed him that all the mountains and valleys of Tibet were filled with every kind of herb. The Jowo would say, “For each Indian herb there is in Tibet somewhere a corresponding substitute, and at times the Tibetan herb can even be quite a bit more effective, and this is of particular benefit to the poor.”*

(*It’s interesting to note here that sometimes Tibetan herb manuals ['khrungs-dpe] are attributed to the authorship or inspiration of Tārā, including the one that has the title Sgrol-ma'i Sngo-'bum).

090

jo bo thang sman gyi sbyor ba kha bsos gcig sdeb bya ba / mkhas pa g.yu thog gi brgyud pas shes te nan tar sman dpyad la mkhas pa yin / 

There is one recipe for a herbal decoction of the Jowo called kha-bsos gcig-sdeb [Welfare United in One?] known to the lineage of Master Yutok, so his (Atisha’s) knowledge in herbal treatments is persisting.

khong gi sman yig nas kyang 'di ni jo bo rje nyid la / sgrol mas ne tsor sprul byas nas // bod la phan btags lung yang bstan // dbul phongs nad kyis nyen pa la // kha bsos gcig sdeb bkod pa yin // kho bos gso ba'i don ma rmongs // snang ba sman du shar ba 'di // rgya yi la sgo 'gags gyur kyang // kho bo'i nad gso 'gags mi srid ces bya ba yod gsung /

It also says in his own medical text,

This is what was prophesied to the Jowo himself

by Tārā in the form of a parrot

for the benefit of Tibet.

“As the remedy of illnesses of the poor

is this Welfare United in One composed.

I have not been disrupted in my healing aims

since all phenomena arose as medicines,

so even when the passes to India are blocked

my healing of the sick cannot be impeded.”

091

jo bos bsam yas su sman dpyad yan lag brgyad pa gsung ba'i dus su / brag rgyab kyi dwags po 'bum pa'i phas mnyan pas / nan tar sman dpyad la mkhas par gyur gsung / de ltar gso ba rig pa la yang jo bo shin tu mkhas gsung /  [continues with passage on Atisha's mastery of arts and crafts]

There was a time when the Jowo was teaching the Eight Limbs of Medical Treatment at Samye Monastery and the father of Dwags-po 'Bum-pa of Brag-rgyab heard it from him, so his mastery of medicinal treatments persisted, [he/it is] said. These things show how in healing sciences, also, the Jowo was very learned.*

(*I assume that Eight Limbs of Medical Treatment refers to the work of Vagbhata that was mentioned before in this passage, and not to the Rgyud Bzhi. The not-so-well-known long version of the Rgyud Bzhi's title is Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud. The father of Dwags-po 'Bum-pa of Brag-rgyab could not be identified. Brag-rgyab just means "Back of the Rock," but as a proper place name it is best known as the name of a Kadampa Monastery, in Phan-yul north of the Lhasa area, that was built on top of a huge flat rock. Of course the monastery would not have existed in Atisha's time, but I suppose the place name could be older than the monastery.)

•

Okay then, the task of translation finished — for now such as it is — we may say that it contains no proof at all that Atisha himself knew about any Yutok. What we do know is that the author-compiler of the biography did. And just when did that author-compiler live? Now there is a bit of a problem, although it is mostly thought he lived into the 2nd half of the 12th century, and there is even a chance he or a redactor belonged to a still later century.  In any case, it could well be that he knew about the (so-called) ‘Junior’ Yutok's lineage and intended to refer to it precisely because it preserved a medical teaching of Atisha, thereby demonstrating how influential Atisha was. It does not support the idea that Atisha knew of an imperial period Yutok. Neither did he know of the Four Tantras, I’m quite sure of it since this medical scripture emerged into general knowledge only in the course of the 13th century. But before taking my leave for now, I would just like to emphasize that this kind of conclusion is not in any sense anti-traditional, it in fact follows a critical strain within Tibetan tradition. Or, to put it another way, there have been a number of traditions about the origins of Tibet’s medical scripture, the Four Tantras, and the idea that the one and only Yutok composed it in the late 12th century is one of them. And as far as I can see at this moment it is the correct tradition, the one that proves true.

§   §   §

Literary refs.:

Helmut Eimer, Rnam thar rgyas pa. Materialien zu einer Biographie des Atiśa (Dīpaṃkaraśrījñāna). 1. Teil: Einführung, Inhaltsverzeichnis, Namensglossar, Asiatische Forschungen Band 67, Otto Harrassowitz (Wiesbaden 1979), pp. 179-180.

Helmut Eimer, Rnam thar rgyas pa. Materialien zu einer Biographie des Atiśa (Dīpaṃkaraśrījñāna). 2. Teil: Textmaterialien, Asiatische Forschungen Band 67, Otto Harrassowitz (Wiesbaden 1979), pp. 62-64.

Helmut Eimer, “Hymns and Stanzas Praising Dīpaṃkaraśrījñāna,” contained in: Kameshwar Nath Mishra, ed., Glimpses of the Sanskrit Buddhist Literature (vol. 1), Samyak-vāk series no. IX, Central Institute of Higher Tibetan Studies (Sarnath 1997), pp. 9-32, at p. 16.

Yang Ga (G.yang-dga'), The Sources for the Writing of the Rgyud bzhi, Tibetan Medical Classic, doctoral dissertation, Harvard University (Cambridge 2010), especially p. 92 ff.. This work may be possible to obtain via the internet. Although time and again some prominent Tibetan writers of the past (Kongtrul, the 2nd Pawo Rinpoche, Samten G. Karmay and others) have doubted the existence of the Elder Yutok, it is this author who effectively revived the issue within the Tibetan intellectual community in the 21st century. Yang Ga shows clearly that the Four Tantras were made up of parts of several earlier medical texts available in Tibetan language, including the work of Vāgbhaṭa, as well as incorporating a few 'early drafts' written by Yutok in decades before 1200 CE (Yang Ga believes he died before 1188, although most give his dates as something like 1127-1203).

• D. Martin, “An Early Tibetan History of Tibetan Medicine,” contained in: Mona Schrempf, ed., Soundings in Tibetan Medicine: Anthropological and Historical Perspectives, Brill (Leiden 2007), pp. 307-325, at pp. 317-318:  

“One of these other narratives, set in the eighth century, involves nine boys chosen from among the royal subjects of Khri-srong-lde-btsan for their intelligence, who were made to study medicine.[1]  This has clear analogies in the nine intelligent boys chosen, during the same time, to learn translations, a list called 'The Nine Great Translators.'  It is quite obvious that some of the figures in the list of nine doctors belonged to the eleventh and twelfth centuries, and not to the eighth. Among them is one named Che-rje or Cher-rje Zhig-po, who I suggest is none other than our history writer Che-rje Zhang-ston Zhig-po, transferred, like some of the others very clearly were, back to the imperial period. Christopher Beckwith translates the following words, to the same effect, of the nineteenth-century leader Kong-sprul:

“... although they [the learned scholars] relate how the Nine Learned Tibetan Doctors appeared at the time of the religious kings, it is quite wrong, since they mostly appeared in the time of the later propagation of the [Buddhist] doctrine.”[2]

---

[1] See Taube (1981: 15-16), who bases himself on the Mkhas-pa'i Dga'-ston and on Rechung Rinpoche's book, but see also Sde-srid (1982: 174). 

[2] Beckwith (1979: 306). Centuries before Kong-sprul, Dpa'-bo (1986: 1525) expressed essentially the same idea, that these nine doctors were not in fact contemporary with the Dharma Kings, but emerged gradually in later history. Perhaps needless to tell for most contemporary historians of Tibet, Tibetan history writers of the past were often critical of their sources, and puzzled over how they ought to be read, much as we do in this paper. Their works therefore do not necessarily deserve to be lumped together and dumped into the polemical category 'historiography' any more or less than do the writings of modern Tibetologists.

•

An interesting side point — Much that is in the Atisha biography passage is obscure to us. Not only that, it doesn’t jibe with what we can find in medical histories about his medicine-related activities. The Desi’s medical history, as translated by Gavin Kilty, recipient of this year’s Santaraksita Award for a different book he translated, says this: 

“The master and sole protector Atiśa Dīpaṃkara and Naktso Lotsāwa translated Daryakan Ambrosia Meat Preparations and compiled various medical instruction texts such as Net of Treatments for the Head.” 

For this, see p. 171 of Desi Sangyé Gyatso, Mirror of Beryl, Library of Tibetan Classics, Wisdom (Boston 2010).

A earlier medical history by Zur-mkhar-ba (ca. mid-16th century), in its chapter eight at page 263, has different information. The full reference to the published version is this:

Sman-pa-rnams-kyis Mi Shes-su Mi Rung-ba'i Shes-bya Spyi'i Khog-dbubs (Gang dag byang chub sems dpa'i spyod pa spyod par 'dod pa'i sman pa rnams kyis mi shes su mi rung ba'i phyi nang gzhan gsum gyis rnam bzhag shes bya spyi'i khog dbug pa gtan pa med pa'i mchod sbyin gyi sgo 'phar yangs po), Si-khron Mi-rigs Dpe-skrun-khang (Chengdu 2001).

The passage reads:  mkhris rims dug thabs zhi bar byed pa dang / sha sbyor bdud rtsi dar ya kan gnyis jo bo rje dang nag tsho lo tsā bas bsgyur.  According to this, the Lord Jowo and his translator Nagtso translated two works, one that seems to be on toxicology (or on contagious bile disorders?) and the other qualified as a particular type of medicinal preparation, one that evidently was made using meat, called a dar-ya-kan. It's been known since  1980 that this Tibetan word is derived from theriac, thanks to Christopher I. Beckwith’s brief but important article on the subject, “Tibetan Treacle: A Note on Theriac in Tibet,” Tibet Society Bulletin, vol. 15 (June 1980), pp. 49-51. This may be difficult for you to find, and for this I must apologize. Beckwith points out, among other interesting things, the fact that a recipe for dar-ya-kan belonging to the Brang-ti school of Tibetan medicine, actually includes flesh of a snake, a blue snake to be more exact.

In the western parts of Eurasia, theriac types of preparations, often very complicated to make with their long lists of difficult-to-find ingredients, were usually intended to counteract poisons, could also famously include flesh of poisonous snakes, but were also used against pestilences, including plague. On these points, see Christiane Nockels Fabbri, “Treating Medieval Plague: The Wonderful Virtues of Theriac,” Early Science and Medicine, vol. 12, no. 3 (2007), pp. 247-283. 

Galen composed a whole treatise entirely devoted to theriac, or was it written by some Pseudo-Galen? For the Greek text and translation, try here.

Theriac Jar.  For the source, click here.

Afterword (October 30, 2017):

We all know well from experience that things often well up unexpectedly at the last minute. It most often happens to me when I’m putting up a blog. I was looking back at Chris’s articule (my ad hoc portmanteau for miniscule article) and decided to look up his reference to the dar-ya-kan text included in the medical compendium called Gser bre chen mo. So imagine my surprise when I found it bears nearly the exact title that Zur-mkhar-ba's medical history ascribed to Atisha:  Mkhris rims dug thams cad zhi bar byed pa'i bdud rtsi (on p. 235, line 3), (earlier on line 3) Dar ya kan gyi sbyar thabs and (at p. 240, line 2) Mkhris rims bcos thabs bdud rtsi dar ya kan gyi sbyor ba. I should go into this more, especially with Halloween fast approaching, but I don't have the stomach to list and identify all the ingredients. Anyway, the recipe with all its grossness really isn’t the most exciting thing here. That would be the little lineage at p. 240, which reads:  

'di'i rgyud pa ni 'gron bu zad pa'i gtsug lag khang dang / jo bo thugs rje chen pos / rje btsun 'phags ma sgrol ma [note: 'jig[s] pa brgyad skyobs] la rgyud / de nas jo bo rje [note: thugs rje chen po'i sprul pa] lha cig la gnang / des rims par rgyud te / g.yu thog rgyal 'bum la dngos grub du babs pa la / da lta kho bo brang ti bdag gi lag len bgyis shing ...  

I won’t give a laboriously footnoted translation of this, just to say that the dar-ya-kan recipe with various types of flesh including black snake and blue snake flesh was supposed to be granted to Atisha by Târâ herself, was then passed on from generation to generation until it fell as a siddhi to one named G.yu-thog Rgyal-'bum, and is now being put into practice by myself, Brang-ti.

I haven't identified the Yuthok family member named Rgyal-'bum yet. I imagine Bill McGrath may have more to say about all this since he completed a dissertation earlier this year exactly on the Brang-ti medical tradition. Usually this particular Brang-ti Dpal-ldan-rgyal-mtshan is placed in the 13th century, so we'd seem to be in early days, but McGrath puts him in the 14th, and says the Gser bre was redacted late in the 14th. Anyway, a medical teaching attributed to Atisha fell to a member of the Yuthok lineage after all.

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Oh my, just when I thought I was done and could turn in for the night, I see that just minutes ago a new blog on the Yuthok controversy popped up at Khabdha blog (press here) entitled Rje-yi Bla-sman G.yu-thog-pa ni Dus-rabs Bcu-bdun-pa'i Yar-sngon gyi Yig-cha-rnams-nas Rnyed Thub-pa zhig Yin  — my rough translation, “The Yuthok who Served as Royal Physician can Indeed be Found in Texts Prior to the 17th Century,” its author being one 'Ju Bstan-skyong. I will grant the author the point that the Rgya Bod Yig-tshang of 1434 CE does indeed place the "Nine Physicians" in imperial times. But this is precisely the point that the 2nd Pawo Rinpoche, in his history written between 1545 and 1564, as well as Kongtrul about a century before our times, regarded as a mistaken move based in confusion.* All these nine doctors, every last one of them including Yuthok, lived in the 11th-13th centuries, and not in imperial times. So I’m not sure if any extremely significant historical problem has been solved by moving the date of origins of the idea of the imperial period Yuthok back by one century. To judge from the names of the foreign physicians supplied in the 1434 history, it appears likely that the 17th-century author of the Elder Yuthok’s biography used it as a source or inspiration. So the blog makes a real contribution that may help puzzle out the bigger picture that would show how the Elder Yuthok of imperial times was brought into existence in the 16th and 15th centuries. Now please excuse me, I need to give my feverish thinking a rest.

(*Besides these important intellectual and spiritual figures of the Tibetan past, the blog by Tshangs-dbang-dge-'dun-bstan-pa mentions as doubters of the imperial period Yuthok’s existence the Fifth Dalai Lama, his regent Sangs-rgyas-rgya-mtsho, as well as a Karma Kagyü writer 'Be-lo Tshe-dbang-kun-khyab [b. 1718]. Actually, 'Be-lo's passage rejecting of the existence of an Elder Yuthok is quoted in another Khabdha blog that I had until now overlooked:   

Thub-bstan-phun-tshogs, G.yu-thog Rnying-ma'i Skor-gyi Dris-lan 'Khrul-'joms Dgu-sbyor, to try to translate, “Answers to Questions about the Elder Yutok: A Nine-Ingredient Medicine for Vanquishing Error,” posted at Khabdha blog on October 28, 2017. 

It has a very interesting discussion of the issue, bringing forward sources not previously known to me, and is much recommended. I hadn’t been previously aware that 'Be-lo had ever written a history of medicine, and to the best of my knowledge it has never been published, although it should be.)

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Additional source on Atisha's medicine (November 28, 2017):  Even if not terribly significant, I suppose, given how recent the source is, I just noticed this in the 2011 edition of Brag-dkar Rta-so’s 1817 medical history, at p. 314:

Click to expand, if needed.

This just says that Atisha and his translator Nag-tsho translated a text called “Meat Recipe Elixir Dar-ya-kan,” and composed a number of scattered [medical] instructions.  The source is this one:

Brag-dkar Rta-so Sprul-sku Mi-pham-chos-kyi-dbang-phyug (1775-1837), Dpal-ldan Gso-ba Rig-pa'i Khog-'bugs Bsdus-don Nyung-ngu'i Ngag-gi Gtam-du Bya-ba Drang-srong Kun-tu Dgyes-pa'i Rol-mo, contained in: Kun-mkhyen Brag-dkar-ba Chos-kyi-dbang-phyug-gi Gsung-'bum, Khenpo Shedup Tenzin (Kathmandu 2011), in 13 volumes, at vol. 12, pp. 233-380.