Saturday, December 16, 2017

Foreign Doctors in Tibet? An Old Zhijé Source Shows Up

“Bla-ma Mkhas-pa Bi-ji-ba” after a manuscript of the Yellow Edged Volume.
Likely meant as an icon of Tsan Bashilaha, or at least a member of his medical lineage.


A few of our regular readers might think we are getting too ensconced in obscure corners of the universe of possible knowables. I’m not sure I can change their minds, although I ought to apologize. Every blog has a strong connection with what’s going on in my own life or in the world, even if it may not be so evident every time. What I can do is say right away what this blog is going to be about so you can decide if you want to go further into it or not. I am aware doing this is in clear violation of the rule to give evidence first before coming to conclusions. Anyway, this is where we’re going with or without you:  

There are basically two lists of foreign physicians who had input into Tibetan medicine during the time of the empire:  List A as I call it, comes from the first non-Yuthok-lineage Tibetan medical history, the one by Cherjé dating to 1206 (or 1266). Some time ago I noticed that this list contrasted markedly with another list in the Elder Yuthok biography (seemingly composed in the 17th century) that I will call List B, so I tended toward the conclusion that List A was much older and probably a lot more authentic. I’m made to reassess this position, since a newly emerging old medical history by a Zhijé school follower named Nyedowa, dating to somewhere around 1300, has List B, while a medical history by Drangti that I now estimate to date from around 1375 contains a variant of the same. Looking into this triad of 13th-14th-century histories, we can say that none of them were aware of an Imperial Period Yuthok, and that none of them mention the name of Galen (or Ga-le-nos, confirming something Yoeli-Tlalim said several years ago).* If you find anything interesting in that, read on, but if you don’t, go ahead and stop reading whenever you like.

(*In general I’m now inclined to say that Galenos usurped the place of Tsan Pashilaha as initiator of Greek medicine in Tibet, pushing him up by a century, and this would explain how their biographies are confounded, as if the story is the important thing, not the person it belongs to. I’m beginning to see some sense in this confusing set of signals.  Each one of the three medical texts knows a little bit about the [12th-century] Yuthok by the name G.yu-thog Mgon-po, which is interesting, since they don’t even seem to know the longer name G.yu-thog-pa Yon-tan-mgon-po. In this blog I ignore the small medical histories from the decades surrounding 1200 composed by Yuthok and his disciple Yeshezung, although it is important to us to know that they are there, and they are the earliest Tibetan medical histories in existence to the best of my knowledge.   The chronological order of medicine histories is:  Yuthok > Yeshezung > Cherjé > Nyedowa > Drangti.)

It may seem, too, judging from some of this year’s blogs, that Tibeto-logic has turned in the direction of medical history. I assure you it’s only temporary. True, I’ve had an on-again off-again interest in Tibetan medicine since back in the 70’s. I wouldn’t say I know much yet. I’m not ready to hang up a shingle or perform diagnostic procedures or anything at all that practical. My first and only real teacher in that area of study, a traditional doctor from Mongolia sometimes known as “Louis Lama” after the street he lived on, was mainly famous for attending on Yul Brenner.

But enough with the name dropping already, I just wanted to say that my main motives have been to understand medical texts, not just because they are interesting — and of course they are — but because their vocabulary is often very important to know and recognize in other genres of Tibetan literature. I know it may come as a shock to some, but Tibetan medicine is my main reason for being interested in the subject of medicine at all. It’s practically true that whatever modern cosmopolitan medicine I have studied (beyond basic high-school biology and an early interest in herbal remedies) I’ve studied because I wanted to understand Tibetan medical texts better.


I’ve always been on the lookout for newly appearing old history books, too. And my readers who are as rare as they are dear to me are all well aware of my fascination for Padampa and his Zhijé tradition. So if I stop to count them up, I have a lot of reasons to get inordinately worked up about the book I’ll tell you about soon.


It happens from time to time that a previously unknown Tibetan history blindsides us by slipping into published form before we even knew it could possibly exist. In the present case, it’s something buried in a huge collection of facsimiles of mostly cursive manuscripts, so the chances of it being noticed are still very slim, all the more reason to write about it right away.


I’ll have more to say about the newly revealed medical history written by a lineage holder of the Zhijé School in a minute. But first let’s look at the rather well-known idea that there were foreign doctors who were influential in early days in Tibet, either through their medical writings or by their physical presence. Modern practitioners often present as established fact that there was a major medical conference in imperial times, a subject I won’t go into now although I see reasons to find this certainty amusing in its naiveté. (Please show me one source even close to being contemporary to the event and then we can start talking about it.) It isn’t always easy or even possible to decide whether a given foreign physician actually came to Tibet or just his writings, or just knowledge of his writings, but as time goes on we ought to keep trying to find out who they were and where they stayed if we can.


In a recent blog, I went a little bit into the issue of how the Four Tantras — regarded by nearly everyone as the single-most authoritative medical source for Tibetan practitioners of medicine — was created, largely on the basis of earlier writings, by the one and only Yuthok Yönten Gönpo somewhere near the last decades of the 12th century. Often overlooked in the discussion is a small piece of internal evidence found near the end of the fourth and last Tantra, in its next-to-last chapter. This passage confesses in a surprisingly direct way that a lot of materials from all over the known world went into its making.  Yangga quotes it in his dissertation, at p. 262:
Through their manifestations, the Tathagatas taught, for the welfare of all sentient beings, medical compounds in India, moxibustion and vessel cleansing therapy in China, primarily venesection in the Dolpo area, pulse and urine diagnosis in Tibet, “The Hundred Thousand [Teachings on] Medicine” to the circle of gods, the eight sections of Caraka to the circle of sages, the “Black Treatise of Mahadeva” to the circle of non-Buddhists, and the “Cycle of Teachings on the Lords of the Three Families” to the circle of Buddhists. All of these medical traditions are collected and presented in this treatise. There is not another medical tradition which has not been included in this treatise.860
The official bilingual edition of the same passage (Subsequent Tantra, p. 295), reads like this, including the introductory sentence Yangga left off:
Then again Sage Yidlay Kye made this request, “O Great Sage Rigpa'i Yeshi, are there any medical practices which are not included in this Tantra?” To this request, he replied, “For the sake of all sentient beings, the Medicine Buddha, in his different emanations, taught the compounding of medicines in India, moxibustion and Channel cleansing therapy in China, venesection therapy, mainly in Dholpo and diagnosis through pulse and urine in Tibet. He gave a discourse on the Vase of Medical Practice to the retinue of Gods, the eight sections of Charaka Samhita to the retinue of Sages, the Tantra of Black Shiva to the retinue of Non-Buddhists while giving the ‘Lord of the three families’ to the Buddhist retinue. Everything is explained in a concise form in this Medical Tantra. There is no medical practice that is not included in this Tantra.
By the way, this version of the text with English translation published by the Men-Tsee-Khang in Dharamsala H.P. says on its very title page that it is “by Yuthok Yonten Gonpo,” but without specifying whether it was an elder or younger Yuthok. You have to read quite deeply into the front matter to figure out if there was a preference for one over the other. Anyway, one very interesting thing about this outline of various sources integrated into the Four Tantras is the mention of Dolpo district, now in northern Nepal. It may seem odd that such a small and perhaps to most people not-so significant place would have its contributions placed on the same level as India and China. Still, this fits with what we can know from some of our earliest listings of foreign doctors that we will get to momentarily. Dolpo doctors are credited with the medical technique of venesection (gtar-ga), which just means therapeutic bleeding. Another fancy word for it is phlebotomy. You might imagine this means using leeches, but you would be wrong. Yangga (p. 257) says their use was unknown to Tibetan medicine.*
(*For yet another English translation , see Gavin Kilty’s in Desi’s history, p. 86.)
A few comments on this passage: “Channel cleansing” must be a way of speaking about acupuncture based on how it is supposed to work, by making the Chi flow through the correct channels. Apart from the famous golden needle therapy, acupuncture isn’t much on display in Tibetan medicine, although moxibustion is well known there. The Tibetan word is me-btsa', and it means not only the practice but perhaps primarily the points on the body where the moxa ought to be applied.  And me-btsa' is also used in geomancy for points on the earth that are regarded as crucial (as in earth moxa point, or sa'i me-btsa'). I think me-btsa' literally means fire tending, but it also seems to me it could be one of those Tibetanizing borrowings of a foreign word. I just haven't been able to puzzle this one out. The word moxa in moxabustion is supposed to come from a Japanese word for mugwort since in practice mugwort was often used for tinder. Moxibustion appears to be a compound half Japanese and half Greek. How many of those can you think of?


It is when we reach the Tibetan contribution to Tibetan medicine that hesitations enter in. What I mean is that for us today nothing could be clearer than that Tibetan medicine received its pulse diagnosis, a significant part of it at least, from China (proven among other things by the borrowing of Chinese terminology in the Four Tantras) and its urine diagnosis from Greek, Byzantine or early Islamic sources via the Somaradza.* 
(*We went into this already in January of this year in this blog. Medicine in the Islamic world was largely inspired by and filled with Greek medicine as preserved through the Byzantine Era, primarily of Hippocratic & Galenic varieties, although we ought to mention "prophet medicine" as well [and I know there were indeed some early influences from the translation of Sanskrit medical sources], not to mention regional influences. The world of Islamic medicine in India is simply called 'Greek' or Unani medicine. The name Unani is, just like Sanskrit Yavana, ultimately from the place name Ionia in Greece. The Yu-na and Yo-na forms of the same are also known in early Tibetan geographical sources.)

So, even if we may have some problems with it, we cannot deny that, given our idea that these words were composed by Yutok in the late 12th century, this would be a remarkably early Tibetan source for a listing of the foreign sources integrated into Tibetan medicine.* But unlike the source we will put on display shortly, it doesn’t name any doctors, and the names of the foreign physicians are particularly fascinating to me. I suppose the fascination largely stems from a desire to puzzle out who they were, and I hope my readers are ready and willing to help out in this quest.

(*Of course there are still problems that require investigation that could change our minds. One is that Jangdag (Byang-bdag) the 15th-century initiator of the Jang System, one of the major schools of Tibetan medicine, excludes the last two chapters of the Later Tantra from his commentary on the Later Tantra and gives them one separate commentary of their own, numbering the chapters Chapter One and Chapter Two. Clearly Jangdag did not believe they properly belonged to the main body of the Later Tantra, and I suggest something or another should be made out of this fact.)

Although there are other non-Tibetan-language sources we might mention, there are by now three articles that focus on the lists of foreign physicians: one by F. Garrett and two others by D. Martin. The suggestions Martin made about possible identities of the foreign physicians have been found to be both plausible and ludicrous — in the views of different reviewers, naturally. I’m sure plausible was what he was aiming for. Of course speculation is usually regarded as a bad thing among seasoned academics, but there are times when clutching at straws is the best we can do given the nature of the evidence available. Nevertheless, formulating alternative hypotheses that may conceivably find support or fall flat is quite valid, and sometimes it's hard to know the difference between speculation and hypothesis forming, if there in fact is one. In this case, the foreign Byzantine (Phrom ~ From ~ Rome, i.e. Byzantium) physician’s name is parsed as Tsan Pashilaha, ignoring the phantom Sanskritism shi-la that tends to grab and pull people's attention in the wrong direction. But why, I wonder! If he is a foreign doctor from somewhere other than Indic culture, a piece of Sanskrit is probably the last thing we ought to expect. The Tsan is plausibly explained as a clan name, perhaps the Tzan clan of the Trebizond region, while the Pashilaha is imagined to conceal the common Byzantine name shared among commoners, doctors and kings (as also a title for kings in general) Basil[eos].


For the time being my main goal is not to argue for one or another identity so much as to add an important early testimony, a previously unknown medical history by a Zhijé scholar and lineage holder named Nyedowa (སྙེ་མདོ་བ་ཀུན་དགའ་དོན་གྲུབ།  1268-1328).  His grandfather Tsondrü Sengge was the youngest of the Rog brothers. All three Rog brothers were disciples of the main holder of the Later Transmission lineage named Tenné.  Tsondrü Sengge, who became the first chair of Nyedo in 1207, had three sons. The eldest son, Sönam Pel, was installed at Nyedo in 1229.  Our author Nyedowa (as we’ll go on to call him) was the youngest of the three sons of Sönam Pel, becoming head of Nyedo in around 1316 following the death of his predecessor and oldest brother Nyedo Kunga Zangpo. These generations of the heads of Nyedo were as a group in interesting connections with the Drikung and Karma Kagyü schools as well as Kâlacakra lineages, so we may assume that their line of Zhijé transmission was absorbed into one of them as their lineage appears to disappear in the 7th generation following Padampa. Other Later Transmission lineages would continue right up until the time of Tsongkhapa and beyond. We know that both the first and second Dalai Lamas had close family connections with Zhijé followers.


The same Nyedowa that concerns us today was already known as an author of two different writings that can be categorized as histories.  The first is the appendix he added to the 1277 version of the history of the Later Transmission of Zhijé that was composed by his older brother, in order to bring it up to date. This is available. The other is his history of the Kālacakra Tantra's transmission entitled Clusters of Precious Substances: The Emergence of the Glorious Kālacakra, that is known by title but still as far as I know unavailable.

The medical history has a simple title that may be simply translated, The Origins of Medical Science together with its History. Based on its content we should add that this history is very much about Tibet’s medical history and not so interested as some others are in Indian medicine. I would have never known that this history existed and I would’ve never had the idea to procure a copy of it without the help of William McGrath. It has been published in the form of a facsimile of a cursive manuscript, so it isn’t particularly easy for many Tibetanists to read. For this reason I will type out the relevant part in Wylie transcription and relay what it says there in a rather hasty translation attempt. Sometimes in spots where the present manuscript is too obscure I had to rely on close parallels found in the medical history by Zur-mkhar-ba, who clearly copied large parts from Nyedowa.


First the passage on medicine during the early 7th-century reign of Songtsen Gampo:
de nas gdung rabs lnga na / spyan ras gzigs kyi sprul srong btsan sgam pos dam pa chos kyi srol stod [gtod] pa ltar / gso rig gi'ang [.7] srol btod / rgyal po sku snyung pa de dus bod nang sman pa med pas / rje blon rnams kyis bka' bgros nas / 'thon mi sam bho †a / glang khams pa go cha na gnyis la rje'i phyags (?) gser gyi pa tra 'dzub gang pa [.8] bdun dang / gser phye bre do skur nas phyog nas sman pa rgya gar nas dharma râ dza dang / phrom nas phrom rgyal mu rje the phrom yi sras rgyal po btsan pa shi la ha dang / gsum gdan drang nas byon pa ra sa [2r] 'phrul snang du bzhugs su bcug /

Then, five generations after Lha Totori, the emanation of Avalokiteshvara by the name of Songtsen Gampo opened the way of the Holy Dharma. As he was doing so he also opened the way for medical science. In those days when the king got sick there were no physicians inside Tibet, so the lords and ministers held a meeting and sent off Thonmi Sambhota and Lang Khampa Gocha with seven royal golden certificates filled with their thumbprints and a couple of ounces of gold powder. From the foreign lands they invited three physicians. From India, Dharmarâja; from Byzantium, the Byzantine king Mu-rje The-phrom's son King Btsan Pa-shi-la-ha, and thirdly and lastly xxxx. When they arrived they were given places to stay in Rasa Trulnang Temple.*
(*There is an obvious omission of one doctor here, very likely the name of the Chinese doctor.  Rasa Trulnang Temple means the one today best known as the Jokhang.  One database lists 168 persons with name Basil in the centuries it covers (641-867), making it one of the most common names. I was thinking The-phrom could be Theophron, a possible Greek personal name, but Theophron couldn’t be found there.)  
rje'i sku la gso ba'i dpyad dang sman mdzad pas snyun dngos (dang gso?) / de nas rgyal pos gser phye bre lnga gzhal ba dang / phyi rabs (phyin nas?) bzang po la za 'og gi stan dang  / seng ldeng gi sga dang / gser g.yu'i srab kyis [.2] brgyan pa phul te / bzhugs par zhus pas rgya gar nag gi sman pa ni bzhugs par ma gnang mod kyi 'on kyang sman dpyad kyi srol gtod pa ni / dharma râ dzas rlung mkhris bad kan gsum du phye nas de'i gnyen po sman gyis 'bu shag che chung logs pa [~la sogs pa] sgyur ro //  [.3]
Then [they] performed therapeutic procedures on the emperor's body and prepared medicines, so that the illness was cured. Then the king weighed out five ounces of gold and went to them. As a boon, he presented them with silk cushions, saddles of acacia wood, harnesses adorned with gold and turquoise. When he requesting them to stay on, the Indian and Chinese physicians declined the invitation, so the medical treatments they passed on were as follows: Dharmarâja translated works including the longer and shorter versions of the 'Bu-shag* after separating wind, bile and phlegm humours, making medicines as their remedies.
(*The 'Bu-shag text Kongtrul, p. 414, attributes to the time of Songtsen Gampo.)
ha shang ma hâ kyin dhas spyi gtsug nas rkang thil pa na chad kyi dgos bcos kyi dpyad thor bu ba mang du sgyur nas gshegs so //
The Hoshang Mahakyindha translated several miscellaneous treatments for needed repairs of illnesses and breakages from the soles of the feet to the top of the head.
btsan pa shi la has / ja log gi dpyad gsum dang / rma bya ne tsho de po gsum gyis gsungs pa'i sku gsum gyi skor log pa [~la sogs pa] sgyur zhing [.4] bla'i sman par bzhugs shing khab bzhes / de la sras gsum byung pa ni che shos gtsang du btang pa la / la stod byang gi bi ji'i rgyud pa snyes (snyems?) byung ngo //
Tsan Pashilaha translated works including the cycles of the three bodies that speak of the three: peacock, parrot and rooster, and the three counterintuitive (ja-log, =gya-log) treatments. Then he stayed on as the High Physician (bla'i sman-pa) and took a wife. They had three sons, the eldest of whom was sent to Tsang Province, where he was forebearer of the lineage of Biji in Latö Jang.
'bring po g.yor por stang ste g.yor po sa gtsub pas mgo la mkhas dgos gsungs nas / na ga [.5] ra dza'i mda' bcos / na ran dza na'i gzer bdus / mda' bcos le'u bzhi pa / rtsa ba rin po 'phrul gyi bzhi skor skor / 'grel dmyal khrag 'jag che chung gnyis / mgo dpyad la bzhi / bu dgu / lha ba'i mgo 'dren che chung / za hor [.6] rgyal po'i lag gnon / rtsa bcos pa'i man ngag bsdus pa / srog gi 'khor lo che chung gnyis / mda' bcos klad pa bcos pa dang bcas pa bskur ro [~bsgyur ro] // de las lho stong kha'i sman pa rnams byung go //
The middle son was sent to Yorpo. The ground of Yorpo was rough,* so they said they needed a wise man for their head. Then he translated [a long list of texts, with texts on arrow wounds and head injuries prominent among them]. From him emerged the physicians of southern Tongkha.
(*Note: Based on parallels I think this ought to be saying, "Since Yorpo was a rough land [the Emperor] said they needed someone skilled in treating head injuries." I imagine this is about the roughness of the local people and not the landscape.)
chung shos dbu rur [.7] bzhag ste dbu ru mi ngan pas 'khrug pa mod (yod?) pas yan lag dang byang khog nang ste / de po'i (?) sku bstod smad kyis gsang brtsal ba / ne tsho'i sku stod kyi lus la kha mar gdags pa / rma bya'i sku [2v] stod smad kyis chings dang chas kyi rin 'od gsal ba la / gnas lugs gzhi la mkhas pas rgol ba tshar gcod pa / bla ma rgyud pa'i gdams pa / theg pa so so la mkhas pa dris pa [2.] nges shes bskyed pa / shri rab can gyi gdams pa / gdams ngag gi gal mig (bdal yig?) la mkhas pas rmongs pa'i 'khrul bzhi sel ba / lag len dmar khrid kyi gdams pa drug pa phrom gyi dbye ba drug pa [.3] ces bya ba bte (btod?) / de logs pa [~la sogs pa] byang khog dang yan lag gi dmigs / rtsa dang / tshigs dang / rus pa dang / gsun dang rgyus pa dang / rnag dang chu ser gyi gnad bcos thabs mang po dang / byang khog la stod rin po che gser gyi sgrum bu / smad rin po che lcag [.4] kyi sgrum bu / log non rin po che bang mdzod kyi sgrum bu / ro khra phying (khrad bying?) khrel 'phrul gyi me long la 'grel pa brgyad / gnad kyi yi ge gsum / mi 'gyur ba'i btag pa gnyis / ma lnga bu lnga'i gdams pa'i // de lhas par bzhugs pa'i rgyud pa la sog po [.5] sman pa zhes grags so // dus ding sang ni rabs chad nas med do // sman rgyud 'dzin pa 'di gnya' dang mtha' bzhi logs pa'o [~la sogs pa'o] //
The youngest son stayed in the Central Horn where bad men were feuding so the Emperor said they needed a specialist in injuries of the limbs and torso ... [That only made sense in the parallel text, not here... I won’t translate the rest of this bit yet. It is mostly titles of the works he translated, primarily on wound-associated topics] ...  Those who remained in Lhepa formed a lineage that became known as Sogpo Doctors. Nowadays this ancestral lineage has come to an end and no longer exists.  But the holders of the medical lineage include today’s Gnya' and Mtha'-bzhi among others.*
(*Zur-mkhar-ba in his medical history thinks it a contradiction to say these other medical lineages from the imperial period are continuing this one, but I just read our text as saying that in so far as the medical teachings of the Biji lineage still survived at the time of writing, they survived within these two other schools. The Biji lineage proper was already history, yet some of its practices continued.)

Now the Nyedowa history moves on to the time of Trisongdetsen, basically covering the 2nd half of the 8th century.  Although this is the part that is of most interest, it is also longer and more involved. We won’t translate it here, but focus on the list of foreign physicians who visited Tibet during his time. Tibetan-language readers who don’t despise Wylie will be able to read it all in the link I’ll supply later on. All I would like to do for the remainder of this blog is to lay out the early evidence for two distinct lists of foreign physicians, both going back at least as far as the 13th century. Indic names are wherever possible turned into fine Sanskrit names with diacritic marks and everything. As part of my dream that some historian of Eurasian medicine will recognize some of the non-Indic names, I’ve supplied them also in phonetic versions. Please, if something strikes you as a possibility, share your idea in the comment section so we can seriously contemplate it together.



§  §  §

Two Different Lists of Foreign Doctors

Source for List A —

This is the list of foreign physicians as found in the 1204 (or possibly 1264) history by Cherjé, based on the Tucci manuscript kept in Rome. The heading that describes them appears as: mkhas-ldan mnga' rig[s]-gi lugs (School of the ‘Scholarly Powerful Families’ [?], but they are later referred to as lnga rig-pa'i mkhas-pa, ‘Scholars of the Five Sciences’), which is so much more likely to be correct. Chinese and Tibetan medicines each is given a separate category of its own, which explains why they are lacking in this particular context.  Here I put up, next to Cherjé’s, the comparable list of ten different national [non-Tibetan] medical systems in Drangti’s history (unlike Cherjé’s it includes Chinese medicine in its list). For the Drangti list, originally courtesy of Kurtis Schaeffer, I’ve compared the partial manuscript with the 2005 publication, pp. 70-71, and noted the differences. Neither the Cherjé nor the Brangti supplies any specific time frame for the authors it mentions here, but Brangti later on gives a version of List B as well (placing its doctors in the time of Trisongdetsen):


Cherjé’s history:
Drangti’s history (perhaps ca. 1375): Ten different national [non-Tibetan] medical systems:
[1a] Slob-dpon Dpa'-bo [Ācārya Śūra, here meaning Vāgbhaṭa] composed four texts (titles listed).
[1] Slob-dpon Dpa'-bo [Ācārya Śūra, here meaning Vāgbhaṭa] composed Yan-lag Brgyad-pa'i Snying-po Bsdus-pa etc.  Western Kashmir (Kha-che Nub-phyogs) System.
[1b] Brtan-pa'i-blo-gros [Sthiramati] composed Dri-ma Med-pa'i [xxx], etc. Kashmiri (Kha-che) System.
[2] Brtan-pa-blo-gros [Sthiramati] composed Dri-med Gzi-brjid etc. Eastern Kashmir (Kha-che Shar-phyogs) System.
 [2] Dzi-na-mi-tra [Jinamitra] composed Gso-ba Stong-dgu-bcu-rtsa-gcig [‘A Thousand Ninety-One Healing Methods’], etc. Orgyan (U-rgyan) System.
[3] Dzi-na-mi-tra [Jinamitra] composed Gso[-ba] Stong-dgu-brgya-rtsa-bzhi-pa etc.  Urgyan (Dbu-rgyan) System.

 [3] Pra-a-nan-ta [Śrī Ānanda in Sde-srid’s history] composed Gnas-'gyur Gsum [Three Transformations in the Situation], etc. Magadha (Dbus-'gyur-'chang) System.
[4] Tra-a-nan-ta [?] composed Gnas-'gyur Gsum[-pa] etc. Nepal Valley (Bal-po) System.  [Note: the 2005 publication, p. 71, has Shrî A-nan-ta.]
 [4] Su-ma-ti-kirti [Sumatikīrti] composed Bsdus-sbyor Gsum [Three Abbreviated Preparations], etc. Newar (Bal-po) System.

 [5]  Ur-pa-ya [?] composed Chos-'byung Drug [Six Origins of Things], etc. Arabo-Persian (Stag-gzig) System.
[5] Ur-ba-ya [?] composed Chos-'byung Drug etc.  Arabo-Persian (Stag-gzig) System. [fol. 26b] (Note: The 2005 reads Ud-pa-la.)
 [6] Rdo-rje-'bar-ba composed Mi-'jigs-pa'i Mtshon-cha Che Chung [Greater and Lesser Weapons of Fearlessness], etc. Dolpo (Dol-po) System.
[6] Rdo-rje-'bar-ba composed Mi-'jigs Mtshon-cha etc.  Dolpo (Dol-bu/Dol-po) System.
 [7] Legs-pa'i-rgyan composed Ga-gon-gyi rdol-thabs Su[m]-bcu-rtsa-lnga [Thirty five Methods for Spontaneous Emergence of Ga-gon], etc.  Uighur (Hor) System.
[7] Legs-pa'i-rgyan-gyi-blo-gros composed Ga-gon-gyi Dol-thabs etc.  Uighur (Hor) System.

Here the 2005 adds two national systems with anonymous authors:  [a] Rgyud Gsum-gyi Mdo-byang Che Chung etc.  Turk (Dru-gu) System  [b] 'Dus-pa Rin-po-che'i Srog-'khor etc.  Sogdian (Sog-po) System.
[8] Brtson-'grus-snying-po composed Sum-khugs, etc.  Tangut/Xixia (Me-nyag) System.
Only the 2005 edition has this:  Brtson-'grus-snying-po composed Gsum-khungs etc.  Tangut (Mi-nyag) System.
[9] Rgyal-ba'i-rdo-rje [Jinavajra or [Vi]jayavajra??] composed Yan[ lag] bdun pa [Seven Limbs], etc.  Khotanese (Li) System.
[8] Rgyal-ba-rdo-rje composed Yan-lag Bdun-pa etc.  Khotanese (Li) System.
[10] Btsan Pa-shing-la-ha [Tsan Pa-shi-la-ha] composed the Tshad pa'i 'gros 'ded (‘Drawing the Course of the Fever’), etc.  Phrom ('Brom, sic) System.
[9] Tsam Pa-shi-la-ha composed Tshad-pa 'Bros 'Ded etc.  Byzantine (Khrom) System. The 2005 has Tsan Pa-shi-la-ha, and [oddly] spells Khrom as Khroms.


[10] Ha-shang Ma-ha-ya-na [Hoshang Mahoyen] composed [six text titles given in the text] etc.  Chinese [Rgya-nag) System. 

For a later source, yet one with some superior readings, see Gavin Kilty's translation of Desi's history, p. 169.


Sources for List B —

[B.1] Snye-mdo-ba's ca. 1300 medical history, fol. 3r. These physicians were invited in reign of Trisongdetsen (Khri-srong-lde-brtsan): 

[1] [From India] a tsarya Shanting-garba.
[2] From Kashmir (Kha-phye) Gu-ya-badzra.
[3-5] From China (Rgya-nag) Stong-gsum-gang-ba, Bha-la-ha-shang, & Ha-ti-sa-ha.
[6] From Tazik (Stag-gzig) Sog-po Ha-la-shan-tir.  Note: There are signs a bit of text was dropped here, and the name of the Tazik (Arabo-Persian) physician is the very thing that must be missing here.
[7] From the Turks (Gru-gu) Se-mdo-'od-chen.
[8] The Dolpo physician (Dol-po'i sman-pa [illeg. syllable]) Dharma-shi-la.

On 4r, Nyedowa lists them again, each with a list of their translations that would be presented to the Emperor. Except the first, only their nationalities are supplied in this context, not their proper names: 

[1] slob dpon Shanting-garba.  The [Indian] Teacher Śāntigarbha.  slob dpon shanting garbas bas shâkya thub pa mngos kyis sya [~gsungs] pa'i bse sgrom dmar po dang / sangs rgyas sman lhas sya [~gsungs] pa'i shlau ka sde bzhi dang / bdud rtsi [.4] lhung zer [~zed] che chung dang / bdud rtsi dum snying dang / spyan ras gzigs gyis gsungs pa'i spungs pa sde lnga dang  / rdo rje 'chang gis mdzad pa'i tsa ra ka'i grel pa dang / slob dpon klu sgrub kyis mdzad pa'i rtsa mdo' la sogs pa rnams la 'gyur byas so //
[2] Rgya-nag-gi sman-pa.  The physician[s] of China.  rgya nag gi sman pas / 'jam dpal gyi [.5] gsungs pa'i sbyor ba dang / byang khog don khrems / yan lag gi mda' las byung pa / rin po che'i mdzod lnga la sogs pa dang me chu go zlog dang / thor bu'i dpyad dang / chu dpyad / 'khrugs dpyad / me rtsa'i lag len sgran me dang / dug dpyad me lce 'khor lo [.6] logs [~la sogs] pa rnams sgyur ro //
[3] Kha-phye'i sman-pa.  The Kashmir physician.  kha phye'i sman pas / sman gyi dpyad mdo dgu pa dang / spyad kyi phreng sel bar byed pa mun pa'i sgrol me dang / man ngag gnad kyi phra thig dang / rdo rje 'chang zla dga'i gzhu chung [~gzhung chung] mdor bsdus pa rnams sgyur ro //
[4] Sog-po'i sman-pa.  The Sogdian physician.  sog po'i sman pas [.7] mgo mu rnyegs skor brgyad rtsa 'grel dang / rtsa bcos pa'i man ngag ljon shing che chung gnyis / 'dus bcos thobs rin chen srog gi 'khor lo / sog po sha thag bcan gyi rgyud / dug gso ba gar log rgyal po'i shi bsos bcog brdungs rnams so //  [4v]
[5] Dol-po'i sman-pa.  The Dolpo physician.  dol po'i sman pas / sangs rgyas sman lhas seng sdeng nags kyi sgrol me byin gyis rlabs te / sman gyi lha mo brgya rtsa gnyis kyi bshad pa'i mi 'jigs pa brgyad kyi mtshon cha dang / gab pa bsal byed dang / nad ngos 'dzin pa'i le'u lnga pa la rten nas 'tsho [.2] mchi rtya [~'chi rtags] kyi le'u dang / rtsa'i legs nye brtag pa dang / gtar kha'i dpyad rnams sgyur ro //
[6] Gru-gu sman-pa.  The Turkic physician.  gru gu sman pas / phyag na rdo rjes gsungs pa'i nag po rgyud gsum dang / de'i mdo byang che chung gnyis dang / 'dra bar 'byed pa dung gi mig can dang / nags su 'jug pa g.yu'i [.3] dra ba can / gu na sha tra bam po lnga brgyangs logs pa dang / rta'i dpyad rnams sgyur te / de bzang dpyad dang ngan dpyad gnyis las / dang po la rta la khams lngar phye te / 'ol ba rlung gi khams / jag ro me / ro rgyu chu / mgo rtse pa / gyi ling nam kha'i khams so //  [.4]  ngan spyad la rta'i nad / lhed la rgo g.yung gnyis / lcam ma bu gnyis / bye gsar rnying gnyis / gyen bu dang thur bu gnyis / gam pa la phyi gam pa brgyad / nang gam pa la brgyad / 'khrugs drod mo dang bcu bdun /  mtheng la drug bcu gcig tu phye ba'o // 
[7] Bal-pa'i sman-pa (i.e., Bal-po'i sman-pa, from Kathmandu Valley).  bal pa'i sman pas [.5] 'phags pa byams pas lha dang lha min rnams la gsungs pa / 'gram bam tig dang / sbyor ba brgya pa dang / rin po che sman gyi ''khrung dpe dang / thur dpyad dang / lhog pa'i gso thab rnams sgyur ro //


[B.2]  Brang-ti Dpal-ldan-'tsho-byed, Bdud-rtsi Snying-po Yan-lag Brgyad-pa Gsang-ba Man-ngag-gi Rgyud-kyi Spyi-don Shes-bya Rab-gsal, Smanrtsis Shesrig Spendzod series no. 148, Tashi Y. Tashigang (Delhi 2005), p. 77.  These physicians Drangti locates in the time of Trisongdetsen (last half of 8th century): 

[1] Rgya-gar-gyi sman-pa a-tsarya Shan-ti-garbha. / From India, the physician Ācārya Śāntigarbha.
[2] Rgya-nag-nas Stong-gsum-gang-ba. / From China, Tongsumgangwa (Tibetan for 'Triple Thousand Universe Filled').
[3] - - - Bha-ma-ha-shang. / [From China,] Bhama Hoshang.
[4] - - - Ha-ri-pa-ta. / [From China,] Haripata [the name appears Indic, not Sinitic].
[5] Stag-gzig-nas Sog-po Ha-la-shan-dhīr. / From Arabo-Persian lands, the Sogdian Halashandhir.
[6] Gru-gu-nas Seng-ge-'od-chen. / From Turkestan, Sengé Öchen.
[7] Dol-po-nas Khyo-ma-ru-tse. / From Dolpo, Kyomarutse.
[8] Bal-po'i sman-pa Dha-na-shi-la.  / Physician of the Nepal Valley Dhanashila (perhaps Dānaśīla was intended?).

[B.3] The nine physicians who came to Tibet at the invitation of Emperor Trisongdetsen according to Zur-mkhar-ba’s sixteenth-century medical history (pp. 255-6), evidently based on the just-given passage of Drangti’s medical history, yet not identical to it:

From India (Rgya-gar):
1. Shan-ti-garbha [Śāntigarbha].
From Kashmir (Kha-che):
2. Guhya-badzra [Guhyavajra].
From China (Rgya-nag):
3. Stong-gsum-gang-ba.
4. Bha-la Ha-shang.
5. Ha-ti-pra-ta.
From Tazig (Stag-gzig):
6. Sog-po Ha-la-shan-ti.
From "the Turks" (Dru-gu):
7. Seng-mdo-'od-chen.
From Dolpo (Dol-po):
8. Khyol-ma-ru-rtse.
From Nepal Valley (Bal-po):
9. Dharmā-shi-la [Dharmaśīla].


[B.4]  The comparable passage in the biography of the Elder G.yu-thog-pa attributed to Lhun-grub-bkra-shis (perhaps only written in the 17th century) is translated into English in Rechung Rinpoche Jampal Kunzang, Tibetan Medicine Illustrated in Original Texts, University of California Press (Berkeley 1976), pp. 202-209. The same text in the original Tibetan (based on the 1982 edition, pp. 100-101) reads as follows, with the original Tibetan and an English translation side by side. Notice how this source adds Tsan Pashilaha to the end of List B:

[1] Rgya-gar Shantiṃ-garbha'i lugs la lus spyi gso ba'i yan lag bdud rtsi'i chu rgyun.
Indian Śāntigarbha.  Associated text: The Branch Covering the Healing of the Whole Body: Flowing Stream of Elixir.
[2] Rgya-nag ni sman-pa Stong-gsum-gang-ba'i lugs la byis pa gso ba'i yan lag chung dpyad nyi ma'i 'od zer.
Chinese physician Stong-gsum-gang-ba.  The Branch Covering the Healing of Children: A Ray of Light for Treating the Small.
[3] Ma-hā-de-wa'i lugs la mo nad gso ba'i yan lag zla ba'i dkyil 'khor.
[Chinese] Mahādeva.  The Branch Covering the Healing of Women's Ailments: Circle of the Moon.
[4] Dharma-buddha'i lugs la gdon nad gso ba'i yan lag rdo rje pha lam.
[Chinese] Dharmabuddha (?).  The Branch Covering Dön Spirit Diseases: The Diamond.
[5] Bal-po'i sman-pa Da-na-shī-la'i lugs la rgas pa gso ba'i yan lag gnad kyi mdzub tshugs.
The Nepal Valley physician Danaśīla.  The Branch Covering Old Age Ailments: Sticking the Thumb in the Vulnerable Spot.
[6] Kha-che'i sman-pa Khun-badzra-gyi lugs la dug nad gso ba'i yan lag rus sbal gyi 'gyur 'gros.
The Kashmir physician Guṇavajra (?).  The Branch Covering Curing of Ailments from Poisons: The Changing Condition of the Turtle.
[7] Sog-po'i sman-pa Na-la-shan-dir-pa'i lugs la rgas pa gso ba'i yan lag bcud kyi rgya mtsho.
The Sogdian physician Nalashandirpa (?).  The Branch Covering Old Age Ailments: Ocean of Nutrition.
[8] Dol-po'i sman-pa Khyo-ma-ru-rtse'i lugs la ro rtsa gso ba'i yan lag dga' bde 'phel byed.
The Dolpo physician Khyomarutsé (?).  The Branch Covering the Treatment of Virility: Making Joy Increase.
[9] Gru-gu'i sman-pa Seng-ge-'od-can-'phel-byed-kyi lugs la btsal ba thig gi yan lag ro bkra 'phrul gyi me long.
The Turkic physician Sengge-öchan-peljé (?).  The Branch Covering Lines of Vermillion (?): The Amazing Mirror of Anatomical Charts.
[10] Khrom-rgyal Mu-rtse The-khrom-gyi sras Btsan Pa-shi-la-hi'i lugs la khrom gyi dbye ba drug pa la sogs pa yin no.
Tsan Pashilahi, son of the Byzantine King Murtsé T'etröm (?). The Byzantine Six Divisions etc.*

*I’ve suggested before the possibility that by Six Divisions, the Galenic idea of the Six Non-naturals** (sex res non naturales, to give the Latin) could be intended. These were factors of diet and activity that require regulation to achieve a healthy balance in the body. In Galenic medicine they are regarded as potential causes or preventers of ailments. In general they cover the territory of what would in older times have been called hygiene, and nowadays preventative medicine. I know that "non-natural" sounds odd to everyone, but that only means that they are not body-intrinsic (not part of the body's natural constituents), but rather have to do with interactions between the body and the external world. I’ve speculated already about possible or plausible ways to explain the names given here, on the assumption they are Byzantine Greek names. I invite you to come with other ideas besides my own.

**There are a number of important articles on this subject, so I hope to study them before commenting further. An ordinary listing of the Six Non-naturals follows:  1. air (climate), 2. exercise (and rest), 3. food (and drink), 4. sleep (and wakefulness), 5. elimination of wastes and 6. emotional states. There must be a reason for the 'six-ness' found in the teachings of both Tsan Pashilaha of Byzantium and Urpaya of Arabo-Persian lands. In both regions the Six Non-Naturals were widely known. But we need additional reasons to believe in this particular connection.
  


The colophon of the new-old Nyedowa medical history. It gives the title
Sman-dpyad-gi Lo-rgyus dang Byung-tshul,”
and the author’s name Snye-mdo'-ba
Kun-dga'-don-grub.
Click on the photo to enlarge it. 

If you would like an unverified yet complete transcription, try clicking this link.



Biblio-cues:

Note: I don't include earlier works by academics such as C. Beckwith, M. Taube and so on, regardless of their importance since references may be found in the more recent works that are listed here: by Garrett, Martin and Yoeli-Tlalim.
Bi-ci'i Pu-ti Kha-ser [The Biji Volume with Yellow Edges], Bod Rang-skyong-ljongs Sman-rtsis-khang, Bod-ljongs Mi-dmangs Dpe-skrun-khang (Lhasa 2005). That Bi-ci in the title is the same as Bi-ji, the borrowing from Persian or a Persian-influenced language.

Brang-ti Dpal-ldan-'tsho-byed, Bdud-rtsi Snying-po Yan-lag Brgyad-pa Gsang-ba Man-ngag-gi Rgyud-kyi Spyi-don Shes-bya Rab-gsal, Smanrtsis Shesrig Spendzod series no. 148, Tashi Y. Tashigang (Delhi 2005). The author has been awarded dates everywhere between the 13th and 15th centuries, but I now think his history likely dates to around 1375, give or take several decades. 
  
Cherjé (Che-rje).  See the two articles of Martin.

Desi Sangyé Gyatso, Mirror of Beryl: A Historical Introduction to Tibetan Medicine, tr. by Gavin Kilty, The Library of Tibetan Classics no. 28, Wisdom (Boston 2010).

Drangti (Brang-ti).  See under Brang-ti.


Elisabeth Finckh, “Practice of Tibetan Medicine: Notes on Moxibustion (me btsa'),” Tibetan Studies, Naritasan Shinshoji (Narita 1992), vol. 2, pp. 443-450.


Frances Garrett, “Critical Methods in Tibetan Medical Histories,” Journal of Asian Studies, vol.  66, no. 2 (May 2007), pp. 363-387.


Jamgön Kongtrul Lodrö Tayé, The Treasury of Knowledge, Books Two, Three and Four: Buddhism’s Journey to Tibet, tr. by Ngawang Zangpo, Snow Lion (Ithaca 2010), pp. 414-415 has moved the three great physicians from the first half of the 7th up into the last half of the 8th century:  
“When Buddhist King Trisong Deutsen’s Rule began, three great physicians known as the three emanated sons met in Tibet: Dharmaraja from India, Mahakyinda from China, and Viji Champa Shilaha from Ferghana or Persia. They worked together to compose a major text, a medical treatise that conforms with their kingdoms’ traditions; its root text was entitled A Cluster of Jewels; its commentary, Wheels of the Sun and Moon. When Champa Shilaha was about to return to his homeland, he gave his son a cycle of instructions entitled The Yellow Manuscript of Miji. Since it was offered to the king, it is also called Blazing Radiance: The King's Master Copy...  ... ... The account of nine royal physicians from Tibet’s four frontiers coming to Tibet during the last part of the king’s [Trisongdetsen’s] life lacks substance. What occurred is that a beloved horse of the king fell ill, so that the king ordered “Find and bring me nine physicians who are skilled healers.’ Thus, five [physicians] were brought to Tibet and cured the horse: Trugu Ze’uto from China, Khulö Muken of Zhang Zhung, Mugen Trizik of Mongolia, Choro Mangpozi of Tibet, and Tana Chukyé of Azha. At the king’s command, these five masters composed a text uniting the essential medical instructions of all five kingdoms. This was offered to the king and its tradition was thereby established...”  
My note: One has to read both Viji and Miji as Biji (I know Mi-ji is in the typeset reprint edition, vol. 1, p. 589; I’m just saying it shouldn’t be). I also prefer to read Tsen Pashilaha in place of Champa Shilaha.  The typeset reprint has the names of the physicians who were called to cure the royal horse: Rgya'i Phru-gu Ze'u-tho, Zhang-zhung-gi Khu-lod-mu-khan, Hor-gyi Mu-gan Khri-gzig, Bod-kyi Cog-ro Mang-po-gzigs, and 'A-zha'i Tha-na Chu-skyes.  Their ethnicities are (in same order) Chinese, Zhangzhung, Uighur, Tibetan and Tuyuhün. So far I’ve gotten nowhere with the proper names themselves, apart from the one from Tibet whose name is quite an ordinary Old Tibetan style name with the wellknown clan name Cog-ro. Anyway, this would be fodder for some future blog on foreign veterinarians in the history of Tibetan hippology. Anyway, we can see that the account of the foreign physicians in the late 8th century is discounted by Kongtrul and replaced with an account of five local and foreign horse doctors.
Leonard W.J. van der Kuijp, “Za-hor and Its Contribution to Tibetan Medicine, Part One: Some Names, Places & Texts,” Bod Rig-pa'i Dus-deb (=Journal of Tibetology), vol. 6 (2010), pp. 21-50.

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. A Tibetan-language translation by Tsering Samdrup is forthcoming: Rgya-gar-gyi Gso-ba Rig-pa'i Lo-rgyus Bod Snga-rabs-pas Mdzad-pa zhig. If you think you need it, look here.


——, “Greek and Islamic Medicines’ Historical Contact with Tibet: A Reassessment in View of Recently Available but Relatively Early Sources on Tibetan Medical Eclecticism,” contained in: Anna Akasoy, Charles Burnett & Ronit Yoeli-Tlalim, eds., Islam and Tibet: Interactions along the Musk Routes, Ashgate (Farnham 2011), pp. 117-143.


V. Nutton, “Archiatri and the Medical Profession in Antiquity,” Papers of the British School at Rome, vol. 45 (1977), pp. 191-226. Note especially p. 193: “The earliest attested meaning of archiatros is that of a personal physician to a ruler...” and observe as well the alternative title basilikos iatros, finding its earliest usages in Hellenistic Period Syria and Egypt.

Nyedowa.  See under Snye-mdo-ba Kun-dga'-don-grub.


Rechung Rinpoche, Tibetan Medicine: Illustrated in Original Texts, University of California Press (Berkeley 1976), first published in 1973. The relevant part is a chapter entitled “Gyu-thog and the Foreign Doctors" from the translated biography of the Elder Yutok, at pp. 202-209, but note also pp. 15-18, with its sketch of Imperial Period medicine. But do beware of the dates and place name identifications.  For example, on p. 16 he says Khrom is a province in Eastern Tibet.

Sde-srid Sangs-rgyas-rgya-mtsho.  See under Desi Sangyé Gyatso.


Snye-mdo-ba Kun-dga'-don-grub (1268-1328), Gso-ba Rig-pa'i Byung-tshul Lo-rgyus dang bcas-pa [The Origins of Medical Science together with Its History], contained in:  Bod-ljongs Bod-lugs Gso-rig Slob-grwa Chen-mor Bzhugs-su Gsol-ba'i Dpe-rnying Dkar-chag [Catalogue of Ancient Books Kept at Tibet’s Tibetan Medical College], Bod-ljongs Bod-lugs Gso-rig Slob-grwa Chen-mo (Lhasa 2014), vol. 20, text no. 18, in the form of an 11-folio cursive manuscript reproduction.  The title I’ve given is the title of the 2-volume catalog, and not of the 30-volume facsimile set (for the latter look here).


The Subsequent Tantra from the Four Tantras of Tibetan Medicine, Men-Tsee-Khang (Dharamsala 2011), this being the first edition, and the first translation of this part of the Four Tantras. Since they have published translations of the Root Tantra and the Explanatory Tantra in an earlier volume in 2008, that leaves only one of the four untranslated, the Directions Tantra. The reason is of course its relative difficulty, but also its sheer length. Each of the Directions Tantra’s 92 chapters covers a major physical disorder, or class of disorders, with recommendations for treatments.

Yang Ga (G.yang-dga'), The Sources for the Writing of the Rgyud bzhi, Tibetan Medical Classic, doctoral dissertation, Harvard University (Cambridge 2010).  A more accessible writing on the textual sources of the Four Tantras may be his article “The Origins of the Four Tantras and an Account of Its Author, Yuthog Yonten Gonpo,” contained in: Theresia Hofer, ed., Bodies in Balance: The Art of Tibetan Medicine, Rubin Museum (New York 2014), pp. 154-177.


R. Yoeli-Tlalim, “Re-Visiting Galen in Tibet,” Medical History, vol. 56, no. 3 (2012), pp. 355-365. Ronit finds that Galen enters into the Tibetan medicine only in the 17th century, and is unknown in earlier works. As surprising as this may seem to some, I think it is correct. I can find no evidence that would contradict it.

Zur-mkhar-ba Blo-gros-rgyal-po (or, Legs-bshad-tshol, b. 1509), 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), in 385 pp.  This history appears to make quite a bit of direct use of the Nyedowa history, which makes it especially valuable for checking our single manuscript witness.


བླ་སྨན།  ~  archiatros
  • A note on BLA-SMAN with the meaning royal physician (in imperial period, but also later on used for physicians of local scions of the royal house).  Since the famous one who is also given the title Bi-ji (well known to be a title of Persian origin) came from Byzantium (Phrom), it is interesting to note that the Byzantine period Greek term archiatros has two parts that closely correspond with the two parts of bla-sman (iatros means physician).* See the biblio-clues under Nutton. 
(*For what it’s worth, I’ve just now searched OTDO for variants on the bla-sman title and didn’t find any instance of usage there. Not surprising, since not much that could be described as medical literature is found in this database. In fact, when you search for and find medical terms, they are most likely to be in divination treatises.)

Monday, October 30, 2017

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 Vajrapāi. 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 (Dīpakaraśrīāna). 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 (Dīpakaraśrīāna). 2. Teil: Textmaterialien, Asiatische Forschungen Band 67, Otto Harrassowitz (Wiesbaden 1979), pp. 62-64.

Helmut Eimer, “Hymns and Stanzas Praising Dīpakaraśrīāna,” 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 Dīpakara 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.


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.)

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.
 
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