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Frances Garrett (Published December 2002; Revised July 2007)

Pharmacy in Tibetan Medicine

The term "pharmacy" refers to the development of medicinal materials; "pharmacology," sometimes also called "pharmaco-therapeutics," refers to the clinical application of medicinal substances. This page will eventually discuss both of these topics but for now focuses primarily on pharmacy.

These pages will introduce viewers to aspects of Tibetan pharmacy as practiced and studied today in Lhasa, Tibet. Most of our videos were filmed at the Factory of Tibetan Medicine, a branch of the Lhasa Mentsikhang.

In Tibetan therapeutics, nutritional and behavioral recommendations are traditionally considered initial therapies for many health disorders (see Therapeutics page), but Tibetan pharmacology, involving medicinal preparations that most commonly take the form of pills, has a history as long as that of Tibetan medicine itself. Tibetan medicine has one of the world's most sophisticated forms of natural pharmacy, involving herbal products and other substances that occur naturally in the Tibetan environment. In English, we refer to plants that are used as medicinal remedies, rather than as food, as "herbs" or "medicinal herbs."

Herbs are used medicinally in nearly all cultures of the world. With some herbs, only certain parts of the plant are used, such as the stem, root, bark, seed, or fruit, whereas with others, the entire plant may be utilized. In many cultures, various types of animal products are used medicinally as well. In Tibetan medicine, herbs, animal products, minerals, and precious stones are all used in various combinations.

Materia Medica

Environmentally, the Tibetan and Himalayan region is of crucial importance as Asia's principal watershed and the origin of many of Asia's major river systems, and as such it is a critical determinant in the weather systems across Asia. The flora of Tibetan regions alone includes more than six thousand plant species, many of which are unique to the area. The great environmental diversity of the area belies the fundamental misconception of the notion of Tibet as a sparse, desert-like environment. While the region does possess desert areas such as the Tarim basin, in fact even the relatively sparse highlands of Tibet (the chang thang) boast a wealth of medicinally valuable herbs and are home to rich grazing areas for a variety both domesticated and wild animals. Although seventy percent of Tibet is grassland, the wider Tibetan cultural areas contain a vast range of environmental regions, such as pastoral semi-deserts, steppes, conifer and birch forests, alpine meadows, and subalpine humid pastures, not to mention being home to the earth's highest mountains. In addition to hosting a wide range of animals, this area is also rich in mineral resources, such as coal, borax, chromium, lithium, uranium, iron, copper and semi-precious stones.

According to a complex classification schema, all plant, mineral and animal matter are characterized according to two main aspects of the substance's potency. The particular qualities attributed to a given substance are memorized by physicians as they are presented in traditional medical texts.

ImageThe first aspect determining potency has to do with how a given medicinal substance is linked to the five main elements of fire, water, earth, air, and space. The elemental make-up of the medicinal substance determines its nature, taste, primary qualities, and secondary qualities.

The nature of a substance is either warming, cooling, or neutral; plants with a cooling nature are used on hot disorders, and those with a warming nature are beneficial to cold disorders.

The taste of a substance may be sweet, sour, salty, bitter, hot or astringent. All medicinal substances are further characterized by primary and secondary qualities that are known to affect the humors of the body in various ways.

The eight primary qualities are heaviness, oiliness, coolness, bluntness, lightness, coarseness, heat, and sharpness.

The seventeen secondary qualities are smoothness, heaviness, warmth, oiliness, "stableness," coldness, bluntness, coolness, flexibility, fluidity, dryness, non-oiliness, heat, lightness, sharpness, coarseness, and mobility.

Second, medicinal materials are also classified according to their intrinsic potency or power. Here there are eight divisions, such as aromatic power, shape of drug, auspicious power, power from prayers, and so on.

According to the Four Tantras, raw medicinal materials are catagorized into seven types [1]:

Category

Example

Pharmaco-dynamics

Precious substances (rin po che)

Turquoise

Anti-toxin, hepatic, anti-phlogistic

Rocks and minerals (rdo)

Serpentine

Constipative, febrifuge

Soil and minerals (sa)

Sulphur

Haemostatic

Trees (shing)

Santalum album Linn.

Febrifuge (heart and liver)

Nectarous (rtsi)

Musk

Anti-toxin, vermifuge, nephritic, hepatic

Shrubs (thang)

Glycyrrhiza glabra Linn.

Antitussive, expectorant

Herbs (ngo)

Picrorhiza kurroa Royle

Hepatic, coagulant, febrifuge

Study videos:
Warehouse of Medicinal Materials: A doctor introduces the warehouse in which medicinal materials from around the world are stored.
Warehouse of Medicinal Materials, Part Two: The director of the factory discusses the warehouse of medicinal materials.
Obtaining Medicinal Materials: A doctor comments on the difficulties of obtaining some medicinal materials.
Medicinal Materials in the Warehouse, Part One: The director of the factory discusses medicinal materials stored in the factory's warehouse.
Medicinal Materials in the Warehouse, Part Two
Medicinal Materials in the Warehouse, Part Three

Learn more:Image
Kletter and Kriechbaum's Tibetan Medicinal Plants offers a good introduction to medicinal substances, an essay on the environmental habitats of medicinal plants in Tibetan regions, and sixty comprehesive plant monographs. Also see Tibetan Medical Paintings, pgs. 62-83; and Quintessence Tantras, pgs. 124-188.

NOTES:

[1] Chart adapted from Fundamentals of Tibetan Medicine According to the rgyud-bzhi (Dharamsala: Tibetan Medical and Astrological Institute, 1981).

Medicinal Compounds

Tibetan pharmacy generally uses multi-component preparations rather than those consisting of a single drug. While pills are by far the most common form of preparation, formulations may other forms as well. Unlike in most Euro-American forms of herbal preparation, where ingredients are ground into powder form before being combined with other ingredients, in Tibetan formularies the necessary ingredients for a given multi-component preparation are first mixed together, generally in their full plant form, and then they are ground into powder. Tibetan medicinal preparations therefore consist most commonly of a combination of substances. Most ingredients are herbal, although mineral and animal substances are sometimes used as well. Tibetan preparations are compounded into the following forms:

Study videos:
Medicinal Compounds: Part One: A doctor discusses the factory room in which medicinal materials are initially brought together.
Medicinal Compounds: Part Two: A doctor at the factory discusses pills that are made from a variety of medicinal materials.
Medicinal Compounds: Part Three: A doctor at the medicinal pill factory discusses pills that are made from a variety of medicinal materials.
Medicinal Formulations: A doctor explains techniques of Tibetan medicinal formulation.
Terminology: phye ma (powders): A doctor at the Tibetan Medicine Factory describes the meaning of the term "phye ma."
Terminology: thang (decoctions): A doctor at the Tibetan Medicine Factory describes the meaning of the term "thang."

Learn more:
Kletter and Kriechbaum's Tibetan Medicinal Plants offers a good introduction to medicinal substances and compounds, an essay on the environmental habitats of medicinal plants in Tibetan regions, and sixty comprehesive plant monographs. Also see Tibetan Medical Paintings, pgs. 62-83; and Quintessence Tantras, pgs. 124-188.

Techniques of Pharmacy

Study videos:
Making Tibetan Medicine: Step One, the factory office that is involved in the identification of medicines.
Making Tibetan Medicine: Step Two, the factory room in which herbs and other medicinal materials are ground into powder
Making Tibetan Medicine: Step Three, scenes from the factory room in which powderized medicinal materials are further processed
Making Tibetan Medicine: Step Four, the factory room in which pills are shaped and sorted.
Making Tibetan Medicine: Step Five, the factory room in which pills are initially dried.
Making Tibetan Medicine: Step Six, the factory room in which pills are sorted.
Making Tibetan Medicine: Step Seven, the factory room in which pills are coated.
Making Tibetan Medicine: Step Eight, the factory room in which pills are baked in ovens.
Making Tibetan Medicine: Step Nine, the factory room in which pills are dried in large ovens.
Packaging Pills: Part One, a factory room in which pills are packaged individually
Packaging Pills: Part Two, a factory room in which individually packaged pills are placed in boxes for shipping
Changing Techniques of Pharmacy, a doctor responds to a question about whether there is any conflict between modern techniques of pharmacy that rely on machinery and traditional methods of making medicines by hand.

The Factory

Study videos:
Medicine Factory Operations : A doctor comments on some aspects of factory operations at the Tibetan Medicine Factory.
Medicine Factory Shipping Room : A doctor introduces the shipping room of the Tibetan Medicine Factory.
Medicine Factory Dispensary : A doctor introduces the dispensary of the Tibetan Medicine Factory.