TK 36 - Detail (14).jpg [15/20] Title: Detail of Medical Instruments (XIV) - Thangka Thirty-Six Caption: The top instrument in this panel is a hollow tube with "a head shaped like a ladder" (Dorje & Meyer, 83). It is used to blow powdered medicines into the throat. Although this is not entirely clear, it appears that the middle instrument can be inserted into the top instrument and act as cauterizing tool for the uvula. The instrument at the bottom of this panel, along with the similarly shaped tool beside it, is used for administering enemas to a patient. In Tibetan medicine there appear to be two types of enemas used: "anuvasana," one containing fat and "niruha," a different type made through decoction (a process by which medicines are extracted from plants by boiling them in water.) This enema creates results quickly. When treating constipation, there are two methods used. In one of these methods, this instrument is inserted into the sphincter and medicine is administered as the patient lies on their back with their feet upwards for a few hours. For a period of time, the patient also clasps his feet together, which is helpful in relieving wind disorders. Although this technique along with one other method is used for severe constipation, Tibetan medicine also has three mild forms of laxatives composed of ginger and other ingredients. The final instrument on the far right is used for cleaning out wounds. Sources and Further Reading: Bhagwan Dash: pg 14-15 Dhonden: pg 172 & 189 Dorje & Meyer: 83 & 239