Knowledge and Context in
Tibetan Medicine
Edited by
William A. McGrath
LEIDEN | BOSTON
For use by the Author only | © 2019 Koninklijke Brill NV
Contents
Introduction: Navigating the Ocean of Tibetan Medical Literature vii
William A. McGrath
A Note on Transcription, Transliteration, and Bibliography xvi
List of Figures xvii
Contributors xviii
Part 1
The Vicissitudes of Meaning in Context
1
A New Sense of (Dark) Humor in Tibet: Brown Phlegm and
Black Bile 3
Henk Blezer
2
A Preliminary Study on the Biography of Yutok Yönten Gönpo the Elder:
Reflections on the Origins of Tibetan Medicine 59
Yang Ga
3
“Secret Medicine” in the Writings of Sanggyé Gyatso: The Encoded
Esoteric Material of Therapeutics 85
Tony Chui
4
Visceral Anatomy as Depicted in Tibetan Medicine
Katharina Sabernig
5
The Modern Biomedical Conception of Cancer and Its Many Potential
Correlates in the Tibetan Medical Tradition 140
Tawni Tidwell
111
Part 2
Medicine and Religion in Context
6
The Nine-Fold Magical Cord Cycle: Investigating ’Phrul gyi the gu brgu
skor, a Wartime Medical Manual 199
Tsering Samdrup
For use by the Author only | © 2019 Koninklijke Brill NV
vi
Contents
7
Knowledge, Imagery, and the Treatment of Communicable Disease in
the Vase of the Amṛta of Immortality: A Preliminary Analysis of a
Nyingma Medical Corpus 218
Carmen Simioli
8
Tantric Divination and Empirical Diagnosis: A Genealogy of Channel
Prasenā Rituals in the Tibetan Medical Tradition 261
William A. McGrath
9
Madness and the Spirits: Examining the Role of Spirits in Mental Illness
in the Tibetan Communities of Darjeeling 309
Susannah Deane
10
Material Presentations and Cultural Drug Translations of Contemporary
Tibetan Precious Pills 337
Barbara Gerke
Index
369
For use by the Author only | © 2019 Koninklijke Brill NV
chapter 7
Knowledge, Imagery, and the Treatment of
Communicable Disease in the Vase of the Amṛta
of Immortality: A Preliminary Analysis of a
Nyingma Medical Corpus
Carmen Simioli
1
Introduction: The Vase of the Amṛta of Immortality and Its Status in
the History of Tibetan Medicine
Throughout the centuries, societies have formulated varieties of philosophical,
medical, alchemical, and religious responses to outbreaks of pestilence and
communicable diseases.1 Tibetan medical sources from the tenth to the late
seventeenth century describe complex but uniform epistemological postures
concerning the causalities of rimtsé (rims tshad) or “epidemic fevers” and nyenné (gnyan nad) or “infectious diseases,” which subsumes eighteen harsh infective and malignant diseases. In Tibetan medical collections from the tenth
century onwards, we find references to these ailments, which were explained
as physical disorders, but, as in many other cultural contexts,2 demonology
played a significant role in understandings of their pathogenesis. Accordingly,
it can be observed that in these sources the empirical approach to the diagnosis of diseases is often interrelated with divination and religious curative
methods.
When addressing the issue of epidemics and infective diseases, we shall
consider to what extent the theories and the practices of Buddhist Tantric
medicine came to exert influence on Tibetan medical tradition, and in particular which textual traditions played a prominent role in codifying Tibetan
1 For alchemical responses, see Chiara Crisciani and Michela Pereira, “Black Death and Golden
Remedies: Some Remarks on Alchemy and the Plague,” in The Regulation of Evil: Social and
Cultural Attitudes to Epidemics in Late Middles Ages, ed. Agostino Paravicini Bagliani and
Francesco Santi (Firenze: Sismel-Edizioni del Galluzzo, 1998), 7–40. For religious responses,
see Andrew Cunningham, “Epidemics, Pandemics and the Doomsday Scenario,” Historically
Speaking 7 (2008): 29–31.
2 Siam Bhayro and Catherine Rider, eds., Demons and Illness from Antiquity to the Early-Modern
Period (Brill: Leiden, 2017).
© koninklijke brill nv, leiden, 2019 | doi:10.1163/9789004404441_008
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
219
epidemiology.3 The medical literature on nyenné and rimné reflects, in a wider
sense, the comprehensive nature of Tibetan medical system, which encompasses other complementary disciplines, such as alchemy, iatrochemistry, and
magic (las la sbyor ba, lit. the “application of [ritual] activities”). Although, in
the course of time, the differentiation between the respective literary genres
has generally become clear cut, medical texts on epidemics were closely
connected to the alchemical literature of “extracting essences” (bcud len =
Skt. rasāyana), treatises of iatrochemistry (dngul chu’i grub pa’i bstan bcos =
Skt. rasasiddhiśāstra), and “grimoires” (sngags be’u bum, lit. “collections of
mantras and spells”; las sna tshogs be’u bum, lit. “collections of ritual acts”).4
The expectation of finding a valid remedy for mortal disorders, which, as anticipated, were conceived as liminal entities in the midst of corporeal and
spiritual reality, prompted pharmacological research on the one hand, and the
redaction of ancient ritual literature on the other. Thus, the historical connection between medical and ritual literature can be found in the search for a
universal medicine prepared by means of alchemical techniques.
What today is known as the Four Tantras (rgyud bzhi), the seminal treatise
of the Tibetan medical tradition attributed to Yutok Yönten Gönpo (g.yu thog
yon tan mgon po, twelfth century), is the result of a long process of reception,
systematization, and canonization of diverse medical theories and practices,
which reached its climax during the fourteenth century.5 In this source, among
3 On Tantric medicine see for example Vesna Wallace’s consummate essay on the Kālacakratantra: Vesna A. Wallace, “Medicine and Astrology in the Healing Arts of the Kālacakratantra,”
in As Long as Space Endures: Essays on the Kālacakra Tantra in Honor of H. H. The Dalai Lama,
ed. Edward A. Arnold (Ithaca, NY: Snow Lion Publications, 2009), 179–91.
4 On the definition of rasāyana in Sanskrit medical and alchemical literature see Dagmar
Wujastyk, “Acts of Improvement: On the Use of Tonics and Elixirs in Sanskrit Medical and
Alchemical Literature,” History of Science in South Asia 5, no. 2 (2017): 1–36. On Tibetan
rasāyana see Barbara Gerke, “Treating Essence with Essence: Re-inventing bcud len as
Vitalising Dietary Supplements in Contemporary Tibetan Medicine,” Asian Medicine:
Tradition and Modernity 7, no. 1 (2012): 196–224; and Barbara Gerke, “Treating the Aged and
Maintaining the Health: Locating bcud len Practices in the Four Medical Tantras,” Journal of
International Buddhist Studies 35, nos. 1–2 (2012): 329–62. On rasaśāstra in Tibetan literature, see Carmen Simioli, “Alchemical Gold and the Pursuit of the Alchemical Elixir,” Asian
Medicine: Tradition and Modernity 8, no. 1 (2013): 43–77. For a detailed definition of magic as
category of knowledge and expertise in the Tibetan context see Bryan J. Cuevas, “‘The Calf’s
Nipple’ (Be’u bum) of Ju Mipham (’Ju mi pham): A Handbook of Tibetan Ritual Magic,” in
Tibetan Ritual, ed. José Ignacio Cabezón (Oxford: Oxford University Press, 2010), 165–86.
5 Since the cosmopolitan imperial epoch (seventh-eighth centuries CE), the Tibetan medical system started to assimilate and integrate elements from other medical traditions. See
Christopher I. Beckwith, “The Introduction of Greek Medicine into Tibet in the Seventh
and Eighth Centuries,” Journal of the American Oriental Society 99, no. 2 (1979): 297–313; Dan
Martin, “An Early Tibetan History of Indian Medicine,” in Soundings in Tibetan Medicine, ed.
For use by the Author only | © 2019 Koninklijke Brill NV
220
Simioli
the diverse rasāyana formulations, mercurial compounds clearly epitomize
the ideal of the universal panacea. Not unlike the Āyurvedic concept of the
rasāyana that “pacifies all disorders” (sarvopaghāta śamanīya), the countermeasure called the “precious reversal suppressant, universal pacifier of all
the diseases” (zhi bye kun log gnon rin po che) can dispel any kind of harsh
disease, including epidemics, and can even protect from demonic attacks and
poisoning.6 Since alchemy and magic represent two categories of operative
knowledge that share the same philosophical substratum of “dependent arising” (rten ’brel = Skt. pratītyasamutpāda), they permeate each other. Therefore,
along with the alchemical idea of the manipulation of substances to create a
perfect medicine, we find the secret potencies of materia medica that pertain
to natural magic (the sympathies and the antipathies existing in the whole
of nature), as well as ritual practices (invocations, the use of incantations to
summon and also exorcisms), and also the conjunct preparation of magic
diagram or circles (’khor lo) and sacred images (gzugs brnyen), which typify
image magic.7
Mona Schrempf (Leiden: Brill, 2007), 307–25; Dan Martin, “Greek and Islamic Medicines’
Historical Contact with Tibet,” in Islam and Tibet: Interactions along the Musk Routes, ed.
Anna Akasoy et al. (Burlington, VT: Ashgate Publishing Company, 2011), 117–44; William A.
McGrath, “Vessel Examination in the Medicine of the Moon King,” in Buddhism and Medicine:
An Anthology of Premodern Sources, ed. C. Pierce Salguero (New York, NY: Columbia
University Press, 2017), 501–13; Anna Akosay and Ronit Yoeli-Ylalim, “Along the Musk Routes:
Exchanges between Tibet and the Islam World” in Asian Medicine, Tradition and Modernity 3
(2007): 217–40 ; Ronit Yoeli-Tlalim, “On Urine Analysis and Tibetan Medicine’s Connections
with the West,” in Studies of Medical Pluralism in Tibetan History and Society, ed. Sienna
Craig et al. (Halle: International Institute for Tibetan and Buddhist Studies GmbH, 2010),
195–211; Ronit Yoeli-Tlalim, “Re-visiting ‘Galen in Tibet,’” Medical History 56, no. 3 (2012):
355–65; Ronit Yoeli-Tlalim, “Central Asian Mélange: Early Tibetan Medicine from Dunhunag,”
in Scribes, Texts, and Rituals in Early Tibet and Dunhuang, ed. Brandon Dotson, Kazushi Iwao,
and Tsuguhito Takeuchi (Wiesbaden: Reichert-Verlag, 2013), 53–60; and Ronit Yoeli-Tlalim,
“Between Medicine and Ritual: Tibetan ‘Medical Ritual from Dunhuang,’” in Tibetan and
Himalayan Healing: An Antology for Anthony Aris, ed. Charles Ramble and Ulrike Roesler
(Kathmandu: Vajra Publications, 2015), 739–46. For further analysis of this process of unification, standardization, and modes of knowledge transmission in the Tibetan medical
system, see William A. McGrath, Buddhism and Medicine in Tibet: Origins, Ethics, and
Tradition (Charlottesville, VA: Doctoral Dissertation at the University of Virginia, 2017).
6 This formulation appears in the Ultimate Tantra (phyi’i rgyud) of the Four Tantras. See Bdud
rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud (Lhasa: Bod ljongs mi rigs dpe
skrun khang, 1982), 601/9–12.
7 Image magic with its astrological and philosophical implications, as well as its divinatory,
medical and apotropaic uses, have been largely investigated in western studies. For a detailed
study on textual amulets see Don C. Skemer, Binding Words: Textual Amulets in the Middle
Ages (Philadelphia, PA: University of Pennsylvania Press, 2006). For a theoretical approach
to the concept of simulacra in Tibetan Buddhism see Stephan Beyer, The Cult of Tara: Magic
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
221
These disciplines are part of the instructional corpus of the Tibetan medical tradition, which is an immense body of practical occult lore, grounded
in Tantric Buddhist knowledge. These narratives and ritual practices were
gathered up over the centuries and condensed in the literature of “accomplishing medicine” (sman sgrub), a genre structured according to the model
of Mahāyogatantra that flourished in Tibet between the twelfth and the thirteenth centuries.8 In these scriptures, alchemy and various forms of magic
merged with evocation rituals (sgrub thabs) aimed at producing a ritually empowered “amṛta of immortality” (’chi med bdud rtsi).
The Great Vase of the Amṛta of Immortality (’chi med bdud rtsi bum chen;
hereafter Vase of Amṛta), whose contents will be examined in this study, belongs to this literary genre. I will be using two redactions of the Great Vase:
the first is included in the nineteenth century Precious Treasury (rin chen gter
mdzod) redacted by Jamgön Kongtrül Lodrö Thayé (’jam mgon kong sprul
blo gros mtha’ yas, 1813–1899) and Jamyang Khyentse Wangpo (’jam dbyangs
mkhyen brtse’i dbang po, 1820–1892); the second belongs to the Collection of
Prominent Medical Works Ascribed to Padmasambhava (slob dpon pad ’byung
gi sman yig gces bsdus), which is a volume included in the publication series
of ancient medical works redacted by the Arura Medical Institute and Tibetan
Medical Research Association in Tsongön (Kokonor, Qinghai).9 The Vase
of Amṛta formally conforms to the category of treasure texts (gter ma), the
revealed-scripture tradition ascribed to Padmasambhava, and is a medical oriented textual cycle completely devoted to the cure of nyenné and rimtsé. Other
titles are, indeed, contained within the corpus of the Vase of Amṛta, each alluding to its contents and structure, such as the Medical Corpus in Eight Branches
(gzhung yan lag brgyad pa), the Trilogy of Tantras of the Medical Methods (gso
dpyad rgyud don skor gsum pa), or the Three Precious Heaps of Medical Methods
and Ritual in Tibet (Dehli: Motilal Banarsiddass, [1973] 2001); for an analysis of an iatromantic
image see Ronit Yoeli-Tlalim, “A Tibetan Image of Divination: Some Contextual Remarks,” in
Imagining Chinese Medicine, ed. Vivienne Lo and Penelope Barrett (Leiden: Brill 2018), 429,
fig. 9.
8 On “accomplishing medicine” see for example: Francis Garrett, “The Alchemy of
Accomplishing Medicine (sman sgrub): Situating the Yuthok Heart Essence Ritual Tradition,”
Journal of Indian Philosophy 37, no. 3 (2009): 207–30; and Cathy Cantwell, “The Medicinal
Accomplishment (sman sgrub) Practice in the Dudjom Meteoric Iron Razor (gnam lcags spu
gri) Tradition: Reflections on the Ritual and Meditative Practice at a Monastery in Southern
Bhutan,” Journal of the Oxford Centre for Buddhist Studies 8 (2015): 49–95.
9 (1) ’Chi med bdud rtsi bum pa, in Rin chen gter mdzod (Paro: Stod lung mtsur phu’i par khang,
1980), vol. 46 (ngo, ha), 1.1–124.1 (hereafter ’Chi med bdud rtsi bum pa [1]); and (2) ’Chi med
bdud rtsi bum pa, in Slob dpon pad ’byung gi sman yig gces btus (Beijing: Mi rigs dpe skrung
khang, 2006), 1–193 (hereafter ’Chi med bdud rtsi bum pa [2]).
For use by the Author only | © 2019 Koninklijke Brill NV
222
Simioli
(gso dpyad rin chen spungs bag gsum pa).10 Another significative appellation is
the Scroll of Quintessential [Teachings] (yang thig gces shog dril), which alludes
to the Nyingma doxographical category of pith instructions.
Despite being redacted in these rather late collections, the rediscovery of
the Vase of Amṛta is specifically attributed to Dorbum Chökyi Drakpa (rdor
’bum chos kyi grags pa), a mysterious yogin from Ngari (mnga’ ris). We find scattered references to Dorbum within the Vase of Amṛta, regarding his physical
appearance and his tantric implements: he was a yogin of small stature (bong
thung) and had a particular spot on his forehead, which caused him to be also
known as the “one endowed with the peacock brilliant mark” (’od kor rma bya’i
mdongs can); and he owned a fanged skull (ga li [=ka li] rkan so can).11 The
Vase of Amṛta provides us with the approximate date of its rediscovery that
took place “in the year of the sharp-minded hare” (blo gsal yos bu lo la ’don).
A detailed description of this event is to be found in Dorbum’s hagiography:
according to this work, the yellow scroll of the Vase of Amṛta emerged directly
from the hearth of Hayagrīva, the “resplendent subjugator of arrogant beings”
(zil dregs zil gnon) at the temple of Jang Tradüntsé (byang pra dun rtse).12
The chapter on the calcite (cong zhi) theriac in the modern redaction of
the Vase of Amṛta, which should correspond to the final section and the colophon of nineteenth-century version of the Vase of Amṛta, reveals that this
manuscript is a scribal work. The copyist (yi ge pa), who calls himself as Sönam
Rinchen (bsod nams rin chen), provides us with a few temporal and geographical data. After restating the role of Dorbum as treasure-finder (gter ston), the
copyist starts narrating the account of a so-called “sky-holder” (gnam ’chang),
who connected the transmission of the manuscript to the “noble clan of those
[wearing] shining thunderbolt-proof [armor?] in the lineage of Minyak” (mi
nyag rigs la thog thub mdongs kyi rus). The copy was written “during the waxing period of the moon in the fourth Mongolian month of the [male] earth-dog
year (sa khyi hor zla bzhi pa’i yar ngo la), when 2496 years had passed after the
Nirvāṇa of the Buddha, in the sacred land with the horned Khyung mountain
10
11
12
’Chi med bdud rtsi bum pa (1), 6v/5–7r/6; and ’Chi med bdud rtsi bum pa (2), 9/6–24. The
first title refers to the exposition of the issue of epidemics in eight points (primary and
secondary causative factors; time and place of the outbreak; diagnosis; ritual protections
and therapeutic countermeasures); the other refer to its major subdivisions in the three
main tantras devoted to the general exposition of the contents, diagnosis, therapeutics,
and apotropaic rituals.
’Chi med bdud rtsi bum pa (1), 115v/6; ’Chi med bdud rtsi bum pa (2), 55/6–8.
’Jam mgon kong sprul blo sgros mtha’ yas, Gter ston brgya rtsa’i rnam thar (Lhasa: Bod
ljongs mi dmangs dpe skrun khang, 2007), vol. 1, 137/ 9–17.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
223
as its center.”13 Although I have not been able to date this copy of the manuscript based on the provided chronological data, these elements allow us to
state that this copy was first redacted no earlier than the thirteenth century.14
Despite the paucity of historical data provided by these manuscripts, however, the Vase of Amṛta has an intriguing lineage history that connects it both
to the Nyingma treasure tradition and to the Tibetan medical tradition. In the
Current of the River Ganges: Enumeration of the Received Teachings on the Vast
and Profound Sacred Dharma (Gang ga’i chu rgyun; hereafter Current of the
River Ganges), the Fifth Dalai Lama Ngawang Lozang Gyatso (ngag dbang blo
bzang rgya mtsho, 1617–1682) clearly identified the Vase of Amṛta as a “northern treasure” (byang gter) and connected it to important religious and medical figures, such as the “treasure finder” (gter ston) Trashi Topgyel (bkra shis
stobs rgyal, 1550–1603) and the physicians of the famous Drangti (brang ti)
and Zur families, even connecting the Vase of Amṛta back as far as the twelfthcentury Yutok. Although a definitive historical study of the medical lineage
of the Vase of Amṛta is beyond the scope of the present chapter, we will
consider the inter-textual lineage of the Vase of Amṛta in the thirteenth and
fourteenth centuries, as well as its transmission in the influential medical collections of the seventeenth century.
The intertextual lineage links the Vase of Amṛta to the iatrochemistry
of mercury procedures (dngul chu btso bkru) that originated in Orgyenpa
Rinchen Pel’s (o rgyan pa rin chen dpal, 1229/30–1309) alchemical system and
that were transmitted through important collections, such as the Drangti’s
Great Measure of Gold (gser bre chen mo) and Lhatsün Rinchen Gyatso’s (lha
btsun rin chen rgya mtsho, fourteenth century) Collection of Drongtsé (’brong
rtse be’u bum). Moreover, the Vase of Amṛta probably served as source for the
fourteenth-century redaction of the chapter on precious stones remedies of
the Ultimate Tantra of the Four Tantras.15 Fragments of the Vase of Amṛta are
13
14
15
Compare ’Chi med bdud rtsi bum pa (2), 101/1–112/9; with the final section and the colophon of ’Chi med bdud rtsi bum pa (1), 118r/–123r/6.
The manuscript of the ’Chi med bdud rtsi bum pa (2) might have been written after the
Mongolian final conquest of Tangut reign in 1226 and the consequent settlement of
Tanguts in the eastern territorial areas of Tibetan plateau. Certainly, it was composed
later than the introduction of the “Mongolian month” (hor zla) to the Tibetan calendar in
the thirteenth century by the Drogön Chögyel Pakpa Lodrö Gyeltsen (’gro mgon chos rgyal
’phags pa blo gros rgyal mtshan, 1235–1280), who was the preceptor of Kublai Khan.
See Dpal ldan rgyal mtshan, Brang ti lha rje’i rim brgyud kyi man ngag gser bre chen mo
(Lhasa: Bod ljongs mi dmangs dpe skrun khang, 2005),144–78; Lha btsun Rin chen rgya
mtsho, ’Brong rtse be’u bum dkar po (Beijing: Mi rigs dpe skrun khang, 2005), 278/20–
283/24. See also Carmen Simioli, “The ‘Brilliant Moon Theriac’ (Zla zil dar ya kan): A
Preliminary Study of Mercury Processing according to the Vase of Amrita of Immortality
For use by the Author only | © 2019 Koninklijke Brill NV
224
Simioli
included in other sections of the Great Measure of Gold and consist of short
recipes and spells for curing specific rim and nyen diseases, such as the rim
disease of the gall bladder and the bile duct (mkhris rims), or the rim disease
affecting the gastrointestinal tract (rgyu gzer). The treasure text is referred to
as the Innermost Essence of the Vase of Amṛta (bdud rtsi bum pa yang snying)
and Guru Padmasambhava’s “oral pith instruction source” (man ngag =
Skt. upadeśa) transmitted through the Drangti medical system.16 With this information in mind, it might be possible to assume that at least sections of the
Vase of Amṛta circulated widely and were preserved in the indirect medical
textual tradition from the thirteenth century onward.
At the turn of the seventeenth century, the speculative models, which guided the interpretation and classification of epidemic fevers and infective diseases in Tibet, were well-established conceptions rooted in the study of the
Four Tantras, as well as in the study of formative magical and alchemical scriptures. Sanggyé Gyatso (sangs rgyas rgya mtsho, 1653–1705), regent (sde srid) of
the Fifth Dalai Lama and leading academic theorist of medicine, composed
several commentarial works on the Four Tantras, including a subsidiary collection entitled the Camphor That Dispels the Torments of Fevers, the Sword That
Cuts off the Lasso of Untimely Death: Supplements to the Excellent Tantra of Oral
Instructions (man ngag yon tan rgyud gyi lhan thabs zug rngu’i tsha gdung sel
ba’i kat pu ra dus min ’chi zhags gcod pa’i ral gri; hereafter Supplements to the
Instructional Tantra). The contents and structure of its chapters devoted to
nyenrim reflect the clear authorial intent of systematizing all of the notions
on these diseases distilled from authoritative medical and religious sources
in a coherent and legitimate body of knowledge. Sanggyé Gyatso also supplemented the instructions of the Four Tantras with a plethora of recipes, spells to
consecrate medicines, and protective rituals derived from tantric sources, presenting them as an expansion of something inherent in the medical classic.17
In the twenty-sixth chapter on “contagious fever” and “Nepalese disease”
(bal nad), and in thirtieth chapter on the “nyen disease afflicting the brain”
(klad gzer), Sanggyé Gyatso states his indebtedness to several tantras of the
“early translation” (snga ’gyur) and of the “late translation” (phyi ’gyur) schools.
He tried to produce a perfect “synthesis of the pith instructions drawn from
16
17
(’Chi med bdud rtsi bum pa) and Its Influence on Tibetan Pharmacological Literature,”
Revenue d’Etudes Tibétaines 37 (2016): 391–419.
Brang ti lha rje’i brgyud kyi man ngag gser bre chen mo, 203/3–204/13; 236/13–237/8;
252/17–253/6.
On the secret recipes of the Supplements, see Tony Chui, “‘Secret Medicine’ in the Writings
of Sanggyé Gyatso: The Encoded Esoteric Material of Therapeutics,” in the present
volume.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
225
the ‘treasure texts’ ascribed to Padmasambhava.”18 The contents of the
Supplements to the Instructional Tantra reflect not only the place of magic in
Sanggyé Gyatso’s medical thought, but it can also offer a perspective on the status of specific ritual magic texts in the history of Tibetan medicine. Plumbing
the intricate web of literary references in the Supplements to the Instructional
Tantra, we find that Sanggyé Gyatso quoted passages from a treasure text entitled the Great Guru’s Vase of Amṛta (gu ru chen po’i bdud rtsi bum pa),19 which
can be identified as the Vase of Amṛta on the basis of intertextual analysis. As
we can infer from the Current of the River Ganges, upon which Sanggyé Gyatso
relied to describe the contents of the Vase of Amṛta in his medical historiography, the Vase of Amṛta in question seems to coincide with the textus receptus
preserved in the nineteenth-century Precious Treasury collection.20 The influential role of this scripture in the Supplements to the Instructional Tantra was
certainly due to the Fifth Dalai Lama’s lineage of transmission.
In the seventeenth century, the Vase of Amṛta became one of the most authoritative sources concerning the treatment of epidemics and poisoning.
Deumar Tendzin Püntsok (de’u dmar bstan’ dzin phun thsogs, b. 1672), important theorist and physician, frequently cites the Vase of Amṛta in his chapter
devoted to the treatment of the “black disease, union of the three” (nag po
gsum sgril). Like the Drangti physicians, Deumar calls it the Innermost Essence
of the Vase of Amṛta and classifies it as an oral instruction.21
The lineage of transmission of the Vase of Amṛta can be traced up to nineteenth century. The Precious Treasury collection not only preserves the textus
receptus of the Vase of Amṛta but includes a series of related instructional texts,
such as the Essential Daily Practices of the Vase of Amṛta (bdud rtsi bum pa’i
rgyun khyer snying dril), the transmission and guiding explanations of the Vase
of Amṛta authored by the luminary Jamgön Kongtrül, who worked alongside
with the treasure finder Jamyang Khyentsé Wangpo for the preservation of the
18
19
20
21
Sangs rgyas rgya mtsho, Man ngag gi yon tan rgyud gi lhan thabs (Xining: Mtsho mi rigs
dpe skrung khang, 1991), 175/11–176/3.
Sangs rgyas rgya mtsho, Man ngag gi yon tan rgyud gi lhan thabs, 184/8.
I have compared the catalogue of contents provided in the Gang ga’i chu rgyun and the
contents of ’Chi med bdud rtsi bum pa (1) and ’Chi med bdud rtsi bum pa (2). For references
see the previous note and Ngag dbang blo bzang rgya mtsho, Zab pa dang rgya che ba’i
dam chos kyi yig gang ga’i chu rgyun, in Gsung ’bum (Gangthok: Sikkim Research Institute
of Tibetology, 1991–95), vol. 1 (gsan yig ka), 340/1–345/9. See also Gavin Kilty, trans., Mirror
of Beryl: A Historical Introduction to Tibetan Medicine (Boston, MA: Wisdom Publications,
2009), 177–85.
De’u dmar btan’dzin phun tshogs, Gso rig gces btus rin chen phreng ba (Xining: Mtsho
sgnon mi rigs dpe skrun khang, 1993), 205/14–218/3.
For use by the Author only | © 2019 Koninklijke Brill NV
226
Simioli
treasure text tradition.22 This work has been included in a modern extended
edition of the Yutok Heart Essence (g.yu thog snying thig), an anthology of
ritual practices related to different medical lineages.23 This brief conspectus
provides us with some noteworthy elements. The medical lineage of the Vase
of Amṛta can be traced back to the fourteenth century, when it was considered an authoritative recipe book and spell book whose excerpts circulated
through important medical collections and were part of the secret oral transmissions connected to medical lineages. Its influential role was mainly related
to the codification of mercurial procedures. Its importance increased in the
seventeenth century due to Nyingma lineage of the Fifth Dalai Lama. Its history is intertwined with the renaissance of the treasure-tradition within the
non-sectarian (rigs med) movement of the nineteenth century. The presence
of Jamgön Kongtrül’s text in the modern redaction of the Yutok Heart Essence
shows that the ritual practice based on the Vase of Amṛta is effectively part of a
set of accomplishing medicine rituals connected to the medical tradition still
being practiced today.
Drawing on the contents of the Vase of Amṛta, it is possible to determine
other relevant elements that can allow us to better situate the Vase of Amṛta in
the broader contexts of medical and alchemical literatures. Specific passages
will illustrate how in the Vase of Amṛta, the alchemical quest for the long-life
elixir and the search for the ultimate remedy against pestilences and poisons
came to be conflated. The core part of this paper will be devoted to the analysis of the whole spectrum of diagnostic methods and rituals described in the
Vase of Amṛta: its contents stretch from medical rubrics to divinatory prognosis (kha dmar). The work also deals with the preparation and consecration
of “medical compounds” (sbyor ba) known as theriac (dar ya kan), the preparation of magical “unguents” (phyug sman), and “protective amulets” (srung
’khor), or ritualized therapies. Before discussing the contents of the Vase of
Amṛta, it is necessary to first briefly introduce the concept of nyenné and rimné
22
23
Jamgön Kongtrül, Bdud rtsi bum pa’i rgyun khyer snying dril, in Rin chen gter mdzod (Paro:
Stod lung mtsur phu’i par khang, 1980), vol. 47 (ci, ha–a), 1r/1–3r/1. The Index of Treasure
Texts Dealing with the Protection [From Epidemics] (Srung ba’i kha byang) by Jamyang
Khyentsé Wangpo, includes the Vase of Amṛta, among other important magic-medical
sources. See Slob dpon pad ’byung gi sman yig gces btus, 367–89.
G.yu thog snying thig (Beijing: Mi rigs dpe skrun khang, 2007), 11–13. This has been edited
by the Arura Institute and Medical Research Association in Tsongön. Based on the Lhasa
Chakpori (lcags po ri) redaction of the collection authored by Karma Jigmé Sengé (karma
’jigs med seng ge, nineteenth century), this anthology has been expanded with the addition of writings composed by authors from different historical periods.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
227
as expressed in ancient authoritative and canonical sources from the tenth to
the seventeenth century.
2
The Etiology of Nyenné and Rimné According to Canonical Medical
Sources: Physical Causation, Morbific Airs, and Demonic Poisons
This preliminary investigation intends to probe the coexistence of different
explanatory models and the considerable uniformity of the medical discourse
on nyenné and rimné from the twelfth to seventeenth century. Its core focuses
on the analysis of sections from the Instructional Tantra (man ngag rgyud) of
the Four Tantras, which has been compared with the Sons’ Benefit (bu don ma),
an ancillary treatise ascribed to Yutok Yönten Gönpo. We will also briefly refer
to a medical source predating the Four Tantras, known as the Moon King (zla
ba’i rgyal po). This analysis of the Instructional Tantra, will be complemented,
when considered necessary, with references to exegetical writings such the
Blue Beryl (baidurya sngon po) and the Supplements to the Instructional Tantra
authored by Sanggyé Gyatso.
The Tibetan etiology of nyenné and rimné ultimately developed in the
context of ancient Āyurvedic concepts. The selected sources provide a threefolded epidemic causality: diseases are determined by natural factors, supernatural factors, and are related to a moral causality. The taxonomy of nyenné
and rimné proposed by both the Sons’ Benefit and the Instructional Tantra notably corresponds with the etiological models provided by the Tibetan translation of the Compendium of the Essence of the Eight Branches (yan lag brgyad
pa’i snying po bsdus pa = Skt. aṣṭāṅgahṛdayasaṃhitā; hereafter, Essence of the
Eight Branches),24 the well-known classic of Āyurveda authored by Vāgbhaṭa
(pha khol).
According to these scriptures, the “three disturbing elements” (nyes pa
gsum) and blood (khrag) are the dominant physiological models for interpreting nyenrim. Rimné are classified in four categories corresponding to each of
the cited “disturbing elements” as well as their “combination” (’dus pa).25 These
24
25
Yan lag brgyad pa’i snying po bsdus pa, in Sbyor ba brgya ba dang yan lag brgyad pa’i snying
po bsdus pa sogs (Beijing: Mi rigs dpe skrun khang, 2005), 309/12–316/11.
There are six classes of rim diseases forming three couples of diseases, each associated
with one of the “three disturbing factors”: a) Epidemics fevers associated with “wind”
(rlung rims), i.e. febrile states associated with insomnia called yerbu (yer bu), are characterized by intensive shivering, called darbu (’dar bu), which manifests in the prodromal
phase of the disease; b) epidemic fever associated with “bile” (mkhris rims), i.e. lepgen (leb
rgan), are characterized by yellow watery eyes and mucus, the disease of atrocious pain
For use by the Author only | © 2019 Koninklijke Brill NV
228
Simioli
three elements are potential pathogenic factors influenced by wrong behaviors, in particular excessive exhausting actions (drag shul), an imbalanced dietetic regimen (kha zas ma snyoms), and unusual changes in the climate that
happen when the “seasons display inappropriate features” (dus bzhi’i ’byung ba
dman lhag log; lit. the “elements of the four seasons are less or more than appropriate, or the opposite”).26 The fourth class of rim diseases is conceived as a
clear manifestation of demonic assaults. The term used to identify the diseasecarrier demon is dön (gdon), which refers to an evil uncanny force sent by nonhuman beings and therefore referred to as negative influence of malevolent
“elemental beings” (’byung po).
In order to gain a clear picture of how nyenné and rimné are interpreted in
the Instructional Tantra, we will now turn to the concept of contagion. In the
Instructional Tantra, the term rim, which literally means “gradual,” is glossed
as follows: (a) it refers to a disease that enters the body thorough the nose
and subsequently affects the other “entrances” (’jug sgo), i.e. it manifests by
penetrating the skin, then gradually affects the flesh, the channels, the bones,
and the organs; (b) it describes the contagious nature of the disease, which
can spread through impure solid substances (dri dngos) or “air” (rlung) and
“smoke” (du ba) emanating from the “disease breeding ground” (nad yod sa),
and by infecting one after another, finally reaching “epidemic proportions”
(yams su rims kyis ’gos pa).27
Among the causes for such contagions, “impurity” (dri ma) is primary. The
term refers to physical defilements, deriving from the contact with impure
substances (human and animal), the pungent odors of infected bodies (nad
dri), and the effluvia that infest insalubrious places. This concept is further
developed within the context of the subgroup of nyen diseases. According to
the Instructional Tantra, unpleasant smells descend from the sky as pestilential vapors that are disseminated by irate goddesses, become morbific stains
that enter the body, and affect the organism. The Sons’ Benefit refers to the
celestial miasmas of diverse colors exhaled by mother goddesses (ma mo)
26
27
of the brain (glad zer); c) epidemics associated with “phlegm” (bad kan rims), i.e. diseases
characterised by aphasia and mental torpor (rmongs bu), are diseases characterized by a
state of dullness and muteness (lkugs pa). Bu don ma (Beijing: Mi rigs dpe skrung khang,
2009), 84/1–86/10. For a further analysis of the Bu don ma, see Henk Blezer, “A New Sense
of (Dark) Humor in Tibet: Brown Phlegm and Black Bile,” in the present volume.
Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud, 641/13–14.
Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud, 243/11–12. See also
Sangs rgyas rgya mtsho, Gso ba rig pa’i bstan bcos sman bla’i dgongs rgyan rgyud bzhi’i
gsal byed baidur sngon po’i mallika (Lhasa: Bod ljongs mi dmangs dpe skrun khang, 1982),
642/1–4.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
229
as disturbances that provoke specific rim diseases.28 The morbific stains are
invisible entities called parpata, categorized as sinbu (srin bu), which are
described at length in Sanggyé Gyatso’s Blue Beryl and Supplements to the
Instructional Tantra.
Nevertheless, “impurity” also refers to moral faults that occur due to social and religious transgressions, as well as the desecration of nature and the
dwellings of supernatural beings, which determine demonic influences.29 The
Moon King identifies “impurity” (mi gtsang), “malice” (’khon), and the “bad
smell of burning impure animal substances” (gzhog pa) as the “immediate
causes” for the onset of gaklhok (gag lhog), a specific class of contagious disease characterized by swelling throat and ulcers. According to this text, the
“disturbances” (’khrugs) of “planetary gods” (gza’), “lunar mansions” (rgyu
skar), “ferocious goddesses” (ma mo), and “local deities” (sa bdag) are causative factors of poxes (’brum bu).30 This idea is reiterated in the eighty-first
chapter of the Blue Beryl: the demonic assaults of nyen spirits (gnyan gdon)
are provoked by (1) the destruction or (2) the profanation of deities’ dwellings.
Here “impurity” refers to polluting substances (grib can)—human odor, garbage, leftovers, and so forth—thrown into spirits’ abodes. Fireplaces are also
considered impure when the burning stoves (thab) leak various substances
such as water (water extinguishes fire and leaves wet ash), blood, butter, or
milk. Other impure substances include “burning animal parts,” such as skin,
fur, and bones, which produce “foul smoke” (dud ba ngan). Impurity can also
be more abstract, referring to the “performance of wanton actions” (’jol nyog
spyod pa), such as slaughtering animals, Buddhist monks or Bönpos who have
no time to properly perform the “preliminary practices, sādhana meditation,
and ritual activities” (snyen sgrub las gsum), or contaminating spirit dwellings
with impure substances used for “black curses” (mthu gtad).
28
29
30
The female spirits called ma mo are ichnographically represented as wrathful sorceresses
with emaciated and pendant breasts, bringing sacks full of diseases. In some cases, the
ma mo are hybrid figures with animal heads. See René de Nebesky-Wojkowitz, Oracles and
Demons of Tibet: The Cult and Iconography of the Tibetan Protective Deities (Delhi: Book
Faith India, 1993), 269–72. Bu don ma, 84/3–4.
See Giuseppe Tucci, Le Religioni del Tibet (Roma: Edizioni Mediterranee, 1996), 217.
Sman dpad zla ba’i rgyal po (Leh: Tashigang, 1989), 69r/3–6. This disease is a classified
as a hybrid nyenrim disease; its onset is characterized by the eruption of pustules and
bulla caused by excessive impure blood and “yellow fluids” (chu ser, lit. “yellow water”)
beneath the skin; the process of suppuration starts from the feet and spreads overall the
body. There are two categories of poxes: 1) “white poxes” (’brum dkar) caused by the combination of phlegm, wind, and cold disorder (bad rlung grang ba shas che); and 2) “black
poxes” determined by bile and blood (mkhris khrag shas che). See Byams pa ’phrin las et al.,
Bod lugs gso rig tshig mdzod chen mo (Beijing: Mi rigs dpe skrun khang, 2006), 599.
For use by the Author only | © 2019 Koninklijke Brill NV
230
Simioli
The idea of contagion is related to a multidimensional perception of “impurity,” which involves magical-religious conceptions and also has moral connotations. This aspect reflects, again, a correspondence with ideas developed
in Vāgbhaṭa’s work, and it is also comparable to the similar category of “errors
of judgment” found in the Compendium of Caraka (carakasaṃhitā):31 the individual predisposition to be affected by contagious fevers is rooted in negative mental attitudes and emotions, such as harboring hate, ager, fear, longing,
and suffering, which are conceived as immediate causes of rim fevers.32 When
moral degeneration and decadence penetrate every social level, contagious
fevers reach epidemic proportion. This point is particularly stressed in the
Instructional Tantra and even more radically, as we will see, in the prophetic
Vase of Amṛta, which starts with the narration of the fall of human society as
the cause of pestilence and demonic forces.
Another fundamentally remarkable correspondence between the Instructional Tantra and the Vase of Amṛta concerns the idea of poison in relation to
demonic influences. While Vāgbhata’s Essence of the Eight Branches clearly distinguishes the scents of plants (sman dri), poisons (dug), and demonic attacks
(gdon gzhugs) as three different causes of rim diseases, the Instructional Tantra
describes “poisonous influences of malevolent spirits” (’byung bo’i gdug) as a
possible cause of contagion. This interpretation is restated in later exegetical
sources, such as the Blue Beryl and the Supplements to the Instructional Tantra.33
3
Etiology and Taxonomy of Nyen and Rim according to the
Vase of Amṛta
The etiological models described in the Vase of Amṛta are consistent with
those already examined. Both the natural and the demonic aspects of
nyenrim are considered concomitant, but in the context of this prophetic literature, the moral and the supernatural causes of the disease are emphasized.
According to the Vase of Amṛta, human arrogance and misbehaviors outrage
31
32
33
See Dominik Wujastyk, The Roots of Āyurveda: Selections from Sanskrit Medical Writings
(London: Penguin Books, 2001), 79–91.
Yan lag brgyad pa’i snying po bsdus pa 312/23–313/4; Bdud rtsi snying po yan lag brgyad pa
gsang ba man ngag gi rgyud, 243/9–10; and Gso ba rig pa’i bstan bcos sman bla’i dgongs
rgyan rgyud bzhi’i gsal byed baidurya sngon po’i mallika, 641/14–19. See also Sangs rgyas
rgya mtsho, Man ngag gi yon tan rgyud gi lhan thabs, 97/6–7.
See the previous note. See also Olaf Czaja, “The Four Tantras and the Global Market:
Changing Epistemologies of Drä (’bras) versus Cancer,” in Medicine Between Science and
Religion, ed. V. Adams et al. (New York, NY: Berghahn Books, 2011), 286.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
231
the demons and gods of the eight classes (sde brgyad), and in turn the ferocious mamo exhale noxious (dug can) breath (kha rlangs), which forms clouds
in order to disseminate deadly diseases. The final five hundred years of our
cosmic eon are called a “dark age” (snyigs dus) of moral and spiritual degeneration, characterized by the dissolution of the social order and by the downfall of
religious vows, wars, famine, and the diffusion of pestilence. The nature of the
disease is vividly described using an imaginative and codified language, as can
be inferred from this passage of the Vase of Amṛta, entitled Treatment for the
All-Encompassing Oblivion: The Amṛta of Riving the Dead (cog ’gyel bcos thabs
bdud rtsi shi sos):
[…] During the five hundred eons of degeneration, atrocious and horrific diseases [will appear]. They will be called the “poisonous allencompassing oblivion,” or the untimely death that befalls unexpectedly,
baring its teeth with a sardonic grin. Trying to dispel them will be like facing a raging fire. They will be the death that comes under the conditions
conducive to epidemic infections, and they will be difficult to cure. The
mere sound of them will strike terror […].34
The nyen disease described in the Vase of Amṛta comes under the category
of the “black poisonous all-encompassing oblivion” (ha la cog ’gyel nag po),35
a complex concept that simultaneously defines both the virulent and the
deadly aspects of the pathology. Its symptoms are compared to those of a potent “poison” (ha la). Its fatal nature is expressed by the term chokgyel (cog
’gyel), which portrays the image of a multitude of falling corpses claimed by
the disease, which “steals their life-supporting breath” (lus srog dbugs ’jags
par byed pa).36
The dramatic description is ultimately accomplished with the demonic embodiment of the disease, which is represented by a ferocious sardonic mask.
Nyen refers to a particular class of liminal beings dwelling in natural abodes,
but at the same time it also identifies a particular class of diseases, heralds
of divine ire, pathologies that are characterized by the presence of a noxious
34
35
36
’Chi med bdud rtsi bum pa (1), 71v/1–3.
’Chi med bdud rtsi bum pa (1), 73/7.
The Great Dictionary of Tibetan Medicine describes this nyen disease, which mainly affects
the brain and the heart, as follows: dug can srin bus bskyes pa’i gnyan nad stobs chen snying
dang klad pa la phog nad yod do kun ’gyel te srog ’dor byas pa’i don (Byams pa ’phrin las
et al., Bod lugs gso rig tshig mdzod chen mo, 998).
For use by the Author only | © 2019 Koninklijke Brill NV
232
Simioli
parasite in the organism (dug can srin), which is related to the increasing impure yellow serum (chu ser) and blood.37
The term nyen, which already connotes the malignant nature of the diseases, is often correlated to specific adjectives, such as “wild” (rgod pa), thereby
revealing the interpretation of the disease as an aggressive force, similar to a
wild animal that can feed on human flesh. This is the initial phase of the disease, which corresponds to the demon’s bite (gdon gyi so bas bzung ba).38 The
description of the disease called lhokpa (lhog pa), which subsumes different
kinds of ulcers and swelling sores, is a paradigmatic representation of the fiery
essence of nyenné. Lhokpa is described as follows:
[Among] the signs of the disease [by which one can diagnose lhokpa]
there is the [taxonomic] category of the four elements. The lhokpa disease associated with the wind element [is characterized by] pale and soft
[pustules], the swelling is temporary and pulsating, and it is similar to a
belly full of yogurt. The lhokpa associated with the fire element is bloody
and painful, it manifests as a strong fever that flares up quickly and is
permeated with a heat, which possess the quality of a flaming immeasurable mansion. The lhokpa disease associated with the water element is a
swelling disease, soft and wet, and characterized by cool vesicles, which,
to using a metaphor, [are cold] as a blue glacial turquoise lake. The lhokpa
disease associated with the earth element is firm and solid; the swelling
is firm and black in color and spreads over the head. It is similar to an
iron pan turned upside down with the opening [on the ground]. Besides,
there are the two categories of wild and wildest. The wild one spreads as
quickly as a running elephant, the pain is strong, and it rides on the channels. The wildest is characterized by a large swelling [similar to] a volcano
and it spreads radiating towards the edge [of the wounds]. It is also called
the thorny plant with nine heads.39
Here wild (rgod) and wildest (yang rgod) represent two distinct categories
of this disease, or two different degrees of the same disease. This taxonomy
and the related terminology are also kept in later works on nyenné, such as
Supplements to the Instructional Tantra.40 The preservation of this metaphorical
37
38
39
40
’Chi med bdud rtsi bum pa (2) 40/ 17–18. See also the Guru’s Lesser Vase (gu ru bdud
rtsi bum chung), which also was rediscovered by Dorbum. Slob dpon gso rig gces btus,
193/10–11: […] ming ni srin bu par pa ta zhes bya ba yin//.
’Chi med bdud rtsi bum pa (2), 10/15.
’Chi med bdud rtsi bum pa (2), 123/19–124/11.
Sangs rgyas rgya mtsho, Man ngag gi yon tan rgyud gi lhan thabs, 208/13–209/8.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
233
language is indicative of a certain level of coherence of the intellectual representation of these ulcers in pre-modern Tibetan medicine.41 Interestingly, this
same description is found in the Son’s Benefit, where this description is said to
drawn upon an oral pith instruction text (man ngag).42
According to the Vase of Amṛta, the natures of all the diseases are identical, but what differs is the specific organ or part of the body that is affected.
The five macro-categories of nyenné are distinguished as follows: when the
disease manifests externally (phyi ru byung ba), it becomes the aforementioned lhokpa (lhog pa), which has also three subcategories of “doe disease” (yu
mo),43 the “lhok disease affecting internal [organs]” (khong lhog), and the “lhok
disease affecting the calf” (byin lhog). When lhokpa affects the throat (gre bar
byung ba), it is gakpa (gag pa); when it affects the viscera (don la babs pa), it is
zertung; when it affects the hollow organs (snod par babs ba), it is “the pain afflicting the gastrointestinal tract” (rgyu zer) and “pain afflicting the upper part
of the body” (stod zer).44 Along with these five, the texts enumerate the following rimné and nyenrim diseases: “epidemic influenza” (chams rims); “white and
black poxes” (’brum dkar dang nag), and other similar diseases called bekgé
(beg ge), “yellow-eye disease” (mig zer), or even the “disease affecting the brain”
(klad zer); “plague” (byis rims, lit. “an epidemic [spread] by rats”); “dysentery”
(dmar bshal); “twisted esphagus” (mid ’chus); and “sardonic grin” (’dzum ltag
dgye), which aligns with the category of tetanus.45
41
42
43
44
45
In the history of ancient Eurasian medical systems, there are analogous cases. For example, the Hippocratic Corpus describes the nature of ulcers as “wild” or even “ferocious,”
using a vocabulary inherited from Greek tragedies. Indeed, as the Hippocratic doctors
transformed the metaphorical language of tragedy into technical language, medical
scholars drew upon the imaginative and religious representation of disease provided
in visionary works such as the ’Chi med bdud rtsi bum pa. For a further reading on the
Hippocratic concept of epidemics see Jacques Jouanna and Neil Allias, trans., “Disease
as Aggression in Hippocratic Corpus and Greek Tragedy: Wild and Devouring Diseases,”
in Greek Medicine from Hippocrates to Galen, ed. Philips van der Eijk (Leiden: Brill, 2012),
81–96.
Bu don ma, 121/1–122/2.
“Doe disease” (yu mo) is a swelling disease characterized by spotted pustules similar to
small pox. ’Chi med bdud rtsi bum pa (1), 111v/4–112v/1.
’Chi med bdud rtsi bum pa (1), 63v7/1–69v/4.
The disease causes spasms that affect the facial muscles resulting in the appearance of
a sardonic grin; it causes spasms of the back muscles and the consequent arching of the
neck bones and spine. See ’Chi med bdud rtsi bum pa (1), 93r/5–93v/4.
For use by the Author only | © 2019 Koninklijke Brill NV
234
Simioli
3.1
Diagnosis and Divinatory Prognosis of Nyenrim According to the
Vase of Amṛta
The following section will be devoted to the examination of the diagnostic
techniques described in the Vase of Amṛta: we will observe how the hermeneutics of pathology are based on a detailed differential description of the
diseases, which starts from the general symptomatology and proceeds to the
specific symptoms, and lead to the localization and the identification of the
noxious demons. The passages reveal a methodical accuracy that is a distinctive feature of a medical mentality: the spectrum of the symptoms, which in
itinere becomes more and more specific, serves as frame of reference to isolate
the significative morbific features, reconstruct the taxonomy of the pathology
(see the above description of ulcers), and consequently apply the right cure.46
The description provides us with a sophisticated depiction of the internal
body, which is the result of overlapping models of physiology that originated
in tantric and medical matrices. The analyzed sections unfold an internal landscape of intricate paths (lam) connecting functional organs to hollow organs
and sense organs (section 3.2), and hint to the visionary system of subtle light
channels called “lamps” (sgron ma) of the Nyingma Great Perfection (rdzog
chen) tradition (sections 3.2 and 3.3). The discussion will illustrate the inextricable twofold nature of the diagnostic process described in the Vase of Amṛta,
at the same time divinatory and based on empirical observation.
The main diagnostic sections of the Vase of Amṛta are: (a) the root diagnostic
tantra, entitled Union of the Sun and Moon (rtags pa nyi zla kha sbyor), otherwise called the Mañjuśrī Heart Essence: Union of the Sun and Moon (’jam pa’i
dbyangs kyi thugs kyi bcud nyi zla kha sbyor);47 (b) its commentary entitled
the Exegetical Tantra Mañjuśrī Heart Essence: Union of the Sun and Moon,
otherwise called the Exegetical Tantra: The Sun Illuminating the Diagnostic
Signs (brtags pa nyi ma’i snang gsal bshad rgyud);48 (c) the Innermost Pillar
of the Vital Force (yang gsang srog gyi ka chen);49 and (d) the Great Treasure of
Vital Strength (srog gter chen gyi gyad).50 Both the Mañjuśrī Heart Essence texts
begin with the invocation of Mañjuśrī, the primordial Buddha Vagiśvara, and
46
47
48
49
50
On empiricism in Tibetan medicine see Janet Gyatso’s groundbreaking work: Janet
Gyatso, Being Human in a Buddhist World: An Intellectual History of Medicine in Early
Modern Tibet (New York, NY: Columbia University Press, 2015).
’Chi med bdud rtsi bum pa (1), 7v/1–9v/1; ’Chi med bdud rtsi bum pa (2), 10–12.
’Chi med bdud rtsi bum pa (1), 9v/1–12v/5; ’Chi med bdud rtsi bum pa (2), 10–19.
’Chi med bdud rtsi bum pa (1), 44v/4–45v/6; ’Chi med bdud rtsi bum pa (2), 47–52.
’Chi med bdud rtsi bum pa (1), 35v/4–38r/1. In the ’Chi med bdud rtsi bum pa (2), 40–44; the
title is the Medical Compounds of the Great Treasure of the Vital Strength (srog gter chen gyi
sbyor ba).
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
235
his Bodhisattva youthful form, Kumāra. Being the embodiment of transcendent wisdom, he discerns the different aspects of these fatal diseases and can
guide the practitioner during the diagnosis, thus the signs will appear clear
to him as the “vision of the rising sun light” (rtags nyin shar dang ’dra). The
diagnostic procedure is conceived as a process of divine inspiration (rtogs pa
dang ldan pa dang zhing lha’i nga rgyal dang ldan).51 As we can infer from an
analysis of the corpus, however, the diagnostic instructions in the root and exegetical tantras are also based on the detailed empirical observation of general and specific symptoms (spyi dang byed brag gi brtags) that manifest in
connection with the three aspects of the diseases, which are “wind” (rlung),
fever (tshad), and nyen. This is the reason why the disease is called the “black
one, union of the three” (nag po sum sgril). Although, as we shall see, the progression of the disease is associated with the three humors, the connection of
the demoniac disease with deviant winds is particularly stressed and points to
an ancient medical conception, developed in different medical contexts. The
Carakasaṃhitā describes the normal and abnormal function of wind with its
divine creative and destructive powers, in nature and humanity.52 The perverted wind-demonic force (guiqi 鬼气) also characterizes epidemics and the class
of xie 邪 diseases in traditional Chinese medicine.53
In order to diagnose the disease, the physician observes changes in the patient’s physical appearance and the physiopathology of pain through “channel examination” (rtsa brtags) and “uroscopy” (chu brtags). According to this
system, every disease is associated with the “three disturbing factors,” as well
as with “cold” (grang) or “heat” (tsha) manifestations of the febrile states and
with the “categories of the five elements” (’byung ba lnga’i rigs). The prodromal
phase of the disease, which is called the “gray unripened state of the disease”
(skya rims ma smin), is related to “wind” and fever. In this phase, the demonic
attack is detectable through the interpretation of “turbid dreams” (rmi lam
nyag nyog). The following excerpt describes the “wind” aspect of the disease:
In the case of “wind,” the pain is acute at dawn and in the evening (tho
rangs dang dgong shin tu rlang); ocular bulbs are painful and the person
may faint (mig ril na ’gyel snyoms byed); buzzing in the ears (rna ’ur) and
despair (snying mi dga’) arise, as well as febrile states characterized by
51
52
53
’Chi med bdud rtsi bum pa (2), 18/4–5.
Priyavrat Sharma, Carakasaṃhitā: Text with English Translation (Varanasi: Chaukhambha
Orientalia, 2014), 81–84.
Vivienne Lo and Sylvia Schroer, “Deviant Airs in Traditional Chinese Medicine,” in Asia
Medicine in Globalisation (Philadelphia, PA: University of Pennsylvania Press, 2005),
45–66.
For use by the Author only | © 2019 Koninklijke Brill NV
236
Simioli
intensive shivering (’dar bu). The symptoms are similar to those of “cold
diseases that belong to the category of the element water” (grang ba’i
nad ltar g.yo ’byung chu’i rigs); the pain is so strong that the bones of the
lower part of the body seem to boil (ro smad kyi rus pa khol). The “pulse
is empty and submerged” (rtsa stong bying) or “scarcely perceptible”
(nyams chung); feces and urine are retained and fever moves through the
circulatory system (rtsa chu dal ba rtsa kha tsha ba ’ong).54
The state of fever places these diseases under the “category of the fire element” (’byung me’i rigs), which are characterized by intense “shivering and
straight body hair” (phrum ser khyer), “dry nose and mouth” (kha sna skams),
and a “quick pulse” (rtsa mkhyogs). The intermediate and increasing state of
the disease (’bar rgyas rtags) is the visible sign of nyen. During this phase the
disease manifests the symptoms of “phlegm” (bad kan), “bile” (mkhris pa), or
combined disorders (’dus pa). The first category is characterized by a “black
tongue” (lce nag), “deterioration of the sense faculties” (dbang po nyams), a
submerged and “profound pulse” (gting rtsa), or a “subtle pulse” (phra rtsa)
and an “accelerated pulse” (myur rtsa). The latter category is associated with
the “element space” (’byung nam mkha’i rigs) and shows all the symptoms together (kun ’dus pa). The disease process culminates in irreversible injuries of
functional organs (don la ’babs). It should also be said that this diagnostic section finds correspondences in the general description of symptoms provided
in the Sons’ Benefit and the Four Tantras.55
3.2
Pathogenic Demonic Pulses in the Vase of Amṛta
The “pulses of obstructive beings” (bgegs rtsa) are the abnormal pulses of
functional organs and reveal the class and the nature of demonic forces. Every
functional organ is associated with a sense organ and one of the five elements,
which are considered “mounts of the obstructive forces” (bgegs ’byung ba bzhi
nam kha’ dang lnga rta la zhon). These pulses show clear similarities with descriptions provided in the Ultimate Tantra (phyi’i rgyud) of the Four Tantras
and with the medical literature predating it, such as the Lamp of Sunrays (nyi
zer sgron ma) attributed to Nāgārjuna. Every organ corresponds to a specific
class of elemental beings. According to the Vase of Amṛta, “king spirits” (rgyal
po) are related to the heart; “demons of madness” (smyo ’dres) are related to
the lungs; “serpent spirits” (klu), “earth lord spirits” (sa bdag), and “haunting
54
55
’Chi med bdud rtsi bum pa (2), 14/1–8.
Bu don ma, 84–99; Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud, 243
et passim.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
237
ghosts” (bstan) are related to the liver; “mother goddesses” (ma mo) and serpent spirits are related to the kidneys; and “cannibal demons” (sa srin) are related to the intestines.56
These obstructive forces are localized through: (a) their entrances (’jug sgo);
(b) their “wandering pathways” (’grims pa’i srang); (c) “regions and residences”
(yul gnas); and (d) “fortresses” (rdzong).57 A geographic imaginary is involved
in the construction of the environment for the description of the pulses.
(a) The demon of the regal caste (rgyal rigs) mounts the fire element and enters the body from the life-force cakra (srog ’khor) aperture of Brahmā at the
top of the head. The demon of the servile class (dmangs rigs) mounts the water
element and enters the body from the door of the “karmic wind of formative
actions” (’du byed las kyi rlung) or from “nerves and tendons of the heel of the
foot” (rkang mthil chu rgyus sgo). The demon of the aristocratic class (rje rigs)
mounts the wind element and enters the body from “right subtle channel”
(ro ma’i sgo). The Brahmin demon (bram ze) mounts the earth element and
enters the body from the “door of the left subtle channel” (rkyang ma sgo
nas ’jug). The outcaste demon (gdol ba can) is a “friend of the space element”
(nam mkhar ’grog) and enters the body from the central “all-vibrating channel”
(kun ’dar ma).
(b) The king demon wanders from the triangular path of the heart to the
tongue. The aristocratic demon wanders from the “snowy mountain path of
the lungs” (gangs ri glo ba’i lam) to the nose (dri ’dzin lam); the Brahmin wanders from the “quartz-mountain path of liver” (mchong ri mchin lam) to the
eyes (gzugs’ dzin lam); the servant wanders from the “kidney path of nyen”
(mkhal ma gnyan lam) to the ears (sgra ’dzin lam); and the outcaste wanders
from the “spleen path” (mtsher lam) to the lips.
(c) The king demon’s domain is the “triangular region of the heart” (zur
gsum snying gi yul), and its residence is the intestines (rgyu ma nag du gnas);
the aristocratic demon’s domain is the snowy mountain of the lungs while its
“residence is the colon” (long gi nang gnas); the Brahmin’s region is the quartz
mount of the liver; its residence is the gallbladder (mkhris pa’i nang gnas); the
servant’s region is the cold region of the kidneys, while its residence is the
56
57
’Chi med bdud rtsi bum pa (1), 43v/2. See also Bdud rtsi snying po yan lag brgyad pa gsang
ba man ngag gi rgyud, 565/15–566/4; Rtsa yig cha nyi zer sgron ma (Beijing: Mi rigs dpe
skrun khang, 2008), 368/8–21. For a further inquiry into the concept of demonic diseases in Tibetan medicine see Susannah Deane, “Madness and the Spirits: Examining
the Role of Spirits in Mental Illness in the Tibetan Communities of Darjeeling,” in the
present volume.
’Chi med bdud rtsi bum pa (1), 42r74–43r/5; ’Chi med bdud rtsi bum pa (2), 48/7–49/17.
For use by the Author only | © 2019 Koninklijke Brill NV
238
Simioli
urinary bladder (lgang pa). The outcaste’s region is the secret spleen and its
residence is the stomach (pho ba’i nang du gnas).
(d) The king demon lives in the heart-fortress, the “mind-lake of memory”
(tsi ta dran pa’i mtsho); the aristocratic demon lives the kidney-fortress, the
“tent-like-lake of the breath” (gur khyim dbugs gi mtsho); the Brahmin lives in
the liver-fortress, the “quartz-mountain and lake of blood” (mchong ri khrag
gi mtsho); the servant lives in the kidneys-fortress, the “lake of urine and cold
disease” (grang ba chu’i mtsho); and the outcaste lives in the spleen-fortress,
the “lake of fever and composite disorders” (tsha ba ’dus pa’i mtsho).
3.3
The Signs and Pulses of Death
The “final signs of death” (tha ma ’chi rtags) are detected through the observation of “dissolving sense-faculties” (dbang thim) and can be predicted by examining the channels (’phar rtsa sgo nas brtags) and by interpreting premonitory
secret signs. In this section, we will analyze the first two methodologies, while
the third will be considered in the next section. In particular, we will observe
that, according to the text, each external sign of a limited or absent sense faculty corresponds to an internal sign concerning an injured or collapsed functional organ, which ultimately reveals the dissolution of the related elemental
constituent (don lnga’i khams nyams).
The dying process is essentially the “dissolution of the five elements” (’byung
ba thim) and takes place when the elements fade one into another, in reverse
order to that of the birth process.58 The Vase of Amṛta does not refer to the visions experienced during this dissolution, which are usually found in other tantric texts. The breathing process indicates radical changes of the directions of
subtle winds, which start from the nostrils (sna rlung g.yas g.yon ’gyu chad log).
When the earth element dissolves into the water element, the spleen is injured
and the sensation of intense heaviness prevails. The process continues with
the water fading into fire, which corresponds to dysfunctions of the kidneys,
indicated by the dissolution of the sense-faculty of hearing. Subsequently, the
element fire fades into the wind causing deficiency of body heat. This is a sign
that the disease has reached the liver and therefore leads to the dissolution
of the faculty of sight. Then consciousness dissolves into the wind elements
and “breath is reversed” (dbugs ldog); it connotes injury to the lungs and the
dissolution of the faculties of smell. When the heart is injured, the faculty of
taste is hindered.
58
The second chapter of the Explanatory Tantra (bshad rgyud) of the Four Tantras is devoted to the description of the birth process or “formation of the body.” See Bdud rtsi snying
po yang lag brgyad pa’i gsang ba man ngag gi rgyud, 16/7–20/7.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
239
Death pulses also show clear similarities with the description provided in
the Ultimate Tantra and the Lamp of Sunrays. Among these pulses there are:
(a) those regarding the signs that a “disease of the water class that manifests
in the case of a disease belonging to the class of the fire element” (chu rtags
me la byung), which means that the fevers and the pulses typical of a febrile
state show characteristics that are usually associated with cold diseases; and
(b) the process opposite to the previous one that occurs when the “signs of
the diseases usually associated with the class of the fire element manifest in
case of a disease characterized by the element water” (me rtgas chu la byung).59
This irregular manifestation is considered to be a result of the deceiving action
of these demonic diseases. In another section of the text is said that, when
hot and cold diseases present anomalous signs (tsha grang ma snyoms), the
physician should be able to discern the real cause of the diseases through his
or her penetrative knowledge, similar to an arrow of awareness (rig pa’i mda’),
or like the blacksmith’s instrument, which can “dismember the illusory body”
(sgyu lus dum bur btub) created by the demons.60 In this passage it is affirmed
that, to cure the nyen disease, it is indispensable to rely on the scriptures, to
know the nature of the disease (ngo ’dzin) and then accordingly apply the right
cure (knowing the potencies of the medical substances; apply moxibustion or
bloodletting; dietary and behavioral prescriptions). When these criteria and
measures are insufficient, however, the physician will not fail due to the inspiration of the invoked divinity.
What follows is a description of the death pulses expressed through similes
of the exegetical tantra, the Union of the Sun and Moon, which again includes
some correspondences with the above mentioned Four Tantras and Lamp
of Sunrays.
When the pulse resembles a frog jumping in the water, one is about
to die.61
When the pulse resembles a falling drop or a bird that pecks grain from
the ground, one is about to die.62
59
60
61
62
’Chi med bdud rtsi bum pa (2), 17/10.
’Chi med bdud rtsi bum pa (2), 8/1–4 and 21/1–4. See similar definition of the demonic
pulse in the Gso ba rig pa’i bstan bcos sman bla’i dgongs rgyan rgyud bzhi’i gsal byed baidur
ya sngon po’i mallika, 1537/10: […] rtsa mi snyoms pa.
This corresponds to the death pulse of a combination of phlegm and bile.
This corresponds respectively to the death pulse of phlegm and the union of phlegm and
wind.
For use by the Author only | © 2019 Koninklijke Brill NV
240
Simioli
When the pulse resembles a great banner blowing in the wind, one is
about to die.63
When the pulse resembles to dropping saliva of a bull, one is about
to die.64
As we can see here in the Vase of Amṛta we find only seven of the eleven pulses
of death described in the Ultimate Tantra, excluding those regarding the weak
pulse of a strong person, the pulse of long debilitated person, and the deviations in the bile pulse.65
3.4
Premonitory Signs of Death
Two groups of extraordinary premonitory signs are provided by the Pillar of
the Vital Force (srog gyi ka chen) and by the Treasure of the Vital Force (srog
gter chen gyi gyad). All the signs are obscure metaphors correlated to exact
interpretative keys. The Treasure of the Vital Force compares these signs to the
hermetic images appearing in a mirror (brtags pa ’phrul kyi me long), therefore
creating a parallel between this divinatory prognosis and prasenā divination.66
What follows is the translation of the signs described in the Pillar of Vital Force:
If on the top of the mountain of the magical wheel the turquoise mist
disappears, one is about to die.
If the vapor emanated from the head dissolves, one is about to die.
If the signs of pristine cognition disappear in the lamp-radiance of the
ocean, one is about to die.
If the iris, queen of the eye, appears soulless, one is about to die.67
If the pillar of the Sky and Earth is destroyed in the space, one is about
to die.
If the two forearms in the space appear like being cut off in the middle,
one is about to die.
63
64
65
66
67
This corresponds to the death pulse of wind.
This corresponds to the death pulse of combined humors.
’Chi med bdud rtsi bum pa (2), 17/15–20. See also Rtsa yig cha nyi zer sgron ma, 371/8–372/1.
Rgyud bzhi, 565/4–6.
’Chi med bdud rtsi bum pa (2), 43/11–12. On prasenā divination see William A. McGrath,
“Tantric Divination and Empirical Diagnosis: A Genealogy of Channel Prasenā Rituals in
the Tibetan Medical Tradition,” in the present volume.
’Chi med bdud rtsi bum pa (2), 51/9–10: […] rgya mtsho mdangs kyi sgron ma la ye shes rang
rtags yal na ’chi. The iris (mig gi rgyal mo) is the residence of the subtle channel where
inner wisdom manifests on the outside through vivid eye light.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
241
If the sound of the ḍākinī ceases within the inner recess of the forest, one
is about to die.
If there are no sounds in the ears, one is about to die.68
If one of the five guards that stay together, stands up one is about to die.
If the artery of the ring finger pulsates, one is about to die.69
If the sun rises on the wheel of magical manifestations, one is about to
die.
If the body heat of the legs vanishes, one is about to die.70
If from the maṇḍala of water and great bliss, the moon goes down, one
is about to die.
If semen is emitted, one is about to die.71
The sign of the pulsating ring finger similarly occurs in the Ultimate Tantra as
a sign of the demonic forces, or nyen: the “life-force channel” (bla rtsa), which
is connected to the concept of life essence (srog) and life span (tshe), can be
detected thought the pulse of the ring finger.72 The Exegetical Tantra (bshad
rgyud), the second treatise of the Four Tantras, includes the premonitory signs
of death regarding optical illusions appearing in the space, the examination of
unusual shapes of the body shadow, as well as the analysis of iris luminosity.73
These series of metaphors remind one of the cryptic images described in the
Union of the Sun and Moon (nyi zla kha sbyor) of the Seminal Essence (snying
thig) scriptures of the Great Perfection (rdzogs chen), part of the Collected
Instructions (man ngag sde).74 The following quotations are two examples of
68
69
70
71
72
73
74
’Chi med bdud rtsi bum pa (2), 51/12–13: nag ’dabs gsang ba’i brag phug tu/ mkha’ ’gro’i rang
sgra chag na ’chi/ rna ba’i sgra chag na ’chi//.
’Chi med bdud rtsi bum pa (2), 51/13–14: sdud byed so ba mi lnga nad so ba mi gcig lang na
’chi/ srin lag gi rtsa ba ’phar na//.
’Chi med bdud rtsi bum pa (2), 51/14–15: sprul ba ’khor lo’i grong khyer nas nyi ma gyen la
’dzeg na ’chi / rkang pa’i drod yal na ’chi//.
’Chi med bdud rtsi bum pa (2), 51/15–16: bde chen chu’i dkyil ’khor nas zla ba thur du babs na
’chi/ sa bon ’dzag na ’chi//.
Baidurya sngon po, 1559/1–4.
Bdud rtsi snying po yan lag brgyad pa’i gsang ba man ngag gi rgyud, 32/11; 33/1–5;37/7–16.
According to Ronald Davidson (Tibetan Renaissance: Tantric Buddhism in the Rebirth of
Tibetan Culture [New York, NY: Columbia University Press, 2005], 228–29), the Collected
Instructions (man ngag sde) most probably were compiled around the eleventh and the
twelfth centuries. See also the Instructions on the Six Lamps from the Aural Transmission
from Zhang zhung of the Great Perfection (rdzogs pa chen po zhang zhung snyan rgyud las
sgron ma drug gig dams pa): its sixth and last chapter is very similar to the Nyi zla kha
sbyor section on the signs of death but contains further explanations. Zhang zhung snyan
rgyud zhang zhung snyan rgyud las sgron me drug gi gdams pa. In Zhang zhung snyang
rgyud kyi gsung pod (Lun grub steng: Sde dge par khang, [n.d.]), 10a/5–11a/6.
For use by the Author only | © 2019 Koninklijke Brill NV
242
Simioli
the paradigmatic correspondence: “When the pillar of the Sky and Earth is destroyed, one is about to die” (gnam sa gnyis kyi ka gdun de/ bar snang chag na
’chi); “If the sound of the ḍākinī ceases within the inner recess of the forest, one
is about to die” (nag ’dabs gsang ba’i brag phug tu/ mkha’ ’gro’i rang sgra chag
na ’chi).75 Therefore, we might assume that some diagnostic methods and divinatory techniques exposed in the Vase of Amṛta have connections with, and
could derive from, the notions developed in the context of the early Seminal
Essence literature.
At this stage of the research, the exact history of transmission of these diagnostic techniques cannot be established with certainty. However, the congruences among the various texts point to different literary traditions and
narrative nuclei as possible sources for the development of demonic pulses on
one hand, and for the prediction of signs of death on the other. The first represents a syncretistic literary tradition based on development of pulse taking,
which shows clear similarities with Chinese sphygmology, and had integrated
elements of the ancient Indian Buddhist demonology, magical healing, and
exorcistic methods emblematically represented by specific categories of tantras, such as the Garuḍatantras (see section 4). In this tantric literature the ailments of the human body are attributed to divine factors, and magico-religious
means are utilized in the cure. In the Tibetan medical context, the syncretic
elaboration of pulse-taking and demonology (bhūtavidyā) is well represented
by the scriptures ascribed to Nāgārjuna, such as the Moon King and the Lamp
of Sunrays. This second literary tradition has developed from a hermeneutic
sensibility that originated in the tantric investigation of ontological and soteriological themes. In this literature the examination of the nature of the mind
and death and dying processes are associated with yogic and contemplative
techniques for experiencing them. The cited Seminal Literature sources are
paradigmatic examples of these concepts.
75
’Chi med bdud rtsi bum pa (1), 44v/3–49v/1. The first verse is explained as an optical illusion that arises when staring at the forearms fixed in a particular position. For an analysis
on the corresponding verses in the Union of the Sun and Moon, see Giacomella Orofino,
Sacred Tibetan Teachings on Death and Liberation (Bridport, Dorset: Prims-Unity Press,
1990), 33, 93. See also Nyi zla kha sbyor chen mo gsang ba’i rgyud, in Rnying ma rgyud bcu
bdun (Dpal yul rdzong: A ’dzom chos sgar par khang, 2000), 28r/1–6; and Zhang Zhung
snyan rgyud las sgron ma drug gi gdams pa (Lun grub steng: Sde dge par khang, [n.d.]),
10a/5–11a/6.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
243
3.5
Knowing the Body and Defining the Nature of the Diagnostic Process:
Overlapping Models of Physiology
The Vase of Amṛta provides us with a complex image of the body that integrates
elements of different medical systems with demonology and tantric physiology. In the following, this imagery will be used as a guiding thread for reexamining the previous sections. In light of these therapeutic systems, we will also
consider the diagnostic processes as a joining of divination and observation.
As seen, the architecture of the body is organized according to spatial and
temporal patterns. The perspectives are pushed inwards, moving from material embodiment (skin, muscle, bones, organs, and arteries) to the luminescent innermost essence of being (subtle channels, winds, and awareness).
Accordingly, it can be observed that the first step of the diagnostic process is
the perception of the body through visual observation (patient’s physical appearance and mental status), pulse taking, and urine analysis. Therefore, the
signs (rtags) are interpreted in order to formulate a series of inferences and
establish a prognosis. This process is complemented by speculative models:
the medical approach to the diseases is underpinned by the theoretical apparatus of Buddhist cosmology, physiology, and knowledge of the nature of
mind and its structures. The disease process is not only outlined according to
Āyurvedic humoral physiopathology, but it also mirrors the dissolution of the
elements (earth, fire, water, wind, and space), which regulates the state of constant metamorphosis of the entire universe.
The internal body is depicted as a microcosm, a reflection of the tantric
knowledge of subtle channels. It evolves around an axial construction, the
vital pilaster (srog gi ka chen) formed by three right, left, and central channels
(ro ma, skyang ma, and kun ’dar ma). The first two are connected on a more
physical level to breath and blood, while the third is connected to emptiness,
thus its materiality is considered very subtle. The channel of “karmic wind of
formative actions” (’du byed las kyi rlung) is associated to the triad: this corresponds to the channel of “karmic wind” (las kyi rlung), related to the arising of
discursive thoughts and karmic propensity, which is in several Great Perfection
sources and is described as abiding in the lungs or located between lungs and
heart.76 This channel might correspond to the “life channels” (tshe’i rtsa) of
vital breath, also described in Tibetan medical literature, such as the Exegetical
Tantra.77 According to Vase of Amṛta, consciousness and conceptual thoughts
76
77
Daniel Scheidegger, “The First Four Themes of Klong chen pa’s Tshig don bcu cig pa,”
Revue d’Etudes Tibétaines 16, no. 2 (2009): 67–68.
Janet Gyatso, Being Human in a Buddhist World: An Intellectual History of Medicine in Early
Modern Tibet (New York: New York University Press, 2015), 202.
For use by the Author only | © 2019 Koninklijke Brill NV
244
Simioli
arise due to the karmic wind, whereas the mind itself is located at the center of
the heart: the word citta (tsit ta) defines both the mind and the heart, which is
considered its palace, and is connected to memory (dran pa).
The text is consistent with the conception of mind luminosity developed
in the Seminal Literature of the Great Perfection. It shows similarities with
the conception of luminous channels or “lamps” (sgron ma), and in particular
the Vase of Amṛta refers to the capacity of “pristine awareness” (ye shes) to
show its luminosity (mdangs) through the eyes, elements that also indicate
the presence of a channel connecting heart to the eyes.78 Cognition (shes pa)
is associated to another channel called the “vital channel” (srog rtsa). Its affliction causes alteration of the mental status (shes ’khrul), as well as bloody
eyes and pain radiating all over the torso. This channel seems to be connected
both to the nervous system and the cardio-vascular system, as well as to the
life-force (bla rtsa) channel since it can be detected at the ring finger channel
(srin lag).79 Indeed, according to the Vase of Amṛta, cognition is also related to
different organs: it relates to the heart, whose role seems to be associated with
the clarity of thoughts, therefore, when the heart is affected by nyen, thought
loses its clarity (dran pa mi gsal shes pa ’tshub, lit. “unclear memory and turbid/
confused cognition”). Cognition is also related to the liver and spleen, which,
when damaged, determine different levels of “heavy cognition” (shes lci; shes
pa shin tu lci).80 In the first case, the problem occurs because liver cannot purify the blood, causing a disease that aligns to jaundice (mkhris nad, lit. “disease
of the gallbladder”; mig ser, lit. “yellowish eyes”); consequently this disorder
affects the brain (klad gzer), causing a loss of brain functions and bloody eyes.81
An injured spleen affects the formation of concepts and mental focus (dmigs
thams cad g.yo bar byed).82 We can assume that, even though the text does not
refer to the “vital channel” as “black or white vital channels” (srog dkar nag),
a distinction applied in the medical literature, it describes the vital channel
in terms of the functions associated to these two categories of channels. The
text provides us with the description of the location of the “vital channel” in
the physical body. Its upper extremity coincides with the cakra on the top of
the head (srog ’khor spyi gtugs). There also are scattered references within the
chapters explaining the secret points of moxibustion (me btsa’ gsang dmigs):
the secret point of the vital channel is located at the sixth vertebral digit, which
78
79
80
81
82
For further inquiry on “lamps” and their categories see Daniel Scheidegger, “Lamps in the
Leaping Over,” Revue d’Etudes Tibétaines 8, no. 10 (2005): 40 et passim.
’Chi med bdud rtsi bum pa (2), 63/13–18.
’Chi med bdud rtsi bum pa (2), 15/14–16/1.
’Chi med bdud rtsi bum pa (2), 15/21–24; 177/4–5.
’Chi med bdud rtsi bum pa (2), 12/ 17–18.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
245
is not far from the “equidistant point between the black and white” (dkar nag
mtshams), and the so-called “secret point of the heart” located at the intersection of the horizontal line between the nipples and the vertical distance between the throat cavity and the breast bones.83 Therefore, we can assume that
the “vital channel” extends from the head crown downward, passing through
the throat and heart, and connecting to the brain and the eyes.
This microcosm conforms to precise heuristic schemata of correspondences and contrapositions: geographical elements, citadels and paths establish a
web of connections among functional organs (heart, liver, kidneys, spleen, and
lungs) and hollow organs (intestine, colon, gallbladder, urinary bladder, and
stomach). This system of correspondences between the two groups of organs
derives from Chinese influence.84 The contraposition of mountains and lakes
denotes the nature of organs in terms of solidity and softness, and in particular
the watery aspect indicates the function, or the faculty associated to each vital
organ. The description involves anatomical details, such as those regarding the
intrathoracic triangular region with the heart at its center covered by the tentshaped lungs, an image that recalls the medical representation of the body
reproduced in the famous seventeenth-century medical paintings.
The landscape of the body is inhabited by wandering spirits that move
through the channel-paths, which connect the functional organs to the sense
organs. Therefore, by observing the sense faculties and detecting the deviating pulses, it is possible to understand which demonic classes have afflicted
the patient. The notion of five demonic fortresses is similar to the description
of spirit castles (mkhar) inhabited by pathogenic demons in the Diagnostic
Signs and Cures of the Eighteen Kuṣṭha Diseases Based on the Tantra of Peaceful
and Irate Manifestations (mdze rigs bco brgyad kyi rtags rdo rje bde khros kyi
dgongs pa las byung ba), ascribed to Nāgārjuna.85 According to this work, a
certain group of symptoms reveal the demonic fortress, and consequently the
right cure is administered. In the Vase of Amṛta the internal landscape might
be considered to be a demonological chart, envisioned in order to individuate the hiding spirits. It illustrates specific body areas or points that are to be
manipulated through different categories of moxibustion, such as “burning
83
84
85
’Chi med bdud rtsi bum pa (2), 125/16.
The Vase of Amṛta does not include a clear formulation of the “triple burner” (sam se’u),
the sixth hollow organ of Chinese medicine, which was assimilated in Tibetan medicine
through works like the Moon King. See William A. McGrath, “Vessel Examination in the
Medicine of the Moon King,” in Buddhism and Medicine: An Anthology of Premodern
Sources, ed. C. Pierce Salguero (New York, NY: Columbia University Press, 2017), 501–13.
Klu sgrub, Mdze rigs bco brgyad kyi rtags rdo rje bde khros kyi dgongs pa las byung ba, in
Slob dpon klu sgrub kyi sman yig (Beijing: Mi rigs dpe skrun khang, 2008), 140–42.
For use by the Author only | © 2019 Koninklijke Brill NV
246
Simioli
moxibustion” (me bsreg) or “warming moxibustion” (sdigs me), and bloodletting (gtar), which are prescribed as external therapies in the case of ulcers,
swelling diseases, poxes, and diseases afflicting the internal organs of the
upper and lower parts of the body (stod gzer and rgyu gzer). In this context, the
therapies are ritualized and reconfigured as methods to tear away the demonic
nyen from the body.
The healer is also instructed to observe the body in search of the wandering
nyen spirits. This should take place within the “vital channel” from the crown
of the head to the “red eye-channel” (mig dmar) below the navel at the groin
area, at the armpit point (dpung dzum), at the “ratna point of the wind channel” (rtsa rlung rat na), and at the heart secret point. Then, applying the “moxa
to close the channel” (rtsa’i ’bros ’phrang bsdoms), the practitioner should
block the demonic flow by burning a circumscribed area at the its perimeter
and then in the middle, where the nyen abides.86 Other two emblematic descriptions regard the “warming interdependent moxibustion” (sdigs rten ’brel
gyi me) and the “mirror moxibustion” (me long btugs me). The first consists of
burning the secret points of the first vertebral digit at the nape of the neck, the
sixth vertebral digit and at the secret point of heart, while reciting mantras to
tear away the serpent spirits from the body. The latter starts with an examination of the pulse and an analysis of a patient’s feces (’khru mdog) to individuate the injured hollow organ. Afterwards the mirror-moxibustion should be
performed using a mirror as an implement: it has to be applied directly on the
skin and where it reflects a specific form or, we might say when the practitioner
scries a significant vision, that point or area should be burned or pierced, since
this would be considered the demonic residence.87
A lengthy description of these two kinds of moxibustions is also provided
by Deumar: when performing the first kind of moxibustion, the practitioner
should visualize himself/herself as red fiery goddess and recite the mantra of
interdependence. In the second case, the evoked divinity dissolves in a consecrated mirror (pra thim), which is then used for moxibustion.88
In the Vase of Amṛta, the body is a system intelligible on multiple levels.
The evidence and visions of its nature and alterations change according to
the methodology of diagnosis. The signs are structured according to physician’s experiential understanding of the body and its functions; moreover, the
86
87
88
’Chi med bdud rtsi bum pa (2), 125/13–18.
’Chi med bdud rtsi bum pa (2), 140/21–24: […] mdun rgyab du me long btsugs pa de la gzugs
kyi rtags me long la snang ba de la btsod kyi me btsas bsreg.
De’u dmar bstan ’dzin phun tshogs, Lag len gces rigs sdus pa sman kun bcud du sgrub pa’i
las gyi cho ga kun gsal snang mdzod ces bya ba bzhugs in Dri med shel gong dang dri med
shel phreng dang lag len gces bsdus (S. W. Tashigang: Leh, 1970), 565/6–566/9.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
247
interpretation is substantiated by acquired knowledge based on the textual
tradition (zhung bzhin, lit. “according to the scriptures”) and divine inspiration.
In respect to the latter aspect, it should be said that in different passages the
text affirms that the interpretation of signs and the medical practice is guided
by Mañjuśrī or by a wrathful divine manifestation (see the next section). In
this sense the terminology “arrow of awareness” used to penetrate the illusion
created by demons and understanding the nature of the disease, assumes the
value of contemplative “state of awareness” (rig pa), which allows the physician
to discern the three causes of the disease (nyen, fever, and wind) and individuate the injured/afflicted organ. This divine arrow represents the trace of the
ancient divination and exorcistic ritual of sucking away (’jib rgyab) the disease,
which is alleged to be of Bön origin. This practice is carried out by setting up a
special divination-arrow (mda ’dar) to pierce the demon residence found by a
mirror and a bowl to collect the puss from the infected blood and serum.89 In
the Vase of Amṛta, the Reversal Suppressant [Ritual] of Sucking [the Infection]
with the Adamantine Sow’s Tongue (log gnon phag mo’i ljags ’jibs) clearly refers
to this practice: the healer is the manifestation of the Black Sow Goddess who
devours the nyen with her meteoric lips, a lancet (gtsag bu) is used to cut the
pustules of ulcers is envisioned as the “fangs of a wild boar” (phag rgog mche
bar bsgom), and the purulent serum sucked away from the scars becomes nectar.90 The use of mirror as a scrying implement associated with the practice of
moxibustion and the ritualized therapies to exorcise pathogenic demons not
only substantiates the divinatory aspect of the diagnosis, but also shows how
different methodologies have been adapted and assimilated in the Tibetan
medical tradition.
4
Magical Protection and Invulnerability: How to Realize the Vajra
Armor and Manipulate the Secret Potencies of Materia Magica
In the Vase of Amṛta, ritual magic (evocation rituals), image magic (preparation
of textual amulets), natural magic (uses and consecration of materia magica),
and alchemy merge into complex apotropaic rituals for averting diseasecarrier demons. The Long [Ritual] Vajra Armor of Meteoric Metal (nam lcags
rdo rje’i khrab ring) and the Armor that Protects the Vital Force (srog gi srung gi
89
90
de Nebesky-Wojkowitz, Oracles and Demons of Tibet, 365–66.
’Chi med bdud rtsi bum pa (1), 110r/1; ’Chi med bdud rtsi bum pa (2), 152/11.
For use by the Author only | © 2019 Koninklijke Brill NV
248
Simioli
go cha)91 describe the powerful practice of “vajra armor” (rdo rje’i khrab, otherwise called go cha or go khrab), which allows for the achievement of magical
invulnerability, of an unspoiled divine and immortal body. Not different from
the kavaca rituals found in diverse Hindu traditions,92 “vajra armor” includes
a certain set of practices: the recitation of magical formulas, the summoning of a divinity to enter the practitioner’s body, and the transformation into
a divine being. It also involves the preparation of protective textual amulets
(srung ’khor, lit. “protective wheel”), magical unguents (phyug sman), pills (ril
bu), and powders (phur ma). The preliminary purification process consists of
lengthy recitations of sūtras (mdo sde), “dietary prescriptions” (mi ’phrod za,
lit. “unwholesome food”), and sexual abstinence. The central practice includes
two phases: (1) “internal protection” (nang gi srung), which involves incantations, amulets and empowerments of medical substances; and (2) “secret protection” (gsang srung), or the meditative practice centered on the wrathful
blue Khyung (garuḍa).
Given the venomous nature attributed to nyenné and rimné diseases, the
Vase of Amṛta represents the conflation of a long-life nectar and an alexipharmic antidote. Different sets of substances called the “nine heroes” (dpa’ bo rnam
dgu),93 which belong to different categories of materia medica, are the fulcrum
of arcane alchemical procedures aimed at transforming substances into an
antidote for poisons and other diseases. The definition of the “nine heroes”
indicates their intrinsic therapeutic potencies and occult virtues (nus mthu),94
91
92
93
94
’Chi med bdud rtsi bum pa (1), 12v/1–16v3; ’Chi med bdud rtsi bum pa (2), 24–29; and ’Chi
med bdud rtsi bum pa (1), 104r/1–117v/6; respectively.
For a further inquiry see Karel R. Van Kooij, “Protective Covering (Kavaca),” in Selected
Studies on Ritual in the Indian Religions, ed. Ria Kloppenborg (Leiden: Brill, 1983), 118–29;
and Bühnemann, “Maṇḍala, Yantras and Cakra.”
The lists of substances provided in the ’Chi med bdud rtsi bum pa present some variations.
According to ’Chi med bdud rtsi bum pa (2), 24/16–18; the nine substances are gla ba, gu
gul, gi wang, shin kun, shu dag, sman chen, a ru ra, ldong ros, and sgog skya. According to
’Chi med bdud rtsi bum pa (2), 65/8–10; there are ten substances, i.e. gul nag, bong nga nag
po, spru nag, gla ba, shing kun, shu dag, mu zi, stag sha, ldong ros, and sa tshur. According
to ’Chi med bdud rtsi bum pa (2), 70/12–1; (a) the substances used for preparing the protective unguent are: gla ba, gu gul, shing kun, shu dag, rma chen, ldong ros, gi wang, tharnu,
and sgog skya; and (b) the substances used for the medicinal powders are: sha chen, spru
nag, stag sha, gla ba, mu zi, bong nga, yung ba, and ru rta.
Mthu means power and in general is used to indicate black curse. In this context, it refers
to the magical protective and reversal or exorcistic power (bzlog pa) of substances and
amulets. ’Chi med bdud rtsi bum pa (1), 14v/6–15r/1; ’Chi med bdud rtsi bum pa (2), 27/2–9:
[…] thams chad ’tshogs pa’i zu gu la sogs pa nus mthu yis// nad kyi bkal ba byung gyur rang
la ’gos pa mi srid do//[…] ’chi bdag bdud las bzlog par ’gyur […].
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
249
which are mainly apotropaic virtues. In this group there are substances of animal origin such, as musk95 and bezoar stones,96 which are considered excellent antidotes for poisoning. There are also plant exudate such as the guggul
gum resin,97 whose medical and ritual uses are well documented since ancient
Vedic times. There are substances of mineral origin such as sulfur and realgar, two important ingredients of mercurial medicine.98 The text enumerates
the myrobalan fruit,99 famous for its rejuvenating potencies, along with plants
used for curing different kinds of communicable and malignant diseases,
95
96
97
98
99
Gla ba. It is categorized as “essence medicines” (rtsi sman). Most probably it corresponds
to the male musk deer, responsible for the production of musk (gla rtsi can), which is
used in Tibetan medicine. It can be identified with the Siberian Moschus moschiferus
Linnaleus, see for example Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi me long (Beijing:
Mi rigs dpe skrun khang, 1995), 102; however, there are other possible identifications. See
Olaf Czaja, “The Substitution of Materia Medica in Tibetan Medicine: An Inquiry into
Traditional Tibetan Treatises,” East Asian Science, Technology and Medicine 46 (2017):
174–75. According to Jampa Trinlé et al. (Byams pa ’phrin las et al., Bod lugs gso rig tshig
mdzod chen mo, 116–17) gla rtsi can cure “poisoning” (dug nad), “kidney diseases” (mkhal
nad), nyen fevers, and infective “sin diseases” (srin nad). For detailed references on ancient medical uses of musk in Tibetan and Arabic medicine see Akosay and Yoeli-Tlalim,
“Along the Musk Routes,” 217–40.
Gi wang. See for example Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 99; and
Byams pa ’phrin las et al., Bod lugs gso rig tshig mdzod chen mo, 127–28. Both sources
describe giwang as a powerful remedy to cure poisoning, rim diseases, different kinds of
fever such as the fevers in infants (byis pa’i tshad), febrile states connected to several organs and in particular those affecting the liver and the bile duct (mchin mkhris gtsor rgyur
don snod kyi tshad sel), and episodes of hysteria followed by collapse and shivering (smyo
’bog brgyal dang ’dar ba).
Gu gul also belongs to the category of “essence medicines”; according to Gawa Dorjé (Dga’
ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 120) it is identifiable as Commiphora
mukul and is particularly efficacious in annihilating different kinds of obstructive spirits
and planetary hindrances (bgegs skrod, ’dre klu, bdud dug gsod; gza’ gsod); according to
Jampa Trinlé (Byams pa ’phrin las et al., Bod lugs gso rig tshig mdzod chen mo, 98–99) this
substance is particularly efficacious in curing “leprosy” (mdze nad) and other categories
of nyenrim diseases.
Mu zi and ldong ros. See for example Dga’ ba rdo rje,’Khrungs dpe dri med shel gyi me long,
72–73; 67–68.
A ru ra is commonly identified with the chebulic myrobalan fruit. See for example Dga’
ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 167–69. It is considered a very potent
rasāyana substance. It cures different kinds of fever and eye diseases, and “dispels evil
forces” (gdon sel ba).
For use by the Author only | © 2019 Koninklijke Brill NV
250
Simioli
epidemics, and poison-induced fevers, such as ferula,100 costus,101 turmeric,102
locoweed,103 the purgative root of tharnu (thar nu),104 Notopterygium,105 and
the poisonous black aconite.106
100
101
102
103
104
105
106
There are several identifications of shing kun plant, the majority belong to the Ferula species. For a detailed discussion see Czaja, “The Substitution of Materia Medica in Tibetan
Medicine,” 195–96. According to Gawa Dorjé (Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi
me long, 299–300) and Jampa Trinlé et al. (Byams pa ’phrin las et al., Bod lugs gso rig tshig
mdzod chen mo, 912–13) there are two variants of the shu dag plant both from the aquatic
Araceae species: the white one (shu dag dkar po) is identifiable with Acorus gramineus
Soland; the black one (shu dag nag po) is identifiable with Acorus calamus. Most probably, the author of the ’Chi med bdud rtsi bum pa, refers to the latter because this variant,
according to the mentioned sources, “can overcome diseases characterized by ‘impure
serum’ (chu ser), bad wounds and ‘putrefactions’ such as the gaklhok disease” (gag lhog
rma ngan rul ba rnams gcod la chu ser skam) and can also “bring out nyen fever” (gnyan
tshad gyen du ’dren par byed pa).
Ru rta is commonly identified with plants of the Asteraceae family commonly known as
Costus. For a detailed discussion see Czaja, “The Substitution of Materia Medica in Tibetan
Medicine,” 194–95. For further references on the therapeutic potential of Saussurrea
Lappa, see Kulsoom Zahara et al., “A Review of Therapeutic Potential of Saussurea lappa:
An Endangered Plant from Himalaya,” Asian Pacific Journal of Tropical Medicine 7, no. 1
(2014): 60–69.
Yung ba, according to Gawa Dorjé, is identifiable with Curcuma longa, a perennial plant of
the Zingiberaceae family, particularly effective against envenomation and nyen diseases.
See Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 192.
Stag sha is usually identified as a locoweed species. See Czaja, “The Substitution of
Materia Medica in Tibetan Medicine,” 197–98. According to Jampa Trinlé (Byams pa ’phrin
las et al., Bod lugs gso rig tshig mdzod chen mo, 321–22) there are two variants of stag
sha, both can cure nyen fevers, poison-induced fevers (dug tshad), different nyen diseases
and “swelling diseases” (skrangs po’i rigs), such as lhog pa, and chronic diseases (’bras
nad) that most closely aligns with the biomedical category of cancer. On this topic see
Twani Tidwell, “The Modern Biomedical Conception of Cancer and Its Many Potential
Correlates in the Tibetan Medical Tradition,” in the present volume.
Thar nu is a purgative root, which can cure lhog pa and nyen fevers. See Byams pa ’phrin
las et al., Bod lugs gso rig tshig mdzod chen mo, 336.
Spru nag. Gawa Dorjé (Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 240) identifies it with the Notopterygium forbesii Boiss. This plant can cure nyen and rim diseases,
“toothache” (so na ba), can stop “hemorrhages” (khrag shor ba), leprosy, urological, and
gastrointestinal disorders, can cure diseases connected to the yama type of sinbu (ya
srin), a kind of animalcule or parasite, which according to Tibetan medical texts can affect eyes and ears, thus the yama disease most closely aligns to sinusitis.
Bong nga nag po is usually identified as a “black variant of aconite” belonging to the
Aconitum species of Ranunculaceae family. See for example Dga’ ba rdo rje, ’Khrungs dpe
dri med shel gyi me long, 244–45. In the rasaśāstra literature, this poisonous plant is enumerated among the “five major poisons” (dug chen lnga) used to process mercurial compounds. See Simioli, “Alchemical Gold and the Pursuit of the Alchemical Elixir,” 62. Both
Gawa Dorjé (Dga’ ba rdo rje, ’Khrungs dpe dri med shel gyi me long, 245) and Jampa Trinlé
(Byams pa ’phrin las et al., Bod lugs gso rig tshig mdzod chen mo, 661) agree in identifying
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
251
The nine heroes should also be understood in term of their other appellation, “reversal suppressants” (log gnon). In the Scroll of Reversal Suppressant
Antidotes (log gnon gnyen po’i shog dril), all the substances are defined as the
“heroes that defeat Yama, the Lord of Death” (’chi bdag ’joms pa’i dpa bo).107
According to the Vase of Amṛta these virtues can be exploited to empower a
series of medical compounds, such as the five types of theriac (dar yak an).108
Theriac combines a plethora of ingredients, many even potentially venomous,
such as aconite, toxic animal substances, such as frog meats, or different kinds
of minerals, including mercury, which are substantially detoxified (’dul ba, lit.
“subjugated”) through complex alchemical processes.
These compounds are otherwise known as the “five nectars” (bdud rtsi lnga)
and are hence associated with a category of consecrated substances that play a
key role in the tantric context of “accomplishing medicine” literature and rituals.109 To be effective, the group of hero-substances undergoes a consecration
ceremony of accomplishing medicine (rab gnas sman grub), which starts with
an evocation ritual (spyang dren pa) aiming at transforming the substances in
ambrosia. Both the celebrant and the medicine become recipients of divine
107
108
109
sman chen with a variant of bong nga nag po: according to Gawa Dorjé, it corresponds to
the Aconitum kongboense Lauener, which is otherwise called btsan dug sman chen. Rma
chen is not identified, most probably it is a corrupted transcription of sman chen.
’Chi med bdud rtsi bum pa (1), 96v/6–97v/1. See Simioli, “Brilliant Moon Theriac.” Their
formulations are not unique to the Vase of Amṛta. See for example the Medical Compound
of the Nine Black Substances to Overcome Every Disease and Evil Force (nag po dgu sbyor ba
nad gdon kun ’joms) preserved in the Bye bya ring srel. See Zur mkhar ba mnyams nyid rdo
rje, Man ngag bye ba ring bsrel pod chung rab ’byams gsal ba’i sgron me (Lanzhou: Kan su’u
mi rigs dpe skrun khang, 1993), 727/6–728/16.
The five key substances of the theriac compounds in the ’Chi med bdud rtsi bum pa are:
mercury (dngul chu), as the key element of the “brilliant moon-theriac” (zla zil dar ya kan)
[’Chi med bdud rtsi bum pa (1), 88r/2–93r/5; ’Chi med bdud rtsi bum pa (2), 87–92]; calcite
(cong zhi), which is the key substance of the “fat-theriac” (tshil bu dar ka yan) [’Chi med
bdud rtsi bum pa (1), 118r/5–123r/6; ’Chi med bdud rtsi bum pa (2), 101/2–112/9]; locoweed
(stag sha) that acts as the key substance of the “meat-theriac” (sha dar ya kan) [’Chi med
bdud rtsi bum pa (1), 86r/46–88r/2; ’Chi med bdud rtsi bum pa (2), 82/8–86]; myrobalan
or Therminalia chebula (a ru ra), which is the main ingredient of the “bone-theriac” (rus
pa dar yak an) [’Chi med bdud rtsi bum pa’ (1), 81v/6–84r/6; ’Chi med bdud rtsi bum pa
(2), 79–82/7]; Chrysosplenium carnosum H. (gsha’ g.ya’; lha mo g.ya’, g.ya’ kyi ma), a key
ingredient of blood-theriac (khag dar yak an) [’Chi med bdud rtsi bum pa (1), 50v/1–56r/6;
’Chi med bdud rtsi bum pa (2), 93–101/1]. On Chrysosplenium carnosum see Dga’ ba rdo rje,
’Khrungs dpe dri med shel gyi me long, 283.
On consecrated nectars see Garrett, “The Alchemy of Accomplishing Medicine,” 300–26.
For use by the Author only | © 2019 Koninklijke Brill NV
252
Simioli
beings; in particular, each of the nine heroes is associated with a specific
Buddha’s manifestation.110
In order to achieve invulnerability, the nine substances must be eaten with
food and used to prepare a magical unguent. The text instructs one to intake,
or literally to “thrust into the body” (nang zug gu gzud),111 these substances in
order to protect the organs. The medicinal powder, once amalgamated with
animal fat or butter, becomes an unguent used to anoint the eight important points of the body (gnas brgyad), precluding them from demonic forces.
Inserted in the amulets, the powders cast out demons.
The Vase of Amṛta conforms to the model of the “Khyung texts” of the
Mahāyogatantra literature, which can be compared with other tantric medical
literatures centered on the cult of the Garuḍa and connected to the knowledge of poisons and their herbal and ritual healing methods.112 It prescribes
the practitioner to visualize himself as a powerful bird-of-prey deity, the transcendent emanation (sprul ba’i ye shes) of the wrathful “Great Noble Lord of
the Secrets” or Guhyapati (gsang bdag rje bstun chen po) Vajrapāṇi, who is unified with Hayagrīva, the “resplendent subjugator” of evil beings. The Khyung
should be envisioned while churning the primordial ocean with his “blazing
meteoric beak and claws” (gnam lcags ’bar ba’i mchu sder) and devouring the
serpent spirits that cause nyenné and rimné. The visualization is animated by
theomorphic figures which represent the wheel of life: eagles and ravens, wild
boars, and poisonous and medicinal snakes (dug sbrul dang sman sbrul).113
While absorbed in this non-dual state of profound and indissoluble communion with the real divine nature,114 the officiant is able to draw down the
virtues of divine intelligences. One is then instructed to impart them upon, or
better yet, infuse them into the images and diagrams inscribed with magical
formulas by reciting the incantations and empowering the medical powders
110
111
112
113
114
’Chi med bdud rtsi bum pa (1), 40r/5–6; 41v/2–3: […] sman so so rang rang gi// lha bskyed de
de’i steng du ye shes sems pa spyan drengs la// mchos stod bskur bsol bar gdab bar bya; […]
sman lha a ru ra gu ru yab yum sman chen gla ba// thugs rje chen po shu dag// manju shri
gi wang//gsang bdag gu gul// rta mgrin shin kun//bdud rtsi khyil ba mu zi// sgrol ma chig
skyes//.
See ’Chi med bdud rtsi bum pa (2), 24/16–20; ’Chi med bdud rtsi bum pa (1), 91v/3; provides
a different spelling: […] phru gu ’jug//.
Gregory Hillis, “The Khyung Texts in the Rnying ma’i Rgyud ’Bum,” in The Many Canons
of Tibetan Buddhism, ed. H. Eimer and D. Germano (Leiden: Brill, 2002), 313–32. For references on Garuḍa medicine, see Michael Slouber, Early Tantric Medicine: Snakebite,
Mantras, and Healing in the Garuda Tantras (Oxford: Oxford University Press, 2017).
’Chi ned bdud rtsi bum pa (2), 71/9–22.
’Chi med bdud rtsi bum pa (1), 12v/6; ’Chi med bdud rtsi bum pa (2), 25/5: […] mi rtogs stong
ba’i ngang nyis las// lha’i nga rgyal ma brel ba//.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
253
and pills. The texts recommend preparing the amulets at auspicious times
to attune them astrologically to the planets and constellations,115 and to use
specific writing supports (black sheets of paper, fabric, or bark), material such
as inks made of gold, cinnabar, or black Chinese ink mixed with precious
substances, and envelopes made from five-colored silk, all of which need to
be consecrated.
Textual amulets are illustrated with powerful iconic elements: the three
figures of Vajrapāṇi, the Khyung, and the black wild boar (phag nag), which
accomplish the function of devourer of evil nyen and snake-demons,116 are
decorated with their specific mantras in order to bestow them with magical
efficacy. The “Khyung remedy” (gnyen po khyung) or “condensed protective
diagram” (sgril ba’i srung ’khor), represents the sophisticated union of the diverse divine figures and their mantras. This textual amulet is a maṇḍala diagram, which replicates the primordial universe within six concentric circles
(mu khyu) drawn at the center of the Khyung’s body. As with every magical
wheel, this diagram is characterized by a specific orientation determined by
sacred geometrical and geographical elements and also by the orientation of
the Khyung’s head. The Khyung’s shoulders should be marked with the mother
and father cakras representing the two lineages and smeared respectively with
bezoar and saffron (representing the male and female sexual fluids); and his
head can be oriented towards one of the two wheels overpowering the specific lineage or look at front in order to potentiate the practitioner. All of the
circular patterns should contain a mantra and, each part of the Khyung body
should be marked with mantras and smeared with empowered fragrant medical substances.117
During the consecration ritual the lunar and solar cakras written on the
palms of the sacred Khyung should be joined and the Essence of Interdependence
Mantra (rten ’brel snying po) should be written on the back of the paper sheet.
These final actions embody the nonduality of reality through its symbols
(union of the solar and lunar cakras) and mantra, which condenses the ontological ground of the magical act. The mantras and the magical formula will be
not analyzed here; however, it should be said that its general meaning refers
115
116
117
’Chi med bdud rtsi bum pa (2), 68/8: […] zla stod rgyal dang rta chen brgyad//. ’Chi med
bdud rtsi bum pa (2), 73/ 6–7: […] dus tshod gza’ skar gyi gnad rang gi bla gza’ bla skar bla
nyi ma dang po ’o.
This interpretation of the boar is substantiated by other sections of the ’Chi med bdud rtsi
bum pa, such as the cited Reversal Suppressant [Ritual] of Sucking [the Infection] with the
Adamantine Sow’s Tongue (log gnon phag mo’i ljags ’jibs). ’Chi med bdud rtsi bum pa (1),
110r/1; ’Chi med bdud rtsi bum pa (2), 152/11.
’Chi med bdud rtsi bum pa (1), 117r/3–117v/6; ’Chi med bdud rtsi bum pa (2), 64/21.
For use by the Author only | © 2019 Koninklijke Brill NV
254
Simioli
to the annihilation of any evil forces, adjuring the demons by the name of the
afflictions they cause (rims thams cad la svāhā), and bestowing a powerful protection on the “holder” (’chang ba po = Skt. dhara, the one who mastered the
magical formula) from all kinds of poisons emerged from the prime kālakūṭa
poison (ha la ha la).118
Finally, the textual amulets should be rolled up and wrapped in colored silk,
ready to be bound to the body of the patient (worn around the neck or arm, or
tied in the hair). The amulets are considered to be also effective against any kind
of sorcery or negative astral influence, misfortune, or natural calamity. They
also protect children from ghosts’ assaults (chung sri), and they can even bestow fortitude (dpa’ la ’dzangs) and fecundity (gshin la ’dzangs).119 The magical
diagrams and unguents can also be used to protect residences by applying them
on the door lintels (sgo ltag), and they are used during extensive ritual to protect
the entire land from the outbreak of pestilences or to stop their spreading.120
These magico-alchemical sections allow us to restate some considerations
about the composite structure and the contents of the Vase of Amṛta. This corpus is rooted in the religious discerning of epidemics and communicable diseases. Indeed, due to the apocalyptical and prophetical frame of this literature,
the diffusion of the diseases reflects the eruption of evil and corruption in the
human world: communicable diseases originate in invisible entities, which
are conceptualized as demonic. Therefore, apotropaic rituals are the ultimate
methods to tear away the disease from the body. The threefold subdivision of
the Vase of Amṛta, claimed by the various titles attributed to it (see the introduction), mirrors a specific conception of medical knowledge as a tripartite
system (diagnosis, therapeutics, and rituals), and operative forms of knowledge, such as alchemy and the art of amulets, are considered essential.
5
Conclusion
The contents of the Vase of Amṛta reveal an intricate web of connections,
with diverse historical and literary traditions. The wide array of topics associated with epidemiology, such as channel examination and the techniques
for divinatory prognosis insert the Vase of Amṛta in the context of Seminal
Essence literature, alongside magical and apotropaic procedures that relate it
to the broader literature of Mahāyogatantra. As we have seen there are several
118
119
120
’Chi med bdud rtsi bum pa (2), 25/21–26/19.
’Chi med bdud rtsi bum pa (2), 69/16–70/5.
’Chi med bdud rtsi bum pa (1), 15r/1–15v/1; and ’Chi med bdud rtsi bum pa (2), 27/9–28/1.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
255
important correspondences between the contents of important medical sources such as the Ultimate Tantra and other sources, including the Vase of Amṛta.
In particular the connections regard the body physiology, the taxonomy, and
the etiological models of nyen and rim diseases. The title of the Quintessential
Scripture (yang thig gces) defines not only to the esoteric nature of this corpus
but also refers to the interrelation of different theoretical models deriving from
Āyurveda, tantric alchemy, and demonology within this source.
In the history of Tibetan medical thought, the Vase of Amṛta represents a
refined attempt to codify and systematize medical theories and practices in
a coherent and comprehensive body of knowledge. The structure of the Vase
of Amṛta reflects a clear authorial intent of keeping the secrecy of teachings, a
methodology akin to the principle of “dispersed knowledge” we find in other
alchemical traditions.121 The language is often metaphorical and the information is scattered here and there, disseminated in main sections and ancillary
explanatory scrolls and chapters, which clarify the main ritual and alchemical
sections. The explanatory sections are called “strengths” (gyad), which might
refer both to the mastering of magic-alchemical arts and to the effective application of this power to the opus. Another term for referring to these sections is
“keys” (lde’u mig), which disclose the real and deep meanings of the scriptures.122
This terminology, which has ancient origins, in this context means “commentarial” or “interpretative” and could refer to the hermetical tradition based
on the precious contribution of the transmitters of the text.123 According to
Deumar’s analysis of this corpus, these keys are the “filial texts” (bu yig) included in the Vase of Amṛta, which proceed from the main “maternal texts”
(ma yig), and are a medium (them ltar, lit. “door threshold” or even “ladder”)
for ascending to a deeper understanding of medical knowledge.124
Despite its mysterious origin, the history of the transmission of the Vase
of Amṛta appears to be connected to important medical collections. In the
fourteenth century, physicians culled fragments or entire sections from the
rituals and the pharmacopeia of the Vase of Amṛta, which was considered an
121
122
123
124
See for example, Lawrence Principe, The Aspiring Adept: Robert Boyle and His Alchemical
Quest Including Boyle’s “Lost” Dialogue on the Transmutation of Metal (Princeton, NJ:
Princeton University Press, 2000), 143 and passim.
The complete series of “keys” and “strength” can be found in ’Chi med bdud rtsi bum pa
(2), 33–34; 38–39; 53–55; 55–58; 58–61; 79–112; and 135–42. These sections are also complemented by two groups of minor scrolls: ’Chi med bdud rtsi bum pa (2), 149–53; 154–59; and
163–93.
See Michael Walter’s comparison of Tibetan alchemical tradition and Gnosticism in
Michael Walter, The Role of Alchemy and Medicine in Indo-Tibetan Tantrism (Bloomington,
IN: Doctoral Dissertation at Indiana University, 1980), 13–27.
De’u dmar bstan’dzin phun tshogs, Gso rig gces btus, 94/19–95/12.
For use by the Author only | © 2019 Koninklijke Brill NV
256
Simioli
authoritative recipe source and a repository of an ancient magical and alchemical lore. At the turn of the seventeenth century, the hermetical corpus of the
Vase of Amṛta was examined in exegetical literatures and served along with
other apocryphal writings as extensive treatises on nosology. However, further
and more detailed research on the contents of the Vase of Amṛta and its intertextual legacy might allow us to better understand the historical connection
between the “accomplishing medicine” literature of the Nyingma tradition and
canonical medical sources.
References
Tibetan-language Sources
Byams pa ’phrin las. Gangs ljongs gso rig bstan pa’i nyin byed rim byon gyi rnam thar
phyogs bsgrigs. Beijing: Mi rigs dpe skrun khang, 2000.
Byams pa ’phrin las and Bod rang skyong ljongs sman rtsis khang, eds. Bod lugs gso rig
tshig mdzod chen mo. Beijing: Mi rigs dpe skrun khang, 2006.
De’u dmar btan’dzin phun tshogs. Gso rig gces btus rin chen phreng ba. Xining: Mtsho
sgnon mi rigs dpe skrun khang, 1993. BDRC W21588.
De’u dmar btan’dzin phun tshogs. Lag len gces rigs sdus pa’i sman kun bcud du sgrub
pa’i las gyi cho ga kun gsal snang mdzod ces bya ba bzhugs so. In Dri med shel gong
dang dri med shel phreng dang lag len gces bsdus. Leh: Tashigang S. W., 463–590.
BDRC W23762
Dga’ ba rdo rje. ’Khrungs dpe dri med shel gyi me long. Beijing: Mi rigs dpe skrun khang,
1995.
Dpal ldan rgyal mtshan. Brang ti lha rje’i rim brgyud kyi man ngag gser bre chen mo.
Lhasa: Bod ljongs mi dmangs dpe skrun khang, 2005.
G.yu thog snying thig zhes bya ba gzgugs so. Beijing: Mi rigs dpe skrun khang, 2007.
’Jam mgon kong sprul blo sgros mtha’ yas. Gter ston brgya rtsa’i rnam thar. Lhasa: Bod
ljongs mi dmangs dpe skrun khang, 2007. BDRC W1PD83972.
Lha btsun Rin chen rgya mtsho. ’Brong tse be’u bum dkar po. Beijing: Mi rigs dpe skrun
khang, 2005. BDRC W1PD2.
Ngag dbang blo bzang rgya mtsho. Zab pa dang rgya che ba’i dam chos kyi yig gang ga’i
chu rgyun. In Gsung ’bum, vol. 1 (Gsan yig ka). Gangthok: Sikkim Research Institute
of Tibetology, 1991–95. BDRC W294.
Nyi zla kha sbyor chen mo gsang ba’i rgyud. In Rnying ma rgyud bcu bdun (A ’Dzom par
ma). Dpal yul rdzong: A ’dzom chos sgar par khang, 2000. BDRC W1KG11703.
Pha khol (Vāgbhaṭa). Yan lag brgyad pa’i snying po’i bsdus. In Sbyor ba brgya pa dang
yan lag brgyad pa’i snying po bsdus pa sogs. Beijing: Mi rigs dpe skrun khang, 2005.
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
257
Phags pa klu sgrub (Nāgārjuna), Hashang Ma hā ya na, and Vairocana (Bai ro tsa na)
(transl.). Sman dpyad zla ba’i rgyal po: The Somarājabhaisajyasādhanā, an Indian
Medical Work by Nāgārjuna in Its Tibetan Translation by Hashang Ma hā ya na and
Vairocana. Leh: T. Y. Tashigang, 1989. BDRC W29577.
Phags pa klu sgrub (Nāgārjuna), Hashang Ma hā ya na, and Vairocana (Bai ro tsa na).
Rtsa yig cha nyi zer sgron ma. In Slob dpon klu sgrub kyi sman yig gces btus. Beijing:
Mi rigs dpe skrun khang, 2008.
Phags pa klu sgrub (Nāgārjuna), Hashang Ma hā ya na, and Vairocana (Bai ro tsa na).
Mdze rigs bco brgyad kyi rtags rdo rje bde khros kyi dgongs pa las. In Slob dpon klu
sgrub kyi sman yig gces btus. Beijing: Mi rigs dpe skrun khang, 2008.
Sangs rgyas rgya mtsho. Gso ba rig pa’i bstan bcos sman bla’i dgongs rgyan rgyud bzhi’i
gsal byed baidurya sngon po’i mallika. Lhasa: Bod ljongs mi dmangs dpe skrun
khang, 1982. BDRC W2DB4602.
Sangs rgyas rgya mtsho. Man ngag gi yon tan rgyud gi lhan thabs. Xining: Mtsho mi rigs
dpe skrung khang, 1991.
Slop dpon pad ma ’byung gnas. ’Chi med bdud rtsi bum pa. In Rin chen gter mdzod
vol. 46. Paro: Stod lung mtsur phu’i par khang, 1980.
Slop dpon pad ma ’byung gnas. ’Chi med bdud rtsi bum pa. In Slob dpon pad ’byung gi
sman yig gces btus. Beijing: Mi rigs dpe skrung khang, 2006.
G.yu thog yon tan mgon po. Bdud rtsi snying po yan lag brgyad pa gsang ba man
ngag gi rgyud. Lhasa: Bod ljongs mi dmangs dpe skrun khang, 1982. BDRC W1KG1315.
G.yu thog yon tan mgon po. Bu don ma. Beijing: Mi rigs dpe skrung khang, 2009.
Zhang zhung snyan rgyud las sgron me drug gi gdams pa. In Zhang zhung snyang rgyud
kyi gsung pod (Sde dge par ma). Lun grub steng: Sde dge par khang, [n.d.]; BDRC
W00EG1016835.
Zur mkhar ba mnyams nyid rdo rje. Man ngag bye ba ring bsrelpod chung rab ’byams
gsal ba’i sgron me. Lanzhou: Kan su’u mi rigs dpe skrun khang, 1993.
European-language Sources
Akosay, Anna, and Ronit Yoeli-Tlalim. “Along the Musk Routes: Exchanges Between
Tibet and the Islamic World.” Asian Medicine: Tradition and Modernity 3 (2007):
217–40.
Beckwith, Christopher I. “The Introduction of Greek Medicine into Tibet in the
Seventh and Eighth Centuries.” Journal of the American Oriental Society 99, no. 2
(1979): 297–313.
Beyer, Stephan. The Cult of Tara: Magic and Ritual in Tibet. Delhi: Motilal Banarsiddass,
2001.
Bhayro, Siam, and Catherine Rider, eds. Demons and Illness from Antiquity to the
Early-Modern Period. Brill: Leiden, 2017.
For use by the Author only | © 2019 Koninklijke Brill NV
258
Simioli
Bühnemann, Gudrun. “Maṇḍala, Yantras and Cakra: Some Observations.” In Maṇḍalas
and Yantras in the Hindu Traditions, edited by Gudrun Bühnemann, 13–56. Leiden:
Brill, 2003.
Cantwell, Cathy. “The Medicinal Accomplishment (sman sgrub) Practice in the
Dudjom Meteoric Iron Razor (gnam lcags spu gri) Tradition: Reflections on the
Ritual and Meditative Practice at a Monastery in Southern Bhutan.” Journal of the
Oxford Centre for Buddhist Studies 8 (2015): 49–95.
Crisciani, Chiara, and Michela Pereira. “Black Death and Golden Remedies: Some
Remarks on Alchemy and the Plague.” In The Regulation of Evil: Social and Cultural
Attitudes to Epidemics in Late Middles Ages, edited by Agostino Paravicini Bagliani
and Francesco Santi, 7–40. Firenze: Sismel-Edizioni del Galluzzo, 1998.
Cuevas, Bryan J. “‘The Calf’s Nipple’ (Be’u bum) of Ju Mipham (’Ju mi pham): A Handbook
of Tibetan Ritual Magic.” In Tibetan Ritual, edited by José Ignacio Cabezón, 165–86.
Oxford: Oxford University Press, 2010.
Cunningham, Andrew. “Epidemics, Pandemics and the Doomsday Scenario.”
Historically Speaking 7 (2008): 29–31.
Czaja, Olaf. “The Substitution of Materia Medica in Tibetan Medicine: An Inquiry
into Traditional Tibetan Treatises.” East Asian Science, Technology and Medicine 46
(2017): 119–212.
Czaja, Olaf. “The Four Tantras and the Global Market: Changing Epistemologies of Drä
(’bras) versus Cancer.” In Medicine Between Science and Religion: Explorations on
Tibetan Grounds, edited by V. Adams, M. Schrempf, and S. Craig, 265–96. New York,
NY: Berghahn Books, 2011.
Davidson, Ronald M. Tibetan Renaissance: Tantric Buddhism in the Rebirth of Tibetan
Culture New York, NY: Columbia University Press, 2005.
de Nebesky-Wojkowitz, René. Oracles and Demons of Tibet: The Cult and Iconography of
the Tibetan Protective Deities. Delhi: Book Faith India, 1993.
Garrett, Francis. “The Alchemy of Accomplishing Medicine (sman sgrub): Situating the
Yuthok Heart Essence Ritual Tradition.” Journal of Indian Philosophy 37, no. 3 (2009):
207–30.
Garrett, Francis. “Tapping the Body Nectar: Gastronomy and Incorporation in Tibetan
Literature.” Journal of the History of Religions 49, no. 3 (2010): 300–26.
Gerke, Barbara. “Treating Essence with Essence: Re-inventing bcud len as Vitalising
Dietary Supplements in Contemporary Tibetan Medicine.” Asian Medicine:
Tradition and Modernity 7, no. 1 (2012): 196–224.
Gerke, Barbara. “Treating the Aged and Maintaining the Health: Locating bcud len
Practices in the Four Medical Tantras.” Journal of International Buddhist Studies 35,
nos. 1–2 (2012): 329–62.
Hillis, Gregory. “The Khyung Texts in the Rnying ma’i Rgyud ’Bum.” In The Many
Canons of Tibetan Buddhism. PIATS 2000: Proceedings of the Ninth Seminar of The
For use by the Author only | © 2019 Koninklijke Brill NV
Communicable Disease in the Vase of Amṛta
259
International Association of Tibetan Studies, Leiden 2000, edited by H. Eimer and
D. Germano, 313–32. Leiden: Brill, 2002.
Gyatso, Janet. Being Human in a Buddhist World: An Intellectual History of Medicine in
Early Modern Tibet. New York, NY: Columbia University Press, 2015.
Jouanna, Jacques. Disease as Aggression in Hippocratic Corpus and Greek Tragedy: Wild
and Devouring Diseases. In Greek Medicine from Hippocrates to Galen. Selected
Papers by Jacques Jouanna translated by Neil Allias, edited with a preface by Philips
van der Eijk. Leiden-Boston: Brill, 2012: 81–96.
Kilty, Gavin, trans. Mirror of Beryl: A Historical Introduction to Tibetan Medicine. Boston,
MA: Wisdom Publications, 2009.
Martin, Dan. “An Early Tibetan History of Indian Medicine.” In Soundings in Tibetan
Medicine: Anthropological and Historical Perspectives. Proceedings of the 10th Seminar
of the International Association of Tibetan Studies, edited by Mona Schrempf,
307–25. Leiden: Brill, 2007.
Martin, Dan. “Greek and Islamic Medicines’ Historical Contact with Tibet.” In Islam
and Tibet: Interactions along the Musk Routes, edited by Anna Akasoy, Charles
S. F. Burnett, and Ronit Yoeli-Tlalim, 117–44. Burlington, VT: Ashgate Publishing
Company, 2011.
McGrath, William. “Vessel Examination in the Medicine of the Moon King.” In Buddhism
and Medicine: An Anthology of Premodern Sources, edited by C. Pierce Salguero,
501–13. New York, NY: Columbia University Press, 2017.
McGrath, William. Buddhism and Medicine in Tibet: Origins, Ethics, and Tradition.
Charlottesville, VA: Doctoral Dissertation at the University of Virginia, 2017.
Orofino, Giacomella, Sacred Tibetan Teachings on Death and Liberation. Bridport,
Dorset: Prims-Unity Press, 1990.
Principe, Lawrence. The Aspiring Adept: Robert Boyle and His Alchemical Quest
Including Boyle’s “Lost” Dialogue on the Transmutation of Metals. Princeton, NJ:
Princeton University Press, 2000.
Scheiddeger, Daniel. “Lamps in the Leaping Over.” Revue d’Etudes Tibétaines 8, no. 10
(2005): 40–64.
Scheiddeger, Daniel. “The First Four Themes of Klong chen pa’s Tsig don bcu gcig pa.”
Revue d’Etudes Tibétaines 16, no. 3 (2009): 43–73.
Sharma, Prayavrat. Carakasaṃhitā (Text with English Translation). Varanasi:
Chaukhambha Orientalia, 2014.
Simioli, Carmen. “The ‘Brilliant Moon Theriac’ (Zla zil dar ya kan): A Preliminary Study
of Mercury Processing according to the Vase of Amrita of Immortality (’Chi med
bdud rtsi bum pa) and Its Influence on Tibetan Pharmacological Literature.” Revue
d’Etudes Tibétaines 37 (2016): 391–419.
Simioli, Carmen. “Alchemical Gold and the Pursuit of the Alchemical Elixir.” Asian
Medicine: Tradition and Modernity 8, no. 1 (2013): 43–77.
For use by the Author only | © 2019 Koninklijke Brill NV
260
Simioli
Skemer, Don C. Binding Words Textual Amultes in the Middle Ages. Philadelphia, PA:
Pennsylvania University Press, 2006.
Slouber, Michael. Early Tantric Medicine: Snakebite, Mantras, and Healing in the Garuda
Tantras. Oxford: Oxford University Press, 2017.
Tucci, Giuseppe. Le Religioni del Tibet. Roma: Edizioni Mediterranee, 1996.
Van Kooij, Karel R. “Protective Covering (Kavaca).” In Selected Studies on Ritual in the
Indian Religions, edited by Ria Kloppenborg, 118–29. Leiden: Brill, 1983.
Lo, Vivienne, and Sylvia Schroer. “Deviant Airs in Traditional Chinese Medicine.” In
Asian Medicine and Globalisation, edited by Joseph S. Alter, 46–66. Philadelphia, PA:
University of Pennsylvania Press, 2005.
Wallace, Vesna A. “Medicine and Astrology in the Healing Arts of the Kālacakratantra.”
In As Long as Space Endures: Essays on the Kālacakra Tantra in Honor of H. H. The
Dalai Lama, edited by Edward A. Arnold, 179–91. Ithaca, NY: Snow Lion Publications,
2009.
Walter, Michael L. The Role of Alchemy and Medicine in Indo-Tibetan Tantrism.
Bloomington, IN: Doctoral Dissertation at the University of Indiana, 1980.
Wujastyk, Dagmar. “Acts of Improvement: On the Use of Tonics and Elixirs in Sanskrit
Medical and Alchemical Literature.” History of Science in South Asia 5, no. 2 (2017):
1–36.
Wujastyk, Dominik. The Roots of Āyurveda: Selections from Sanskrit Medical Writings.
London: Penguin Books, 2001.
Yoeli-Tlalim, Ronit. “A Tibetan Image of Divination: Some Contextual Remarks.” In
Imagining Chinese Medicine, edited by Vivienne Lo and Penelope Barrett, 429–40.
Sir Herry Wellcome Asiane Series, vol. 8. Leiden: Brill 2018.
Yoeli-Tlalim, Ronit. “Between Medicine and Ritual: Tibetan ’Medical Ritual’ from
Dunhuang.” In Tibetan and Himalayan Healing: An Anthology for Anthony Aris, edited by Charles Ramble and Ulrike Roesler, 739–46. Kathmandu: Vajra Publications,
2015.
Yoeli-Tlalim, Ronit. “Central Asian Mélange: Early Tibetan Medicine from Dunhunag.”
In Scribes, Texts, and Rituals in Early Tibet and Dunhuang, edited by Brandon Dotson,
Kazushi Iwao, and Tsuguhito Takeuchi, 53–60. Wiesbaden: Reichert-Verlag, 2013.
Yoeli-Tlalim, Ronit. “On Urine Analysis and Tibetan Medicine’s Connections with
the West.” In Studies of Medical Pluralism in Tibetan History and Society, edited by
Sienna Craig, Mingji Cuomu, Frances Garrett, and Mona Schrempf, 195–211. Halle:
International Institute for Tibetan and Buddhist Studies GmbH, 2010.
Yoeli-Tlalim, Ronit. “Re-visiting ‘Galen in Tibet.’” Medical History 56, no. 3 (2012): 355–65.
Zahara, Kulsoom et al. “A Review of Therapeutic Potential of Saussurea lappa: An
Endangered Plant from Himalaya.” Asian Pacific Journal of Tropical Medicine 7,
no. 1 (2014): 60–69.
Zhen Yan. “rTsa in the Tibetan Manuscripts from Dunhuang.” Translated by Vivienne
Lo. Asian Medicine 3 (2007): 296–307.
For use by the Author only | © 2019 Koninklijke Brill NV