Misdiagnosis or Political Assassination? Re-examining the Death of Panchen Lama Lobsang Palden Yeshe from Smallpox in 17801 Lobsang Yongdan (University of Bonn) Introduction n the mid 18th century the Qing dynasty was considered one of greatest empires in the world. The population was increasing, people were prosperous and imperial power was growing. Its military had conquered many parts of Inner Asia, and European powers like the British wanted to establish trade relations with China. The ruling class were Manchus and they paid great attention to their Manchu roots, customs and rituals and considered themselves natural allies of the Mongols. Since the Mongols were followers of the Tibetan Gelugpa tradition, the Manchu also built Tibetan monasteries and translated a great number of Tibetan books from Tibetan into Mongolian and Manchu. Qianlong (1711–1799), the sixth emperor of the Qing dynasty, paid close attention to Tibetan Buddhists and surrounded himself with many learned monks and scholars. The special relationship was conducted through Buddhist religious rituals, practices and ceremonies. When Tibetan Buddhist lamas gave religious teachings and initiations, and performed Buddhist rituals for Emperors and officials, the Emperors gave monetary compensation, titles and sometimes even military protection to these lamas or Buddhist priests. Because of this religious relationship, after the founding of the Qing dynasty, successive emperors invited many Tibetan lamas to Beijing, Dolon Nor and Chengde to give religious teachings and instructions to them and their Mongol and Manchu subjects. As exemplified by the fifth Dalai Lama’s visit to Beijing in 1652, inviting lamas to Beijing and China was one of the most important parts of Qing imperial ritual activity. I 1 This is supported by an ANR-DFG funded research project, “Social history of Tibetan societies”. The author would like to thank Charles ramble for giving very helpful suggestions and comments. Lobsang Yongdan, “Misdiagnosis or Political Assassination? Re-examining the Death of Panchen Lama Lobsang Palden Yeshe from Smallpox in 1780”, Revue d’Etudes Tibétaines, no. 58, Avril 2021, pp. 60-80. Misdiagnosis or Political Assassination? 61 The Dalai Lama and the Panchen Lama were the highest and most important lamas in the Tibetan Buddhist world. While it was the third Dalai Lama who spread the Gelugpa traditions to Mongolia, the successive Panchen Lamas took a great interest in promoting Tibetan Buddhism in Mongolia. Many important Lamas both from Tibet and Mongolia were trained under the Panchen Lamas. In the mid-eighteen century, the sixth Panchen Lama was the most important lama, not only by virtue of his status a member of this incarnation line, but also a person who had many intellectual abilities and personal qualities. At the time, after the death of the seventh Dalai Lama (1708–1757), the eighth Dalai Lama was relatively young (1758–1804) and was not as active and influential as his predecessors, notably the fifth and seventh Dalai Lamas. Thus, the sixth Panchen Lama was respected by the Qing court and highly regarded by the officials in the East India Company. During the course of his life, he was not only a religious figurehead, but also an important scholar who left several volumes of works on many different subjects in Tibetan. He was one of the earliest Tibetan scholars to engage with Europeans and their ideas. For example, after conversations with George Bogle, he wrote a series of notes on European geography. Thus, what better way to celebrate the seventieth birthday of the Qianlong Emperor than by inviting the Panchen Lama to Beijing? The invitation was important not only in political terms, but also had religious and ritual significance. The Panchen lama accepted the emperor’s invitation to Beijing. During this visit, which took place in 1780, the Panchen Lama passed away. Tibetan and Qing officials gave the cause of death as smallpox, and Purangir, an Indian middleman mediating between Tibet and the British also claimed that the Panchen Lama died from smallpox (Purangir 1800: 469-70). At least, that is how the Qing imperial court portrayed the incident, and was the version that others believed. Most Tibetans also believed that this was the case, However, immediately after his death, many people, including some Tibetans, raised doubts about this account, and there has been always been a rumour that the Qing officials were somehow responsible for the sixth Panchen Lama's death. In the late 18th century, this had political and military significance. Because of these rumours and the disputes about the wealth of the Panchen Lama, the 10th Shamarpa went to Nepal and assisted the invading Nepalese army. This resulted in the ban on the reincarnation of the 10th Shamarpa by the Kashag until the 20th century. However, scholars who have studied this subject have dismissed the rumour as nothing more than that – a groundless rumour (Cammann 1949: 16-17). This also suggests that the British officials showed their own ignorance and prejudice towards the Qing imperial court (Teltescher 2006: 250-51). 62 Revue d’Etudes Tibétaines Then, the biography of the Panchen Lama presents a rather long and complicated story of his death. On the surface, it also suggests that the cause of the Panchen Lama’s death was smallpox. However, after careful reading of the Panchen Lama's biography and other relevant documents in Tibetan, which were produced in the later 18th and the 19th centuries, it is clear that the Panchen Lama’s death was not a medical inevitability. Rather, it was the result of a chain of mistakes, from medical misdiagnosis to doubtful political decisions. The Panchen Lama’s one biographical account is entitled rJe bla ma srid zhi'i gtsug rgyan paN chen thams cad mkhyen pa blo bzang dpal ldan ye shes dpal bzang po'i zhal snga nas kyi rnam par thar pa nyi ma'i 'od zer zhes bya ba (The Guru Lama crown ornament of world, the omniscient one: Lozang Penden Yéshé’s biographical account known as “Sunlight”), written by the second Jamyang Zhépa Künkhyen Jikmé Wangpo (1728-1791), also known more briefly as Jikmé Wangpo, from Labrang Monastery. According to the biography, while one of the Panchen Lama’s attendants and the Qing imperial court doctor believed that he had smallpox, some, including Changkya Rölpé Dorjé and the Panchen Lama’s personal physician, did not believe that he had the disease. Importantly, no one thought he had the black smallpox (the most severe and deadly form). Although these Tibetans did not accuse anybody, including Qing officials, of murdering the Panchen Lama, they did suggest that something could have been done about it. If certain medical steps had been taken, his death could have been prevented. Jikmé Wangpo was not an ordinary Lama. He was not only the author of the official biography but also one of the trusted students of the Sixth Panchen Lama. Importantly, he was involved directly with the planning, discussion and finally the implementation of a program of inoculation. He and his doctor inoculated several hundred of the Panchen Lama’s attendants. In 1784, this fifty-seven old man decided to go back to Central Tibet to seek old Tibetan manuscripts and books. In November 1785, while he was in Tashilhunpo Monastery, he was asked by the Panchen Lama’s elder brother, Yingsa Lozang Jinpa, commonly known as Chungpa Hutukhtu, and by Sopon Chumbo, also known Lozang Khéchok, to write the official biography. In 1786, over five months from early March, he wrote a long and detailed two-volume biography (1991: 345-251), after being given all official records about the Panchen Lama. Jikmé Wangpo not only provided all aspects of the Panchen Lama’s life, from his childhood to his death in Beijing and the final bringing of his ashes to Tashilhunpo Monastery, but also included detailed discussions, debates and decisions about smallpox. Therefore, this work is not just an official biography but is also an eyewitness account of smallpox. On the surface, the biographical account Misdiagnosis or Political Assassination? 63 repeats the official narrative, but in subtle ways it also provides confusing and conflicting information. His biography is well-known among Tibetans and Tibetologists. Sarat Chandra Das (1849–1917), an Indian scholar of Tibetan, studied this work and Nima Dorjee Ragnubs translated a section of it under the title “The Third Panchen Lama's Visit to Chengdu” in 2004. Similarly, the Qing imperial court left a trail of court documents and papers on him; the British had Purangir at the Panchen Lama’s court; he provided information on what he witnessed and heard about the Panchen Lama to the British officials in India, so that the British also had some information on the Panchen Lama’s death.2 The question is, how did the Panchen Lama die? What was the cause of death? Was it smallpox or something else? The Panchen Lama was a well-known figure and many people have written about him and his death. As far as I know, no modern scholar has examined the death of the Panchen Lama in the light of his Tibetan biography. If this is the case, then this article is the first attempt to investigate the circumstances surrounding the sixth Panchen Lama’s untimely death. Smallpox in Tibet Smallpox is an infectious disease caused by either of two virus variants, known as Variola major and Variola minor. Before its eradication in 1979, smallpox was known as the greatest killer in the world. It caused more destruction and devastation than any other disease. In the course of human history, many civilisations all over the world developed various treatments and ritual prayers with a view to preventing it. Smallpox played an important role in shaping this relationship. The study of smallpox is a well-established field and many scholars have written its general history; such as Donald R. Hopkins’ work, The Greatest Killer: Smallpox in History (2002) and Gareth Williams' work Angel of Death: the Story of Smallpox (2010). There are also many scholars who have worked on smallpox in China and India. For example, Joseph Needham claims that China was the earliest country to develop inoculation as a preventive measure with practices that go back at least to the eleventh century (1980: 28). Although some scholars have speculated that neither the Chinese nor the Tibetans had an adequate knowledge of medical practices and procedures to inoculate the Panchen Lama (Teltscher 2013: 211, Liusen 2012 ), Tibet also had a long history of smallpox. Tibetans studied the 2 According to Scuyler Cammann, this report first was published in Alexander Dalrymple's Oriental repertory (London, in periodical form, April 1796, and as a book in 1808; pp. 145-64 of the latter) and republished by Turner ( Cammann 1949: 5 ). 64 Revue d’Etudes Tibétaines disease and developed a variety of methods and treatments for it, with a great number of medical works on the subject being produced. In the course of the history of Tibet a great number of medical works dealing with smallpox were produced and Tibetans practiced various preventative methods for centuries. In Tibetan medical texts, smallpox is known as drumne (’brum nad, “the disease of falling scabs”) , inoculation (brum 'debs [literally the planting of smallpox]) and quarantine to minimise the spread of this disease, and was attributed to the female goddess, known as Mamo Khandro (Ma mo mkha’ ’gro). The Tibetan medical work The Four Tantras (Rgyud bzhi ) has one chapter on smallpox that gives a detailed account of the name, causes and treatments associated with it. When smallpox struck, as if often did, there were usually historical and biographical accounts that mentioned the events. In particular, during the 17th and 18th centuries, as many military incursions from Mongolia and China occurred and Tibetans’ travel to Inner Asia increased, smallpox often struck in Tibet and devastated its communities and people. When the disease afflicted the Mongol army in 1633, for example, no one was able to go to the camp to make peace between the Tibetan and Mongol armies. It was the 4th Lozang Chökyi Gyeltsen (1570–1662), who was immunized from smallpox, who went to the Mongol army camp and made the peace between the Tibetans and Mongols. Smallpox not only had a devastating impact on the people in Tibet, but it also greatly influenced how Tibetans conducted their relations with outsiders. All people, especially those who came from China, were suspected as potential carriers of smallpox to Tibet. Lobsang Yeshe (1663–1737), the predecessor of the 6th Panchen Lama, did not go to China because of the fear of smallpox, in spite of the Kangxi Emperor’s repeated invitations and insistence (Schwieger 2015: 85). As destructive as it was, there were no effective treatments for this disease. Before the late 18th century, there was only one preventative measure known: inoculation or variolation. In using the dry scabs of smallpox from a former victim, a doctor would deliberately inject a preparation or put dry smallpox scabs onto a healthy person who had never had smallpox. As a result of this procedure, the subject would contract a minor and less dangerous form of smallpox and would then be immunized from this disease. Before Edward Jenner’s vaccinations this was the most effective way to prevent or avoid dangerous smallpox. However, the practice was not without its own risks. The danger of contracting a virulent form of the disease as a result of inoculation could be high, which meant that many of the people who underwent this treatment might die as a result. Thus, there was some reluctance to take this medication. Misdiagnosis or Political Assassination? 65 Among the medical historians, there are extensive debates about the origins of inoculation. Among these civlizations, China and India usually feature at the top of the list. However, For a long time Tibetans had known that smallpox could be used against smallpox. I have found Tibetan sources that indicate that Tibetans may have been among the earliest people to leave records of inoculation, earlier even than the Chinese and Indians.3 In the mid-18th century, the practice of inoculation was widespread throughout the Tibetan Buddhist world. Some monasteries became centres of inoculation. Sumpa Khenpo Yeshe Paljor (1704–1788), an important Gelugpa master in the Amdo region, wrote in his autobiography, “In the Iron Dragon year (1760), the existing white smallpox in Kokonor became known and heard, so I sent people to collect smallpox scabs. Then I inoculated my master cook Zhidar. Then this lineage spread to Tibet, China and Mongolia and this practice has been continuously practised to the present day” (Sumpa Khenpo 2015: vol. 1, 737–38). He claimed to have inoculated thousands people in Tibet, Mongolia and China. In 1772, smallpox struck Tashilhunpo Monastery. In order to avoid smallpox, the Panchen Lama and his entourage took refuge at Shang Déchen Rapgyé Ling, a branch monastery of Tashilhunpo. They stayed there for three years. When George Bogle (1746–1781), a Scottish diplomat, came to see him, he and his party had go to Shang Déchen Rapgyé Ling. In the course of many long and friendly conversations with the Panchen Lama, Bogle recounted how Lady Mary Wortley Montagu (1689–1762) had introduced a form of inoculation from Turkey to England; people were no longer afraid of contracting smallpox (MSS; Teltscher 2013: 137). Because of these backgrounds, the Panchen Lama was clearly aware of the dangers of smallpox and its effect on individuals and communities. China: the cradle of smallpox Without doubt, many Tibetans considered that the invitation to the Panchen Lama was important. Primarily, it was an honour and a privilege to be invited to the court by the Qing emperor, not only because the emperor was a patron but because he was also a Buddhist. It was seen as the responsibility of Buddhist teachers to go wherever devout disciples invited them to come to teach and spread the Buddhist Dharma. Thus, many lamas were willing to undertake the journey. Particularly, after the Manchus took over Beijing in 1644, many Tibetan lamas came to the capital with their attendants, bringing with them Buddhist texts or relics or medicine. When returning to Tibet, they 3 I shall explore this in the due course. 66 Revue d’Etudes Tibétaines came back with camel loads of silver coin, precious stones, furs, silk, fabrics, and products that were only produced in China, but exported by Russians and Europeans. Thus, for Tibetans who were immunised from smallpox, going to China was considered as one of the avenues to riches and prestige. However, while regarding China as the land of Manjushri, Tibetans also viewed it as the land of infectious diseases, including smallpox. People who were not immunized against smallpox were reluctant to go there. If someone had not had smallpox already, traveling to China was considered as a risk to life and the fear of contracting smallpox was one of the primary reasons for avoiding visiting China. The Qing’s relationship with their Inner Asian subjects, mainly Mongols and Tibetans, was not only exercised through politics, military conquests and economics, but also through cultural and medical conduits. Thus, some background to Tibetan perceptions of smallpox in China is an important part of this article. China had a long history of smallpox and had developed various treatments for this disease. In the course of Chinese medical history, the Chinese documented smallpox as early as the fifth century BC and the physicians in the country had adopted various terms and methods to treat it (Needham 1980). Following their establishment of the Qing Dynasty in 1644, the Manchus established several bidousou (isolated shelters) to quarantine smallpox victims (Chang 1996: 172). Kangxi ordered the inoculation of his children and imperial family members. When Mongol children flocked to Kangxi’s military camp in the Ordos, he inoculated some of these children too (Perdue 2009: 48). In the mid18th century, the Qianlong ordered to publish a medical text known as The Golden Mirror of Medical Orthodoxy, which included several methods of inoculation. In general, China considered smallpox as a disease of children. Even in the The Golden Mirror, it is part of pediatric medicine (Hanson 2003: 139). For centuries, however, like many Europeans in the 19th century (Heinrich 2008), Tibetans also viewed China as the cradle of smallpox. If someone had not had smallpox already, traveling to China was considered as a gamble on one’s life. Thus, if we read the biographical accounts of some Tibetan lamas, the fear of smallpox in China was one of the primary reasons to avoid going to China. Initially, for example, the second Jamyang Zhépa Künkhyen Jikmé Wangpo did not go China because of smallpox (Gungtang Konchok Tenpai Dronme 1990: 110). Similarly, after hearing the Panchen Lama was visiting China, Sumpa Khenpo Yéshé Penjor (1704–1788) told his friends , “if he has not had smallpox already, China has a lot of infectious disease. His body, which is like a white lotus without any impurity, should not go to the foulest of swamps” (Sumpa Khenpo 2015: vol. 1, 565). This reflected Misdiagnosis or Political Assassination? 67 how Tibetans felt when they had to undertake journeys to China; traveling to China was both blessed and cursed. Thus, the Panchen Lama’s decision to travel to China was not an easy one to make, especially in view of the precedent of declining many such invitations that had been set by his predecessors. In particular Unlike the Chinese, who had had a long history of exposure to smallpox, Tibetans believed that they were especially susceptible to this disease. One of the long-term residents in Beijing, the fourth Tsenpo Nomön Hen (1789-1839), an eminent Tibetan geographer and physician, who also introduced the techniques of Jennerian vaccine to Tibet(Yongdan 2016) , wrote in his medical text, “in this time of degeneracy, all infectious diseases, and especially smallpox, are active. Particularly, as we Tibetans are easily susceptible to this disease, we should focus more on the methods of protection and prevention (Tsenpo 2007: 211). This great Tibetan physician is claiming here that Tibetans were especially susceptible to smallpox, and is advocating vaccination and inoculation. Discussion on inoculation When the 6th Panchen Lama made the decision that he would undertake the journey to China, smallpox was at the forefront of his mind. On the long journey from Tashilhunpo to Chengde, there were many discussions and debates about smallpox, mainly about whether or not one should agree to be inoculated, and who should receive this treatment. From these discussions we can see how divergent views were expressed, and how a possible misdiagnosis led to the demise of the Panchen Lama. In particular, these discussions also show how the Qing officials and the Tibetans had a different understanding and attitude towards to smallpox and inoculation. Finally, the Panchen Lama made the decision that the rest of his entourage ought to be inoculated in spite of the Qing officials’ objections. According to the Panchen Lama’s biography, the earliest discussion occurred while he was on his way to Kumbum monastery in Amdo. The Panchen Lama and his entourage left Tashilhunpo monastery on the 10th of April 1779 and were approaching the borderland of Amdo. After learning of his imminent arrival, Jikmé Wangpo, his future biographer, sent his chief attendant Tenpa Dargyé to greet the Panchen Lama’s party. In the greeting letter, he gave a warning about smallpox and asked the Panchen Lama to consider what kinds of measures and preparations were needed for people who were not immunised against the disease (Gungtang Konchok Tenpai Dronme 1990: 279). On the 23rd of September, Jikmé Wangpo himself went to greet the Panchen Lama. He caught up with the party in front of Amnye Machen, one of the holiest mountains in Golok. At the camp, several people from the 68 Revue d’Etudes Tibétaines Panchen Lama’s entourage asked Jikmé Wangpo for inoculation against smallpox; he inoculated these people without any incidents, and they recovered quickly. After hearing this news, the Panchen Lama was pleased and asked Jikmé Wangpo to inoculate more people. Again, Jikmé Wangpo inoculated 150 people from the Panchen Lama’s party and all recovered from it quickly (Gungtang Konchok Tenpai Dronme 1990: 282). This experiment suggests that Jikmé Wangpo and his doctor had clearly mastered the technique of inoculation. On the way to Kumbum monastery, the discussion about smallpox and inoculations continued. On October 11th, they passed through the Tso Ngönpo territory 4 and arrived at Tongkor monastery; symbolically, they had arrived in the borderland of China, the land of smallpox. The Panchen Lama gave an initiation known as Ritröma Loma Gyönma, which is based on the goddess Gyönma, known as one who eliminates all diseases (Jikmé Wangpo 2002: vol 2, 793). The entourage stayed for several months in Kumbum monastery, and discussions about smallpox and inoculations continued. In January in the Iron Mouse year (1780), as they were preparing to leave China, it was decision time. The Panchen Lama told his brother, who was working as his treasurer at that time , Sopön Chumbo, a cup bearer , “Like the two of you, many of us are still not immunised from smallpox, and so far we have not done anything about it. Now what do we need to do?” He reminded them that measures had to be taken. Privately he also told Jikmé Wangpo, “Since there is much smallpox in China, if we do not do something about it, all these people be at serious risk of catching this disease. When the time comes, you have to go there to help them ” (Jikmé Wangpo 2002: vol 2, 820-821). On March 10th, they arrived in the fortress town of Zhuang lang 庄 浪, today’s Zhuanglang County in Gansu province. Until now, even though they had held many discussions and debates about the implication of having inoculations, a decision had not been made. Finally, in this city, after consultation with his closest officials and attendants, the Panchen Lama decided that all officials and attendants who had not been immunised needed to be inoculated, including his brother and Sopön Chumbo. This medical task was given to Jikmé Wangpo, his attendant Kachu Lozang Könchok and the personal physician Trinlé Gyatso. He also chose Alasha as the location where all these people were to be inoculated. After the decision was made, the Panchen Lama summoned his brother and Sopön Chumbo and said: 4 A reference to Mongol and Tibetan territories that were created by the Qing authorities after the war of the Water Hare year (chu yos dus 'khrug chen mo). Misdiagnosis or Political Assassination? 69 “Tomorrow the two of you and others who are not immunised against smallpox are leaving for Tengyé Ling monastery in Alasha for inoculation, and should make preparation for this occasion. Although this is an unthinkable event, because of the bliss of [the Three] Jewels, there won’t be any problem; please put your trust in me” (Jikmé Wangpo 2002: vol. 2, 840). Without any exceptions, the Panchen Lama simply told them that they needed to go Alasha for inoculation. However, this decision did not go down well with his brother and Sopön Chumbo. They said “we are certain that the Panchen Lama has had a minor form of smallpox, so we also can accept inoculation. However, we are coming with you to serve you. We have never thought of going anywhere without you. Please don’t ask us to go somewhere” (Jikmé Wangpo 2002: vol. 2, 840). Here they claimed that they were certain the Panchen Lama had had smallpox. They could not think of going anywhere without him. This was figurative speech rather than a rejection of the prospect of inoculation. Then the Panchen Lama insisted: “I have no problems. If the two of you don’t go, then the other people won’t either, so the two of you must go” (Jikmé Wangpo 2002: vol. 2, 840). They had no choice but to accept the Panchen Lama’s decision. So far, the discussions and debates had occurred among the Panchen Lama’s officials and close students like Jikmé Wangpo. The Qing officials were excluded from these discussion and decisions. Now, since more than three hundred people, including the Panchen Lama’s brother and Sopon Chumbo, were moving away from the Panchen Lama’s camp, the Qing officials needed to be informed. Three days after the Panchen Lama made the decision, on March 13th, the Panchen Lama summoned two Qing officials to the camp and told them of his decision: “ I will send a group of people led by my elder brother and Sopön Chumbo to Alasha to be inoculated. You two ministers do not need to worry about it. They won’t take very long and the conditions of this disease are not serious. Please do not report this to the emperor” (Jikmé Wangpo 2002: vol 2, 844). In the meantime, he asked two Qing officials for assistance regarding food, lodging and transportation for these people. After hearing the Panchen Lama’s decision, the two officials were shocked and told the Panchen Lama: 70 Revue d’Etudes Tibétaines “It does not matter what decision you have made. Since we were sent here by the Emperor to assist you, we have to report all important matters to the Emperor. This is a serious decision” (Jikmé Wangpo 2002: vol 2, 844-845). Then the two officials told the Panchen Lama about the imperial customs and traditions surrounding inoculation: “At the Qing imperial court, we have internal customs and traditions for inoculating people. But it is only done to children under ten years old. There is no custom of inoculating people who are ten years old and above. The season of inoculation also must be when trees are about to blossom (summer). … Drungpa Khutuktu (his brother) is almost fifty years old, the rest of the entourage are older than twenty years old, and most of them are in their thirties to sixties” (Jikmé Wangpo 2002: vol 2, 845). In short, here what the Panchen Lama proposed and what the Tibetans were planning to do was completely different from what the Qing officials were accustomed to or familiar with. The Qing officials gave the reasons for their objection as follows: “As you have suggested, even if we do not report this to the Emperor immediately. We have to tell you this. If Chungpa Hutukhtu and others have problems, we cannot say that we did not warn you and did not tell you our customs. If the Emperor found out, our necks would be on the line. So, please do not do this” (Jikmé Wangpo 2002: vol 2, 844-845). The officials were citing imperial customs and traditions to warn the Panchen Lama that this inoculation should not proceed. Even if they did not report this news to the Emperor immediately, he would have found out soon enough if something happened to these people as a result of the medical procedure, and this would have resulted in their being beheaded. In the short, they did not want to take any responsibility for this. While we have these Tibetan accounts, no official Qing reports about the discussions are available. From the Tibetan sources we can see how the Panchen Lama and the Qing officials differed on the issue. While the Panchen Lama agreed that inoculation was a risky medical procedure, they also differed on some medical procedures and political authority. For the Panchen Lama, as Jikmé Wangpo showed, the dates of inoculation and the ages of patients were not an issue. As long as there were good physicians to conduct this procedure, it could be performed anywhere, to anyone irrespective of age, and in any season. As the Qing officials point out, the Qing imperial court had established Misdiagnosis or Political Assassination? 71 rules and regulations on this practice. So, it was not surprising that the officials were alarmed at the Tibetans’ intention to inoculate these people in the coming spring. Importantly, they had different views on authority. The Qing officials had been sent by the Qianlong Emperor to oversee the Panchen Lama’s journey to Beijing; all important matters had to be referred to them, and they had to report back to the Emperor. However, after consulting his attendants, the Panchen Lama made his own decisions and simply informed the Qing officials. The Panchen Lama solved the impasse by taking personal responsibility. According to his biography, he said: “I am aware of the imperial customs, the times of inoculation and the ages of people. In principle, it is an unthinkable decision. After serious prayers to the [three] precious jewels and investigations, there won’t be any problems. The emperor won’t do anything about it. Frankly, as the two officials stated, if my elder brother and others go to China without being inoculated, from this point on, we have to cross thousands of people and pass through many cities and towns. Many of these places are sources of smallpox. If someone is affected, we Tibetans have almost no chance of surviving. Many people will be affected. Without any doubt, this will be of great concern to us. Whatever we are doing here is a service to his majesty. So if you have reported it to him, I can guarantee that you won’t reveive any punishment from the emperor or incur his displeasure. Moreover, you will be rewarded: I take all responsibility for this” (Jikmé Wangpo 2002: vol 2, 840-846). After the Panchen Lama took personal responsibility for his actions, the Qing officials seemed to withdraw their opposition and permitted the Panchen Lama’s entourage to be inoculated as he had advised them. On March 24th, the Panchen Lama sent three hundred of his entourage, led by his brother and the treasurer, Drungpa Khutukhtu Sopon Chumbo, to Tengyé Ling monastery in Alasha. This monastery was chosen because Alasha Wang and Dakpo Rinpoché (Dwags po rin po che) had gone there and were willing to help (2002: 846). For conducting this medical procedure, he sent Jikmé Wangpo and his doctor to perform this procedures. As mentioned above, the two of them had already inoculated some people in Golok and they must have mastered the procedure and techniques. The biographical account does not say how three hundred people were inoculated in the same place at the same time; however, during the quarantine, the patients could not go out. The letters were exchanged between the Panchen Lama and Jikmé Wangpo. After leaving his three hundred attendants in Alasha, the Panchen Lama, along with 72 Revue d’Etudes Tibétaines the Qing officials, slowly travelled toward to Chengde. On April 11th, they crossed the Yellow River and arrived in Ordos. On May 10th, when the Panchen Lama was in Ordos, the first of party who were to be inoculated arrived, led by Sopon Chumbo. The next day, they crossed the Yellow River again and arrived in the Tumed region of Inner Mongolia and slowly travelled toward Hohhot. In Hohhot, on May 21st, the Panchen Lama sent a letter to say that all the immunisations had been successful (Jikmé Wangpo 2002: vol 2, 880). On May 27th, Drungpa Khutukhtu and the rest of the people who had gone to Alasha for inoculation joined the entourage. This marked the end of the operation. On the 1st of June, the Qianglong Emperor wrote back and said: “I heard the report about the successful inoculation to Drungpa Khutukhtu, Sopon Chumbo and other hundred people arrived in the place called Umita. This is indeed a very important decree. I am very happy about it. On the way here, the weather was getting warm. The people, and in particular, the treasurer ( Drungpa Khutukht) were immunised from smallpox. I was worrying about it. After your arrival in Alashan, hundreds of attendants were inoculated. Even though the treasurer was fifty years old, he was successfully inoculated. This must come from your bliss and it is an auspicious sign. I am happy about it. It is really admirable that you did not consult me about this issue. It spared me anxiety” (Jikmé Wangpo 2002: vol 2, 888-889). This was how the official biography of the Panchen Lama and Tibetan sources portrayed the discussions and debates about inoculation and how the Panchen Lama made his decision. From these conversations and debates, we may note that several important issues emerge among different groups. First, as the Panchen Lama and his entourage departed from Tibet and approached the Chinese border, smallpox was the chief concern amongst all the members of the party, including the Panchen Lama himself. While people like Jikmé Wangpo openly advocated inoculation, others, including the Qing officials, were less enthusiastic. Secondly, these concerns and debates exposed a difference of opinion over smallpox and inoculation. For the Qing officials, smallpox was a children’s disease, and inoculation was for children who were no more than ten years old. Tibetans did not see it that way. It was the disease of all ages and in particular, Tibetans were susceptible to it. Thirdly, It was the Panchen Lama who made the decision to inoculate the members of his party who were not immunised from smallpox, and it was also his decision not to inoculate himself. Did this decision cost him his life in Beijing? Misdiagnosis or Political Assassination? 73 The last days of the Panchen Lama With festivals and official functions held for him by Mongols and the Qing officials in Mongolia and Jehol, on September 1 the Panchen Lama’s party arrived in the Western Huangsi (Western Yellow Temple), which had been specifically built for him by Qianlong5. On October 24th, he told his brother and other attendants that he had a pain in his forehead. They asked whether he needed to see doctor or not. He replied that “it is not a major issue, and it is unnecessary to see the doctor”. He did not have any special symptoms on October 25th; but his attendants were worried and brought his Tibetan doctor to see him. After checking his pulse, his physician said “ all pulses seem normal. He may not need medicine. But in order to relieve his headache, he could take some pills” (Jikmé Wangpo 2002: vol. 2, 1067). On the 26th, he even went to Changkya Rölpé Dorjé’s residence in Beijing and took part in a feast here. However, he did not eat much; he said it was nothing to worry about – he was simply not hungry. Sopon Chumbo said, “You have been complaining of some sort of headache since the 24th or 25th; however, all diagnosis appears to be normal, but let us ask Changkya Rölpé Dorjé to check your pulse” (Jikmé Wangpo 2002: vol 2, 1070). The pulse was checked and the doctor said that it was nothing serious, but it would be a good idea to take some pills. After returning to his residence, on the 26th, the Panchen Lama stayed in his room and cancelled all official functions. While he was resting, his attendants conducted many religious rituals, including prayers and donating a large sum of money to 7,500 beggars in Beijing. During the day, the emperor sent a minister to see him, and offered him a thangkha by Qianlong himself. After seeing the Panchen Lama’s condition, this minister asked whether it needed to be reported to the emperor or not. The Panchen Lama replied that it was not necessary. However, at the request of Sopon Chumbo and his brother, he did not see people for several days. Then again, his doctor checked and did not find any unusual signs. Still, Sopon Chumbo and brother were worried, and asked him to take some pills. He replied “for years and months, I have not had any heavy food in the afternoon, and it did not affect me. I still do not want to eat the noodles, but I will take some pills” (Jikmé Wangpo 2002: vol. 2, 1079). In the evening, he took some pills and went to bed after taking off all his clothing, which an ordained monk was not supposed to do. On the morning of the 28th, when Sopon Chumbo inquired about his condition, he replied that it had not deteriorated but that he still had some 5 See, Qianlong’s European time piece gifts to the Panchen lama, my incoming article, “Timepieces as Gifts: Exploring European Clocks and Watches in Tibet”. 74 Revue d’Etudes Tibétaines nausea and no appetite. The personal physician checked his pulse and said the condition was the same. However, after seeing some red lesions on his body, Sopon Chumbo suspected that the Panchen Lama might have contracted smallpox, as Sopon Chumbo had also experienced vomiting and nausea while he was in Alasha. They checked his body and noticed some enanthema or red rash on his hands and feet and in his mouth. At that time, Sopon Chumbo told the Panchen Lama that he might have smallpox. However, the Panchen lama was adamant and said that it could not be so, and that they did not need to worry about it. In order to check again, they invited Changkya to diagnose him. After checking the pulse again, Changkya reconfirmed his diagnosis and said the pulse was as normal as before. However, whether he was going to live or not depended on his will. “If it is, this must be reported to the emperor and I will do that” (Jikmé Wangpo 2002: vol. 2, 1082). Then Changkya reported the Panchen Lama’s condition to the emperor. On the same day, the emperor sent a message to his brother and Sopon Chumbo, saying that he had heard about the Panchen Lama’s illness and that he would visit him the following morning. Early on the morning of the 29th, the emperor came to see him. Sitting on a wooden chair near the Panchen Lama’s bed, the emperor expressed his sadness and then inquired about the conditions of his illness. After leaving the bedchamber, he instructed the sixth prince Yongrong (1744-1790), Changkya Rölpé Dorjé, and the other two ministers to take care of the Panchen Lama. The emperor also instructed the people who surrounded the Panchen Lama to make less noise. After returning to the Palace, the emperor sent one of his favourite ministers, Heshen (1750-1799), and two imperial doctors to check on the Panchen Lama. The doctors checked the pulse and said: “from this red rash, he appears to have a minor smallpox but his pulse suggests that the illness is not serious. His pulse is different from anybody else’s” (Jikmé Wangpo 2002: vol. 2, 1082). Then they gave him two pills and left for the day to report to the emperor. On the same day, again, the Panchen Lama asked his attendants to perform a number of ritual practices for him, including distributing a donation of 2,300 silver coins to 5,727 beggars. In the evening and morning he took the medicines that had been prescribed by the imperial doctors. On October 30th, two imperial physicians and the sixth prince came to see him. At mid-night, he told the emperor’s messenger that he was feeling fine. On November 1st, the sixth prince, Changkya Rölpé Dorjé and two imperial physicians came to see him. After checking his pulse, the doctors informed him that his condition had not deteriorated. Changkya Rölpé Dorjé suggested that he should take more pills. However, during the day, his condition worsened. Once, he looked at the Misdiagnosis or Political Assassination? 75 sky as he saw something, and smiled. He said he felt extremely warm and asked his attendants to remove the animal skins that covered the bed, and asked to be dressed in thin clothing. He told his attendants to prepare some ritual practices. Finally, he asked the two Indians who were traveling with him to be brought to him. One was not at home, but the famous Purangir was there. He was brought into the bedchamber, where the Panchen Lama said something to him in Hindi, though the biography does not record what he said. The Panchen Lama passed away at sunset on the 1st of November in the Iron Mouse year (1780). It is important to understand the final stage of the Panchen Lama’s life: the diagnosis and symptoms of his illness, and what might have caused his death. Without forensic evidence, a detailed analysis of the body and medical records, it is difficult to determine whether the Panchen Lama died from smallpox. However, even on his deathbed, whether or not he had the disease, and if so what form of it he had, were intensely debated and discussed. In the midst of these discussions, Sopon Chumbo suspected that the Panchen Lama did have smallpox; the imperial doctor confirmed this. It was after taking pills prescribed by the imperial doctor that the Panchen Lama passed way in his bed in Beijing. Either through embarrassment or shame, the Qing official accounts record virtually nothing about the conditions and the illness of the Panchen Lama. However, his Tibetan biography provides not only daily updates on his condition, and what kind of diagnosis and medicine he received, but also shows how both the Tibetans and the Qing officials conducted rituals, recited prayers and made prayers donations, and that both Tibetan and imperial doctors had treated him (Jikmé Wangpo 2002: vol. 2, 1067-1093). This concludes the official version of story. From this detailed record of the Panchen lama’s final days, it is possible to detect a number of signs of concern. Firstly, there are clear indications of disagreement over the diagnosis. Sopon Chumbo believed that the Panchen Lama had smallpox, and two imperial doctor supported this diagnosis. By contrast, the Panchen Lama himself, his Tibetan doctor and Changkya Rölpé Dorjé believed that whatever he had was not smallpox (Jikmé Wangpo 2002: vol 2, 1079, 1082). Secondly, after his visit, the emperor sent two imperial doctors to treat him. Both doctors claimed that the illness was not serious but that it could be cured, and they gave him some pills. Two days after taking the pills administered by the imperial physicians his condition worsened. He then felt seriously ill and passed away in the evening. 76 Revue d’Etudes Tibétaines What caused the Panchen Lama’s death? This question is not easy to answer. It involves a complex medical history, diagnosis and treatment. Immediately following the Panchen Lama’s death, there was a rumour that the Qianlong Emperor was somehow responsible. Sir George Staunton (1781-1859), who travelled to China with the Macartney’s mission in 1892, might be the first Englishman to express this hypothesis (Cammann 1949: 15). According to this version, Qianlong was jealous of the Panchen Lama’s influence and prestige among the Mongols, and had him poisoned. However, the origin of this rumour is difficult to trace, but many people believed that it originated with the tenth Shamarpa, Mipam Chödrup Gyamtso (1742–1793), a step-brother of the Panchen Lama (Staunton 1797: 52). If that was the case, the rumour did not come from ordinary people in Tibet but originated with one of the Panchen Lama’s relatives. As other Qing scholars have argued, it is unlikely that the Qing officials poisoned the Panchen Lama deliberately. However, we cannot completely rule out the possibility that both the Tibetan and Qing officials were responsible for the death of the Panchen Lama as a result of a misdiagnosis and inappropriate medical treatments. The first question is whether the Panchen Lama really had had smallpox before going to Beijing. If he had already had the disease three times, as he persisted in saying to his doctor and others who believed that this was the case, then smallpox was not the likely cause of his death: it is a medical fact that once a person has had smallpox they would be most unlikely to contract the disease again, something the Tibetans had known for hundreds of years. The Gyüzhi, the fundamental text of Tibetan medicine, mentions that once a person has had smallpox and survived it, he or she will not get it again. The second mistake that the Panchen Lama made was that he did not undergo inoculation like the rest of his entourage. As mentioned earlier, there was extensive discussion about this among the Panchen Lama’s people; while people like Jikmé Wangpo, who insisted that the Panchen Lama should be inoculated, there were Qing officials who argued that the treatment should not even be performed on Sopon Chumbo and his brother, let alone on the Panchen Lama. This detailed information comes from the biographical account of Jikmé Wangpo, which was written by Gungtang Konchok Tenpai Dronme (1762-1823), a famous scholar of Labrang monastery. The account states that the Panchen Lama’s announcement of his plan to inoculate his entourage became a contentious issue between the Qing officials and the Tibetans (1990: 287). Balmang Konchok Gyaltsen (1764-1853), also known as Balmang Pandita, provides more specific information. In his famous work Bkra shis 'khyil gyi gdan rabs rang bzhin dbyangs su brjod pa'i lha'i Misdiagnosis or Political Assassination? 77 rnga bo che (Chronicle of Labrang Tashi Khyil known as “the Sound of the Great Drum”), “Jikmé Wangpo asked the sixth Panchen Lama whether he had smallpox. The Panchen Lama answered that he had had white smallpox after being exposed to an object from adjacent countries. Since it could not be guaranteed that he had smallpox, Jikmé Wangpo again asked the Panchen Lama to be inoculated. He asked twice. The Panchen Lama answered that he had smallpox. On the third occasion when he asked for inoculation, the Panchen Lama said in a playful way that he had had smallpox three times. The Panchen Lama insisted that he did not want to be inoculated” (Balmang Pandita 1987: 98). Since Balmang Pandita has provided neither the details of the object that the Panchen Lama had been exposed to nor how he contracted smallpox from this substance, it is difficult to judge whether it was possible but it seems highly improbable. Balmang Pandita mentions several important things here. Firstly, it was Jikmé Wangpo who inquired whether the Panchen Lama had had smallpox or not. In medical terms, this was significant because if the Panchen Lama had indeed had the disease, he would have been immunised against it and there would have been no cause for concern. The Panchen Lama answered that he had already had smallpox after touching or being exposed to an object from a foreign country. This would have been a most unlikely cause of infection, since the disease was known to be spread through air or by contact with infected people. It was highly unlikely that an object brought from a foreign country would have infected the Panchen Lama. It may be that, with this medical impossibility in the mind, Jikmé Wangpo asked the Panchen Lama three times to be inoculated, but the request was refused. Of course, Balmang Pandita did not blame anybody but the low merit of sentient beings in this degenerate era. This is of course a Buddhist sentiment, implying that the reincarnations of lamas such as the Panchen Lama come to the world to save sentient beings from suffering, but that in this case the beneficiaries had insufficient merit to ensure that he remained in the world. What we have to remember here is that the Panchen Lama believed that he had had smallpox, and therefore did not need inoculation. Finally, let us assume that the Panchen Lama had had smallpox before going to Beijing and that what he had at the time of his death was not smallpox. The question then is, what illness did he have in Beijing? What about the two imperial doctors who prescribed medicine? As mentioned earlier, there were no medicines that could have cured smallpox. Was it possible that the two imperial doctors had made a misdiagnosis and gave the wrong medicine to the Panchen Lama? If 78 Revue d’Etudes Tibétaines that were the case, the rumour that his death was somehow connected to the Qing imperial court was not completely baseless. So, what kind of disease might the Panchen Lama have had? It is impossible to speculate; he could have had any one of a number of diseases with similar symptoms such as measles, for example. At the very least, he must at some point in his life have manifested the symptoms of a smallpox-like disease to justify the belief that he had had the disease before. There is also a political dimension here which must be considered: the difference in the ways the Tibetans and the Qing officials saw smallpox. For the Qing officials, smallpox was a child’s disease, and inoculation was only given to children under ten years old, and the two officials accompanying the Panchen Lama simply stated this position to him. For Tibetans, it was a risky medication; but neither the age of persons nor the season was significant, something that was unthinkable for the Qing; the Tibetan decision to inoculate adult men was shocking to the officials traveling with the Panchen Lama. Even if the Panchen Lama had wanted to have an inoculation, would the Qing officials have allowed it? While the Panchen Lama opposed it on the medical grounds, the Qing officials opposed it for political reasons and out of consideration for court rituals. As the Qing officials clearly expressed, they not only had strict imperial orders to take care of the Panchen Lama’s travel, but also had a duty to monitor his activities. These officials did not have any power to prevent the Tibetans from being inoculated, but in the case of the Panchen Lama, it appears that they had strict imperial orders to inform the emperor of everything he did. Although the biographical sources do not explicitly mention how they discouraged the Panchen Lama from being inoculated, it is implied that the officials tried to stop all Tibetans from receiving the treatment. Whatever the case, the Sixth Panchen Lama’s death in Beijing seems to be a more complicated matter than the official histories portray. It involved many critical decisions, both on political and medical grounds; however, medical misdiagnosis appears to be the main reason for his death, while a combination of events fostered a rumour that the Qing officials were somehow responsible. 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