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Tara Rokpa's links with TTM

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Basic Principles:

Although not endowed with our present-day means to confirm their theories, the sages of ancient India believed the universe to be - on a molecular level - a vast sea of matter, energy, movement and bonding, against a neutral backdrop of space. They called these five omnipresent factors of existence the Five Elements. This ever-changing phenomenal sea appears - on a gross level - as all the animal, vegetable and mineral phenomena we perceive as life. A human body is a highly-complex microcosm composed of these five elements, just as the universe in which that body moves is an immensely complex macrocosm composed of the five elements. One might compare this awareness of the Five Elements to our knowledge that a printer uses only three colours and black to produce all the manifold array of his work. The end result - a Gauguin reproduction, for example - contains millions of hues and is very complicated yet each point of colour remains a simple product of the four inks.

Professor Khenpo Tsenam, Tibet's most famous exponent of TTM, in jovial mood, mixing medicines in a master class at the Tara College
When imbalance of the five elements in the human body (as a whole or in one or more of its organs or systems) gives rise to sickness, balance can be restored by drawing upon the elemental resources of the world around it. This can be done through modifying behaviour, changing diet, giving medicine or applying specific treatments (see below). Tibetan medicines use plants, minerals and so forth, the own elemental qualities of which are known to increase or decrease one or more of the bodily elements.

Furthermore, centuries of pragmatic experience has revealed the short and long term effects of the different materia medica on the various tissues and organs of the body and on specific ailments.


TTM points to three biodynamics , known in Tibetan as nyes pa gsum: three (potential) pathogens. These group all the various bodily systems into three groups (related to the elements) which normaly ensure the overall "good running" of the psycho-physical complex which is a human being. As such we could almost call them "Three healthogens". However, when their normal functioning is disrupted, they become pathogenic and eventually illness ocurs. These three biodynamics are very similar to the tridosha of Indian ayurvedic medicine (see note below).

Like a good mechanic caring for a car engine, the TTM physician tries to spot weaknesses in the system before specific breakdown occur on their account. Some of TTM is therefore a prophylactic medicine dealing with unhealthy tendencies before they cause the patient to present with serious clinical problems. However, since many people only consult a doctor when things are quite badly wrong, the major part of this medical science - in practice - is concerned with an immediate treatment of the specific ailment with which the patient presents while at the same time dealing with any underlying imbalance discovered in the three domains of pathology .

Many notions of physiology, pathology and therapeutics found in TTM have their origins in Indian Buddhist and Siddha medicine. Buddhism was itself eradicated in India from the 12th century CE. Its medical science became integrated with Hindu ayurvedic medicine, predominant in the north of the subcontinent. A rather diminished form of Siddha Medicine still exists in the south.

TTM describes anatomy through an extended metaphor of a house, in which in which there are major channels of life-sustaining activity, some very critical points to protect and certain metabolic pathways to nurture. In the body, there are certain vulnerable mechanisms which become the targets of pathogenic aggression. Life is principally sustained by the metabolic heat of digestion and the subsequent sevenfold metabolic chain, regenerating the bodily tissues and producing excreta. The metabolic process is very important in Tibetan medicine, which sees good diet and digestion as the main key to good health. The three great domains of pathology play important roles in digestion and this sevenfold metabolic chain. They are the vectors of good health, when in balance and undisturbed, and of illness, when disturbed. In the latter case they are known as the origins of pathogenic aggression.

The basis for diagnosis of ailments depends upon - as in all medical systems - the perspicacity of the physician. Logic and deduction play a major role in the doctor's assessment of the situation. The more so, as here we are in a world without blood tests, x-rays or laboratories. Using the evidence gathered through a general physical examination, careful questioning, thorough and subtle pulse palpation and urine examination, the physician sets in motion a programme of treatment designed to bring the person back into balanced health. This can involve any or all of four levels of therapeutic means:

   advice on lifestyle, showing how work, environment, personal and family relationships etc. influence health,
   dietary regulation, using food and drink intelligently to help the body back to balance,
   medication involving over 2,000 substances, usually in combination (sometimes up to 70 or more are present in one medicine). These are designed to either calm or cleanse Calming treatments take the form of decoctions, pills, powders, pastes, medicinal butters, calcinates, extracts and medicinal brews. Cleansing remedies include lubricatives, purgatives, emetics, nasal medications, enemata and those which cleanse the system generally.
   various (mainly external) treatments. such as medicinal baths, ointments, hot or cold fomentations, blood-letting, moxibustion and minor surgery.

The physician follows a high moral and ethical code. This is seen as playing an important role in the healing art. The general idea is to reduce subjectivity, by the physician being - in general and especially during consultation and pulse palpation - not simply another human being complicating the situation with his own personal presence and subjective interpretation, but a calm presence of universal, compassionate peace: a sort of universal mirror which will reflect accurately the situation of the patient. Pulse palpation is perhaps the most vivid example of this. Pulse is said to be the messenger between the patient and the docotr. Some Tibetan physicians describe pule palpation as "listening to the patient's body". To achieve the state of deep quiet needed to 'listen' effectively, the physician trains in meditation and prayer. In the past, most TTM doctors were Buddhist and their professional practice was their own path of spirituality and their way of serving the community. One should neither underestimate nor overestimate this spiritual dimension of TTM. Results from TTM clinics with doctors trained under the Communist regime (i.e. without the Buddhist aspect of training) have shown that TTM stands very effectively on its own feet as a medical system without it. However, those TTM doctors with wide experience of TTM both with and without the spiritual and ethical dimension all seem agreed that it is more effective with it, especially concerning the doctor-patient relationship.




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