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TTM Medical texts describe
over 2,000 substances used to make medicines in TTM. In practice,
the largest hospitals employ up to 800 and a doctor in a remote
valley, sourcing and making his or her own medicines, may use
around 100. Traditionally, the medical texts point to eight
areas of resources which may be effectively employed to treat
ailments:
'precious' substances,
such as gemstones, precious metals and rare articles (for Tibet)
such as Abalone shell
minerals
derived from rocks, such as iron salts
minerals
derived from soft rock and earths, such as sulphur, calcites,
hot spring deposits etc.
aromatics
and rare essences, (for Tibet) such as nutmeg, clove,
cardamon or rare animal extracts (see important
section below) such as bezoar or musk. Salts are also included
in this category, be they saline salts, water or earth-sourced,
or the likes of Glaubers salt etc.
tree-sourced materia; a varied
category including woods, such as sandalwood, eaglewood etc.
but also tree fruits and nuts, such as the famous arura
plum, as well as peppercorns, amber etc.
perennials and sturdier plants
herbs, annuals and smaller plants
animal products
(see important section below)
FORMULATION The
above ingredients are rarely used in isolation. They are usually
combined with each other in order to counter any secondary effects
and also in order not only to deal with specific symptoms and
ailments but to bring the whole system back into balance. It
is very common for 5, 8, 10, 15, 20, 30 or even more of these
substances to be carefully combined in order to respind to a
specific patient's condition. The resulting compounds bear the
name of the main ingredient + the number in total of ingredients,
e.g. Eaglewood 20, Saffron 13 or Pearl 70.
The three main principles underlying
the compounding of Tibetan Medicines are:
A medicine should not only calm the disease, but should also
be able to restore the body at the same time.
It is not enough to aim at just calming the disease, but one
must also make sure that the medicine does not have any harmful
side effect.
Once an illness is calmed by a medicine, the medicine should
be such that it prevents the illness from recurring. These principles
underlie the whole art of making medicines.
GATHERING
OF MEDICINAL PLANTS When collecting wood, aromatics,
perennial and herbal ingredients, there are certain procedures
mentioned in the Fourfold Tantra which a Tibetan doctor must
observe.When collecting medicinal plants, a positive state of
mind is important. The plants should grow in the right habitat:
Cooling plants should grow in a cold climate, facing north,
without sun, at a higher altitude.
Warming plants should grow in a hot climate, in the sun, facing
south, in a dry place.
Good medicine should grow in a solitary place, where the plants
are not disturbed by humans or animals.
The plants should grow in a clean, spacious and pleasant place,
with good light, and should be healthy, and undamaged by insects
or by the weather.
The plant should have the right appearance, colour and taste,
and have strong root.
The plants should be picked
at the right time. Medicines are collected in accordance with
the five elements and the four seasons:
Roots, stems and trunk-parts of the plant should be collected
in late autumn, when the vegetation starts to dry and wither.
Leafy parts of the plant, sap and stalks should be collected
in the summer (in Tibet this coincides with the rainy season),
when the plants are in full bloom.
Flowers and flowering tops should be picked in late summer.
Fruits and seeds should be picked in mid-autumn, before the
frost sets in, when they are fully ripened.
Barks, inner rind and resins should be collected in spring,
when the weather starts to warm up and the saps are rising.
There needs to be proper sorting
and drying
If possible, cooling and warming plants should be kept in different
rooms for storage until they are compounded into medicines.
Each plant should have its own container, and plants with a
very strong scent such as garlic (Allium sativum), onion (Allium
cepa), and asafoetida (Ferula asafoetida) should be kept separate
from other plants.
When drying and during storage, plants should not be contaminated
by smoke or bad smells from urine, excrement, etc.
They should be kept in a clean and well-ventilated environment.
Freshness: medicines should
be made from plants picked in the same year.
All medicines are to be made
according to the formulae mentioned in the traditional texts,
which describe precisely which part of the plant is to be used,
when these plants are to be collected, how they should be dried,
prepared and compounded and the exact proportions of each ingredient.Compounded
medicines are to be kept in a special place and treated with
care and respect.
PREPARATION Various
processes are applied to get the best out of these raw materials.
This may mean, in a first instance, simply separating the most
potent leaves from the rest of the plant or using mechanical
and simple chemical means for isolating a mineral from its ore.
It also included sun-drying, cleansing, pounding, grinding etc.,
as necessary to prepare the raw ingredient for mixing, as well
as, in some cases, extremely complex and labour-intensive processes
of detoxification. Once ready for mixing, they are combined
according to strict orders and procedures, carefully taught
by master to student. Indeed, even the gathering of the materia
medica is - in the best circumstances - personally supervised
by the physician in order that the material be gathered in the
location and at the time of highest potency and purity. The
resulting products are pills, powders, decoctions, medicinal
butters, ointments, medicinal baths, inhalations, enemas etc.
designed to have little or no side effects.
THE
TARA ROKPA DATABASE & IMAGE BANK:: In order to prepare
for the vast research which needs to be undertaken into Tibetan
materia medica, Tara Rokpa is building up a database,
linked to an image bank. Although Tibet and Western China were
highly-prized by the great plant hunters and explorers of the
19th and 20th century, the information and plant recognitions
they brought back leads to considerable confusion. In cases
where recognitions are at odds, it is impossible to choose and
the best solution has been to include all recognitions in a
database while nevertheless privileging data ara Rokpa itself
gathers through its own contact with eminent doctors and scientists
in Tibet. Part of the confusion comes through different plants
with similar therapeutic properties being used under the same
medical name in different areas, according to availability.
One must recall that the Tibetan plateau is 7 times the surface
area of France, with regions very isolated from each other and
presenting differences of climate and topography. Furthe complication
has been caused by the work of Tibetan refugee doctors in India,
Bhutan and Nepal, using local resources which (in Western terms)
are botanically quite different.
The Tara Rokpa database now
has almost one thousand entries, recording the Tibetan name,
its pronunciation, the preferred Latin recognition, other recognitions
made by plant-hunters, a popular name (where one exists), taste,
post-digestive potency, potency, processing methods, geographical
origin, uses, an image bank reference etc.
The image bank has over one
thousand photos and illustrations.
an entry from the Tara Rokpa database
CHANGES DUE TO ENVIRONMENTAL AND ECOLOGICAL
CONSIDERATIONS: Things have changed
dramatically in the last century. Animal and plant resources
which were once sufficient to provide for the needs of sparse
local populations have now become rare or threatened with extinction.
It is no longer ethical to use products from rare wild animals
nor is it right to deplete stocks of unique high altitude plants.
Fortunately, substitutes exist for most of these rare materials
and Tara Rokpa and its associated medical institutions on the
Tibetan plateau are taking pains to follow an ethically correct
policy with regard to sourcing its materia medica. Furthermore,
we are keen to set up village industries which will cultivate
rare species of plant and we already have set up protected areas
on certain mountainsides.
CHANGES
DUE TO EUROPEAN & AMERICAN LEGISLATION: The
law regarding what a TTM doctor can prescribe varies from country
to country. Tara's clinics operate in the UK at present. In
our global modern reality, changes in legislation in other European
countries and in the USA are followed with interest. As things
stand, TTM operates as a heral medicine. This precludes the
use of gemstones, minerals, many earths and animal products.
Among the plant resources, some are banned, even though the
detoxification processes used in TTM have not been researched.
Fortunately, the great 19th Tibetan scholar, scientist and physician,
Mipam Rinpoche, devised a whole series of substitutes coming
from the plant world. We use these in our Tara clinics and they
are proving effective on Western patients. Ideally, however,
huge sums of money need to be invested in proper clinical trials
on the vast traditional range of medicines, as they almost
certainly have much to offer, given the great medical systems
which lie behind them and the centuries of effective use on
millions of people.
THE
NEED FOR RESEARCH: We find ourselves
in a situation where one of the world's great systems of traditional
medicine is being discovered by the modern West. Insofar as
its medicines are concerned, there is doubtless much to be learnt
both about the therapeutic uses of individual materials as well
as about the theory and practice of their combination and the
resulting synergy. Furthermore, before Western patients can
truly benefit from these ancient formulae, large-scale research
needs to be done to credible double-blind standards both to
authenticate the value of these medicines and to guarantee their
safety.
THE
NEED TO ESTABLISH PURE & SUSTAINABLE SUPPLIES: Urgent
effort needs to put into stopping the pillaging of the rare
plant and animal resources of the Tibetan plateau in order to
satisfy the Asian market. This will be best accomplished by
creating high-altitude farms of materia medica as a cottage
industry for the indigenous Tibetan people, who lack employment.
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