Textual Scholarship, Medical Tradition, and Mahyna Buddhist Ideals in Tibet

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    The physician without a lineageIs like a fox that seizes the kings throne:He deserves no ones respectThe physician who does not understand the textsIs like a blind person to whom you show something:He can discern neither the disease nor the cure.1

    These words of warning from the Four [Medical] Tantras underscore thecentral place of textual learning for the practice of medicine in Tibet.Textual scholarship in its many forms is an integral part of the medicaltradition in Tibet, or more precisely, of certain formulations of the medicaltradition with an emphasis on scholarship. For certain writers the FourTantras were the subject of a heated scholarly debate, centering in greatpart around text critical issues. In this essay I explore what several influ-ential Tibetan writers have said about the role of textual scholarship inmedical learning, about the place of scholarly learning in a field dedicatedin an ideal sense ultimately to practical application, and about the relation-ship between medical scholarship and the bodhisattva ideal of MahayanaBuddhism in Tibet. Specifically, I argue four points: (1) Debates aboutphilological scholarship in pre-modem Tibet were not limited to discus-sions involving Buddhist literature but are found as well in fields such asmedical scholarship (as well as history, poetics, linguistics, etc.). (2) Suchdebates in medical literature were nevertheless were framed by recourseto the Mahayana Buddhist ideal of the bodhisattva and the injunctionthat bodhisattvas study the five arts and sciences, including medicine.(3) Reports of such debates were part of larger efforts to claim authority bycertain groups of medical scholars at the expense of others by casting doubton both their ability to practice medicine and their adherence to bodhisattvaideals. (4) Finally, I suggest that this rhetoric linking the bodhisattva andthe textual/medical scholar was but one part of an attempt to exert directinfluence over the development of learning and culture on the part of thenewly formed Tibetan theocracy, the Ganden Government of the FifthDalai Lama, at the end of the seventeenth century. Though the central part

    1 Yon tan mgon po, Bdud rtsi, pp. 99.899.10.

    Journal of Indian Philosophy 31: 621641, 2003. 2003 Kluwer Academic Publishers. Printed in the Netherlands.


    of the essay is dedicated to presenting the actual debates about textualscholarship in Tibetan medical literature we must not lose sight of theselarger issues.

    To this end I will look primarily at the scholarly and editorial activi-ties of Sangye Gyatso (Sangs rgyas rgya mtsho) (16531705) the persontraditionally credited with institutionalizing and systematizing the Tibetanmedical tradition under the auspices of the Fifth Dalai Lama, NgawangLobsang Gyatso (Ngag dbang blo bzang rgya mtsho) (16171682)2 and theGanden government during the last decades of the seventeenth century.3 Iwill also look to select figures in the history of the Four Tantras beforehim, including Drangti Paldan Tshoje (Brang ti Dpal ldan tsho byed)(13th/14th c.), Zurkhar Lodro Gyalpo (Zur mkhar Blo gros rgyal po)(1509c. 1573), Darmo Menrampa Lobsang Chodak (Dar mo Sman ram paBlo bzang chos grags) (16381697/1700), and Namling Panchen KonchokChodak (Rnam gling Pan

    .chen Dkon mchog chos grags) (16461718).

    Sangye Gyatsos detailed history of Tibetan medicine, the BerylMirror,4 reveals much about his attitudes toward textual scholarship andits role as a foundation of medical learning and practice, particularly inseveral autobiographical remarks regarding his early study of medicine andthe editing and printing of the Four Tantras. This scholars undertakingsin the philology of medical texts were motivated by an understanding ofthe place of medicine in the traditional Buddhist domains of knowledge:practical arts, medical arts, linguistics, logic and epistemology, and the artof Buddhist learning and realization itself. Like the medieval physiciansof Italy responsible for introducing Greco-Arab medical scholarship toEurope, Sangye Gyatso held medical education to be intimately boundwith these arts and sciences. Thus, the present essay also touches on hismore thematic remarks about the nature of medical learning, and suggestsin the conclusion that his efforts in medical scholarship must be seen as

    2 The Fifth Dalai Lamas activities in this area were largely restricted to patronizingcourt physicians and their work in editing and printing important medical works andcomposing new commentaries upon these works. See Sangs rgyas rgya mtsho, Dpal,pp. 364372.

    3 For summaries of Sangs rgyas rgya mtshos medical activities, see Meyer (1992),pp. 67; Meyer (1995), pp. 16118; Meyer (1998), pp. 2930; Meyer (2003); Rechung(1976), pp. 2122; Yonten (1989), pp. 4547. Modern Tibetan studies include, Dkonmchog rin chen, Bod kyi, pp. 15121; Pa sangs yon tan, Bod kyi, pp. 136143; Byamspa phrin las, Gangs ljongs, pp. 313317; and especially Byams pa phrin las, Sde srid.See also Lange (1976) for a comparative list of his writings. Wang Lei (1994) is a roughparaphrase of the Beryl Mirror.

    4 Sangs rgyas rgya mtsho, Dpal ldan. See Martin (1997), entry 259, for furtherbibliographic information.


    well in relation to his leadership of the Ganden Government (Dga ldanpho brang).

    The basis for much of the present discussion is the final chapter of theExplanatory Tantra, the second of the Four Tantras.5 Chapter thirty-one ofthis tantra, the source of the verse with which I began this essay, proscribesthe qualities of the ideal physician.6 The first lines of the chapter list the sixprerequisites of a physician, which include intelligence, altruism, honor,practical skill, diligence, and knowledge of worldly affairs. Intelligence,the first of these six, is defined at the outset in singular terms: Withgreat, firm, and fine intellect, learn deeply the medical treatises.7 Thesixth prerequisite of the physician, diligence, is in turn divided into fouraspects, the first of which is the following injunction: Learn writing andreading completely, for whether [you] are capable or incapable dependson these.8 In the Blue Beryl, Sangye Gyatso elaborates on these lines bysaying that ones competence in exposition, composition, and debate arebased upon ones ability to read and write.9 The second aspect of diligencein medical training is reliance upon a skilled teacher, who is characterizedin part as someone who has a deep knowledge of medical texts.

    While there are plainly many other qualities required of the well-trainedphysician, chapter thirty-one begins with an explicit emphasis on textualscholarship for both teacher and student. This emphasis may seem proforma, and perhaps somewhat inconsequential in the face of the massivetherapeutic or materia medica chapters of the Four Tantras. This passagefrom the Explanatory Tantra has far reaching implications for the medicalwriters considered in the present essay. Indeed, Sangye Gyatsos BerylMirror can be seen as an extended commentary on chapter thirty-one ofthe Four Tantras, and on these passages of that chapter in particular.

    From the age of eight Sangye Gyatso studied medicine under several ofthe finest medical scholars of the seventeenth century, all under the care of

    5 See Dorje (1992) for a helpful outline of the contents of the Four Tantras.6 Chapter thirty-one of the Explanatory Tantra is represented in plate 37 of Sangye

    Gyatsos medical paintings. See Parfionovitch (1992), vol 1, pp. 8990; vol. 2, pp. 245246.

    7 Yon tan mgon po, Bdud rtsi, pp. 96.296.3: blo che blo brtan blo gzeg gsum ldanpas // gso dpyad mdo rgyas ma lus khong du chud //. See also Clark (1995), p. 223, for analternative translation.

    8 Yon tan mgon po, Bdud rtsi, pp. 98.198.2: rgyu ni dri klog mtha ru phyin parbslab // chod dang mi chod de la brtan par snang //. Quoted in Sangs rgyas rgyamtsho, Dpal ldan, pp. 517.7517.8. See Clark (1995), p. 226. See also the twelfth-centurycommentary on these lines, which employs the same examples; Ye shes gzungs, Grel, f.57a.5.

    9 Sangs rgyas rgya mtsho, Gso ba, pp. 494.3494.5.


    the Fifth Dalai Lama. During his relatively short life of fifty-two years, theregent of Tibet composed three major medical works. In 1687, at the ageof thirty-five, he began a commentary on the Four Tantras known as theBlue Beryl, which he completed one year later, in 1688. Two years afterthis he began his second medical work, an extended commentary on thethird of the Four Tantras, the Instructional Tantra. This extended surveyof medical practice was completed in 1691.

    Eleven years later, in 1702, he began what was to be his last medicalwork, the Beryl Mirror, more commonly known as the Gso rig khogbugs what I have roughly translated as the Interior Analysis of theMedical Arts.10 Sangye Gyatsos Beryl Mirror is explicitly based uponan earlier work by Drangti Palden Tshoje. According to Sangye Gyatso,Palden Tshojes Elucidation of Topics (Shes bya rab gsal) in fact formsthe basis for most medical historiography between the fourteenth and theseventeenth centuries.11

    Sangye Gyatsos survey of the medical tradition is a complex work,integrating medical history, a schematic presentation of the Buddhistteachings, a long prescriptive survey of the qualities of the ideal physician,and several autobiographical passages. The Beryl Mirror is the last of hismajor works, completed in 1703, just two years before his untimely deathin 1705. It is likely, however, that he had been working on this history for anumber of years prior to this. At the close of the work we find a small noterelating the unfavorable circumstances of its creation. Up to age fifty, thatis, until 1702, Sangye Gyatso dictated the work to a scribe. He admits thatthis process of dictation was a major source of error, for his own wordswere often misconstrued by the scribe and written down incorrectly. In1702 Sangye Gyatso considered the work to be only a collection of draft

    10 In the opening verses of the Beryl Mirror Sangs rgyas rgya mtsho elaborates on thetitle of his work, describing it as an exposition (legs bshad) that penetrates (bugs) theinterior (khog) of the medical tradition. See Sangs rgyas rgya mtsho, Dpal ldan, pp. 78:dpal ldan gso ba rig pai rgyud kyi khog / sman pai rgyal pos [8] bzhin du bugs byedpai // legs bshad dri ma spangs pa baiduryai // me long tshe rig drang srong dgyespai bzhin //. Although the implications of the Tibetan term khog bugs/dbug, the nameof the genre of writing in which Sangs rgyas rgya mtsho places his work, have not beenexplored fully, it seems to refer primarily though not exclusively to the historical workson the lineages and texts of the medical tradition, including the presentation of the idealphysicians education and qualities. Indeed, these subjects make up almost the whole ofSangs rgyas rgya mtshos Beryl Mirror. Yon tan mgon po, Khyung, f. 3a.58a.4 offers anearly analysis of the term. The parameters of the genre as delineated by Tibetan scholarsdeserve separate study.

    11 Although this work does not contain the word khog bugs in its title, and Sangs rgyasrgya mtsho does not cite it as such, it is structured in much the same way as both the BerylMirror and Zur mkhar Blo gros rgyal pos Khog dbug (Blo gros rgyal po, Gang).


    notes. Unfortunately, in this same year Sangye Gyatsos eyesight beganto fail. It became difficult for him to see fine objects in the morning andevening, and his ability to write for himself waned. His scribe, ChakarwaPema Sonam (Cha dkar ba Padma bsod nams), thus completed his work. Ispeculate that the work is unfinished as it stands.12

    Perhaps the most interesting passages in the Beryl Mirror are autobio-graphical remarks about Sangye Gyatsos medical education and activities.His reminiscences lead us through some of the most important years in thetextual history of the Four Tantras. From an early age, Sangye Gyatsoexhibited skill in the five arts, and wondered if he might not be the reincar-nation of some former scholar also skilled in the arts.13 Between the agesof thirty and forty this early preference began to produce results. He boaststhat he delighted in whatever textual traditions he encountered, and in addi-tion to running the kingdom found the time to compose twenty volumes onlinguistics, logic, practical arts, medicine, and even Buddhism.14

    Before this time he had memorized the three smaller of the FourTantras, the Root, Explanatory, and the Subsequent Tantras, and hadalready began making his own contribution to medical literature. SangyeGyatso spent a good deal of time engaged in text-critical work on the FourTantras themselves. The textual history of the Four Tantras was of greatconcern for him, and he relates both his and his predecessors efforts toimprove the text. The print of the Four Tantras made at Dratang (Grwathang) in 1546 by Zurkhar Lodro Gyalpo had been used by the court physi-cian to the Dalai Lama, Jango Nangso Dargay (Byang ngo Nang so darrgyas), as the basis for new printing blocks in 1662. Nangso Dargyay feltthat this Dratang print was an authoritative witness ideal for reproduction.Thus, according to Sangye Gyatso at least, he made no effort to use othertextual witnesses for his new print.

    In 1670 Sangye Gyatso began to look at various recensions of the FourTantras himself, and decided that the Dratang print was not as reliableas his elders believed. He became convinced that his master and his courtphysician had made a mistake in relying exclusively on the Dratang print.15He tells us that he thought the version of the Dratang print edited by

    12 This is no more than a rough impression. The Beryl Mirror does not have the highlystructured nature of works such as the Yellow Beryl, the White Beryl, or the Blue Beryl.There are no chapter headings, and though the progress of the work does have a generalcoherence to it, certain subjects receive scant attention in comparison with others.

    13 Sangs rgyas rgya mtsho, Dpal ldan, pp. 372.4372.5.14 Sangs rgyas rgya rntsho, Dpal ldan, pp. 376.2376.7.15 According to Sangs rgyas rgya mtsho, Dpal ldan, Nang so dar rgyas and the lesser

    physicians were convinced that the Byang and Zur traditions were quite different. ButSangs rgyas rgya mtsho felt that the two differed only in minor points, and therefore textual


    Nangso Dargyay to be filled with gaps and confused sections. He there-fore took a chance and told the Great Fifth that his colophon to NangsoDargyays 1662 print was inaccurate when it heaped praise only on theDratang print. Because this most recent edition of the Four Tantras wasprepared under the auspices of the Fifth Dalai Lama, criticizing that textwas tantamount to criticizing the Dalai Lama himself. Sangye Gyatsoseems acutely aware of this dilemma. He was after all, saying that thebodhisattva Avalokitesvara himself did not really know his scripture allthat well.16 His language in describing this situation is supremely defer-ential, and yet the basic point is clear: My master, the Great Fifth [DalaiLama], who knows everything of ultimate meaning and who sees all andeverywhere as if it were in the palm of his hand . . . manifested ignor-ance of the three [smaller] Tantras, the outlines, and the tree-diagrams forthe sake of the lowly.17 The Dalai Lama was pleased at his seventeen-year old pupils industry, and encouraged him to begin re-editing the FourTantras.18 This project was to last twenty-four years, ending in 1694 whenSangye Gyatso had new blocks of the text carved.

    Despite his studies and his extensive writing, Sangye Gyatso admits todoubting his abilities to edit the Four Tantras to the point of anxiety.19 Hewas apparently able to overcome these feelings, however, and provides adetailed account of his efforts. The editorial process was a massive project,in which he consulted over forty separate sutras, tantras, Buddhist treatises,and medical works in order to arrive at good textual readings. In additionto the Dratang print itself he also used at least four other prints of theFour Tantras and a number of old handwritten manuscripts. He specificallynames editors and patrons of prints from Dzonga (Rdzong dga), Gampo(Sgam po), Takten (Rtag brtan), and Bodong (Bo dong), giving us someinsight into the complexity of the textual traditions with which SangyeGyatso found himself confronted. By comparing older manuscripts withthe Dratang print he sought to restore older verses, fix topical headings andoutlines, emend faulty readings, clarify archaic terminology, and eliminatechanges in the text that he considered to be guesses by the uninformed.20

    Despite his critique of former scholars efforts, it is clear that SangyeGyatso drew inspiration from his predecessors. Among many such figures,

    witnesses from both traditions should be used in establishing an improved text of the FourTantras: Meyer (1992), p. 6.

    16 On the development of the idea that the Dalai Lama was a reincarnation of thisbodhisattva, see Ishihama (1993).

    17 Sangs rgyas rgya mtsho, Dpal ldan, pp. 381.6381.11.18 Meyer (1992), p. 6.19 Sangs rgyas rgya mtsho, Dpal ldan, pp. 383.4383.7.20 Sangs rgyas rgya mtsho, Dpal ldan, pp. 385.9385.16.


    Zurkhar Lodro Gyalpo stands out, for he writes of medical scholarshipwith a passion reminiscent of Sangye Gyatso. Born in 1509, Lodro Gyalpolived until at least 1573, when at the age of sixty-four he composed adefense of the Four Tantras as the word of the Buddha.21 He was theauthor of a popular set of commentaries on the Four Tantras, known as theGrandfathers Instructions, and, as we have seen, the editor of the 1546Dratang print of the Four Tantras.

    Lodro Gyalpo adamantly insisted that those learning the medical artsmust study each of the Four Tantras in a particular order. The introductorypassages of his commentaries on the Four Tantras reveal an emotionalscholar distraught at the state of his field. In the opening lines of his1542 commentary on the Root Tantra, Lodro Gyalpo waxes poetic onthe glories of the Four Tantras. The Four Tantras pervade the circumfer-ence of the Himalayas with sweet sounding letters, he eloquently begins,immediately emphasizing the importance of the Four Tantras as text, aswritten word. And it is these sweet sounding letters that must form thebasis for all medical learning. Given its exalted status, the Four Tantrasmandate commentaries with authoritative lineages, which are uncorruptedby the claims of those pretending to be teachers, which refute the doubt,misunderstanding, and incomprehension of others, for it is only suchcommentaries that will provide a solid basis for the continued existence ofthe Four Tantras. It is, of course, Lodro Gyalpo himself who will providesuch a commentary.22 But before he begins his own commentary he offersan emotional critique of the faulty scholarship he perceives around him.23He writes:

    These days, because the actions of scholars are few, pure traditions have not been main-tained. These days the great textual traditions are like milk at the market; the meaningfuland the meaningless have become mixed together. Those wanting to write commen-taries make their explanations hastily, without consulting the text itself. Because of suchexplanations, words and meanings that are contradictory are placed side-by-side. Some[commentators] have made things up by themselves, and amazingly hold to this as theirspecial teaching. They perform mistaken practices of diagnosis . . . and treatment thatstem only from observation. They then say that physicians who explain [things] basedupon texts are not profound, while those that stem from oral instructions are, and theygo elsewhere for instruction. Seeing only such efforts to harm themselves and others withscattered backward practices, my mind reels. Thinking only of the teachings in the medicaltreatises, . . . [and] clarifying every word and meaning, . . . I set about composing this largecommentary, which sets things right!24

    21 Blo gros rgyal po, Rgyud bzhi bka, p. 71.22 Blo gros rgyal po, Rtsa bai rgyud gyi rnam bshad, p. 2.23 Such heated critique as we will see in the following passages is also found in European

    scholarly medical literature: Maclean (2002), p. 215.24 Blo gros rgyal po, Rtsa bai rgyud gyi rnam bshad, pp. 23.


    This passage is noteworthy for a number of reasons, but perhaps mostinteresting is the insight it provides into debates about the relation betweenmedical scholarship and medical practice occurring in sixteenth centuryTibet. Lodro Gyalpo appears to be responding to very real criticisms aboutthe value, or lack thereof, of studying medical treatises. Reading betweenthe lines of this passage, we can posit that there were those who held thestudy of medical treatises to be simply a waste of time, with no value tomedical practice.

    Lodro Gyalpo reacted strongly to this state of affairs. In his 1545commentary on the Explanatory Tantra, he offers a powerful defense ofcommentarial literature in the medical context. He begins by putting wordsin the mouth of his opponent, the physician critical of commentaries:Others say: There are all sorts of commentaries, big, little, and small,on the Four Tantras in general by earlier [writers], and on the ExplanatoryTantra in particular. It is enough. What need is there to write another? Thisreasoning which proves what has already been proven grows weary! 25Frustrated with this attitude, Lodro Gyalpo offers his own polemicallycharged views on the importance of a scholarly approach to medicine. Hedoes admit that, although most commentaries are largely accurate, thereare also a great many that are filled with half-truths and mistaken ideas. Ithas been left to him, apparently, to set things straight. He writes:Those so-called scholars understand [the Four Tantras] narrowly, using sophistry andhearsay to create meanings, which only exist on paper. These days, when all learned peopleconsider the teachings of the medical art, they feel like weeping. For these reasons, I haveinspected and analyzed each letter of the words in the text. With a view toward establishingterminology, I have made an explanation that cleans up the words of the precious teaching,and is a model that will be impressive to scholars, fools, and those in between.26

    Lodro Gyalpo then focuses on the place of the Explanatory Tantra inmedical learning. Again, from the following passage we can see that therewas no lack of debate over the proper direction of medical learning, oreven on the relative value of the different sections of the Four Tantrasthemselves. He writes in a scathing tone:These days, physicians generally think the following: By knowing this ExplanatoryTantra one does no more than repeat words. It is of no benefit to the process of [medical]

    25 Criticism of the value of scholarly commentary for medical practice is found in themedieval Islamic world as well. The Iraqi physician, Ibn Butlan (d. 1063), for instance,makes the following comment in his practical medical manual (Condrad [1995], p. 122):People are dissatisfied at the length to which the learned pursue their discussions andprolixity encountered when these are set down in writing in books; what [laymen] needfrom the sciences is that which will benefit them, not proofs for these things or theirdefinitions.

    26 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 93.993.16.


    practice. [Such physicians also think:] These people who are learned in explanationare deficient in the realm of practice. For this reason they study the Subsequent Tantrawithout studying the Explanatory Tantra. They look narrowly with just a few practicaltechniques from that [Tantra], and leave it at that. Later they express arrogance, [saying]that they do not need to look at the Explanatory Tantra or the Instructional Tantra. These[physicians] who desire to understand the meaning without knowing the words, whichteach the practice, are astonishing.27

    This passage was integrated into later commentaries on the ExplanatoryTantra such as the 1886 work of the court physician of Derge, RinchenOzer (Sde dge Sman bla Rin chen od zer), suggesting that the senti-ment expressed by Lodro Gyalpo in the sixteenth century could still findsympathizers centuries later.28 It is reminiscent of Jangpa Namgyal Drak-sangs (Byang pa Rnam rgyal grags bzang) (13951475) 1468 descriptionof the second of four types of ordinary physicians, the page turningphysicians who simply glance through a few instructions, find somethingthat looks useful, and proceed to diagnose with no real understanding.29To those who would ask what the value of the Explanatory Tantra is tomedical practice, Lodro Gyalpo offers the following step-by-step outline ofthe relation between the theoretically oriented second Tantra and the prac-tice of healing the sick. Taking the progression of topics in the ExplanatoryTantra itself as his framework, he writes:Whoever does not know the Explanatory Tantra does not know the characteristics of thebody. Whoever does not know the characteristics of the body does not know the nature ofillness. Whoever does not know the nature of illness does not know how to do an examina-tion or proscribe diet. Whoever does not know how to do an examination or proscribe dietdoes not know a thing about the medical arts! Therefore, how can those who do not knowthe medical arts know the practice of medicine? It is like someone wandering about in adark room wanting to see something without their eyes!30

    Finally, Lodro Gyalpo proscribes what he considers to be the proper courseof study, which includes each of the Four Tantras: First, [those learningthe medical art] should study only the Root Tantra and the ExplanatoryTantra. When they have learned [these] . . . by heart, they should be intro-duced to the Instructional Tantra and the Subsequent Tantra. Gradually,they need to learn the practice according to the words of the text.31 In

    27 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 95.1395.19.28 Rin chen od zer, Bdud, pp. 146.6146.13. Little is known of this author. The dating

    of this work to 1886 (me khyi) is based upon the apparent mention of two figures in theintroductory verses, Si tu Pan

    .chen Chos kyi byung gnas (1699/17001774) and Jam

    dbyangs Mkhyen brtse dbang po (18201892). See Rin chen od zer, Bdud, p. 4.29 Rnam rgyal grags bzang, Bshad, p. 691 63a.17. See before him Ye shes gzungs, Grel,

    f. 63a.1.30 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 95.1995.24.31 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 95.2596.3.


    these passages Lodro Gyalpo provides a clear rationale for the importanceof textual scholarship to medical learning and medical practice. SangyeGyatso himself couldnt have made it clearer: the only place one can learnthe medical arts is in texts such as the Explanatory Tantra. If the physiciandoes not possess an intimate understanding of these arts, then effectivepractice is simply not possible.

    In his incomplete commentary on the Subsequent Tantra, Lodro Gyalpolaments that most physicians rely only on this the last of the Four Tantras and ignore the previous three. The Subsequent Tantra is valuable, ofcourse, for it . . . clearly teaches the steps of practice according to theorder of its chapters, without mixing them all together, for physicians ofinferior mental skill.32 Although Lodro Gyalpo admits that it is possibleto benefit people by basing ones practice only on this Tantra, those whoreally wish to aid living beings, and those who wish to comment uponthe Four Tantras, will study all four according to commentators of thepast. Clearly, for Lodro Gyalpo a firm grounding in theories of physiology,epidemiology, and reasoned diagnosis must precede medical practice, andthus textual scholarship precedes medical practice. It is also equally clearthat this was not the only vision of the healing arts in his time, and thatthere were those who did not bother with the musings of scholars such asLodro Gyalpo and Sangye Gyatso.

    It was Darmo Memampa Lobsang Chodrak who took up the task ofcompleting Lodro Gyalpos unfinished commentary on the Four Tantras.Lobsang Chodrak was a senior contemporary of Sangye Gyatso, and oneof the physicians working under the Fifth Dalai Lama. Like ZurkharLodro Gyalpo, Lobsang Chodrak was concerned about the state of medicalscholarship in his day. In the introduction to his commentary on theInstructional Tantra, he chastises those who scoff at textual learning ina manner reminiscent of Lodro Gyalpo. Much like his predecessors viewson the Subsequent Tantra, Lobsang Chodrak argues that reliance on thepractical methods of the Instructional Tantra is not enough. He writes withsome humor:

    Even though the Instructional Tantra is a necessity for those physicians who would engagein the practice of healing the sick, learned and insightful physicians do not [just] rely ondexterity. Even though some physicians do not understand [the Four Tantras], they rashlythink that understanding is easy. Some [on the other hand], see the [medical treatises] asdifficult to understand, while others become frightened by the mere sight of a book!33

    In the face of such cowardice on the part of his fellow physicians, LobsangChodrak could not but do his part to uphold the textual tradition of the

    32 Blo gros rgyal po, Phyi mai rgyud gyi rnam bshad, pp. 669.16669.18.33 Blo bzang chos grags, Man ngag rgyud kyi dka grel, pp. 524.10524.14.


    Four Tantras. He goes on to give his reasons for writing a commentary onthe practical instructions of the third Tantra, writing:

    Through the force of time the letters have been ruined, and thus even making an analysis[of the Four Tantras] is [a task] fraught with errors. There is no tradition that producescertainty in the minds of people through fixing [the text] by explaining and studying . . .This great text, a wish-fulfilling jewel, was declining, and the welfare of people was beingharmed. I could not bear to see the sick [try to] heal themselves, left uncared for by others,and so I composed this commentary.34

    For Lobsang Chodrak, text-critical work and commentarial writing werenot simply exercises in scholarly pyrotechnics; they were ethical acts,motivated (at least rhetorically) by the desire to heal the sick. When thetext of the Four Tantras suffers the degeneration inherent in the passageof time, one might say, so do the people of Tibet, and it was LobsangChodraks emotive response to this situation that lead him to write hiscommentary.

    Here we should also mention Namling Panchen Konchok Chodrak(Rnam gling Pan

    .chen Dkon mchog chos grags), editor of the printed

    editions of both the Grandfathers Instructions and Lobsang Chodrakssupplement. The printing of these works was sponsored by the Fifth DalaiLama, and in part by Sangye Gyatso himself. Konchok Chodrak reports aself-deprecating comment made to him by Lobsang Chodrak: Edit [thiscommentary] again for a ignoramus like me!35 Heeding his mastersrequest, in 1679 he set about editing not only the commentaries, but alsothe Four Tantras themselves. In a tone we are by now familiar with, hewrites disapprovingly of previous editors who have done more harm thangood:

    In the time that has passed this [medical] treatise has come under the influence of do-it-yourselfers who are afraid of the great books. Except for the meaning of the words, theyhave given up examining the general meaning. In some cases they merely see somethingeasy to understand every few chapters, and without looking at the authoritative scrip-tures, they simply erase archaic terminology, and thus different readings that are easierto understand have increased.36

    Apparently unafraid of big books himself, Konchok Chodrak set aboutediting both commentary and basic text by assembling many manuscriptsand prints. Of his own editorial process he writes:

    Given this [textual situation], a reliable [editorial reading] cannot be made on the basis of asingle manuscript . . . [I] looked at each book [of various medical treatises]. [I] followed the

    34 Blo bzang chos grags, Man ngag rgyud kyi dka grel, pp. 524.15524.22.35 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 664.20664.21.36 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 664.21664.25.


    finer orthographic points of the Yargyab (Yar rgyab) [that is, the Dratang] print. [I] used the[grammatical treatise] of Zhalu Lotsawa Chokyong Zangpo (Zha lu Lo tsa ba Chos skyongbzang po) [known as] the Zamatok (Za ma tog). I carefully read the words, the meaning,and the outlines, and emended omissions and additions according to the [Dratang] text. Insome chapters that explain the effects of medicines there were points of great disagreement,which I checked against the scattered annotations given by [Darmo] Menrampa LobsangChodrak.37

    Aside from revealing several interesting details regarding his own editorialmethods, Konchok Chodraks comments also help place the activities ofSangye Gyatso in an intellectual context. Sangye Gyatso has been cred-ited with initiating the intense scrutiny of the textual history of the FourTantras, and indeed he himself characterized his work in this way whenhe criticized Jango Nangso Dargyay for relying too heavily on LodroGyalpos Dratang print of the tantras. Yet we can see from KonchokChodraks description of his own editorial activities that Sangye Gyatsowas carrying on work that was already underway. In terms of both inspira-tion and methodological approach, Sangye Gyatso was carrying on acritical tradition dating back at least one hundred years to Lodro Gyalpo.

    As the heir to these scholars efforts, Sangye Gyatso portrays himselfas the medical scholar par excellence. Yet his vision of medical scholar-ship does not begin and end with textual criticism. The value he places onthe textual study of medical treatises is directly related to his conceptionof medicine in relation to the other classically defined arts and sciences,and in relation to the larger Mahayana Buddhist theme of the bodhisattva.Textual scholarship is important not merely because it produces soundlyedited texts or technically correct commentaries; it is important, SangyeGyatso argues, because it is no less than an essential part of the MahayanaBuddhist path. In the introductory passage of the Beryl Mirror38 he locatesthe study of medicine within the proper activity of a bodhisattva. Citinga host of sutras, tantras, as well as Indian and Tibetan sastras, he arguesthat the five arts are all essential components of the path toward enlighten-ment, for they each contribute to the welfare of sentient beings, and thusto the progress of the bodhisattva. The study of treatises on medicalarts is important for the bodhisattva, a certain sutra claims, for by thishumans will become free of the eighty-four diseases of non-virtue. If thebodhisattva can heal beings with such love and kindness, this will causebeings to have faith in the bodhisattva. With this peaceful attitude of faithbeings will remember the Buddha, and thus be ready for the bodhisattvato lead them to the other shore, to enlightenment.39 At the beginning of

    37 Blo gros rgyal po, Bshad pai rgyud gyi rnam bshad, pp. 664.25665.12.38 Sangs rgyas rgya mtsho, Dpal ldan, pp. 820.39 Sangs rgyas rgya mtsho, Dpal, pp. 16.1017.3, citing Anonymous, Thab.


    his history of medicine, then, Sangye Gyatso makes a powerful claim: thestudy of medicine is directly linked to the highest soteriological goal ofBuddhism, enlightenment itself, and therefore the study of medicine, eventhe minutiae of medical texts, is imbued with a value far exceeding itsmost immediate goals, the mastery of a complex body of literature and itsapplication toward improving human life.

    Furthermore, the five arts form an essential part of the bodhisattvasprogress toward omniscience, as the lines from the Mahayanasutralam


    kara cited by Sangye Gyatso (and Yuthok Yontan Gonpo [G.yu thog Yontan mgon po] in his own Interior Analysis long before Sangye Gyatso)suggest: If one is not diligent in the five arts, even the most noble will notbecome omniscient.40 Sangye Gyatso offers a sutra quotation that makesthe equation clear: If the bodhisattva has not studied the five arts, there isno way he will attain the omniscient wisdom of complete enlightenment.Therefore, in order to attain unexcelled enlightenment, one must study thefive arts.41

    If the study of medicine is an integral part of the way of the bodhisattva,the other four arts are also essential to the study of medicine. For SangyeGyatso the limbs of scholarship are incomplete if any of the five artsare neglected.42 In an extended commentary on chapter thirty-one of theExplanatory Tantra occurring toward the end of Beryl Mirror,43 SangyeGyatso argues in more detail that the well-rounded physician must be adeptin all of the five arts. Physicians must be skilled with their hands in orderprepare medicines, or in order to make such medical implements as thegceu, the long brass tube used to administer medicines. They must havea way with words and know how to act in order to put their patients atease. The physician must be skilled in reasoning as well, so as to approachdiagnosis and medical analysis with a clear mind. The language arts are ofparticular importance for the study of medicine. If one does not understandthe language arts, Sangye Gyatso tells us, one will not understand word-formation or word-derivation in medical terminology.44 Since medicaltexts contain many synonyms, the good physician must study such works

    40 Byams pa, Theg, f. 15b.315b.4: rig pai gnas lnga dag la brtson par ma byas na //phags mchog gis kyang thams cad mkhyen nyid mi gyur te // de lta bas na gzhan dagtshar bcad rjes bzung dang // bdag nyid kun shes bya phyir de la de brtson byed // (thirdand fourth lines not translated above); Sangs rgyas rgya mtsho, Dpal ldan, pp. 9.139.17.See also Rin chen od zer, Bdud, pp. 139.4139.7. Ruegg (1995), p. 101, discusses thisverse, namely Mahayanasutralam

    .kara 11.60.

    41 Sangs rgyas rgya mtsho, Dpal ldan, pp. 9.49.8, citing Anonymous, Thab.42 Sangs rgyas rgya mtsho, Dpal ldan, pp. 515.16516.1.43 Sangs rgyas rgya mtsho, Dpal ldan, pp. 508547.44 Sangs rgyas rgya mtsho, Dpal ldan, p. 515.


    as the Amarakos.a in order to easily understand them.45 For similar reasons

    the physician must study poetics, prosody, and even dramaturgy. Astrologyis also included in the well-rounded medical scholars training.

    In short, Sangye Gyatso portrays the ideal physician as a renaissanceman with a deep knowledge of all the major and minor arts.46 One cansee this quite well in a sort of scholarly joke he plays at the beginning ofthe Beryl Mirror. He immediately follows up his introductory verse witha quote, the first of hundreds in the work. Yet where one might expecta verse from the Four Tantras themselves, or from some classic Indianmedical treatise, Sangye Gyatso confronts the reader with four lines fromDan

    .d.ins Mirror of Poetics (Kavyadarsa) (considered, incidentally, to be a

    Buddhist work by Tibetan scholars) signaling to all that in the Beryl Mirrormedicine will not be treated in isolation from the other arts. The BerylMirror, Sangye Gyatso suggests by citing Dan

    .d.in, is written to impress

    the scholar among scholars. May those afraid of books beware!Though Sangye Gyatso may have offered the most sustained effort

    to argue that the work of the physician is the work of the bodhisattva,he was certainly not the first to do so. Indeed it was a pervasive themein the interior analysis (khog dbubs/dbug) genre, of which I will givejust three examples here. In the earliest example presently known, YuthokYontan Gonpo places the development of the enlightened mind upon thebodhisattva path at beginning of nine qualities for which physicians shouldbe renowned.47 Drangti Palden Tshoje includes a command to producethe mind of enlightenment as the last of seven decrees to physicians attri-buted to Trisong Detsen [Khri srong lde btsan]. What is interesting aboutthis instance is that other versions of the same list include no mention ofBodhi.48 Finally, Zurkhar Lodro Gyalpo styles his own Interior Analysisof medical traditions as that of which physicians desiring to engage inthe work of the bodhisattva must not be ignorant.49 In the introductionto this work, Lodro Gyalpo concedes that the teachings of the Buddhaare sufficient in and of themselves to understand all paths. Nevertheless,for the bodhisattva, or one wishing to take responsibility for all beings,

    45 Sangs rgyas rgya mtsho, Dpal ldan, pp. 518.17519.1.46 The call to integrate the study of medicine with other arts and sciences was heard in

    medieval Europe as well, as in, for instance the following passage from Isidore of Seville(570636): The physician ought to know literature, grammatica, to be able to understandor to explain what he reads. Likewise also rhetoric, that he may delineate in true argumentsthe things which he discusses; dialectic also so that he may study the causes and cures ofinfirmities in the light of reason. See Jacquart (1998), p. 199.

    47 Yon tan mgon po, Khyung. 12a.2.48 See Beckwith (1979), p. 304. I will return to this set of decrees in a future essay.49 Blo gros rgyal po, Gang, pp. 2931.


    there is nothing that is not a valid area of study, even non-Buddhist andworldly subjects. A passage from the Introduction to the BodhisattvasWay to the effect that there is nothing without merit for sons of the Buddhaproves Lodro Gyalpos point.50 Like Sangye Gyatso after him, LodroGyalpo devotes a section of his work to commenting on the line from theExplanatory Tantra, Learn writing and reading completely, for whether[you] are capable or incapable depends on these,51 in which he offersa detailed presentation of Sanskrit, Tibetan, and the material of writing:pen, ink, and paper.52 In the final analysis, for Lodro Gyalpo one wishingto become a scholar without reading, writing, and grammar is a source ofamazement, like someone who wants to make offerings to the gods withoutany money.53

    Drawing on the work of contemporary scholars such as the eminentTibetan scholar of medicine, Jampa Trinley (Byams pa phrin las) (b. 1928)and Fernand Meyer, who has done much to bring Tibetan medical scholar-ship before the western scholarly public, I have sought here to understandsomething of the activities of Sangye Gyatso, his colleagues, and selectpredecessors in the area of medical scholarship. Yet while I have dealtexclusively with medical texts in this essay, I have come to this materialwith specific questions in mind about the role of textual scholarship inTibetan scholarly culture as a whole. In an earlier essay I sought to detailthe specific editorial and philological methods that went into collecting,editing, and preparing the collected works of a particular Buddhist writerwho happened to be active during Sangye Gyatsos lifetime.54 In the colo-phons to his writings, practically every aspect of the editorial process andthe process of textual production more broadly was detailed, commentedupon, and called into question. Clearly these were important matters ofcritical reflection for the editors of this Buddhist masters works.

    I hope I have shown that these textual issues were of no less importancein the medical traditions, and that the well-known voluminous printing ofmedical literature during the late seventeenth century developed amidsta heated debate about the relation of philology to application. With thewidespread use of block-printing texts could be disseminated on a widescale. Those who controlled the creation, distribution, and use (that is, the

    50 Blo gros rgyal po, Gang, pp. 5.15.13. Blo gros rgyal po cites Zhi ba lha/ Santideva,Bodhicaryavatara, ff. 14a.3

    51 Yon tan mgon po, Bdud rtsi, pp. Blo gros rgyal po, Gang, pp. 361.4373.12.53 Blo gros rgyal po, Gang, pp. 373.7373.9.54 Schaeffer (1999). See also Schaeffer (forthcoming) on Tibetan editorial method and



    institution of education) of such texts controlled ideally, at any rate theproduction of knowledge. The extent to which the prescriptive writings ofSangre Gyatso and others actually had an effect on the practice of medi-cine and medical learning is an important subject to which further researchshould be devoted, but which lies outside the scope of this essay.

    What I would like to suggest instead by way of conclusion has todo with the internal logic of the defense of medical scholarship. For themedical scholars discussed here, medical books and the areas of expertiseassociated with them were utilized as symbols in the construction andmaintenance of authority. The defense of textual scholarship outlinedhere strongly criticizes those physicians who do not have the propertraining. Indeed, it seeks to determine what proper training is. Whencoupled with the rhetorical power of the bodhisattva ideal, such a critiquedenies the legitimacy of medical traditions not sanctioned by SangyeGyatso, Lodro Gyalpo and others not merely on scholastic grounds,but by implying that they are not properly Buddhist. If religion invest[s]specific human preferences with transcendent status by misrepresentingthem as revealed truths, primordial traditions, [or] divine commandmentsand . . . insulates them against most forms of debate and critique, assistingtheir transmission from one generation to another as part of a sacredcanon,55 then the use of the bodhisattva ideal as a defense of a parti-cular medical tradition is a classic example of the function of religiousrhetoric. Seen in this light the link between textual scholarship, medicaltradition, and Mahayana social/soteriological ideals becomes somethingmore; it becomes a persuasive technique to argue for the authority ofcertain groups and against the authority of others. As the lines from theFour Tantras with which I opened this essay say: The physician withouta lineage . . . deserves no ones respect. Like a fox that seizes the kingsthrone, the physician deemed to be without the proper credentials imper-sonates authority. And, again, it was the medical scholars themselves whodetermine exactly the extent of such credentials, or that credentials existin the first place. The defenders of medical scholarship sought to definethe parameters of lineage, to create a tradition by delimiting the extent ofpropriety. One major factor in this delimitation was textual scholarship:The physician who does not understand the texts . . . can discern neitherthe disease nor the cure.

    It is here that we may suggest a further connection. At the close of theBeryl Mirror Sangye Gyatso prays that the Ganden Government will healthe ills that Tibet had incurred through warfare and strife. At the closeof his encyclopedic history of medical traditions, then, Sangye Gyatso

    55 Lincoln (2000), p. 416.


    suggests that the most important healer is none other than the principlebodhisattva of his era, the Fifth Dalai Lama (to whom Sangye Gyatso,not surprisingly, pays homage in the opening verse of the Beryl Mirroras well),56 and his government.57 Sangye Gyatso had spent much of hislife learning under the Fifth Dalai Lama, promoting, and subsequentlyleading the Ganden Government, and there is every reason to believe thathis efforts in medical scholarship were an integral part of these efforts.The founding of an institution of medical learning adjacent to the seat ofgovernment, the Potala, can be understood as well as part of an effort tocontrol the production of medical knowledge. E. Gene Smith has suggestedthat Sangye Gyatso was striving not merely to rule Tibet from the Potala ina strictly political sense, but to create a cultural hegemony extending to avariety of areas, including time (astrology and astronomy), space (ritual),monastic curriculum, and medicine.58 This insight provides a theory toexplain the extraordinary range of subjects Sangye Gyatso took up in hiswriting and their relation to his role as leader of Tibet.59 Just as he under-took to impress upon his subjects the veracity and authority of the FifthDalai Lama as the actual incarnation of Avalokitesvara, the bodhisattvaof compassion, through rituals and a series of written works, so I wouldsuggest he was working to promote his government through the promotionof the medical arts within the larger ideology of the bodhisattva.

    Sangye Gyatso and the other writers I have touched upon are nothingif not passionate about what are, on the surface at least, the most mundanephilological details of the Four Tantras. No doubt, for these scholars thequality of the medical text was directly related to the quality of medicalpractice, the work of the textual critic intimately bound with the work ofthe physician, and the emotionally charged activities of the medical scholarclassically dictated to be part and parcel of the bodhisattvas effort toalleviate the suffering of human beings. However, when considered in rela-tion to Sangye Gyatsos political undertakings, I suggest that this passionhad as much to do with authority as it did words on the page, or evenhealing the sick. The authority of tradition (the medical lineage stemmingfrom Yuthok Yontan Gonpo to Sangye Gyatso himself), the propriety ofa privileged mode of learning (textual scholarship) and a privileged bodyof knowledge (scholarly medicine), and the authority of the governmentof which Sangye Gyatso was leader were all linked and maintained by arhetoric that argued for the inseparability of philology and exegesis from

    56 Sangs rgyas rgya mtsho, Dpal, p. 1.9.57 Sangs rgyas rgya mtsho, Dpal, pp. 560.5560.11.58 Personal communication, May 2001.59 See Ruegg (1995), p. 154.


    altruism, enlightenment, and healing conceived in bodily, soteriological,and political terms.


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    University of AlabamaE-mail: kschaeff@bama.ua.edu


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