KUNPHEN

Social/Health Experts & Network

Dr.   Amchi   Kunzang  (Kunphen)

Amchi Kunsang , Director of the Kunphen Tibetan Clinic
  in Chettrapatti / KTM  and  in   Nyalam / Tibet (TAR)
 
 
 

The Kunphen  Tibetan  Clinic  (Chettrapatti)
 

Since twenty-three years, the KUNPHEN (Kunfen) Medical Clinic was established by Amchi Kunsang in Kathmandu Valley (ie: Chettrapatti/Thamel, Nagi Gompa, Boddhanath Stupa). It was the first modern Tibetan medical clinic to be proposed to the population in KTM.  Dr. Amchi Kunsang Pendok received his medical education at the Tibetan Medical Center in
Lhasa / Tibet (China / TAR) and has practiced medicine for over fifty years.

Every day, some fifty to one hundred patients come seeking help. Not only do Tibetan people use the clinic’s services, but also people from India, Korea, Japan and Western countries who join the local population coming through  its door. For the Asia traveller, treatment at the clinic can help to cope with jet lag, stomach disorders, high altitude sickness and respiratory infections. For others being more interested in maintaining general health and well-being, the amchis might prescribe energy pills, dietary changes, or give information relating to one’s specific health "character", according to the Tibetan tradition.
 
 

Tibetan Medicine is one of the world's oldest surviving medical traditions. It is unique in its completeness, having been preserved intact with its original Tibetan native medical knowledge and subsequently integrated ancient medical systems (ie : Indian, Chinese, Persian and Hellenic), even though some of these traditions had been broken and fragmented through their own historical, cultural or political upheaval. This has been due partly to the history of isolation and guarded secrecy that still surrounds Tibet, but also to the fact that this is a living tradition transmitted both orally and textually through a long lineage of masters and pupils.
 
 

It is a truly holistic system with  spiritual, mystical, psychological, empirical and rational roots which encompass human suffering on all experiential levels. Whilst it may not offer the same efficacy than  modern Western medicine is areas such as infectious diseases or surgery, it is renown for curing  chronic afflictions, psychosomatic and psychological imbalance .

Although researchs in Clinical Pharmacology , on the comparative curative efficacy between the Tibetan system and modern (allopathic) medecine, is a process which has been launched only recently, it has proven nonetheless that Tibetan traditional healing is relevant for most psycho-somatic and  indigenous diseases .

Tibetan medecine is basicaly manufactured from natural herbs and minerals from the Himalayan region, and its healing  and diagnosis process are integral parts of  Tibetan Buddhism,  monastic scholarship and the Himalayan Shamanic culture .
 

( disclaimer: the following text is inspired from selected articles on 
Tibetan Medicine proposed by Kunphen and Men-Tsee-Khan,
of which copyrights belong to these institutions )

Amchi Kunsang , Director of the Kunphen Tibetan Clinic
  in Chettrapatti / KTM  and  in   Nyalam / Tibet (TAR)

  A SHORT  INTRODUCTION   TO  TIBETAN  MEDICINE
 

Tibetan medicine is a traditional system of medicine which has been practiced for over 2500 years and is still practiced today by Tibetans and Nepalese alike, in the rural and urban areas, as well as by some informed Westerners. Tibetan medicine is one of the five major sciences of Tibetan Dharma (Buddhism), and it is called in Tibetan : « gSoba  Rig-pa », namely, the science of  healing. 

It uses rituals, divination, meditation and of course different kinds of natural herbs or ingredients, such as Himalayan trees, rocks, resins, soils, precious metals, saps,  etc… 

However,  more than 90% of a usual Tibetan medicine is based on these herbs,  some precious metals are used for the seven  kinds of precious pill known as  « Rinchen Rilpo » , or more simply : « Precious Pills ». 

While Amchis may become reputed to have efficacy (depending on their ability for diagnosis and chosing the right medicine) on all kinds of illness, from a comparative treatment point of view, it is viewed by most physicians ( PHC Clinics) in Nepal, as being more successful in the treatment of chronic diseases, such as rheumatism, arthritis, ulcers, chronic digestive problems, asthma, hepatitis, eczema, liver problems, sinus problems, as well as in mental health symptoms such as anxiety and problems connected with the nervous system.

On a general basis, the local health workers use modern medecine (allopathic) prescriptions and antibiotics for local infectious diseases such as TB, STD, water-borned viral infections, Cholera …

The basic theory of Tibetan medicine is also based on the concept of  (Karmic) imbalance, namely «  Nyipa sum » . 

These factors of influence are : «  rLung »  (pronounced loong), « mKhris-pa »  and  « Bad-kan ». 

The long-term causative factors of Nyipa sum are the three poisons (Buddhism) : desire, hatred and delusion . 
 
 
 

1. - Nyipa sum
 

What are rLung , mKhris-pa ,  Bad-kan  ?

Before these  terms can be explained it must be pointed out that there is no equivalent  translation of these tibetan terms, except into either Nepali or Sanskrit equivalents, original names are used.
The general description of rLung is that it is a subtle flow of energy and out of  the five elements 
(ie : air, fire, water, earth and ether or space) it is most closely connected with air, in the sense of 
it being the traditional vital element, not chemistry.

Some Amchis say that the rLung is like a horse, and that the human mind is the rider, if there is something wrong with the horse then the rider will not be able to ride properly. Its description is that it is rough, light, cool, thin, hard, movable.

The general function of rLung is to help growth, movement of the body, exhalation and inhalation and to aid the function of mind, speech and body.

rLung helps to separate in our stomachs what we eat into nutrients and waste  products. However its most important function is to carry the movements of mind, speech and body. The nature of rLung is both hot and cold. 
 

There are five  types of rLung.

The first type is called Srog-'dzin (life-grasping rLung). Its location is in the brain and its functions are the swallowing of food, inhalation and spitting, eructation  and sneezing, clearing the senses and intellect, and steadying of the mind.

The second type of rLung is Gyen-rgyu (upward moving rLung). Its location is in the chest and its functions are responsible for speech, the increase of  bodily vigour and health, the giving of lustre to the skin and the promotion of mental endeavour and diligence.

The third type of rLung is Khyab-byed (all pervading rLung). Its location is in the heart. Its locations is responsible for lifting, walking, stretching, grasping of limbs, the opening and closing of the mouth, eyelids, anus etc.

The fourth type of rLung is Me-mnyam (fire accompanying rLung). Its location is in the stomach and its function is to promote digestion and the  metabolism, and ripen the seven bodily sustainers known as lus-zung dhun.

The fifth type of rLung is Thur-sel (downward cleansing rLung). Its location is in the rectum and its function is to expel faeces, urine, semen, menstruation and the foetus.

As for  mKhris-pa,  it is the hot nature within our body and not simply the bile which comes from our gall bladder. 

From out of the five elements mKhris-pa is related to fire. The description of mKhris-pa is oily, sharp, hot, light, pungent and moist. The most  important function of mKhris-pa is to keep in balance the bodily temperature. It helps with the digestion of food and it is what makes us feel hungry and thirsty at the right times. It also gives lustre to the skin and helps to keep the  pores clear. The nature of mKhris-pa is hot like fire or the sun. 
 
 

There are five types of mKhris-pa

The first type of mKhris-pa is called 'Ju-byed (digesting mKhris-pa). Its  location is between the stomach and intestine. Its function is to promote digestion and to break down essential nutrients from foodstuffs and fluids and  then to separate essence and waste. It promotes bodily heat and helps to  provide energy to the other four types of mKhris-pa.

The second type of mKhris-pa is called sGrub-byed (accomplishing  mKhris-pa). Its location is the heart. Its function is that it anger, aggression and hatred. It provides the initial driving force behind the minds of desire, achievement and ambition.

The third type of mKhris-pa is called mdangs-sgyur (colour changing mKhris-pa). Its location is in the liver. Its function is to maintain and promote  the red colouring of essential nutrients in the blood.

The fourth type of mKhris-pa is mThong-byed (seeing mKhris-pa). Its locations is in the eyes and it promotes vision.

The fifth mKhris-pa is mDog-sel (complexion clearing mKhris-pa). Its location is the skin and its function is to clear and promote skin lustre by giving  it a healthy and wholesome colour.
 
 
 

As per Bad-kan is not the phlegm which comes from the chest, it is all the diseases connected with the cold nature called Bad-kan. From out of the five elements it is related to both water and earth. The description of Bad-kan is oily, cool, heavy, blunt,smooth, steady and sticky. 

The main function of Bad-kan is to sustain the bodily liquids. It helps to mix food in the stomach, steady the mind, and it helps to keep our joints flexible. The nature of Bad-kan is cold, like water or the moon. 
 

There are five types of Bad-kan

The first Bad-kan is called rTen-byed (supporting Bad-kan). Its location is   the chest, and it's function is to support the remaining four Bad-kans.

The second Bad-kan is called Myag-byed (mixing Bad-kan). Its location is the upper region and, its function is the mixing of liquid and solid foodstuffs into a semi-liquid state.

The third Bad-kan is called Myong-byed (experiencing Bad-kan). Its location is the tongue, and its function is to sense and experience the six primary tastes.

The fourth Bad-kan is called Tsim-byed (satisfying Bad-kan). Its location is the head, and its function is to increase and satisfy the power of the five  senses.

The fifth Bad-kan is called 'Byor-byed (joining Bad-kan). Its location is the joints and its function is responsibility for the flexibility of the joints.
 
 
 

This were  the type, location and function of the Nyipa sum. When the Nyipa sum are balanced, then what are called the seven bodily sustainers are also balanced. 
 

The seven bodily sustainers are:

To show how this process works, when we eat or drink something, it goes to  the stomach, where the Bad-kan will help to mix it, the mKhris-pa will help to digest it and the rLung will help to separate the essential nutrients from the waste products. The essence of the essential nutrients will then form blood, the essence of blood forms muscle tissue, the essence of muscle tissue forms fat,  the essence of fat forms bones, the essence of bones forms marrow and the essence of bone marrow forms the regenerative fluid. 
 
 

With the waste products , there are three eliminating functions of wastes: 

This process shows how important it is for rLung, mKhris-pa and Bad-kan to be kept in balance.
 
 
 

2. -  Imbalance  of  Nyipa  sum
 

The long-term causes of the imbalance of  Nyipa sum are the three poisons. 
The short-term causes of imbalance are the time and season,  the influence of spirits, improper diet and improper behaviour.

With regard to the time and season, rLung ariseses at dawn and in the evening in  summer. mhhris-pa arises during the autumn at midday and at midnight. 

Bad-kan arises in the spring, in the morning and at dusk. 

For the influence of spirits there are innumerable disorders brought about by certain contributory    factors or conditions relating to harmful influences or spirits. 

The 360 female spirits influences are connected with desire and attachment and give rise to  rLung. 

The 360 male spirits  influences are connected with anger and hared and  give rise to disorders from mKhris-pa. 

The 360 klu (Skt. Nagas or water  dwelling spirits) and Sa-bdag (specific spirits that govern or haunt particular places) are connected with ignorance and give rise to Bad-kan disorders. If  they happen to be disturbed, all these spirits can cause harm, and people would  have to consult a lama or tantric practitioner for a divination. Through their  help the spirits would be expelled through religious ritual and ceremony.

As for improper diet, if someone eats lots of light foods such as pork, goats  meat, milk and yogurt, strong tea, strong coffee, soya, vegetables, pulses,  skimmed milk continuously, eating only these kinds of foods every day, they  will suffer from rLung problems. If someone drinks lots of milk and alcohol and eats lots of meat, full-fat cheese, nuts, sugar, ice cream, lard, butter,  chocolate, cooks with lots of oil - these cause rKhri-pa problems. When  someone eats lots of raw food such as uncooked meat, salad, raw fish, cold drinks, raw milk they will suffer from problems related to Bad-kan.

With regard to improper behaviour forrLung, if a person does a lot of fasting   and meditation, does not sleep much, takes meats at improper times, has too  much sex, strains or over controls his bowel and urinary functions, has lots of mental pressure and tension and talks too much, then rLung will arise.

 'nKhris-pa arises through straining the body such as by crying heavy loads, digging hard dry soil, running in the middle of the day in the peak of summer, falling through sudden jerks to the body, such as falling off a horse or a roof   and accidents. Bad-kan is caused by behaviour such as doing no physical   exercise, sleeping for most of the day alter eating a heavy meal, taking cold  showers every day, exposing your body through inadequate clothing, and working in damp and cold places.
 
 

          Diagnosis of Nyipa sum when imbalanced

Observation is done by urine analysis and looking at the tongue. A sample of  urine must be the first early morning urine of the patient, and the night before  she should refrain from eating spicy foods, drinking alcohol and having sexual  intercourse. 

In Tibetan medicine urine analysis is divided into eight sections;   the physician examines the colour, vapour, odour, bubbles, sediments and  albumin's of the urine. The colour of the urine is determined by the intake of  food and drink, seasons and diseases.

For the rLung patient the urine is very clear like water and it has big bubbles.

For the mKhris-pa patient the urine is a reddish-yellow colour, there is much vapour and a very strong odour. For the Bad-kan patient the urine is white in  colour and there is little odour and vapour. Generally a reddish colour indicates  a hot disorder while transparency indicates a cold disorder.
 

When observing the tongue, the rLungg patient has a very red, dry and rough  tongue. For the mKhris-pa patient the tongue is yellow with a thick coating. The tongue of a Bad-kan patient is white, smooth and wet.
 

 The second method of diagnosis is by reading the pulse. In Tibetan medicine  pulse reading is divided into thirteen sections. For the Tibetan physician the arts of pulse reading provide an invaluable source of information because the pulse is like a messenger between the doctor and the patient. 

To read the pulse it is very important for the patient to be as rested as possible. The physician place the index, middle and third fingers on the radial arteries. The space between each of the three fingers is the width of a grain of rice, and the fingers are placed half an inch from the crease of the wrist. The physician will use both hands to examine the pulse; the left wrist of a male patient is read first, whilst for the female patient it is the right wrist which is read first.

The third and final method of diagnosis is by questioning - asking the patient how and when the problem started, its location and which sort of food harms  or helps them.
 
 
 

3.- Treatment
 
 

There are  four methods of treatment: 

If the illness is not so serious we need only give advice as to the diet and  behaviour. Generally the rLung patient must try to eat food which has got heavy and nutritional potency, such as lamb, butter, molasses, alcohol, milk,  soups, chicken, garlic, ginger and onions. The mKhris-pa patient should eat  beef; vegetables, fresh butter, fresh low fat cheese, cow's yogurt and buttermilk, drink weak tea, spring water and have less greasy food. The Bad-kan patient should have honey, mutton, fish, barley, wine, ginger  decoction and plenty of hot water and cooked vegetables.

For behaviour the rLung patient should stay in dark and warm places, the  surroundings should be very quiet, and there should be beautiful scenery. He  should have good company such as lovers and close friends. The patient should   also rest both physically and mentally without any worries. For the mKhris-pa patient's behaviour she should have cold baths and showers, sit in shaded          places and walk by the sea and use a cool perfume such as sandalwood. For  the behaviour of the Bad-kan patient, he should have lots of sun, warm fires in   his home; he should do lots of exercise such as prostrations, walking and running.
 

The third method of treatment is the prescribing of medicine. It can be  administered in various forms. In the form decoction, powder, pills etc. For the   rLung patient various herbal ingredients are used such as aqullaria agollocha,  allium sativum, myristica fragrans, asafoetida, santalum album etc.
 

For the  mKhris-pa patient's medicine Amchis use swertia chirata, momordica charantia, holarrhena antidysenterica, aconitum naviculare, ixers gracilis, chrysosplenium  nepalense, swertia hookeri and berberis asiatica etc. For the Bad-kan patient's  medicine Amchis  use chaenomeles, inula helenium, coriandium sativum, meconopsis  discigera, punica granatum, kaempferia galanga and phyllantus emblica etc.
 
 

The final method of treatment is surgery - divided into mild and rough. 

Mild  surgery for the rLung patient includes massage with year-old butter and oily   compresses. Rough surgery for the rLung patient is placing moxa on the   selected points of rLung; these are on the crown of the head, the first, fifth and sixth vertebrae of the spinal cord, the sternum, etc. For the mKhris-pa   patient mild surgery is sitting beneath waterfall and mild purgatives. 

Rough  surgery for the mKhris-pa patient is blood letting and cupping. 
For the  Bad-kan patient mild surgery is hot fermentations, saunas and mild emetics.
Rough surgery for the Bad-kan patient is golden needle therapy and the  application of heated surgical stylets.
 
 
 

Tibetan medicine is a 1300-year-old tradition combining components of Buddhist religion with the original Tibetan herbal medicine, as well as influences from the Indian Ayurvedic and Chinese medical traditions.

Tibetan medicine’s origins are found in ancient Buddhist texts with Sakyamuni Buddha as their source. It is difficult to arrange a precise chronological presentation of medical history as available texts concentrate more on philosophy and practices than on specific dates. In Buddhist sutra and tantra texts, Sakyamuni Buddha took form as the "Medicine Buddha" and taught medical knowledge to his disciples. He also elaborated medical practices in teachings such as the Four Noble Truths. Sakyamuni is also said to have taught the "Supreme Sun Rays Sutra.", the 24th chapter of which contains methods for completely curing diseases. Medicine became one of the ten branches of learning originally studied by all Mahayana Buddhist monks. The teaching flourished in the monastic universities of Northern India (Nalanga).

Tibetan medicine began with the influx of Buddhist Sanskrit texts into Tibet in the seventh century, A.D. King Songtsen Gampo convened a medical conference in Tibet, attended by medical doctors from India, China and Persia. Later, more important conference was held under the aegis of King Trisong Detsen in the ninth century. Medical scholars from many lands translated texts into Tibetan and these were then debated and discussed – this basket of medical knowledge provided the foundation for the Tibetan tradition. 
 

The most important Tibetan text is the Gyu Shi, a translation of the Sanskrit Amrita Ashtanga Guhyopadesha Tantra, since lost in the original. Soon after the great medical conference, Tibet’s first medical college was established. In time, scores of medical schools emerged, usually associated with the country’s large monasteries. 

Traditionally, the doctor, or amchi, had monastic training before delving into medical texts. Today students can complete their medical studies without being a monk or nun, but their under-standing must encompass Buddhist religion as well as the medical scriptures handed down through the centuries. In modern Tibetan medical colleges academic work usually takes about five years to complete and is followed by a three-year apprenticeship. 
 
 

Each individual’s personality and health are influenced by the body humor which is stronger than the others. For example, a high-energy, nervous person who has trouble concentrating or relaxing, would typically be a lung, or wind, person. Lung persons are slim in build, have darker complexions and their attachment to external objects or events is said to be strong. Often this type of person has mental problems: insomnia, loss of memory or headache.

Herbal pills are given to calm the lung and strengthen the other two humors, to promote a balance among the systems. The person is advised to increase his or her intake of rich or heavy foods, such as those which contain milk, fat, oil, eggs, meat or yogurt.
 
 

Medicine Bouddha Thangka