Classic and Contemporary Buddhist Works

Mirror of Beryl - Introduction

A Historical Introduction to Tibetan Medicine


The medical system referred to as “Tibetan medicine” has found its way from its longtime home in Tibet to many parts of the modern world, where it has settled successfully alongside other alternative systems of medical practice. Physicians trained in this medical system and offering traditional Tibetan treatments can now be found in many countries worldwide. Moreover not all practitioners of this medical system are Tibetan nationals; its theory and methodology have attracted students from other countries. Many books have appeared on Tibetan medicine, most offering an overview of its theory and practices, a few giving brief accounts of its history, and even one or two presenting translations of medical texts.

Mirror of Beryl is a detailed traditional account of the origins, theoretical bases, and practices of this ancient and wide-ranging medical system. It was composed by Desi Sangyé Gyatso (1653–1705), a student of the Fifth Dalai Lama and, beginning in 1679, his political successor as well. Much of the historical narrative in the introduction below is summarized from Sangyé Gyatso’s text, a work that, from the time it was written at the beginning of the eighteenth century, has been regarded as the leading authority on the development of medicine in Tibet.

Origins of the Tibetan Medical System

Tibetan medicine as it is practiced today is closely connected with Tibetan Buddhism, but its roots may predate the arrival of the Buddhadharma in Tibet in the seventh and eighth centuries. Some commentators mention the existence of a system of medicine—crediting it with varying degrees of sophistication—within the indigenous Bön or pre-Buddhist culture that flourished in Tibet. Kachuwa Chölothar, for example, in his hitherto untranslated analysis on the origins of Tibetan medicine, puts forward evidence for the existence of a Bön medical system. Some Bön documents say that their founder, Tönpa Shenrap, who was contemporaneous with the Buddha, preached thirteen volumes of medical teachings. One work on Bön history claims his son Chebu Trishé memorized 21,000 medical works.

In Darmo Menrampa’s (1638–1710) Brilliant Jewel Treasury, in answer to a question from an Indian doctor on the kinds of medical practice in Tibet, the eighth-century medical scholar Yuthok mentions medical texts on purgatives, fomentation, balneology, and ointments found in the Shangshung Bön and Yungdrung Bön traditions. Also, Four Tantras, the principal medical reference and subject of study in Tibetan medical training up to the present day, contains a few names of medicines, medicinal compounds, and illnesses that are said to be from the ancient Shangshung language. The concluding chapter of Four Tantras lists mantras that come from Bön religious practice. Some commentators have even suggested that Four Tantras itself is of Bön origin, and that the translator Vairocana, rather than translating it from Indian sources as others have suggested, took it from Bön medical literature. Kachuwa Chölothar says that these days many scholars recognize several principles taught in Four Tantras as being developments of the basic medical practices that existed during the Bön phase of Tibetan history.

From the seventh century onward, evidence suggests that Tibetan medicine developed from three distinct non-indigenous sources. A passage from a work called Weapons of Fearlessness, cited in Mirror of Beryl, talks of three great medical systems, and that ignorance of any of them would exclude one from being counted among the great physicians. The passage continues by naming the purveyors of these systems in Tibet as Bharadhaja, Galenos, and Hsüan Yüan Huang. These three physicians, says Desi Sangyé Gyatso, came respectively from India, “Trom,” and China. India, as is clear from the extensive accounts of Āyurvedic medical literature and practices, is easily identifiable as the Indian subcontinent. China during the seventh century, when these physicians were in Tibet, was under the Tang dynasty with its capital at Chang-an (Xian). The third locale is harder to identify.

Much has been written on the identification of Trom (khrom or phrom). Geographically, it seems to refer to the Central Asian lands west of Tibet whose inroads into Tibet were via the Silk Route. Culturally, it seems to refer to the Greek or Persian culture that had permeated so far east by the eighth century. It can be no coincidence that the Galenos from Trom named above bore the same name as the celebrated Greek physician who graced the Roman courts in the second century b.c.e. Because of this, Beckwith identifies Trom with Rome. Desi Sangé Gyatso and others equate Trom with Taksik (stag gzigs, ta zig), which is tempting to identify with Tajikistan. However, the Five Chronicles, cited by Jampa Trinlé, disputes the identity of Trom with Taksik, stating that Taksik is in the west and Trom in the north. Trinlé goes on to say that some commentators place Taksik to the west of Xinjiang and north of Afghanistan, and that the Bön tradition speaks of regions called Taksik Trom and Taksik Olmo Lungring. Pawo Tsuklak Trengwa talks of the “Hor (Mongolians) similar to the barbarian Taksik or Turks.” It may be that there is an overlap between Trom and the ancient land of Shangshung, from whence came the Bön practices. One of the medicines listed in Four Tantras mentioned above is daryakan, a name said to be from the Shangshung language. This is an ambrosia-like panacea with twenty-five types. However, according to Beckwith:

The word daryakan is patently non-Tibetan in origin, and it is in fact said by Jampal Dorjé to be a Shangshung term. His etymology is rendered most probable in the light of the form taryak, the name of a “Persian” remedy for snake-bite in Swat, land of ancient Shangshung and Tibetan cultural contacts. Since there can be no doubt but that taryak is identical to teryak or deryak, i.e., Arabic tiryaq(un) or diryaq(un), Islamic forms of the word theriac, then (regardless of the actual pathways followed by the drug’s name on its way to Tibet) it is undoubtedly also true that daryakan was originally the compound drug theriac, a very ancient Greek medicinal concoction (theriakon harmakon, or theriake), prepared with snake’s flesh, honey, and numerous other ingredients. Theriac proper was ordinarily a cure-all, but was supposed to be especially good against snake-bite.

These three sources, or “great rivers,” brought their own strains of medical knowledge to Tibet. It seems that Trom in the west, personified by the physician Galenos, brought much anatomical knowledge to Tibet during those early times, in the form of medical works on dissection. Galenos himself stayed on in Tibet and composed several medical works. Through his sons his medical lineage grew and flourished. This medical influence from the west seems to have been predominant around the time of Songtsen Gampo, as evidenced by the fact that Galenos and another physician, Tsenpashilaha, also from Trom, were rewarded with titles and commendations from the king. Tsenpashilaha was also known as Biji, and the lineage of Galenos was known as the Biji lineage, and according to Beckwith, this term is a transcription of a Sogdian word meaning “doctor.” In the succeeding centuries, the Trom influence seems to have waned.

The influence of China in medical matters also appears to have been dominant in the seventh and eighth centuries in Tibet and may have lasted longer than the Trom influence. The Chinese bride of Songtsen Gampo brought an extensive medical text with her from China as a gift for the king. This was translated into Tibetan by Hvashang Mahādeva and Dharmakośa. Later, in the eighth century, the Chinese queen of Jangtsa Lhabön brought many medical and astrological works to Tibet. The Chinese translators Hvashang Mahāyāna, Hvashang Mahākyinda, Hsüan Yüan Huang, and Hvashang Penatseta compiled and translated many medical texts in to Tibetan. These include the renowned Somarāja, whose influence was still evident in the seventeenth century, when Desi Sangyé Gyatso included its teachings on diagnoses from urine and cauterization points in his famous collections of medical paintings. Trinlé states (p. 31) that the great physician, the later Yuthok Yönten Gönpo, in the eleventh century incorporated some of the principles of Somarāja into the edition of Four Tantras that he was supplementing. Dr. Tsering Thakchoe Drungtso, in his recent Tibetan Medicine: The Healing Science of Tibet, also describes urine diagnostic techniques taken from the Somarāja.

Somarāja, translated from Chinese and sometimes attributed to Nāgārjuna, includes chapters on many of the principal treatments found in Tibetan medicine to this day, including purgatives, emetics, channel cleansing, pulse and urine analysis, enemas, suppositories, and bloodletting. However, it also has a chapter on daryakan, which, as asserted above, is of Shangshung derivation. Therefore, it cannot be established that this work or other Chinese compositions are the sources of these diagnostic techniques or therapies. Nevertheless, a passage from Four Tantras cited in Mirror of Beryl states that cauterization and channel cleansing come primarily from China. Also, several works translated from the Chinese deal with pulse and urine analysis. Dr. Tsering Thakchoe Drungtso stresses the differences between traditional Chinese and Tibetan medicine, while admitting similarities in medical theory and practices as well as in diagnostic techniques. Urine divination techniques using a turtle grid described by Dr. Drungtso are distinctly Chinese.

The influence of the Indian or Āyurveda medical system in Tibet was more extensive. From the eighth century onward, inspired by the aspirations of King Trisong Detsen, Tibetan translators and scholars visited India regularly in pursuit of Buddhist literature and teachings. In doing so they brought back compositions on medicine by great practitioners of Āyurveda. The translator Vairocana in the eighth century traveled to India and translated many works on medicine, astronomy, and the Great Perfection, among other topics. According to those who hold it to be of Indian origin, he was the translator of Four Tantras. The Lotus Chronicles, cited in Mirror of Beryl, said of him:

Never has there been a translator like Vairocana,
and there never will be again.
In the future those who speak the languages of India
may be called translators,
but they will come nowhere near Vairocana.
He was called a translator,
in reality he was a pandit.
Generations hence will look on his work
with immense gratitude.

Translator Rinchen Sangpo in the tenth century also traveled to India. He translated Essence of Eight Branches by Śūra, or Vāgbhaṭa, and its extensive commentary Moonlight by the Kashmiri Candranandana. These are found in the Tengyur, the canon of works by Indian masters translated into Tibetan, and became widespread and influential in the medical systems of Tibet. The physician Shangtön Siji Bar in the eleventh century also journeyed to India and returned with many teachings on medicine. Indian physicians also visited Tibet where they introduced various traditions. The last physician to visit Tibet from India was reputed to be Pandit Vanaratna in the fifteenth century.

The Tengyur includes about twenty-two translations of Indian medical works. These include compositions on comprehensive theory and practice of the eight branches of Āyurveda, works on herbal preparations, elixirs, and the alchemical preparation of mercury, and even a veterinary work on the treatment of horses.

Of these Indian compositions, the Essence of Eight Branches or Treatise of Eight Branches (Aṣṭāṅgahṛdayasaṃhitanāma) is regarded within Indian Āyurveda as one of the great works on medicine. The eight branches of Āyurveda are: physical or internal disorders (kāya), children’s disorders (bāla), women’s disorders (mātṛ roga), demonic disorders (bhūta vidyā), surgery for injuries from weapons or wounds (śalyatantra), antidotes to poisons (agada), remedies for aging (jarā), and aphrodisiacs and cures for impotence (vājikaraṇa). The same or very similar eight branches are mentioned in Four Tantras as subjects to be studied.

A passage in Four Tantras describing the origins of the branches of Tibetan medicine says that India was mainly responsible for the preparation or compounding of medicinal plants and minerals. Medicinal substances used as ingredients in compounds are chosen for the powers and tastes effective in combating disorders. These disorders in turn are classified according to their basic cause, which is a disturbance, excess, or depletion of the three humors (doṣa), which are wind (vāyu, vāta), bile (pitta), and phlegm (kapha). Therefore, renowned Indian medical works, such as Eight Branches, the Caraka Saṃhita, and the Suśruta Saṃhita, describe in detail the three-humor pathology, the powers and tastes of single-ingredient medicines, and the compounding of these ingredients. Such detail is mirrored in Four Tantras and other indigenous Tibetan medical compositions. The five therapies (pañcakarma) renowned in Āyurveda have also found their way into the Tibetan medical system and are described in Four Tantras.

Therefore, the principal origins of the medical system in Tibet were those of the indigenous Bön culture, the Greco-Arab cultures to the west, China, and India. Other sources of influence can also be detected. Tibetan sources talk of the “nine royal physicians from surrounding countries.” Alongside Trom, China, and India, these surrounding countries include Kashmir, Drugu, Dolpo, and Nepal. Other sources talk of ten medical traditions, listing Khotan, Minyak, Hor or Mongolia, and Oḍḍiyāna in addition to the above.

Four Tantras

The full name of Four Tantras is Essence of Ambrosia Secret-Instruction Tantra on Eight Branches. This work is the bible of the Tibetan medical science and is met with great praise from all established Tibetan medical traditions. As a single text it contains four main sections or tantras. The first or Root Tantra is an enumeration and overview of the chapters of the other three tantras and an introduction to the three-humor theory. The second or Explanatory Tantra covers embryology, physiology of the human body, causes and classification of disease, diet, medicines, diagnosis, criteria for becoming a doctor, and so on. The third or Instruction Tantra is primarily a comprehensive medical manual for the treatment of specific disorders. The fourth or Final Tantra covers pulse and urine diagnosis; various medicine forms such as pills, pastes, decoctions, powders, mineral medicines; the five cleansing therapies, such as purgatives and emetics; and the five external therapies, such as bloodletting and cauterization.

The format of these tantras is that of a dialogue. Rishi Manasija, a manifestation of the Buddha’s speech, requests the individual chapters from Rishi Vidyājñāna, the manifestation of Buddha’s mind. A rishi (ṛṣi) is a sage, and Four Tantras is a tantra not in the commonly understood sense as an esoteric Vajrayana manual, but in its other meaning of “treatise,” especially as one on the ancient sciences of India, such as medicine, grammar, and the arts. Throughout the tantra, Medicine Buddha, although present, is silent. The discourse takes place in the beautiful medicine city of Sudarśana, surrounded by the four medicine mountains of Gandhamārdana, Himavat, Vindhya, and Malaya or Malabar. The audience consists of Buddhist and non-Buddhist gods usually associated with India, such as Avalokiteśvara, Brahmā, etc., as well as human and celestial physicians and rishis.

At first glance this great medical work appears to be a standard Indian composition or teaching of the Buddha that was eventually translated into Tibetan. The surroundings and the audience are distinctly Indian in name and description. All four mountains are identifiable as ranges in the east, north, middle, and the western ghats of India. All the rishis present in the audience are found in ancient Indian literature. However, a sizeable number of Tibetan medical scholars doubt its Indian origins. They point out that although the text follows generally the principles of the eight branches of Āyurveda, much of the content of the medical work is deliberately geared toward the climate and environment of Tibet. Some chapters, such as those on pulse and urine diagnosis, are decidedly non-Indian. They claim that certain substances mentioned in the text such as white china bowls and tea were not in existence during the time of the Buddha. Substances such as yak meat and roasted barley porridge are distinctly Tibetan foods. Even the clothing described is Tibetan in style. The references to the mother-son and friend-enemy cycles in the chapter on pulse analysis follow the thinking of the Somarāja, which was translated from the Chinese. Moreover, there is no reference to this work in the great canon of translations from India—the Kangyur and Tengyur—and there is no trace of there ever having been a Sanskrit version of the text.

These doubts have given rise to much debate and discussion over the centuries as to the author or authors of Four Tantras. Some commentators consider it to be primarily the word of the Buddha with additions and supplementary material by the later Yuthok. The identification of Sudarśana, its place of teaching, has been identified with Bodhgāya in northern India or Oḍḍiyāna in the west of India. Others maintain it is solely a Tibetan composition, the author being variously the eighth-century translator Vairocana, the elder and younger Yuthok, or the eleventh-century treasure revealer Drapa Ngönshé. Desi Sangyé Gyatso, the author of this work, asserts that Four Tantras was originally taught in Oḍḍiyāna (often identified with the Swat Valley in Pakistan) by the Buddha manifest as the blue Medicine Buddha. It was preserved, some say as a treasure later revealed by Nāgārjuna and Śūra, and eventually translated and brought to Tibet by Vairocana. From there it was either concealed in a pillar at Samyé Monastery by King Trisong Desten or his son to be revealed later by Drapa Ngönshé, or passed on through Padmasambhava as a part of the Transmission tradition. Eventually it came into the hands of the later Yuthok, who revised the work and supplemented it with other medical traditions existing in Tibet at that time, thereby attuning it to the demands of the Tibetan environment.

Most modern Tibetan scholars maintain the tantra to be primarily the work of Yuthok the elder and younger. Troru Tsenam, for example, says that Yuthok the elder took the medical translations made by Vairocana as a basis, added much from his own experience and from the teachings he received from the Kashmiri Candranandana, together with already established indigenous Tibetan medical science, and produced an early version of Four Tantras. This was concealed as a treasure to be later revealed by Drapa Ngönshé and finally reaching Yuthok the younger. Taking this composition as a basis, he supplemented it with teachings from the Āyurvedic Essence of Eight Branches and its commentary and added medical practices and oral-tradition techniques that had developed in Tibet since the time of his ancestor. This work was undertaken accompanied by a pure vision of Medicine Buddha and takes the form of a question-and-answer dialogue between Rishi Manasija and Rishi Vidyājñāna in the manifested medical city of Sudarśana. Because of these exalted credentials, Troru Tsenam says, this work is inseparable from the teachings of the Buddha himself.

Other scholars diverge in various ways from this account, but all Tibetan medical practitioners agree that this composition is the foundation on which later medical science in Tibet was built. The work’s creation may well be the major turning point in the history of Tibetan medicine, when it went from being a purely derivative tradition to being an innovator of medical science in its own right.

Buddhist Influence

As we have seen, the origins of the medical system in Tibet were by no means exclusively Buddhist. Medical practices from the old Bön culture and from the Greco-Arab traditions, for instance, were clearly not Buddhist. Although many of the medical texts translated from India begin with homage to Medicine Buddha, Āyurveda itself is said to predate the Buddha, and to have begun at the instigation of the god Brahmā, and developed by the god Indra, the rishis, and brahman-caste physicians. Nevertheless, medicine arrived in a Tibet that was embracing the Buddhist doctrine, and the science and the religion have become linked. Such a relationship between medicine and religion was inevitable in the world before the advent of modern scientific thinking, and Tibet was no exception.

Buddhism teaches that the root of all suffering lies in ignorance, aversion, and desire. These three states of mind are known as the three poisons, depicted in paintings of the wheel of life as a pig, snake, and chicken, respectively. Illness is an obvious form of suffering. Therefore, although Tibetan medical texts place the three humors at the root of all disease, the deeper root is that of the three poisons. The deep root of phlegm disorder is the pig-like poison of ignorance. The root of bile disorder is the snake-like poison of aversion or anger. The root of wind disorder is the chicken-like poison of desire.

With Buddhism as its spiritual philosophy, Tibetan medicine says that the true path to perfect and permanent health is Buddhist practice aimed at eliminating the three poisons, whereas following medical treatments can alleviate the suffering of illness only temporarily as long as the three poisons reside in the mind. The Buddha is the culmination and final accomplishment of Buddhist practice and is therefore permanently free of any humor imbalance or illness. The accounts in scripture of the Buddha becoming sick toward the end of his life are thus interpreted as mere displays of illness for a pedagogical purpose.

According to the Mahayana Buddhism of Tibet, a buddha is the product of the wisdom of omniscience, total compassion, and unobstructed power. Therefore, a buddha would not only know every disease, the cause of every disease, and the perfect remedy for every disease, but would work effortlessly and compassionately to free living beings of disease. For having such wisdom and compassion, the Buddha is said to be the perfect physician. Desi Sangyé Gyatso himself states:

The physician who eliminates desire, aversion, and confusion, the ignorance that causes these three poisons, together with the wind, bile, and phlegm disorders that result from the three poisons is the blessed Buddha. He is the physician surpassed by no one.

Because of the unobstructed power of this perfect physician, the Buddha is appealed to in his form as Medicine Buddha. Many ritual-based meditative practices and initiations have appeared, focusing on Medicine Buddha, that aim to enhance the physician’s power, overcome disease, lengthen lifespan, and so on. One of the most famous of these is Yuthok Yönten Gönpo’s Heartdrop. This work describes the initiation or empowerment processes in great detail, including, for example, the medical instruments initiation and the ambrosia longevity initiation, followed by the associated generation and completion-stage practices. With these features, it is a practice on a par with those of highest yoga tantra.

In the practice of Mahayana Buddhism, knowledge is pursued to better equip ourselves to help others. On this bodhisattva path, knowledge of the science of medicine is considered a necessary supplement. Because of this, even those who are not medical practitioners will request and receive the Medicine Buddha initiation, with the aim of planting the seeds for future skill in healing. Others will request and receive the initiation when ill in order to supplement medical treatment. It is not an uncommon practice for those suffering from illness to recite with deep faith the Medicine Buddha mantra or to visualize Medicine Buddha at the site of the illness. There are many recorded testimonials to these rituals’ efficacy.

The doctrine of karma is a central pillar of Buddhist philosophy. Essentially, this doctrine preaches that all thoughts and deeds leave imprints on the stream of consciousness that intended them, and those imprints ripen in this and future lives in diverse ways. Our body type, with its strengths and weaknesses and its general constitution, the fortunes and misfortunes we meet through life, and even the environments we find ourselves in, all have their root causes in thoughts and deeds carried out in previous lives. The immediate circumstances that may precipitate pain and pleasure are regarded as mere conditions or triggers that cause the karmic effects to ripen.

Sickness is often brought on by immediate circumstances and conditions—such as poor diet, unhealthy lifestyle, or contagions in the environment— but its deeper, direct cause is said to be karma. This view is not mere fatalism. Illness may have its deeper cause in the past actions of the patient, but it was triggered by particular circumstances. Similarly, the deeper cause of the cure may be the patient’s karma, but the immediate condition for bringing the cure about is the doctor and the medicine. Because of this relationship between illness, remedy, and karma, a patient will often attempt to find a doctor, medicine, or even medical system with which they have a karmic relationship. Medicine will work for some and not for others. Doctors successfully treat some patients and have little success with others. A simple ailment is cured for some but becomes chronic with others. Some recover quickly; some do not. And some do not recover at all. In the world of medicine informed by Buddhism, the seemingly unexplainable course of an illness is attributed to the deeper roots of karma.

Taking into consideration the part that karma plays in the treatment of illness, a physician will sometimes consult the patient’s horoscopes to determine the karmic influence on the illness. If it is thereby determined that no amount of conventional treatment will be effective, the patient often resorts to rituals indicated by an astrological calculation or by the divination of an appropriate lama. Physicians will resort to astrology for other reasons also. Desi Sangyé Gyatso states:

Using [astrology] one calculates the times, directions, and dates when the collecting, preparation, and taking of medicines becomes effective and auspicious. There is a great difference between these benefits and the disastrous consequences that come from not knowing this astrology.

Because of this, medicine and astrology in Tibet enjoy a close relationship.

Yuthok Yönten Gönpo the Elder and Younger

After the introduction of medical systems from abroad and the development of indigenous medicine that occurred in the second half of the first millennium, Tibet saw the appearance of learned physicians of their own. This had its beginnings with the call from King Trisong Detsen in the eighth century for bright young men to engage in the study of medicine, resulting in the arrival of the “nine wise Tibetan physicians.” Among them was Drangti Gyalsang, whose lineage ultimately merged into the Sakya medical lineage; Nyawa Chösang, whose lineage continued well into the time of Desi Sangyé Gyatso in the seventeenth century; and Yuthok Yönten Gönpo the elder.

Yuthok was an almost mythical figure who had made a striking impression as a young man during a conference of foreign doctors held at Samyé Monastery under the auspices of the king. In later years he traveled to India and to other lands to seek out medical teachings, which he brought back to Tibet. Once he brought back from his travels a statue of Medicine Buddha specially made for him by the supernatural serpent-like creatures called nāgas in gratitude for curing their queen. This statue was still in the Potala palace in Lhasa in the seventeenth century during the time of the Fifth Dalai Lama, who prayed before it when suffering with an eye condition and met a successful outcome. Yuthok was the composer of many a work on medicine and founded the first medical college in Kongpo. He is said to have lived 125 years.

Yuthok Yönten Gönpo the younger was a descendent of the elder Yuthok and was born in the eleventh century. Although preceded by several great physicians, such as Drapa Ngönshé, Shangtön Siji Bar, and his own mentor, Roktön Könchok Kyap, his contribution to establishing medicine as a truly Tibetan science was immense. His prolific output of teaching and composition established what were among the first son and disciple medical lineages in Tibet. He reputedly traveled to India six times. He is spoken of in glowing terms as a true incarnation of Medicine Buddha. The Fifth Dalai Lama said of him:

Fusion of all buddha families of the three enlightened bodies,
the lord of medicine, Vajradhara,
in the dance performed according to the minds of disciples,
appears the one renowned as Yuthok Yönten Gönpo,
in reality the naturally arising lord of myriad mandalas.

He was especially influential in the propagation of Four Tantras (or, according to many commentators, its composition).

Consolidation of Medical Science after Yuthok

The later Yuthok Yönten Gönpo left a disciple lineage that begins with the great twelfth-century physician Sumtön Yeshé Sung, as well as a lineage beginning with his son that includes Palden Tsojé of the famous Drangti lineage; the celebrated royal physician Minyima Thongwa Dönden, of the Jang lineage; and Tashi Palsang, in whom the Treasure and Transmission lineages of Four Tantras combined.

As well as producing one lineage of Four Tantras, the revealed Treasure tradition produced a wealth of oral-instruction treatments for a variety of disorders. The most famous of these are the medical treasures revealed by Guru Chökyi Wangchuk and Dorbum Chökyi Drakpa.

The fifteenth century saw the dawn of two of the greatest medical lineages in Tibet—the Jang and the Sur. The Jang tradition began with Jangpa Namgyal Draksang, whose aristocratic father had been honored by the Mongolian emperor Kublai Khan. In later years he himself was awarded the title of Tai Situ by the emperor. He wrote many authoritative works and was especially knowledgeable on the Kālacakra tantra. He had both tantric disciples, including the famous Palden Chökyong, and medical disciples, including Minyima Thongwa Dönden.

The Sur lineage began with Surkhar Nyamnyi Dorjé. It is said that he received a vision of Yuthok, who gave him oral-tradition teachings and pointed out where later commentators had erred in their understanding of Four Tantras and Yuthok’s Heartdrop. His compositions included many definitive reference works on the tastes, powers, post-digestive tastes, natures, etymologies, and functions of various medicines, as well as the famous Relic of Millions, a vast collection of oral-tradition treatments. He was also a dedicated practitioner of tantra and often meditated naked from the waist up using meditation straps to hold his posture. His lineage has produced many worthy physicians. These include Surkhar Lodrö Gyalpo, who produced the first major redaction of Four Tantras and some other works that, while not highly regarded by Desi Sangyé Gyatso, were nonetheless quite influential.

Desi Sangyé Gyatso

Both these lineages were eventually merged by Desi Sangyé Gyatso, the author of the present work, in the seventeenth century during the time of the Fifth Dalai Lama. Ngawang Losang Gyatso, the Fifth Dalai Lama, was not a physician, nor did he concentrate on the study of medicine, but he made a significant contribution to the growth and establishment of this science through patronizing medical schools, encouraging the publication of medical works, arranging the translation of Indian texts, inviting Tibetan physicians from far away to pass on their oral traditions, and generally seeing that all conducive conditions for the above were in place. This he was able to do because of the great political power he now possessed, having nullified the challenge of the Tsang rulers to the west of Lhasa with the help of the Mongolian chieftain Gushri Khan.

Desi Sangyé Gyatso had looked at the redaction of Four Tantras made by Surkhar Lodrö Gyalpo, decided that it was not up to standard, and suggested to the Dalai Lama that he attempt a new redaction. He also came to the conclusion, contrary to other opinion at the time, that the Jang and Sur lineages were not incompatible. Therefore, beginning around 1690, he set to work on producing a new and revised edition of Four Tantras, using a variety of source and reference works; a comprehensive commentary to Four Tantras, known as Blue Beryl; and a supplement to the Instruction Tantra, the longest of the four tantras. These works form a substantial basis of the study of Tibetan medicine even today. He was also responsible for commissioning a remarkable collection of seventy-nine annotated medical and anatomical paintings that illustrate the chapters of Four Tantras. These are still extant and have been published in book form.

In 1696, inspired by a vision of the site as resembling Sudarśana and motivated by the wishes of the Fifth Dalai Lama, who had by then passed away, he founded the famous medical college on Chakpo Hill in Lhasa. There he would sometimes teach the classes himself, and he established the annual expedition to neighboring areas to identify medical plants. He also had great expertise in astrology and composed White Beryl, an authoritative work on all aspects of astronomical and elemental calculation and divination practiced in Tibet at that time. Although he was not a trained physician, he was without doubt an extraordinary scholar, and lived an extraordinary life.

He was born near Lhasa in 1653 as a descendent of Desi Trinlé Gyatso, a former viceroy of the Dalai Lama. He came into contact with the Dalai Lama at a very young age. According to the short account of his life by Dr. Losang Tenzin, when the Dalai Lama visited his family, the four-year-old child clung on to the Dalai Lama’s robe and wanted to go away with him. From the age of eight he was part of the retinue of the Fifth Dalai Lama, who conferred upon him the layman’s vows. Despite depictions of him as an ordained monk, Desi Sangyé Gyatso remained a layman his entire life, something he makes very clear in the present work. From the age of eight he spent much of his time in the Dalai Lama’s presence, benefiting from his vast knowledge. Although he studied with other teachers, the Fifth Dalai Lama became his root guru and bestowed on him many tantra empowerments.

In 1679 the Dalai Lama retired from political life and handed over the reins of power to Desi Sangyé Gyatso, who was only twenty-six years old. And it was a considerable power to fall on such young shoulders. A legal inscription stating that this young man was to be regarded as of equal political status to the Dalai Lama can still be seen in the Potala palace.

He seems to have been very thorough in his administration of the country’s institutions. With the monasteries of Ganden, Sera, Drepung, Tashi Lhünpo, and Mindröling, he overhauled and reviewed their monastic regulations, estates, and sources of income. In the lay community he conducted a census of households and levied taxes where appropriate. In the government he set up many new institutions.

The consolidation of Tibet as a land under a single power residing in the Potala palace at Lhasa was not yet forty years old. Because of this, together with the perceived designs of the Manchu and the instability among the Mongolians, not to mention other internal disputes, the young ruler of Tibet, in keeping with the wishes of the Fifth, decided to conceal from the Tibetan community the death of the Dalai Lama four years later. This secret was maintained for about thirteen years. By the time it was revealed in 1694, the incarnation of the Dalai Lama, Tsangyang Gyatso, was already eleven years old. The subsequent problems involving the Sixth Dalai Lama’s unwillingness to pursue a monastic life are well documented elsewhere.

In 1701 the new Mongolian chieftain was Lhasang Khan, who succeeded his father Tenzin Dali Khan, the eldest son of Gushri Khan, who had been poisoned and died. Together with Desi Sangyé Gyatso he ruled Tibet. However, it seems that Lhasang wanted complete rule of the country. To fulfill this aim he stirred up trouble between Desi and the monasteries of Drepung, Sera, and Ganden and launched personal attacks on the character of the teenage Sixth Dalai Lama. This resulted in a delegation from the monasteries persuading Desi to step down from his position in 1702 and to appoint his son Ngawang Rinchen in his place.

However, this did not placate Lhasang Khan, and in 1704 hostilities again broke out. The monasteries, together with the Sixth Dalai Lama and the First Jamyang Shepa, mediated, resulting in Lhasang agreeing to return to Mongolia. However, Lhasang did not keep his word. He divided his army into two divisions—one headed by his wife Tsering Tashi or Tsewang Gyalmo, the other headed by Lhasang himself—and converged on Lhasa. Desi decided to surrender to Tsering Tashi, calculating that to surrender to Lhasang would endanger his life. However, Tsering Tashi seized Desi Sangyé Gyatso and immediately had him beheaded. When he was found, it was said that the body was still warm. This was in the summer of 1705.

Two years earlier he had completed the present text on the history of Tibetan medicine. He had concluded that previous histories of medicine were not comprehensive or were unduly biased toward the tradition of the author. He first conceived the idea of composing his own history of medicine when he was thirty, however, as he had been suddenly thrust into the time-consuming administrative role of ruling Tibet, this undertaking was postponed until 1703, when he was fifty. It was to be his last composition.

Theory and Practice of Tibetan Medicine

From the diverse origins described above, a science of medicine developed in Tibet from the seventh to around the twelfth centuries displaying the characteristics of these influences. The fundamental theory behind its practices is that of the elements. In his work on Tibetan medicine, Khenrab Gyatso quotes a verse from Four Tantras:

The body is formed from the four elements,
illness to be cured is created by the four elements,
medicine too has the nature of the four elements,
body, disease, and medicine are of similar natures.        

The elements here are those of earth, water, fire, and air together with the element of space. These are the elemental constituents of the body. The text continues:

From earth comes flesh and bones;
from water comes blood, the sense of taste, and liquids;
from fire comes warmth, complexion, the sense of sight;
from air comes breath and the sense of touch;
from space comes the cavities and sense of hearing.

Essentially, nothing in the makeup of the body is outside these five elements, and therefore, all physical disorders are also of these elements. Although these five elements exist in the outer world as well, here the term refers exclusively to the “inner” elements that make up the body. In medical terms the elements of earth and water are together known as phlegm, the element of fire is called bile, and the element of air is called wind. The element of space pervades the other three. These three are literally the three “faults” (doṣa) but are often translated as the “three humors.” As noted above, disturbance, deficiency, or excess of any or all of these humors results in disease.

The humors, or inner elements, share characteristics with their corresponding outer elements. Bile, being the element of fire, is hot, sharp, and so on. Phlegm, having the nature of earth and water, is heavy and cold. Wind with its nature of air is light and mobile. The factors that act upon these inner elements and thereby alter their balance are primarily medicine, diet, and behavior. The external influences of medicine and diet are not different in nature from the five outer elements and so possess characteristics similar to the inner elements or humors.

Medicine, therefore, is prescribed to counter imbalances among the inner elements. Medicine to be taken internally can be single-ingredient medicine or, more commonly, multi-ingredient compounds. These are in the form of pills, powders, pastes, decoctions, and so on. Medicinal ingredients are mineral, herbal, and animal. Likewise, everyday food and drink possesses similar elemental properties that work upon the corresponding inner elements. Even behavior and personal routines can affect the humor balance. Therefore, treatment in the Tibetan medical system may include a combination of medicinal compounds, changes in diet, and harmonious behavior. The theory behind this is summed up in the line taken from Four Tantras and cited above: “Body, disease, and medicine are of similar natures.”

Other treatments are in the form of therapeutics. They include the five cleansing therapies (pañcakarma) and the five external therapies. The first five are found in Indian Āyurveda. They are purgatives, emetics, nasal purgatives, suppositories, and enemas. The five external therapies are bloodletting or venesection, cauterization or moxabustion, fomentation or compress therapy, balneology or embrocating, and the application of lotions and ointments. Other therapies used are the preliminary internal and external oil therapies and channel cleansing therapy.

Treatment using charms, mantras, blessed substances, rituals, and astrological calculations are also common. Four Tantras offer a fourfold classification of the 404 categories of disease, 101 of which are caused by external demonic influence. It is these disorders that are primarily treated with such approaches, but non-demonic imbalances of the humors can also be aided with these treatments. Medicines are blessed or consecrated to increase their potency, and there are elaborate rituals for accomplishing this. Relics that include tiny fragments of the bones, teeth, hair, and robes of great accomplished masters are used as ingredients of special pills or used in fumigation processes. Patients may be required to wear an amulet containing a mantra whose power will aid in curing them of the illness. Often they will invite the monastic community to their home to perform particular rituals, or will request the monks to recite certain scriptures or prayers in the monastery on their behalf. The particular mantra to wear or recite, or the ritual to be performed, is more often than not determined by the patient’s lama rather than his or her doctor. These same lamas can be requested to perform a divination ritual in order to determine the best kind of treatment, the most suitable doctor, and even the prognosis.


Diagnosis in the Tibetan medical system is said to be by visual examination, contact, and questioning. The first refers to the doctor taking note of and examining various physical features of the patient. These include complexion, eyes, tongue, nails, and, in particular, urine. Contact primarily refers to reading the pulse. A visit to a Tibetan doctor often involves bringing a sample of that morning’s first urination for examination followed by a reading of the pulse on both hands. Dr. Tsering Thakchoe Drungtso quotes the fifteenth-century commentator Taktsang Lotsāwa Sherap Rinchen as asserting that pulse and urine diagnosis are distinctly Tibetan and did not originate in India. However, as discussed above, these diagnostic techniques appear in medical works translated from the Chinese and are also found in Āyurveda. It may be that these techniques are not as developed in these countries as they are in Tibet, where undoubtedly they are sophisticated and highly skilled practices.

Urine is said to resemble a mirror, reflecting the nature of bodily disorder. Important considerations in its examination include the time when the urine is passed, the time it is analyzed, and the food and drink taken by the patient the previous evening. Actual examination involves analyzing the color, vapor, bubbles, smell, sediment, and changes in the urine. Analysis detects the status of the humors, and in connection with various diagrams can also detect the presence of spirits.

As with urine analysis, pulse examination is a sophisticated process that may require various dietary and other restrictions for at least a day before the consultation. The time of pulse analysis is important, the best time being early morning. The location for analysis is usually the radial artery running through the wrist. The artery on both wrists is examined by the doctor using three fingers on each hand to determine the condition of the bodily organs and to determine the balance of the humors. Different fingers read different organs.

The pulse is read by observing its characteristics. These can be, for example, weak, hollow, sunken, trembling, fluctuating, slow, fast, tight, and so forth. The pulse is also described using a variety of similes, such as like the bite of a toothless dog, a river flowing from on high, a boiling hot spring, flames, and a thorn. There are types of pulse according to physical constitution. There also seasonal pulses that relate to the elements of wood, earth, fire, metal, and water. Interpretation of these pulses requires the knowledge of the elemental relationships often referred to as mother-child and friendenemy relationships.

Like urine analysis the pulse can be used for divination. There are seven types of pulse used for divination, known as the seven wonderful pulses. Unlike in other pulse analysis, the subject is healthy when these are read. The family pulse is read on a senior member of the family to foretell important occurrences that may befall the household. The guest pulse provides information on a guest about to visit the family. The enemy pulse predicts the outcome of attacking an enemy. The friend pulse provides information about the wealth of the family. The evil-spirit pulse discloses the malevolent presence of a spirit affecting the household. The substitution pulse is read on a healthy member of the family to provide diagnosis of another member unable to reach the doctor. The son’s pulse could be read in order to diagnose the father, for example. The pregnancy pulse is used to determine the sex of an unborn child.

Urine and pulse analysis are discussed at length in Four Tantras and constitute the main diagnostic techniques in the medical system of Tibet.


In Tibet physicians were the products of a one-to-one lineage passed from parent to child, uncle to nephew, or master to disciple, or they were graduates from medical colleges established by celebrated physicians. Family lineages include the Sakya uncle-nephew lineage, the Drangti lineage, and the Tsarong lineage. The celebrated Jang and Sur lineages that began in the fifteenth century contained father-to-son as well as master-to-disciple transmissions. One of the most famous medical colleges was that of Chakpori in Lhasa set up by Desi Sangyé Gyatso himself.

Four Tantras lists the characteristics expected of a physician. They include possessing an honorable character in line with Buddhist criteria, intelligence, an ethical vow, compassion and skill with patients, and good familiarity with the different aspects of medical science. These technical aspects include urine and pulse diagnosis, a grasp of the medical literature, the experience of having observed one’s teacher, and proficiency in prognosis, the use of surgical instruments, different treatments, dietary factors, the five therapies, and the identification of medical substances.

Physicians are strongly urged to avoid becoming tainted with those characteristics that render them “butchers of lives.” These include treating patients only after calculating the benefit they can bring; relying on meager learning; prescribing treatments that are unsafe and untried, ineffective, or based on hearsay; and being “little more than a salesman,” peddling general tonics as targeted cures.

Development of Tibetan Medicine up to the Present

The present work deals with the history of medical science up to the end of the seventeenth century. However, contemporary sources such as the great scholar and preserver of the Tibetan medical tradition, Jampa Trinlé (b. 1928), director of the Lhasa Astro-Medical Institute, whose work was cited above, and the equally accomplished physician and teacher, Troru Tsenam (b. 1926), have composed biographies of important physicians and short histories of Tibetan medical science up to and including the occupation of Tibet by the Chinese.

Influential physicians after Desi Sangyé Gyatso, whose biographies are described in the above two works, include the eighteenth-century Deumar Tenzin Phüntsok, who composed a renowned and very detailed Tibetan materia medica that is still in use today. Also in the eighteenth century Situ Künkhyen Chökyi Jungné, a prolific traveler, journeyed to India, China, Nepal, and Sri Lanka in search of knowledge of the five sciences, including medical traditions and practices. These he translated into Tibetan, sparing himself no hardship in his efforts to enhance the traditions of Tibet. In his later life he founded an educational institute in Palpung Thupten Chökhor in eastern Tibet, attracting students from Amdo and Kham, including Karma Ngelek Tenzin, Khamtrül Chökyi Nyima, Degé Gyalpo Tenpa Tsering, many of whom became renowned physicians in their own right. Of these, Tenpa Tsering recognized the value of propagating in Kham the Four Tantras redacted by Desi Sangyé Gyatso and his Blue Beryl commentary and so took on the task of reprinting and distributing these works in eastern Tibet.

In the nineteenth century Situ Chökyi Gyatso rejuvenated the medical college of the famous Nyingma monastery Kathok Dorjé Den in the Degé district of Kham, while Jamyang Khyentsé Wangpo set up the study of medicine and the other sciences in Degé and at Tashi Lhatsé Monastery in Dzongsar. Kongtrül Yönten Gyatso studied in Kham at the time of the great Rimé movement and became a physician renowned for his magical powers. The renowned Mipham Namgyal Gyatso, or Ju Mipham, also from Degé, includes, in his thirty-five volumes of compositions, commentaries on Four Tantras; instructions on compounding medicines; compositions on anatomy; oral-tradition teachings on rabies; treatments for the ears, voice, and eyes; medical teachings from China; and treatments for cattle.

In the latter part of the nineteenth century, Orgyen Tenzin Gyatso, physician to the Thirteenth Dalai Lama, reprinted Four Tantras and other medical compositions and helped restore the fortunes of the Chakpori Medical College established by Desi Sangyé Gyatso. Karma Jikmé Chökyi Sengé, born in Kham and a student at the Nyingma monastery of Kathok, became such a renowned medical practitioner that he was invited to Lhasa by Orgyen Tenzin Gyatso, where he taught and raised the profile of many works connected with the Nyingma tradition, the early treasure revealers, and in particular Yuthok’s seminal work on combining medicine and tantric ritual, the Heartdrop. He also reprinted many medical works. Trekhang Jampa Thupwang and Jabukpa Damchö Palden, physicians to the Thirteenth Dalai Lama, taught bright students chosen from Chakpori Medical College.

Among these students was Khyenrap Norbu (1883–1962), who became the director of Chakpori Medical College and the Lhasa Astro-Medical Institute, founded in 1916 by the Thirteenth Dalai Lama. Khyenrap Norbu was personal physician to the Dalai Lama and is revered in Tibetan medical circles today. He nurtured about a thousand disciples in the two medical colleges of Lhasa, not only with medical science but with the Dharma, poetry, and grammar. He encouraged women, exemplified by the celebrated female doctor Yangchen Lhamo, to undertake the study of medicine and to halt the decline in interest in gynecology and pediatrics. He also composed many works on medicine. His students were numerous and include many of the doctors who fled into exile in India after the 1959 uprising against the Chinese occupation of Tibet, as well as Jampa Trinlé, the author of a history of Tibetan medicine mentioned above.

Concerning the status of indigenous Tibetan medicine after the Cultural Revolution enforced by the Communist Chinese in the 1960s, both Jampa Trinlé writing in 1988 as director of Lhasa Astro-Medical Institute and Troru Tsenam writing in 1996, probably from eastern Tibet, have no criticism of the state of medical science in Tibet after the Chinese occupation. Troru Tsenam says that after the democratic reforms in Tibet, Chakpori Medical College and the Lhasa Astro-Medical Institute merged to become one. But he makes no mention of the fact that Chakpori was shelled by the Chinese during the Cultural Revolution and damaged almost beyond repair. He talks of health centers and Tibetan medical schools being built in Central Tibet, Shigatsé, and in Kham and Amdo, thereby relieving the hardship of there being no local doctors, of large medical conventions and of the opening of the Lhasa school of Tibetan medicine in 1986. He says that these new schools maintain the principles of traditional Tibetan medicine found in Chakpori and the Lhasa Astro-Medical Institute alongside modern medical knowledge.

Outside Tibet, the Fourteenth Dalai Lama established the Tibetan AstroMedical Institute in Dharamsala in the foothills of the Himalayas in 1961. It was housed in Dharamsala in a rundown wooden building probably built during the days of the British Raj. Dr. Yeshi Dönden and Ven. Lodrö Gyatso were appointed to run the medical and astrological sections. At its inception it had only two students, but it gradually developed as the stock of medicinal ingredients grew and the number of rooms, staff, and students increased. Dr. Khenrab, writing in 2004, says that twelve batches of medical students and six batches of astrological students have graduated over the past forty-three years, resulting in an output of over two hundred doctors and forty astrologers, who now work at the institute, at one of nearly forty branch clinics, or in private practices in India and overseas. Since its beginning, the Tibetan Astro-Medical Institute in exile has had pharmaceutical, research and development, materia medica, and editorial and publication departments. The astrology department produces annual almanacs, calendars, amulets, and horoscopes. Its office in New Delhi exports products all over the world. The staff now numbers 350, and doctors and astrologers from the institute regularly travel worldwide for conferences, consultations, and seminars.

Dr. Dönden opened his own practice in Dharamsala, as did the female doctor Losang Drölma Khangkar, known as Ama Losang. I remember these two doctors fondly and with gratitude. It would not be an exaggeration to say that on more than one occasion Dr. Dönden rescued my wife and me from dreadful illnesses, including hepatitis and pneumonia, during our long stay in Dharamsala in the 1970s. For the home birth of our children in the forests above Dharamsala, Ama Losang gave me detailed instruction on midwifery, and during the birth of our first child she personally trekked up the mountain to prescribe medicine to bring on birth during a long and protracted labor. Our son was born within half an hour of my wife taking her medicine. There are many accounts of these two great doctors delivering health care to the Tibetan refugees, local Indians, and Western travelers and expatriots in and around Dharamsala.

Tibetan medical science has been on a long journey. In the distant past medical systems from other parts of the world converged in Tibet. Together with extant medical practices, they developed into an indigenous medical system that was practiced behind the Himalayas for well over a thousand years. Now that very same medical system, having survived a few threats to its survival, is spreading through the rest of the world as an alternative approach to medical treatment. It brings with it a great variety of treatments and diagnostic techniques, along with a vast stock of compound medicines, all of which testify to those great scholars and practitioners of the past who developed and preserve this unique system. This present work reveals their story.

Structure of the Text

Mirror of Beryl begins with an appraisal of the importance of the five major sciences, especially the science of medicine, and traces the origins of this science in its celestial beginnings. Part 1 then examines the root medical lineages of ancient India. It briefly documents the arising of the Indian Āyurvedic system and recounts the biographies of great medical scholars and practitioners such as Jivaka, a contemporary of the Buddha.

Part 2, on the earlier development of medicine in Tibet, initially focuses on the eighth century, and on such luminaries as King Trisong Detsen, Padmasambhava, and Vairocana. As well as showing the Indian antecedents, the author also examines the considerable influences on Tibetan medicine from China and Central Asia at this time. Part 2 goes on to deal with the propagation of medicine from the eleventh century for the next four hundred years, and recounts the lives of renowned medical practitioners such as Yuthok Yönten Gönpo. Because of the controversy surrounding the authorship of Four Tantras, and its strong association with Yuthok, much of this section is taken up with an examination of its origins. Consequently many pages are spent on a presentation of the main definitions of word of the Buddha (buddhavacana) and subsequent treatises (śāstra) by Indian masters.

Beginning from the fifteenth century, part 3 of the book charts the development of the Jang and Sur lineages, the two main indigenous traditions of Tibetan medicine, and consists primarily of the biographies of the main propagators. After these accounts, the author focuses on the condition and development of medical science during his own lifetime. Here he details the Fifth Dalai Lama’s contribution to the spread of medical science as well as other contemporary scholars and physicians. As Desi Sangyé Gyatso was himself a great medical scholar, as well as interim ruler of Tibet, he describes his own considerable efforts to propagate medical science, both through composition and administrative establishment.

The final topics of the book are in the Tibetan all grouped under the heading “Study of Medicine.” This appears to have been an arbitrary division inserted by a later editor. The section focuses on the fundamental Buddhist practice of devotion to a master, followed by a long and detailed presentation of the three main categories of Buddhist precepts. Although linked to the topic of the study of medicine, this feels like a deliberate departure. This work was Desi Sangyé Gyatso’s last composition and was completed in 1703. It was at this time that twenty-year-old Tsangyang Gyatso, the Sixth Dalai Lama, began to show signs of not wanting to enter the monastic life, and I wonder if the two are not connected.

This text concludes with a brief presentation on the ethical behavior of physicians, the correct attitudes of the student, the author’s own medical practices, and a bibliography of medical histories.


For research and answers to the many queries I had with this project, I spent three months at the Central Institute of Higher Tibetan Studies, Sarnath, India. There I was fortunate to meet with scholars in various fields and to access the excellent facilities there. The obvious dedication of the staff and students has created an almost tangible atmosphere of the love of learning, and in its facilities it is surely the foremost resource for the preservation and continual development of the Tibetan sciences.

Although this is primarily a work on the history of Tibetan medicine, the text nonetheless contains a great number of medical terms, such as the names of diseases, treatments, therapies, medicinal substances, as well as titles of many ancient medical works. Help in identification and translation of these terms has come from Professor Losang Tenzin Rakdho, dean of the faculty of medicine in the Tibetan Medicine Department at the institute. Although a busy doctor involved in teaching consultation and administration, the professor gave freely of his time during my stay in Sarnath. His warmth and kindness extended to frequent invitations to his house for family meals, helping me find accommodation in the institute, and even ministering to me when I came down with a nasty case of food poisoning.

Help in nonmedical areas of the text was provided by Geshé Losang Chödar, also of the Sarnath institute. This included translation queries in areas of Dharma, history, and politics. Geshé-la is the Tibetan editor at the Institute of Tibetan Classics responsible for the critical editions of the Tibetan text. This medical history contains hundreds of citations, and his patient efforts in tracking down the source of these has saved me many months of work. Geshé-la also took it upon himself to make sure I had all requirements for my stay in Sarnath, even down to the essential thermos flask. He was always cheerfully available for queries on identification and location of texts within the vast library complex at Sarnath. His contribution to the completion of this translation has been enormous.

Desi Sangyé Gyatso frequently analyzes the etymology of Indic terms— and in one instance an entire Sanskrit verse—resulting in pages explaining Sanskrit roots, affixes, and case endings. For assistance in this field I turned to the eminent Sanskrit scholar, Venerable Losang Norbu Shastri, director of research and translation at Sarnath and Hindi translator for the Dalai Lama. I am very grateful to him for helping me with these complicated rules, even though he was not well at the time, and for identifying the main Sanskrit grammar work used by Desi in his explanations.

Remaining translation queries were cleared up through Skype discussions with Geshé Thupten Jinpa, president of the Institute of Tibetan Classics in Montreal, Canada. More generally, I am ever grateful to Thupten Jinpa for the privilege of working on the monumental enterprise he has envisioned with the Institute of Tibetan Classics.

I thank my editor at Wisdom Publications, David Kittelstrom, for casting his critical eye over the translation and rendering into clear and comprehensible English those passages where obfuscation had gotten the better of me.


How to cite this document:
© Institute of Tibetan Classics, Mirror of Beryl (Wisdom Publications, 2010)

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