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Re-visiting ‘Galen in Tibet’1

Published online by Cambridge University Press:  20 August 2012

Ronit Yoeli-Tlalim
Ronit Yoeli-Tlalim*
Affiliation:
History Department, Goldsmiths, University of London, New Cross, London SE14 6NW, UK
*
*Email address for correspondence: [email protected]
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Abstract

This paper readdresses the assertion found in much secondary literature that Greek medicine was adopted in Tibet in the seventh and eighth centuries. I discuss some of the traces of Galenic medical knowledge in early Tibetan medicine, and raise the question of why Tibetan medical histories who mention Galen give Galenic medicine a much more significant place than is evidenced in the Tibetan medical literature itself. I discuss some historiographical considerations and argue that the centrality given to Galenic medicine is more indicative of the period in which these sources are written than of the period which they presumably describe.

Keywords

Tibetan MedicineGalenSilk RoadDunhuangTurfanEastern Church
Type
Articles
Information
Medical History , Volume 56 , Issue 3 , July 2012 , pp. 355 - 365
Copyright
© The Author 2012 Published by Cambridge University Press

In his 1979 paper titled ‘The Introduction of Greek Medicine into Tibet in the Seventh and Eighth Centuries’, Christopher Beckwith brought to the attention of scholars the mention of ‘Galenos’ in Tibetan medical histories.Footnote 2 In this article, which has been widely cited in secondary literature,Footnote 3 Beckwith discussed four Tibetan medical histories dealing with the origins of medical knowledge in Tibet. In one of these accounts, the earliest of the four, dating to the sixteenth century, the following account is found:

As for the beginning of the appearance of medicine in Tibet, to begin with there were just some bits of knowledge about nutrition. Later the Chinese consort, brought the [text] called The Great Medical Treatise [Sman dpyad chen mo], which was translated by the monks (ho shang) Mahadeva and Dharmakosa. Then, three doctors were invited, from India – Bharadvāja, from China – Hen-weng-hang-de and from Khrom of Stag-gzigs, Galenos. They translated much from their individual schools. Jointly they compiled the seven-volume text called the Weapon of the Fearless [Mi ’jigs pa’i mtshon cha].Footnote 4

The author of the text, Pawo Tsuglag (Dpa’ bo gtsug lag, 1504–1566), also adds that it was Galenos who ‘stayed [in Tibet] as royal physician’.Footnote 5 Galenos’ stay is a point which is further emphasised by the seventeenth-century author Sangye Gyatso (Sangs rgyas rgya mtsho), who adds the following details:

The king gave gifts to the Indian and the Chinese physicians, and they departed for their own countries. Galenos remained as the royal physician. He stayed mainly in Lhasa and is known for his numerous compositions and commentaries. It is said that, having taken a wife, he had three sons....Footnote 6

The three later Tibetan sources quoted by Beckwith – dating to the seventeenth to nineteenth centuries – locate the visit of these three medical authorities more specifically at the time of the Tibetan King Songtsen Gampo [Srong btsan sgam po] of the seventh century – whose reign marks the beginning of recorded history in Tibet. They thus present us with a history of Tibetan medicine, which was formulated in its initial stages as a synthesis of Greek, Chinese and Indian medical systems.Footnote 7

These sources raise a host of fascinating questions. Although Beckwith discussed a number of them, many important questions remained open. Following up on Beckwith’s groundbreaking work, I was interested, to begin with, in the general contextualisation of these cultural connections.

Traces of Galenic Medicine in Early Tibetan Medicine

My initial question was: could Greco-Arab medicine have arrived in Tibet during the time of the Tibetan empire (seventh to ninth centuries)?

The ‘Islam and Tibet’ projectFootnote 8 provided the necessary context for understanding some important aspects of this cultural background and gave an affirmative answer to this question.Footnote 9 Yes, there is sufficient evidence of cultural connections between Tibet and the Islamic world from the eighth century onwards to suggest that such transfer of knowledge could have occurred.

The question which then followed was: can we find any traces of Galenic medical knowledge in early Tibetan medicine? The answer to this question was affirmative too. Particularly in the area of urine analysis, I found remarkable similarities between an early Tibetan medical text and Ibn Sı¯na’s Canon of Medicine [Qānūn fı¯ al-ṭibb]. In a study dealing with musk, a Tibetan substance well known in Arabic literature from the eighth century, both for perfumery and as a medical substance, we also found many similarities in prescriptions.Footnote 10

Given that my findings concerning urine analysis have not been readily available beyond Tibetological circles, I will briefly summarise them here.Footnote 11 I focused on the urine analysis section as it is discussed in the Medical Method of the Lunar King [Sman dpyad zla ba’i rgyal po, also known as Somarāja], one of the earliest extant Tibetan medical texts, dating to somewhere between the eighth and the twelfth centuries.Footnote 12 Tibetan medical historians have argued at length on the question of whether the text originated from India or from China. When analysing this text, however, one can see some features that are found neither in Indian nor in Chinese medical systems. One such distinct feature is the inclusion of urine analysis as a general diagnostic tool. Having studied a number of urine analysis texts, I found the urine analysis section in the Medical Method of the Lunar King remarkably similar both in content and in structure to the urine analysis section in Ibn Sı¯na’s Canon of Medicine. I have also found a number of loan-words from Arabic and Persian in the Medical Method of the Lunar King, and have reached the conclusion that these two texts share some common tradition.Footnote 13 The main problem with the Medical Method of the Lunar King as a source of information on the formative stages of Tibetan medicine, however, is that the text as we have it today has undergone a process of editing, the extent and dating of which is undeterminable.

Evidence from the Tibetan Medical Manuscripts of Dunhuang

Another group of sources, which could help us to tackle the question of the foreign influence during the formative stages of Tibetan medicine, is the set of the Tibetan medical manuscripts from Dunhuang. These manuscripts were discovered at the beginning of the twentieth century in the walled-up ‘cave library’ in Dunhuang, present-day Gansu Province in western China. Dunhuang was formerly an important town on the Silk Roads, at the centre of a hub of international trade routes of the ancient world. The ‘cave library’, which contained tens of thousands of manuscripts, was sealed in the early eleventh century for reasons which are still being debated by scholars.Footnote 14 The manuscripts have been dispersed among libraries in Paris, London, St Petersburg, Tokyo, Beijing and elsewhere.Footnote 15 Although Chinese is the most important language of the Dunhuang collection, there are also many documents in Tibetan, Sogdian, Khotanese, Sanskrit and Uighur.Footnote 16 The Dunhuang manuscripts are of enormous significance for Buddhist, Central Asian and Chinese history. Their significance for the history of medicine and history of science has only recently begun to be explored.Footnote 17 Being in manuscript form, they have the benefit of not having been edited, thus allowing a glimpse into the formative stage of Tibetan medicine, the period to which our Tibetan medical histories refer.

There are only a few Tibetan medical manuscripts in the collection: three manuscripts (PT 127, PT 1058, PT 1044) deal with moxibustion, one on materia medica (IOL Tib J 756) and two general ones (IOL Tib J 1246 and PT 1057).Footnote 18 We have relatively little to go by, but there is still sufficient material to make a number of important points.Footnote 19 There are many similarities – though also some differences – to Chinese moxibustion texts as found in Dunhuang.

We can find references to Indian influence. The colophon of PT 1044 points, for example, towards India as a source for medical knowledge, saying: ‘This type of method comes from the land of the king of India.’Footnote 20

Several connections with the west can also be detected: PT 127, for example, includes three references to locations to the west of Tibet: Persia (ta zig), Turkic (dru gu) lands and Zhang Zhung, referring probably in the Dunhuang context to a kingdom situated to the northwest or north of Tibet. The reference to Persia appears as a source of paper, saying: ‘If there is bleeding from the nose, use paper from Persia.’Footnote 21 The mention of the Turkic lands refers to bloodletting, saying: ‘[T]he Turkic (dru gu) method [using] iron for cautery and bloodletting (? sur phug)Footnote 22 is also suitable.’Footnote 23

We also find some foreign names of materia medica deriving probably from Persian or Arabic, such as a mention of theriac (Tib.: dar ya kan)Footnote 24 and mentions of camphor. The different forms of the word for camphor – Tib.: ga phor, ka phor and ga phur – mark it as a loan-word, and these spellings link it with the Persian or Arabic form of the word. It is also the case with the spelling of another materia medica Tibetan loan-word in the Dunhuang mss.: kur-kum, referring to saffron.Footnote 25

Another interesting point – which requires further research – is the notion of phlegm, bad kan in Tibetan. A notion which is fundamental to Tibetan medicine, that of the three nyes pa, usually translated as the ‘three humours’, of wind, bile and phlegm, does not appear as such in the Tibetan manuscripts from Dunhuang.Footnote 26 What we do find in the moxibustion manuals are many references to wind (rlung) as the main cause of illness. Bile and phlegm – each mentioned only once – also appear as a source of illness.Footnote 27 The form of the Tibetan word for phlegm – peken (bad kan, or as in the Dunhuang ms: bas kan) – is interesting as it seems to be derived from Persian or Arabic.Footnote 28 The loan-word for phlegm, then, might be a further trace of knowledge transfer from the west.

Looking in post-Dunhuang sources – both before the standardisation of Tibetan medicine as it is formulated in the Four Tantras [Rgyud bzi],Footnote 29 in texts such as the above-mentioned Medical Method of the Lunar King [Sman dpyad zla ba’i rgyal po] and the Biji Book [Bi ji pu ti kha ser], as well as in the Four Tantras themselves, one finds a significant Indian basis, various important Chinese inputs – and some Galenic input. The greater part of the physiological, pathological and pharmaceutical principles are derived from Indic medical notions. The Chinese input includes pulse diagnosis, moxibustion, many of the ideas linking micro- and macro-cosmos, the concepts of the five vital organs and the six hollow organs. The Galenic input includes diagnosis through urine.

All of this, however, does not quite add up to a ‘meta-narrative’ in which Galen settles in Lhasa and establishes a lineage and family, but rather brings us to the conclusion that both in the formative and the mature/classical periods of Tibetan medicine, the Galenic influence is clearly secondary to that deriving from India and China. How then should we understand the primary position given to Galenos in our Tibetan medical histories?

One important text for further examining this question is one of the earliest extant Tibetan-language medical histories, by Che rje zhang ston zhig po, dated to the early thirteenth century. It was not available to Beckwith at the time of his study in the 1970s. This text, recently studied by Dan Martin, sets medical knowledge within what it terms as ‘The Seven Schools’ [lugs bdun], referring to both divine and human realms.Footnote 30 Within the human realm, the list refers to medical systems from: India, Kashmir, Urgyan (in present-day Pakistan), Nepal [bal po], Arabo-Persia [stag gzig], Dol po, Uighur [hor], Tangut/ Xixia [me nyag]; Khotanese [li]; Byzantine [phrom]; Chinese and Tibetan.Footnote 31 Although the text discusses specific names – Tsan pa shi la ha and Urbaya – as doctors who originated from somewhere in the Arabo-Persian–Byzantine world – there is no mention of Galenos. Also – significantly – no preference is given to one system over another.Footnote 32

Perhaps then, the appearance of Galenos in Tibetan historical narratives of the sixteenth century and the prominence which is given to him at that time reflects the period of these texts’ composition more than the period which the texts presumably describe?

The knowledge of Galen at this point in Tibet could have come via numerous routes. Galen, or rather Galenic medicine, was by this time established, or at least well known, in most cultures surrounding Tibet, for example among the Mughals of India, the Jews and Muslims of Central Asia, as well as western missionaries and Christians of the Eastern Church (‘Nestorians’) in China and Central Asia. I will briefly raise here some points relevant to the Christians of the Eastern Church and to Mughal India.

The Eastern Church in Central and East Asia

We have evidence of the presence of members of the Church of the East,Footnote 33 in Central and East Asia from at least the eighth century.Footnote 34 Following the persecution of the Christians of the Church of the East in Persia, many of them fled to Central Asia. We know, for example, that Kashgar and Samarkand were important centres of the Church of the East from the eighth to the tenth centuries.Footnote 35 Indeed, in the Turfan expeditions carried out by Grünwedel and von le Coq in the early twentieth century, many Christian texts in Syriac and in Sogdian were found.

Recent studies have provided extensive detail on Eastern Christianity in Tang China, in Dunhuang and in Turfan.Footnote 36 According to Chinese, Arabic, Syriac and Latin sources, members of the Church of the East were active in China predominantly in two waves: the first was during the Tang Dynasty. A strong re-emergence came in the thirteenth century during the Mongol period, to which we shall return below.

In Dunhuang, the extensive evidence for Christian presence comes from Tang dynasty Chinese sources.Footnote 37 Li Tang has recently enhanced our knowledge of Christian presence and influence in Central Asia through her examination of Chinese Christian documents from Dunhuang.

Other evidence linking the Church of the East with Tibet includes Syriac letters from the Patriarch Timothy I referring to TibetFootnote 38 and Eastern Church monuments from peripheral Tibet.Footnote 39 There are also two Nestorian references in the Tibetan manuscripts from Dunhunag, including a mention of ‘Jesus, the messiah’ and a drawing which appears to be a Nestorian cross,Footnote 40 although we probably need to be cautious not to read too much into this cross.

Did these Eastern Christians bring any medical knowledge with them to central Asia? While the importance of the role of the Nestorians in the transmission of medical knowledge in western Asia is well known,Footnote 41 their role in the transmission of medical knowledge into central and eastern Asia has received hardly any attention to date. Medical texts in Syriac from the ninth to tenth centuries have been found at Turfan, another Silk Road site.Footnote 42 In Bulayiq in the oasis of Turfan, an east Syrian monastery has been found. To date, only a small sample of the monastery’s four hundred to five hundred Syriac texts have been published.Footnote 43 One important advance, however, has recently been made by Professor Sims-Williams, who, in a paper presented in the Turfan Forum on Old Languages of the Silk Road in Turfan in October 2010 and in a paper which was published in the Bulletin of the School of Oriental and African Studies, has been able to demonstrate that the medical fragments from Turfan, which he has translated, reflect medical knowledge which is also attested to in the so-called Syriac Book of Medicines.Footnote 44 As has been pointed out by Pormann and Savage-Smith, although the date of the final compilation of the Syriac Book of Medicines is still unclear, the text contains much material dating to the sixth and seventh centuries.Footnote 45

Christians and Medical Knowledge During the Mongol Empire

The prominence of Eastern Christians and of their medical knowledge in central Asia became particularly significant at the time of the Mongol Empire. Khubilai Khan, himself a son of a Christian mother (Sorkaktani), employed a Christian physician as his personal doctor. Rashı¯d al-Dı¯n, the court-physician turned minister of the Mongol Ilkhanid court, tells us that this Nestorian physician was known as Īsā the Translator.Footnote 46 Īsā’s Chinese biography indicates that he was born in Fu-lin, the Chinese transcription of Rum, the equivalent of what the Tibetan sources referred to above call Khrom, ie. Byzantium. After a particularly successful career as the Khan’s personal physician, he later became a central figure in the medical establishment of the Mongol Empire. He set up the Islamic Medical Bureau (Guanghui) in the main Mongol capital (in what later became Beijing) and later became head of this bureau. He also went as medical envoy to Ilkhanid Iran in the mid-1280s and was back in China by 1287. It appears that while in Iran he met his local colleague, Rashı¯d al-Dı¯n.Footnote 47

Meanwhile, in Mughal India

Islamic medicine came to India with the Moslem conquerors and migrations in the twelfth century and was later established at the Mughal courts in the sixteenth century. In his autobiography, the Fifth Dalai Lama (1617/82) tells us how in 1675 he brought to his court a physician from India known for his expertise in cataract surgery.

This physician, Manaho, is accredited with a work on ophthalmology preserved in the Tibetan Tanjur [bstan ’gyur], the part of the Tibetan Buddhist canon composed primarily of various commentarial works.Footnote 48 The Tibetan title of this short work on the treatment of eye diseases, translated in the Potala by Lhun grub, is Opening the Eyes to See [Mig ’byed mthong ba]. The preface to the text says that the author was a physician of the Indian Shah Jahan and that he came from the country of Paripura. This location is yet to be identified, but according to Dan Martin, Paripura may indicate a link with Persia.Footnote 49 The Fifth Dalai Lama tells us that Manaho taught the art of cataract surgery to a local Tibetan physician, who later performed a successful operation on the Fifth Dalai Lama himself.Footnote 50 An analysis of this interesting text, and a comparison with Islamic ophthalmology of the time, should yield interesting data with which we could further our understanding of the transmission of ophthalmological knowledge in this period.

As discussed by Janet Gyatso, this episode is part of the Fifth Dalai Lama’s active efforts to seek out medical experts from abroad, not only for his own well-being but also with a view of broadening Tibetan medicine’s repertoire of diagnostic, therapeutic, surgical and pharmacological tools.

The person who most likely oversaw the invitation of this foreign physician, along with other physicians from neighbouring countries, was the Fifth Dalai Lama’s regent, Sangye Gyatso. His crucial role in systematising Tibetan medicine needs to be seen in conjunction with his composition of his seminal seventeenth century text on the history of Tibetan medicine. It is in his text on the history of Tibetan medicine that the story on Galenos staying in Lhasa elaborated above is found.

Making Sense of Sixteenth-Century Tibetan Medical Histories

With all this in mind, we can now return to the narrative on Galenos with which we began. This text on how medicine began in Tibet appears in Pawo Tsuglag’s [Dpa’ bo gtsug lag] sixteenth-century history, the Scholar’s Delight [Mkhas pa’i dga’ ston]. This enormous work – the 1986 Chinese printed edition of it includes over 1500 pages – shows a remarkable acquaintance with neighbouring peoples and cultures. The genre of the work is that of ‘religious history’ [chos ’byung]. Like numerous similar works of this genre, the focus of this work is the history of Buddhism in India and Tibet. Pawo Tsuglag contextualises this history within a general description of the world and his detailed accounts on India and Tibet are followed by accounts on the history of Khotan, ancient China, recent China, the Tanguts, and Mongolia. Indeed, this work is considered to be one of the most well-informed Tibetan sources on the Mongol period. The last part is a kind of ‘History of Science’ text, dealing with the five classical fields of Buddhist knowledge – medicine being one of them – and the way they spread. It is in this section that the narrative, quoted above, appears.

In another section of this work, within his discussion of the influence of Tibetan lamas in the Mongol court, we are supplied with an indication that Pawo Tsuglag was aware of the Nestorian presence in the Mongol court. The Tibetan word he uses, a loan-word, is er ka un. This word seems to be derived from the Greek word arkōn [$\acute {\ensuremath{\alpha} } \rho \kappa \acute {o} \nu $], meaning ‘the ruling one’ or ‘an abbot’. According to Paul Buell, who commented on this word in 1968, this form of the word came to the Tibetan via Sogdian and Middle Mongolian.Footnote 51 In Mongolian the word for Christian is erke’ün. Although Paul Pelliot did not support the Greek source of the word, he pointed out that in Persian it is transcribed as ärkäwün .Footnote 52 The apparent path of this word – from Greek – possibly via Syriac – to Sogdian (possibly via Middle Persian) – to Mongolian – and Tibetan – gives us an indication of a possible way this word could have taken its path in relation to medical knowledge.

Galenos’ Colleagues

Returning to the quotes with which we began, we ought to also have a closer look at the two other physicians who allegedly came to Lhasa with Galenos. The accounts mention a Chinese physician and an Indian one. Who are these two colleagues of Galenos?

Beckwith identified the Chinese one as the Yellow Emperor, and the Indian one as Bharadhvāja. The Yellow Emperor is known in the Chinese tradition as the origin of medical knowledge. Bharadhvāja is described in the opening chapter of the Carakasamhitā as the member of the assembly of sages who approaches Indra requesting his help in removing illnesses which had befallen humankind. Bharadhvāja’s request is granted by Indra, who transmits medical knowledge to him. Bharadhvāja then disseminates this knowledge to other sages. Bharadhvāja is also mentioned in other Indian medical treatises, as well as in the Vedic literature, the epics and the Purānas.Footnote 53 Both the Chinese and the Indian physicians are mythical figures. The point that Galen is sharing his knowledge-transmission role with two mythical figures is worth pondering on. How should we interpret the historical role of ‘Galen’ in this context?

This sort of juxtaposition is nothing new to the genre of the religious history [chos ’byung] to which Pawo Tsuglag’s narrative belongs. When dealing with Tibetan historiography,Footnote 54 western scholars have noted it to be essentially of ‘hagiographical and mythical’ form,Footnote 55 containing – what some scholars have termed – ‘a lack of distinction between reality and fiction’ at least in the way we assume them to be defined in western-based scholarship.Footnote 56 A clear-cut distinction between, so-called, ‘historical truth’ and ‘fiction’ may prove to be not only impossible to delineate, but also unfruitful for understanding the Tibetan sources. One common ‘methodology’ for treating such accounts has been to strip what is presented as historical account from what is judged to be, in western eyes, implausible events. The late Michael Aris has pointed out that what in western eyes are termed ‘mythical’ events constitute a fundamental part of Tibetan life.Footnote 57 Geshe Samdhong Rinpoche, one of Tibet’s most learned lamas, and formerly the Prime Minister of the Tibetan Government in Exile, writes in his foreword to another chos ’byung text, Tāranātha’s History of Buddhism in India (1608):

When I walk on snow-laden paths of hills my each footprint appears clear, deep and distinct through which I can trace my path back without effort. But after a while due to wind and fresh snowfall all traces of my footsteps are wiped out in the snow. The residue is what sticks to my imagination. It is the same with the study of history ….

…[T]he logic of today recalling the events of past times with indecisive evidences must surely be inaccurate in many different ways.

The line of demarcation between history and legend is too thin to observe while writing: the two overlap each other unconsciously and unknowingly.’Footnote 58

Samdhong Rinpoche is directing us towards a more careful reading of our sources. The task in front of us is a difficult one, particularly since we stand, as Matthew Kapstein beautifully described it, in front of a hall of mirrors:

[T]he study of early medieval Tibet may be compared without much exaggeration to the view from one end of a great hall of mirrors: there is little basis initially for determining which of the many reflections one perceives actually originate from the opposite end of the hall, which only reveal persons and objects situated in the intervening corridor, which are just optical illusions, and, finally, which are in fact the observer’s own reflection coming back upon himself.Footnote 59

Such a state of affairs, as Kapstein notes, is not unique to the study of Tibet, but other difficulties are unique to Tibet:

The far end appears to be closed off by a curtain, which, so far as we can tell from our vantage point, is translucent and at the same time reflective, with several small gaps through which some parts of the enclosed hallway may be seen. Among other things, we can discern that, in the area immediately behind the curtain, all the mirrors are shattered. The curtain, perhaps, was set in place by an architectural restoration firm that was never able to complete its work….

[T]he far end of the corridor is the history of the early medieval Tibetan empire; the rubble partially visible behind the curtain is the original documentation that survives – above all, the Dunhuang Tibetan manuscripts and the Central Tibetan Pillar inscriptions; the curtain is woven of the great historical myths of the early empire that were elaborated in the centuries following its collapse, and that established the patterns that would dominate all later Tibetan historiography; its translucency represents the incorporation within these myths of authentically ancient traditions; while its reflectivity represents the distinctive perspective of the postimperial period during which they were redacted.Footnote 60

Conclusion

Kapstein’s allegory of the hall of mirrors provides us with a framework with which we can interpret the sources and data I presented above. While there is good reason to believe that trickles of western medicine came into Tibet from its formative stages around the eighth century, based on the ‘bits of rubble’ which we have from this period, ie. the few original sources, we really cannot speak of a ‘Tibetan adoption of Greek medicine’ in the seventh and eighth centuries, as many authors have referred to it. It seems rather that the key role given to Galenic medicine was transposed during the sixteenth and seventeenth centuries back into the days of the Tibetan Empire, for reasons which are probably more reflective of the period of the composition of these histories than of their object of reflection.

References

1. Initial work for this paper was conducted during my Wellcome Trust fellowship ‘Himalayan Melange’ based at the Wellcome Trust Centre for the History of Medicine at UCL. Additional research was conducted during my Wellcome Trust funded project, ‘Re-Orienting Ancient Medicine’, based at Goldsmiths. I delivered a version of this paper at the workshop Medicine and Classicism in Comparative Perspective, organised by David Arnold and Peter Pormann and hosted by the Warburg Institute, in November 2009. I would like to thank Dan Martin and the two anonymous readers of this article for their very valuable comments on a previous version of this paper, and for Chris Beckwith for his inspirational work.Google Scholar

2. Beckwith, Christopher I. , ‘The Introduction of Greek Medicine into Tibet in the Seventh and Eighth Centuries’, Journal of the American Oriental Society, 99 (1979), 297–313.CrossRefGoogle ScholarPubMed

3. See for example, George M. Foster, Hippocrates’ Latin American Legacy: Humoral Medicine in the New World (Langhorne, PA: Gordon and Breach, 1994), 11; Roberta Bivis, ‘Histories of heterodoxy’, in Mark Jackson (ed.), The Oxford Handbook of the History of Medicine (Oxford: Oxford University Press, 2011), 578–597: 594 (note 10); Richard Bulliet et al., The Earth and Its Peoples: A Global History, Brief Edition, 5th edn (Boston, MA: Wadsworth, 2010), 268.Google Scholar

4. Dpa’ bo gtsug lag, Mkhas pa dga’ ston, Delhi edition vol. tsa, fol. 46r. Quoted and translated in Beckwith, op. cit. (note 2), 298–9.Google Scholar

5. Beckwith, op. cit. (note 2), 301.Google Scholar

6. Sangs rgyas rgya mtsho, Dpal ldan gso ba rig pa’i khog ’bugs legs bshad baiḍūryai me long drang srong dgyes pa’i dga ’ ston [Mirror of Beryl: A Well-Explained History of the Glorious Science of Medicine, A Feast to Delight the Rishis] (Lanzhou: Kan su’u mi rigs dpe skrun khang, 1982), 151; Beckwith, op. cit. (note 2), 301; see also the new translation by Gavin Kilty, Desi Sangyé Gyatso, Mirror of Beryl: A Historical Introduction to Tibetan Medicine (Boston: Wisdom, 2010), 148–9.Google Scholar

7. For an illuminating analysis of these accounts and a number of additional variations, see Frances Garrett, ‘Critical Methods in Tibetan Medical Histories’, The Journal of Asian Studies, 66, 2 (May 2007), 363–87.Google Scholar

8. I collaborated on this AHRC funded project with Charles Burnett, Anna Akasoy and Georgios Halkias. The project was hosted at the Warburg Institute, University of London. For more details on the project see the website of the project: http://warburg.sas.ac.uk/index.php?id=160.Google Scholar

9. I have provided an overview of these cultural interactions in ‘Islam and Tibet: cultural interactions – an introduction’, in Anna Akasoy, Charles Burnett and Ronit Yoeli-Tlalim (eds), Islam and Tibet: Interactions Along the Musk Routes (Farnham: Ashgate, 2011), 1–16.Google Scholar

10. On musk and its medicinal uses see Anna Akasoy and Ronit Yoeli-Tlalim, ‘Along the Musk Routes: Exchanges between Tibet and the Islamic World’, Asian Medicine: Tradition and Modernity, 3, 2 (2007), 217–40. For musk in perfumery contexts see, Anya King ‘Tibetan musk and Medieval Arab perfumery’, in Akasoy, Burnett and Yoeli-Tlalim (eds), op. cit. (note 9), 145–61.Google Scholar

11. I presented my findings in the Eleventh Seminar of the International Association of Tibetan Studies in Königswinter in 2006. The published version ‘On urine analysis and Tibetan medicine’s connections with the west’ is part of the collection, Sienna Craig, Mingi Cuomu, Frances Garrett and Mona Schrempf (eds), Studies of Medical Pluralism in Tibetan History and Society (Andiast: International Institute for Tibetan and Buddhist Studies, 2010), 195–211.Google Scholar

12. This text was studied by Fernand Meyer in his unpublished paper ‘Syncrétisme médical en Haute-Asie d’après un texte Tibetain censé avoir été introduit de Chine au VIIIème siècle’. I would like to thank Fernand Meyer for sharing this article with me.Google Scholar

13. These are all discussed in my abovementioned ‘On urine analysis and Tibetan medicine’s connections with the west’, op. cit. (note 11).Google Scholar

14. For an overview on these views see the posts on ‘Secrets of the Cave’ on Sam van Schaik’s earlyTibet blog: www.earlytibet.com.Google Scholar

15. For more details and digital images of some of the manuscripts see the website of the International Dunhuang Project, based at the British Library: idp.bl.uk.Google Scholar

16. See Takata Tokio, ‘Multilingualism in Tun-huang’, Acta Asiatica: Bulletin of the Institute of Eastern Culture, 78 (2000): Tun-huang and Turfan Studies, 49–70.Google Scholar

17. For studies on the Chinese medical manuscripts from Dunhuang see Vivienne Lo and Christopher Cullen (eds), Medieval Chinese Medicine: The Dunhuang Medical Manuscripts (London and New York: RoutledgeCurzon, 2005); Catherine Despeux (ed.), Médecine, Religion et Société dans la Chine Médiévale: Étude de Manuscrits Chinois de Dunhuang et de Turfan, 3 vols (Paris: Collège de France, 2010). The only Tibetan medical texts from Dunhuang which have been studied until now in any western language are those dealing with equine veterinary medicine, see Anne-Marie Blondeau, Matériaux pour l’Étude de l’Hippologie et de l’Hippiatrie Tibétaines: à partir des manuscripts de Touen-houang (Genève: Librairie Droz, 1972).Google Scholar

18. The manuscripts with an IOL Tib J signature are kept at the British Library. Those with a PT (Pelliot Tibétain) signature are kept at the Bibliothèque Nationale, Paris.Google Scholar

19. I discuss the foreign aspects of the Tibetan medical manuscripts from Dunhuang in ‘Central Asian Melange: early Tibetan medicine from Dunhunag,’ in Brandon Dotson, Kazushi Iwao and Tsuguhito Takeuchi (eds), Scribes, Texts, and Rituals in Early Tibet and Dunhuang (Wiesbaden: Reichert Verlag, 2012, in press).Google Scholar

20. PT 1044, line 52.Google Scholar

21. PT 127, line 174.Google Scholar

22. The expression here is not clear. This suggested translation is based on the interpretation of the editors of this text, Byams pa phrin las and Luo Bingfeng. Luo Bingfeng, Tun hong nas thon pa’i bod kyi gso rig yig cha gces bsdus (Pe cin: Mi rigs dpe skrun khang, 2002), 233 (note 158).Google Scholar

23. PT 127, line 182. For previous mentions of this phrase see: Géza Uray, ‘The old Tibetan sources of the history of Central Asia up to 751 AD: a survey’, in János Harmatta (ed.), Prolegomena to the Sources on the History of Pre-Islamic Central Asia (Budapest: Akadémiai Kiadó, 1979), 275–304: 304; Blondeau, Matériaux pour l’Étude de l’Hippologie et de l’Hippiatrie Tibétaines, op. cit. (note 17), 7.Google Scholar

24. On Tibetan theriac see Christopher Beckwith, ‘Tibetan Treacle: A Note on Theriac in Tibet’, Tibet Society Bulletin (Bloomington, Ind.), 15 (June 1980), 49–51; Akasoy and Yoeli-Tlalim, op. cit. (note 10).Google Scholar

25. See Berthold Laufer, ‘Loan-Words in Tibetan’, T’oung Pao, 17 (1916), 404–552.Google Scholar

26. Nyes pa literally means ‘fault’ or ‘trouble’. These correspond to the Indian concept of the three doṣa, as they are termed in Sanskrit. On the problematic translation of nyes pa as ‘humours’, see Yonten Gyatso, ‘Nyes pa: A Brief Review of its English Translation’, The Tibet Journal, 30 and 31 (4 and 1) (2006), 109–18.Google Scholar

27. For bile (mkhris pa) see PT 127, line 169; for phlegm (in the Dunhuang occurrence: bas kan, in later sources: bad kan) see PT 127, line 132.Google Scholar

28. The western origin of this word has been pointed out by Marianne Winder, ‘Tibetan Medicine Compared with Ancient and Mediaeval Western Medicine’, Bulletin of Tibetology, 17, 1 (1981), 5–22.Google Scholar

29. The origin and dating of this work has been a subject of heated debate for centuries. For an overview of these positions, see Samten Karmay, ‘The four Tibetan medical treatises and their critics’, in Samten Karmay (ed.), The Arrow and the Spindle: Studies in History, Myths, Rituals and Beliefs in Tibet (Kathmandu: Mandala Book Point, 1997), 228–37. Most scholars now agree that the Four Tantras dates to the 12th century. On this view see Frances Garrett, ‘Buddhism and the Historicising of Medicine in Thirteenth-Century Tibet’, Asian Medicine: Tradition and Modernity, 2, 2 (2007), 204–24; Leonard van der Kuijp, ‘Za Hor and its Contribution to Tibetan Medicine, Part One: Some Names, Places and Texts’, Journal of Tibetology, (2010), 21–50.Google Scholar

30. For a study of this work see Dan Martin, ‘An early Tibetan history of Indian medicine’, in Mona Schrempf (ed.), Soundings in Tibetan Medicine (Leiden: Brill, 2007), 307–25.Google Scholar

31. For a detailed analysis of the two western components of this and similar lists, ie. stag gzig and phrom, see Dan Martin, ‘Greek and Islamic medicines’ historical contact with Tibet: a reassessment in view of recently available but relatively early sources on Tibetan medical eclecticism’, in Akasoy, Burnett and Yoeli-Tlalim (eds), op. cit. (note 9), 117–43.Google Scholar

32. There are, to be sure, more medical histories that do not mention Galenos, which I am not discussing here. For a discussion of these sources, see Garrett, op. cit. (note 7).Google Scholar

33. On why the term ‘Nestorian’ in this context should be replaced by either ‘Church of the East’ or ‘Church of Persia’, see Peter L. Hofrichter, ‘Preface’, in Roman Malek (ed.), Jingjiao: The Church of the East in China and Central Asia (Sankt Augustin: Monumenta Serica, 2006), 11–14.Google Scholar

34. According to Baum and Winkler, Merv (present day Uzbekistan) may have been Christianised as early as 360. Wilhelm Baum and Dietmar W. Winkler, The Church of the East: A Concise History (London and New York: RoutledgeCurzon, 2003), 46.Google Scholar

35. Hans-Joachim Klimkeit, Die Begegnung von Christentum, Gnosis und Buddhismus an der Seidenstrasse (Düsseldorf: Westdeutscher Verlag, 1986), 11–12; see also B.E. Colless, ‘The Nestorian Province of Samarqand’, Abr- Nahrain, 24 (1986), 51–7.Google Scholar

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37. For an overview and translation of the Chinese Nestorian documents from Dunhuang, see Li Tang, op. cit. (note 36), 103–204.Google Scholar

38. See the various relevant chapters in Jean Dauvillier, Histoire et institutions des Eglises orientales au Moyen Age (London: Variorum Reprints, 1983).Google Scholar

39. Colless has mentioned a rock at Drangtse in Ladakh which has three Nestorian (‘Maltese’) crosses engraved on it, together with inscriptions in Sogdian, Tibetan and other languages. B.E. Colless, ‘The Nestorian Province of Samarqand’, Abr-Nahrain, 24 (1986), 51–7: 52; Hans-Joachim Klimkeit, ‘Das Kreuzessymbol in der zentralasiatischen Religionsbegegnung’, Zeitschrift für Religions und Geistesgeschichte, 31 (1979), 99–115: 103–4. For a photo of the Drangtse rock, see Gerd Gropp, Archäologische Funde aus Khotan, Chinesisch-Ostturkestan (Bremen: Verlag Friedrich Röver, 1974), 367.Google Scholar

40. For more details, see Géza Uray, ‘Tibet’s connections with Nestorianism and Manicheism in the 8th–10th centuries’, in E. Steinkellner and H. Tauscher (eds), Contributions on Tibetan Language, History and Culture: Proceedings of the Csoma de Körös Symposium held at Velm-Vienna, Austria, 13–19 September 1981, Vol. 1 (Wien: Arbeitskreis für Tibetische und Buddhistische Studien Universtität Wien, 1983), 399–429; see also the various relevant chapters in Dauvillier, op. cit. (note 38).Google Scholar

41. See primarily the studies by Raymond Le Coz, Les Médecins Nestoriens au Moyen Âge: Les Maîtres des Arabes (Paris: L’Harmattan, 2004) and Les Chrétiens dans la Médicine Arabe (Paris: L’Harmattan, 2006).Google Scholar

42. Miklós Maróth, ‘Ein Fragment eines syrischen pharmazeutischen Rezeptbuches aus Turfan’, Altorientalische Forschungen, 11 (1984), 115–25. The fragment discussed by Maróth is a Syriac prescription from the 9th to 10th centuries, dealing with hair loss; see also Peter Zieme, ‘Notes on Uighur Medicine, Especially on the Uighur Siddhasāra Tradition’, Asian Medicine: Tradition and Modernity, 3, 2 (2007), 308–22.Google Scholar

43. See Baum and Winkler, op. cit. (note 34), 74.Google Scholar

44. Nicholas Sims-Williams, ‘Medical Texts from Turfan in Syriac and New Persian’ (unpublished paper) and Nicholas Sims-Williams ‘Early New Persian in Syriac Script: Two Texts from Turfan’, Bulletin of the School of Oriental and African Studies, 74, 3 (October 2011), 353–74. I would like to thank Professor Sims-Williams for sharing these papers with me. See also Nicholas Sims-Williams, ‘Sogdian and Turkish Christians in the Turfan and Tun-huang manuscripts’, in Alfredo Cadonna (ed.), Turfan and Tun-huang: The Texts (Florence: Leo S. Olschki Editore, 1992), 51 and 54.Google Scholar

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49. Dan Martin, Tibskrit, entry on: Manaho, available on-line (several URLs).Google Scholar

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52. See Paul Pelliot, Notes on Marco Polo: Ouvrage Posthume, Vol. I (Paris: Imprimerie Nationale, 1959), 49.Google Scholar

53. For an overview of these, see Gerrit J. Meulenbeld, A History of Indian Medical Literature, Vol. IA (Groningen: Egbert Forsten, 1999–2002), 152–4; Vol. IIA, 158–60, 764, 781.Google Scholar

54. In Tibetan there is no one word that correlates to the term ‘history’. We should therefore bear in mind that from the outset, trying to analyse ‘Tibetan histories’ is problematic. In Tibetan literature the following genres have been collectively termed as ‘history’: chos ’byung – origin of religion, religious history; rgyal rabs – stories/histories of kings; ldan rabs – stories/histories of monasteries; lo rgyus – tiding of years, records of years. On the different historical genres in Tibetan literature, see Leonard van der Kuijp, ‘Tibetan historiography’, in José I. Cabezón and Roger Jackson (eds), Tibetan Literature: Studies in Genre (New York: Snow Lion, 1996), 39–56.Google Scholar

55. Tucci, Giuseppe , Tibetan Painted Scrolls, 2 vols, Vol. I (Rome: La Libreria Dello Stato, 1949), 142.Google Scholar

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58. Samdhong Rinpoche, p. xi, Foreword to Tāranātha’s History of Buddhism in India, Debiprasad Chattopadhyaya (ed.) (Delhi: Motilal Banarsidass, [1970] 1997).Google Scholar

59. Kapstein, Matthew , The Tibetan Assimilation of Buddhism: Conversion, Contestation, and Memory (Oxford: Oxford University Press, 2000), 24.Google Scholar

60. Ibid.Google Scholar