Amchi Namgyal Phunrab

An Introduction to “Sorig”

Transcript of the lecture presented at

Karma Chang Chub Chö Phel Ling in Heidelberg on April 3, 2012.

Curriculum vitae: Venerable Amchi Namgyal studied botanic and in 1996 earned the Bachelor of Science Degree at the University of Madras. Due to his interests, he earned the Bachelor of Alternative System of Medicine Degree from the Indian Institute for Alternative Medicine in Calcutta. From 1999 – 2005 he studied with the late Dr. Tenzin Chödrak and Dr. Tenzin Dakpa, who was lecturer at the Tibetan Medical & Astrological College and who was chief medical officer at Medicine Boudha Healing Center in Spring Green, U.S. Namgyal completed the course on Tibetan medicine under Dr. Tenzin Thaye, deputy director at the Pharmaceutical Department of Men-Tsee-Khang, Dharamsala, India. Finally, he went to Tibet and finished his studies on Tibetan medicine there. He has carried out comparative studies with Western medicine and has published numerous articles on medical herbs. In 2012, the Indian Government acknowledged Tibetan medicine as a legal method of treatment but stated that it has to be referred to as “Sorig” (the abbreviation for gso-ba-rig-pa in Tibetan). Sorig means ‘the knowledge of healing.’ In a formal ceremony, the Government of India recognized Venerable Namgyal as an Amchi.

Venerable Namgyal is director of the Choyang Hospital in Mysore, Karnataka, So. India. Also, he and his wife engage in social projects; for example, they see to it that the children of refugees receive a good education and that the elderly are cared for adequately. Amchi-la works at the Old Age Home for Refugees in Mysore. Furthermore, he treats patients who consult him when he offers courses and trains students in traditional Tibetan medicine in India, Norway, and Germany.

Tibetan alternative medicine is one of the oldest healing methods available on Earth. There are Chinese, Ayurvedic, natural, homeopathic, and so many different medical traditions. I won’t speak about the history of Tibetan medicine but directly about the medicine.

We have three energies. The first energy is rlung in Tibetan, which is often translated as ‘wind’; in Ayurvedic medicine it is referred to as ‘water.’ The second energy is mkhris-pa (pronounced tripa), which is ‘bile.’ The third energy is called ba-kan; it is translated as ‘plegm’ and is slime, mucous, etc. In Tibetan medicine we talk about four elements. rLung means the air element. mKhris-pa means the fire element. Ba-kan means the water and earth element. The fourth, the space element, is common for all. These principles are the bases of Tibetan medicine.

The four elements have to be there for our body to be formed. Also, a sperm and egg have to be there, and a karmic relationship has to be there. If they are healthy, then we can form the body; otherwise it is not possible. So, our body is formed by the four elements. The food that we eat and the herbs that we take are also formed by the four elements. Then we have six tastes, eight qualities, seven secondary qualities, and 21 characteristics of energies. We are healthy when all these factors are balanced. Now I will speak about rlung.

One of the characteristics of rlung (‘wind’) is mobility, i.e., it is very changeable. Tension in the neck or in the shoulders is a symptom of changeability. Why? Because a little massage will cure it. But, since it is changeable, tension will return after 2 or 3 days. So, rlung is responsible for three moving activities. They are: speaking, movements of the body, and palpations. There are five types, e.g., life-sustaining rlung, palpating rlung, etc. A rlung anomaly means that there is something wrong mentally, with the nerves, or with the movements in the body. Therefore I always tell my patients, “Before engaging in analytical meditation, please check your mind. Check your state of mind.” In analytical meditation, a practitioner directly goes into the mind, and it is difficult. If there is a rlung disorder, forcing our mind to do analytical meditation will increase the disturbance of the rlung energy, and then mental problems ensue.

The second energy is mkhris-pa (‘bile’). Its main function is warmness of the body, which means it is associated with digestion. There’s a Tibetan saying: “If you want to know if you have a good digestion, go to a mirror and look at your tongue. If it is clean, then there’s no problem. If it’s covered with a whitish-yellow coating, then your stomach isn’t happy about what you are eating.” mKris-pa has five types. For example, if somebody has a fat liver, or a high cholesterol, or blood disorders, or migraine, they have a mkris-pa-related disorder. Bad-kan (‘phlegm’) also has five types and is mainly responsible for regulating the body fluids, in the joints, too. If somebody has a joint pain or a swelling of the joints, it can be due to a bad-kan disorder. Sometimes joint disorders are caused by a combination of bad-kan and mkhris-pa disorders.

There are two factors that can cause a disturbance to the body. One is diet, the second one is behaviour. When speaking about this, I always say that we are ignorant of diet and behaviour. We fail to understand our body, eat food that tastes delicious and feels good in our stomach, but we really don’t know whether the food we like to eat is good for us or not and then have many problems later on. It’s important to understand the nature of our body and to eat and act accordingly. For example, somebody has much gas and suffers from migraine headaches but eats raw, or fermented, or cold food on an empty stomach. Tibetan medicine tells us that this is poisoning our body and causes many future disorders, like cancer. That’s why Tibetan medical texts teach about a balanced diet. Western instructions are totally different than Tibetan medicine, which stresses that we have to check our stomach’s digestive capability. Food is categorized into a heavy quality and a light quality. For example, raw paprika is difficult to digest and therefore it is heavy; cooked paprika is easy to digest and therefore it is light. Salad has a heavy quality because it is difficult to digest. We can eat salad on an empty stomach if our stomach is in a good condition; if it isn’t, we have to eat something warm before we have salad. Tibetan medicine teaches that for the energies to work well, the stomach has to be filled into four parts so it can properly digest a meal - two parts with solid food, one part with liquid, and one part has to be empty.

Drinking is also very important, but you should know how and what to drink. Suppose you want to lose weight, then you have to drink before you eat or you have to wait at least 30 minutes after having finished a meal. If you want to keep your weight, you can drink during your meal. Should you want to gain weight, you should drink immediately after having finished your meal.

We say that boiled water is the cheapest and best medicine that is available on Earth. Drinking boiled water is very good for digestion. It purifies the blood and helps against gas in the stomach, against asthma, hiccups, a common cold, and infections. If you have a problem with your liver, with cholesterol, or if you have a fat liver or gall stones, the best medicine is boiled water that has cooled to room temperature. In the olden times in Tibet and before 1959, we didn’t have a clinic in my village. So my mother treated our fever and colds by exposing boiled water to the moon. She added a little bit of white candy and asked us to drink it; after 3 days our cold was gone. We need to know what to eat and what to drink, according to our stomach and not according to our taste. For example, we should not drink lots of beer at the Octoberfest in Munich.

Many people in Europe have pain in their lower back or knees. The first remedy would be to avoid wrong food and to choose right food. Pain in the lower back is basically caused by a disturbance of the nerves and kidneys and also happens from having had an accident or from having fallen down. There is food that is very harmful then; for example, pineapple and watermelon are cold in nature and are very harmful in those cases. The best medicine to treat pain in the lower back is boiled water, cademon tea, and asparagus, which is also good for the immune system. So, diet is very important. Now I will speak about behaviour.

Behaviour here refers to mental, physical, and verbal behaviour. Mental behaviour is as explained in the above example. Physically we have to act according to the season. For example, we will catch a cold a day or two after we went outside on a cold and windy day without wearing warm clothes. We will have pains in our body the day after we forced ourselves to lift an object that was too heavy for us. I would say that 99 percent of people have a good daily job, return home to a good dinner, and go to bed. Before falling asleep, it would be good to say, “Today I had a wonderful day. I did well. I helped many people. I am very happy and have to go to sleep.” Some people try to go to sleep but their eyes are open; this means that somebody is knocking on their head and therefore their mind is busy. If, before falling asleep, we say to ourselves that we had a wonderful day and speak a word of thanks for being able to go to sleep, then, when we wake up the next morning, our body will be balanced, we will have more energy, and we will be mentally and physically better prepared for the day. On the other hand, we won’t get enough sleep and will be tired the next day if we don’t stop thinking while trying to fall asleep. This leads to a disturbance of the rlung energy; as a result there is the danger of becoming dependent on sleeping pills. Then there is much tension on the neck and back and since the mind is disturbed by the pain, there is a chance of having high blood pressure. These are cases that show why behaviour is very important. Now I will speak about the treatment of pain in the lower back.

Pain in the lower back is a rlung disorder and arises when people say that they have no back problems but expose their back to cold winds. Not being careful makes things worse. Other factors that intensify this problem are walking barefoot and sitting on the floor, on the lawn, or on a plastic chair or cushion. Many of my Western patients tell me that they jump into hot water after having been in cold water and state, “This is good for my body.” I tell them, “Please have compassion for your body. Please don’t do that. You have a beautiful and wonderful body, mind, and speech. Why are you destroying your body?” On the back page of The Times of India is a scientific column that informs readers about medical therapies and latest medicine. I found an article that stated that it is very harmful for the body when people jump from cold water into hot water and that this damages the cells. Maybe this is not totally right, but maybe it is not good for the body. So, wrong eating habits and improper behaviour are the two factors that cause disturbances to our body.

I returned to my village in Tibet after having left 17 years ago. In the past, fertilizers were not used and everything was what is nowadays referred to as “organic.” As a child, I had never heard about cancer or about blood pressure, but now lots of the villagers are suffering from cancer, high blood pressure, gall stones, stomach cancer, and so many other diseases.

Medicine is available in our food. What can we do against high cholesterol? We can add a little bit of fresh ginger, not dried ginger, to a cup of boiled water and drink it; this makes the blood thin and lowers the cholesterol - that’s how simple it is. If we have problems with the nerves, we can spice our food with clove or nutmeg. If we have difficulties falling asleep, we can wash our feet in warm water before going to bed. We can easily fall asleep if we have a massage that warms us or if we massage the soles of our feet, and/or the palms of our hands, and/or the crown of our head, and/or our temples, and our chest. But these massages should not be carried out too often or too intensively if we suffer from high blood pressure or migraine headaches. We have to understand the importance of diet and behaviour and eat and drink what is appropriate and healthy. Then there are no problems. Now I will speak about diagnosing a problem.

In Tibetan medicine, we have pulse reading, urine analysis, and visual diagnosis. (Amchi-la explained how to do pulse reading by showing the points on the wrist and taught:) First we have to look for the pulse of rlung, the pulse of mkhris-pa, and the pulse of ba-kan. (While illustrating where to place the fingers, Amchi-la taught:) It’s said that the pulse of rlung is like a balloon, i.e., you have to press deeper and deeper to feel the pulsation, but you don’t feel it when going too deeply. Identifying mkhris-pa is clearer; the pulse is felt the moment the place on the wrist is touched. It’s said that the mkhris-pa pulse is identified on the surface by very fast pulse beats that are felt clearly but not felt when pressing deeply. A ba-kan pulse is very weak and not clear.

How can we know if somebody has a disorder? This is basic: Tibetan medicine divides all disorders into two categories. A hot disorder is a mkhris-pa disorder; a cold disorder is a ba-kan disorder. rLung is medium, i.e., it can influence both ba-kan and mkhris-pa. (Amchi-la now explains and illustrates in detail how to do a pulse reading and helps the participants of the course practice.)

We have 63 different types of rlung disorders, so there are 63 different pulse readings for rlung. We have 84,000 different kinds of pulse readings for each disorder. But first it must be known what a cold disorder is and what a hot disorder is. Then it will be possible to slowly know what a rlung disorder is, what a ba-kan disorder is, and what a mkhris-pa disorder is. When reading a pulse, we have to be very careful and concentrated to the maximum. It’s said that if somebody’s pulse beats 5 times in every organ and every part of the body - while the Amchi who is taking the reading breaths once -, then that person is healthy. If somebody’s pulse beats more than 5 times in every organ and part of the body – while the Amchi who is taking the reading breaths once -, this indicates a hot disorder, i.e., a mkhris-pa disorder. If it beats less than 5 times, it means a cold disorder, i.e., a ba-kan disorder. Now, we can look at our watch and count how often the pulse beats in one second.

Let me tell a story. I have a patient in So. India who is very old and who made me famous there. Her legs had become swollen. Her son is abbot of a monastery in Kathmandu, so we know each other quite well. He requested that his sister call and ask me to help his mother. The first thing I did when I looked her up late that same evening was that I checked her life-pulse and found that she was okay. We gave her Tibetan medicine along with Western medicine when I saw her again the next day. All her relatives who live in Nepal and in the U.S. were summoned and, thinking she would die, they came to meet her. The 90-year-old lady was very much alive and was very healthy when they arrived, and she still is. So, this is about life-pulse.

Then we have 7 wonders of pulse. We can check a wife’s pulse if her husband is ill, and we can check a husband’s pulse if his wife is sick. If a father isn’t feeling well, we can check his son’s pulse, and vice versa. It’s the same for a mother and among brothers and sisters. It’s important to mention that reading the pulse of a baby or child younger than 5 years is not done on the wrist but is carried out on the back of the ear.

The tradition of pulse reading was very much there in Tibet a long time ago. My teacher in Tibet used to do this, but now it is disappearing in Tibetan society and we don’t have anybody who is really experienced in doing and teaching it. This kind of practice is also available in Muslim medicine; it originated in ancient Persia and is called “unami.” I have a patient in Delhi who told me that when she once had a big problem, she went to Hamdard University, which is very famous for unami medicine. Since the physicians are not allowed to touch women, she was told to hold the end of a thread that was passed to her through a hole in the wall. The physician on the other side of the wall held the other end of the thread, read her pulse, and made a diagnosis. Now I will speak about urine analysis.

We check the color of the urine, its smell, its taste, and look at the particles floating around in the urine, whether it’s clean, and so forth. Everybody can check their own urine. The urine is dark red or very red and smells strongly if somebody has a liver problem, a blood disorder, or a problem with the gall bladder. If somebody’s urine is not transparent and the particles fall to the bottom of a container, that person has a kidney problem. Small white yoghurt-like particles float in the urine if somebody has stomach problems. It is also possible to know through urine analysis whether somebody is going to die or not. Urine that smells like a rotten egg and that is dark red in colour shows that the person is going to die. In that way, each disorder can be diagnosed through a different smell, colour, and particles. Next is the visual diagnosis. Urine analysis is also visual because it is done with the eyes.

First and foremost in making a visual diagnosis is a person’s tongue. Sometimes people’s tongues are dry, which shows that they have an imbalance of rlung energy and blood; this is directly related to the heart. Sometimes the tip of people’s tongues is dark, which shows that they have what we call “a hidden fever,” i.e., an infection in the heart. Sometimes there is a crack on the side of some people’s tongues; this shows that they have a kidney problem. If there are black patches on the middle of the tongue, then this person has stomach and spleen problems. When somebody’s eyes become dry, when there is pressure on their eyes, and when they can’t see well, this shows that their liver is not happy with what they are eating and that something is wrong with their liver. Sometimes people have dizziness or itching in their ears; this shows that there is something wrong with their kidneys. Sometimes people’s lips become dry and don’t react to moisture creams; this shows that their spleen is not happy with them. When somebody’s nose is blocked and the tip of their inner nose becomes very dry, this means that their lungs are not happy. Sometimes the middle of people’s tongues has a deep crack instead of a normal small crack; in that case they have a problem in the heart. These are things that can be seen. We can check the urine, the solid faeces, the blood, the mucous. It is possible to do all these things. Problems in the body are detected by using the above methods of diagnosis. How can we balance a disorder?

The first step to balance a disorder is a healthy diet. Instead of going to a doctor when we have a cold, we can drink boiled water. People who have a problem with their cholesterol can drink boiled water with fresh ginger. People who have a problem with their lower back can have cademon and asparagus. So, the first thing to do when sick is to be a patient and to be the doctor. The second step is correct behaviour. People who have pain in their lower back can treat themselves by not walking barefoot, by not swimming in cold water, and by placing a hot water bottle on their back. If this doesn’t help, they can go to the doctor.

In our tradition, herbs are there. The advantage of herbs is that using them is a holistic approach. Holistic means that the whole body is seen as one entity, so patients are treated mentally and physically. When making herb medicine, we compound 35 different kinds of herbs, or 40 different kinds of herbs, or 4 different kinds of herbs. Supposing somebody has a stomach problem; we compound the herbs in a way that the stomach is helped, without creating another problem in the body. This is why Tibetan medicine is known to have no side-effects. Holistic means that the compounding of herbs is holy, i.e., precious. In Buddhism, we also do lots of rituals while compounding medicine; this benefits both Buddhists and non-Buddhists alike.

If the three therapies don’t work, we have many last methods that are called “accessory therapies.” They are, for example, blood-letting, moksa, golden-needle therapy that is like acupuncture. If they don’t help, we have to really think about what we have to do. We also have massage to help against rlung disorders, massage to help against mkhris-pa disorders, and massage to help against bad-kan disorders. The massages and physical exercises (lüs-sbyong in the Tibetan language) that are becoming popular in Germany are all taught in Tibetan medicine. We also have what is called “five actions” in Ayurvedic medicine; one is the method to cleanse the body. We also have five different kinds of steam baths that we can do. With this I will stop here. If you have any questions, please ask.

Question: “My daughter is losing all her body hair and it has been diagnosed as an autoimmune sickness. Which system would you link this with?”

Amchi: I think this has to do with the stomach. There are 7 body constituents, and losing hair belongs to the division of what is called “the essence of the body.” It is related to the bone and bone marrow. When somebody’s bone and bone marrow don’t get the essence, they lose their hair. The 7 body constituents have to be transformed effectively to maintain the body. When this doesn’t happen, then a person loses their hair. Other possibilities for loss of hair are the external factors of very hot and very cold water or seasonal change, which have to be checked. Basically, if somebody has the defect of being unable to form the essence of the body, they lose their hair. Defects are disturbances of the 3 energies; one is that one of the 3 energies is excessive, and the other is a deficiency. There is a treatment for loss of hair with a special fruit called “amla” in Ayurvedic medicine. I think amla is available at Asian markets in Germany. You have to boil it until it becomes like tea. When it has cooled down to room temperature, you wash your hair with it. This is the easiest method to prevent loss of hair and it might help your daughter.

Next question: “How many plants do you have in Tibetan medicine?”

Amchi: We have 2,294 different plants. There are more if we categorize them into subtitles.

Same student: “Do you use all of them as medicine? Are the precious pills a special kind of treatment?”

Amchi: We use all of them as medicine. Precious pills are a special kind of treatment. There are also herbs and minerals. We have a special way of detoxifying mercury for medical purposes, in which case around 30 or 40 people work together for 45 days and nights to make it.

Same student: “So we only have the precious pills in critical cases?”

Amchi: It depends. You take the precious pill according to your problem, which needn’t be only in very serious cases. When somebody has a liver problem, first we prescribe ordinary medicine and if that doesn’t help, we prescribe precious pills along with the ordinary medicine. If somebody is seriously ill, a precious pill won’t help that much. Also, if after having taken ordinary medicine for a long time, somebody no longer reacts to ordinary medicine, then we add precious pills to go along with their medical treatment. We have 8 or 9 different kinds of precious pills that are taken depending on the disorder. Even if you have no problems, the precious pill is very good for the immune system, for a healthy body, and for longevity of life. My teacher told me that we have one precious pill that he gave to a few of his patients when he travelled to Russia and that it boosted their immune system. So, whether we are sick or not, we can also take it. Some people catch a cold very often, which is a sign of a weak immune system. It’s very dirty in Kathmandu and there’s much pollution. I catch a cold easily and while working in the clinic my patients noticed this. I took the precious pill for 2 months and didn’t have a cold anymore. So, that’s the advantage.

Next question: “I didn’t understand how the pulse is counted for someone who is in a critical condition.”

Amchi: It’s very good if the pulse beats 2 times in one second. It’s not good if it sometimes only beats once in one second and then beats 4 times in one second.

Are there anymore questions? There is a Tibetan saying that I told at Rigpa: Two things are possible if there are no more questions. One is that you understood everything, and the other is that you didn’t understand anything.

Question: “You said that it’s dangerous for the mind to not be in the right place when engaging in analytical meditation. What do you suggest?”

Amchi: While working in the clinic in Kathmandu, I met a woman who was attending a meditation program that a Rinpoche offered at the birthplace of Lord Buddha in Lumbini. She could not control her mind, became wild, and Rinpoche told her to consult a Tibetan doctor before continuing with the course. When she came to me, I let her sit a while and knew what was going on in her body. I did a massage that blocked her channels. She fell asleep, and my assistant and I continued with our other work. When she woke up, she was calm, and I gave her life-force-sustaining medicine. Some people force themselves too much to concentrate, which increases their energy, and then they become wild.

Question: “So the massage calmed her down?”

Amchi: Yes. I always advise my patients to check their mental ability to concentrate before engaging in analytical meditation. It’s said in texts that meditation should be like an accumulation of particles, i.e., small particles form large particles. In that way, first one starts meditating for a second and later for a minute – then two minutes, then three minutes, and so forth. We wish to meditate for an hour, but sometimes we can’t. That’s why I always say that being physically present is very easy but mental presence in meditation isn’t easy. A Rinpoche living in a monastery in So. India always used to talk like that. You have to check your mind, whether you’re really ready for that or not, otherwise it disturbs your rlung and then you’ll have problems. If you are cool, then it’s peaceful meditation.

Next question: “Would you say why there is more dementia among Westerners?”

Amchi: It’s one of the 63 types of rlung energies, and dementia is one kind of symptom. It’s specifically related to the nerves, which determine the brain’s function. We say that the brain is like an ocean of nerves. Multiple sclerosis is also related to this rlung disorder.

Next question: “Is there an education program for Tibetan medicine?”

Amchi: There is one Tibetan doctor in exile and I saw a few doctors who are still practicing in Tibet. We try our best to organize a program with doctors from Tibet and doctors in exile, but it hasn’t been possible. If you are able to get permission, you can visit doctors in Tibet.

Same student: “Are there similarities with traditional Chinese medicine and can the cultural gap be bridged?”

Amchi: I think it’s the same with Ayurvedic medicine. The traditions are there, but they are losing the connection. They are moving more towards the West. In India and China, doctors don’t check the pulse and urine but just do laboratory tests. Talks are going on. I visited the Lhasa University and they are not doing it like that; they use the traditional Tibetan methods. In the past, we could study Tibetan medicine in the Tibetan language, but since 2008 the Tibetan language is banned in schools and universities. It’s very difficult to teach Tibetan medicine in another language. Students at Lhasa University are demonstrating for this reason. They say, “We can’t learn Tibetan medicine in the Chinese language – not at all.” So, there is this big danger. I think they are doing very well at Lhasa University, till now, but the situation has become difficult. Chinese doctors find it unpleasant to check the pulse and smell the urine, so they go the easy way - this is their mistake. Many talks are going on in India and there are few doctors who practice traditional Tibetan medicine. Most of them completely rely on Western research results. Traditional Tibetan medicine is practiced in most Himalayan countries, like Ladakh, Bhutan, and Nepal.

If there are no more questions, I want to thank everyone who organized this program, as well as all members of the Kagyü, all those who support my work, and everyone who attended. We can do these kinds of things because of your kind support. Thank you very much!

Many thanks to Claus Herboth from Neckargemünd near Heidelberg for having provided the recording of the teachings and for the photo of Amchi Namgyal Phunrab. The photo of the dainty flower was offered by Miki from Japan. This lecture was transcribed and arranged by Gaby Hollmann from Munich, who is responsible for inadequacies and any mistakes. Copyright: Amchi Namgyal Phunrab, India 2012. – May traditional Tibetan medicine be preserved, taught, and practiced by many more people who work in the medical profession. And may many people in the world be healed by Tibetan medicine.

Mangalam.