Tag Archives: conferences

International Workshop May 8-10, 2015: Developing an interdisciplinary and multilingual digital knowledge base on Tibetan medical formulas with a focus on stress-related ‘wind’ (rlung) disorders

This report first appeared in the IASTAM newsletter: http://iastam.org/wp-content/uploads/2013/12/IASTAM-newsletter-Summer-2016.pdf

The three-day long workshop brought together international expert physicians and scholars of Tibetan medicine – medical anthropologists, historians, (ethno)botanists, pharmacologists, pharmacists – working with and/or on Tibetan medicine, and also experts in Chinese medicine, as well as IT specialists. The aim was to discuss and contribute toward how an interdisciplinary and multilingual digital knowledge base should look like that could be used in the future as an analytic tool for documenting and analysing Tibetan medical formulas. Processes of cultural translation are intrinsic to such translations between different languages, medical concepts of health and disease, and disciplinary approaches and interests, and therefore are often vexed and problematic.

Prepared by a one-month-long pilot study by visiting scholar-physician of Tibetan medicine, Dr Cairang Nanjia from the Tibetan Medical College, Qinghai University, PRC, and the author of this report, at the time a Wellcome Trust research fellow at EASTmedicine, University of Westminster (2012-2015), this ensuing workshop proved a fruitful platform for discussing some of the outcomes and issues involved in such a complex endeavour. Both pilot project and workshop were co-funded by the British Academy/Leverhulme Small Research Grant combined with private funds by The Sino-British Fellowship Trust. Asian workshop participants were supported by an additional IASTAM fund. The author would like to express her gratitude to these foundations and to IASTAM that made this encounter between scholars from different disciplines truly special and fruitful. This included scholars who rarely discuss their different interests and approaches, physicians-cum-pharmacists from Asia, and pharmaceutical producers focusing on Tibetan formulas.

We focused on a particular Tibetan formula complex containing the main ingredient eaglewood (Lat. different types of Aquillaria; Tib. a ga ru or a gar)—in the following Agar-formulas (Agar 8, Agar 15, Agar 20, Agar 35, Sogdzin 11). These were chosen as case studies for they are usually prescribed in relation to specific classifications of ‘wind’ (Tib. rlung) disorders that can be correlated with what we understand as classic ‘stress’ symptoms, such as insomnia and depression.

Dr Cairang Nanjia began the inquiry by documenting Agar-formulas in Tibetan medical, botanical and pharmacological texts used at present in Amdo, the Tibetan populated parts of Qinghai and Gansu provinces of China, focusing also on their structure, single ingredients and relations to each other. The author related her ethnographic material on different styles of production and prescription practices of Agar-formulas in both China and parts of Europe, and both Cairang and Schrempf co-developed, together with advice from IT specialist Kapetanios a possible multi-level digital knowledge base structure of synonyms and homonyms in order to deal with the complexity of different languages, concepts and terminologies. The preliminary results were presented at the workshop for discussion.

Workshop participants used different sources and analysed them following up on specific questions, such as which texts are important for understanding Tibetan materia medica and formulae and by whom they are produced, prescribed and used today; which ingredients are we actually talking about in a formula; how and why are certain rare or endangered materia medica ingredients in a formula substituted; why and how does a formula work; what is its local, regional, botanical identification; what are ’wind’ (Tib. rlung) disorders in Tibetan medicine and how can one correlate them with biomedical diseases related to ’stress’ (let alone trying to define the fluid concept and the Tibetan dynamic of ’wind’, or what does stress mean to body and mind). Complex issues without doubt constantly required our own translation exercises between Tibetan, English and Chinese languages.

Sources used and topics addressed by the workshop participants ranged from analysing Tibetan historical medical and botanical texts to develop a feasible structure for​ Tibetan formulas (Czaja) to Chinese publications on minority medicines and how information on their materia medica is collected in China (Springer); how the seminal Tibetan medical text, the Four Tantras or rGyud bzhi explains the classification and treatment of rlung disorders (Cuomu); how specific rlung disorders, specially ‘heart wind’ (Tib. snying rlung) and ‘life sustaining wind’ (Tib. srog ’dzin rlung), are taught to Tibetan medical students in Xining (Sanjijia); presenting his experiences as a physician-cum-pharmacist by the eminent co-founder and teacher at the Tibetan medical hospital in Xining (Dr Nyima); how Agar-compounds in their various forms and styles are prescribed in both Asian and European contexts (Schrempf); presenting patient case studies and related prescription practices for ‘wind’ disorders in the UK (Millard) in which, however, no Agar-compounds were used; asking socio-cultural and ethno- as well as medical botanical questions about the difficulties in identifying plant names, such as Aquillaria agallocha (van der Valk, Allkin, Leon); demonstrating salient issues of sustainability of materia medica growing in Ladkah (Padma Gurmet); demonstrating the life work for Tibetan medicine by the eminent scholar and teacher Akong Rinpoche in both his home area of Kham and the UK, focusing on the sustainability of medical plants (Sweeney); how to understand Tibetan materia medica and formulas in relation to TCM while both address stress-related symptoms (Ploberger); how the pharmaceutical company Padma AG has created and adapted the Tibetan formula Sogdzin 11 into Padma Nervotonin (Schwabl and Vennos); and, last but not least, what a digital data base can offer if one is interested in mapping drugs across time and space (Stanley-Baker, Chen Shi-Pei, Brent Haoyang Ho).

The aim of the workshop was to relate and analyse formula and substitution patterns, culturally distinct ideas of efficacy and safety and different disease categories/body images in relation to ways of diagnosing, formulating/producing, prescribing and using these chosen Tibetan formulas. Only careful translations will allow to properly correlate different concepts of Tibetan, Chinese and bio-medicine, keeping regional, national and global regulatory regimes in mind. It would desirable if in the future we could pursue an integrative and synthesising approach to Tibetan Medicine with a sensitivity to various interpretations in this multi-lingual endeavour, as well as trying to correlate different disciplines and practices.

The aim would be to explore careful and meaningful ways of representing Tibetan cultural and medical knowledge and develop suitable key search terms in different semantic networks in order to make such a digital knowledge base a useful tool for researchers and practitioners alike.

For more information concerning the EASTmedicine research group and the workshop, see the group’s website at https://www.westminster.ac.uk/eastmedicine-research-group

 

Workshop Report: Sacred Cures – Situating Medicine and Religion Across Asia

This announcement first appeared in the IASTAM newsletter: http://iastam.org/wp-content/uploads/2013/12/IASTAM-newsletter-Summer-2016.pdf

Workshop Report
Sacred Cures – Situating Medicine and Religion Across Asia
(Max Planck Institute for the History of Knowledge, May 2-4)

This workshop, co-organised by council members Michael Stanley-Baker and Pierce Salgeuro, brought together specialists in the intersection of religion and medicine in the Himalayas and East, South, and Southeast Asia. All together, they examined what work has been done by the terms medicine/religion, or related binaries such as medicine/healing or classical/vernacular. What is clarified or distorted when these categories are mapped onto other languages, periods and regions? They explored commonalities across regions and across time, working from the classical to the contemporary. How do scholars and cultural actors alike produce “medicine” and “religion” as fields and as methods? Taking stock of recent gains in the field, they discussed remaining areas for study, and compared and refined the tools and terms that might be used in that endeavour.

Papers were pre-circulated, and no presentations were made in the workshop. Participants were invited to address the following areas:

  1. Historiography: How has the religion/medicine question been framed by different academic communities?
  2. Materials: What primary sources or archives are available for the given historical periods and/or cultural contexts, and how these afford different kinds of analysis of the question?
  3. Means: What moments, encounters, processes, practices, and relationships produce or reveal significant (re)structurings of medicine and religion?

Many of the panellists are long-standing IASTAM members, and the forthcoming edited volume will be published with IASTAM members in mind.

Speakers

  • Pre-Modern/Classical-Medieval: Donald Harper, Vivienne Lo, Katja Triplett, Michael Slouber, Tu Aming & Joey Hung,
  • Early Modern: Projit Mukharji, Katharina Saberning, Leslie DeVries, Angelika Messner
  • Modern/Contemporary: Helen Lambert, Celine Coderey, Elisabeth Hsu, Geoffrey Samuels, Mona Schrempf
  • Closing remarks: Judith Farquhar & Kenneth Zysk

“WRAPPED IN FLESH”: VIEWS OF THE BODY IN EAST ASIAN MEDICINE

The following is a syndicated post that first appeared at http://circulatingnow.nlm.nih.gov/2015/12/03/wrapped-in-flesh-views-of-the-body-in-east-asian-medicine/ See the original post for the images from the NLM collection that accompany the article.

How do you assess the state of a broken bone when you can’t directly see it? Writing in 1808, Chinese doctor Qian Xiuchang discussed a problem shared by healers world-wide prior to the X-ray age: “When someone has a dislocated or fractured bone, the bone and joint are wrapped in flesh. Looking at it from the exterior, it is hard to get a clear understanding, and there is the danger of making an error.” To improve the state of bonesetting knowledge, Qian compiled Supplemented Essentials on Medicine for Injuries (Shangke buyao). That book can be found in the collection of the National Library of Medicine and is now accessible online.

An innovative feature of Qian’s text is that it includes two drawings of the human skeleton, shown from the front and the back. Chinese medical texts had long included written descriptions of the body’s “bones” (gu), a term that included individual bones as well as palpable bony landmarks. These were particularly important in acupuncture, where practitioners used them as reference points to locate the spots where needles could be inserted. Some acupuncture diagrams also outlined the positions of major bones. However, prior to the nineteenth century, Chinese texts on therapeutic medicine did not contain diagrams of the full skeleton. In 1742, when the Imperial Medical Academy compiled a textbook on bonesetting, the illustrations only indicated the position of bones by labels on the outside of human figures. In 1770, however, the Qing imperial government promulgated a set of official inquest forms in order to standardize forensic investigations on skeletal remains. It was these forensic diagrams of the skeleton that Qian Xiuchang borrowed and reproduced in his work on treating injuries, so that readers could more easily learn the forms of bones hidden beneath the skin.

Qian Xiuchang, a native of Shanghai, had received some degree of classical education and he had presumably once aspired to success in the civil service examinations that defined members of the Chinese socio-political elite. He became interested in injury medicine after he broke his leg. He apprenticed with the doctor who cured him and eventually became successful enough to attract disciples of his own. Seven of them helped to collate his Supplemented Essentials, which discussed a wide range of traumatic injuries caused by weapons, blows, and falls. It also featured a laudatory preface from Su Chang’a, a former Shanghai magistrate who became a supporter after Qian saved the life of a prisoner who had attempted suicide.

It was an era when the Chinese were critically re-evaluating received teachings, including those on medicine. At the time that Qian’s text was printed, another doctor, Hu Tingguang, was completing his own manuscript on injury medicine and also incorporated forensic diagrams of the skeleton. Both books sought to address the shortcomings of the imperial bonesetting manual. Besides using forensic medicine—and diagrams of the human skeleton—to improve their readers’ knowledge of the bones, they also incorporated forensic teachings on “mortal points,” namely spots on the body where injuries were particularly dangerous.

Qian’s Supplemented Essentials thus leads us to consider an understudied aspect of East Asian medical history: how doctors investigated and understood the body’s material structures and components. The present-day view is that “traditional Chinese medicine” is primarily interested in the body’s energies and vital functions and not in anatomy or body structures. Historically, however, that was not precisely the case. East Asian healers argued about how to define the parts of the body and their relation to health, injury, and disease, and like Qian Xiuchang, pursued different methods for improving their knowledge of the body: textual study and introspection, the dissection and observation of corpses, careful observation of healthy and diseased people.

These issues took center stage at an extraordinary workshop. Held October 2-4, 2015 at the University of Michigan, Comparative perspectives on body materiality and structure in the history of Sinitic and East Asian medicinesbrought together an international group of scholars (including historian Michael Sappol of the National Library of Medicine) to discuss medical portrayals and practices of the body, from the first century A.D. to the nineteenth, in China, Japan, Korea, Vietnam, the Mongol Empire, and Tibet.

The workshop explored a number of questions. How did different representations of the body co-exist with each other within a given cultural context? The anatomical images and descriptions in Tibetan medical treatises, for example, included those based on examination of corpses as well as those elaborating humoral and vitalistic beliefs and those metaphorically comparing the body’s components to a palace or to a kingdom’s rulers and ministers . Different body views were linked to different explanations for how and why illness afflicted the body, and to different therapeutic methods.

Competing images of the internal organs circulated in China, Japan, Korea, and Vietnam, and were the subject of debates about how internal structures were connected to each other and to imagined centers of primordial vitality.

The conference also explored the status and value assigned to medical illustration compared to textual descriptions of the body, and how visual conventions from various realms of medicine influenced each other. In early nineteenth-century Japan, for example, both the bonesetting expert Kako Ryōgen (1810) and the surgeon Hanaoka Seishū (1760–1835) employed images in which the body’s flesh was transparent or invisible. Finally, the conference highlighted the historical importance of surgery, bone setting, and other manual therapies that required healers to physically manipulate the body’s components.

The rich diversity of presentations, the wealth of ideas and material, and the lively discussions that ensued, showed the creative vigor of contemporary scholarship on East Asian medicine, enormously facilitated by the increasing number of rare books and manuscripts that have been digitized by the National Library of Medicine and other libraries and made accessible online for researchers throughout the world.