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:

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