History of the Attempted Destruction of Tibetan Culture in Tibet and
the Efforts at Preservation of Tibetan Culture in Exile

essay by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon


An excellent new book has appeared to fill out the limited information on modern Tibet.  It is a history of the Chinese invasion and the Chinese attempts at total domination of Tibet: The Dragon in the Land of the Snows: A History of Modern Tibet Since 1947 (1).  The author, Tsering Shakya, was born in Tibet and later attended London University where he is now a research fellow.  This book is well balanced, providing recognition for Chinese efforts that were aimed at helping the Tibetans (within the confines of the policy to absorb the nation into China) as well as those that were destructive.  The early and dramatic part of the story—the Communist take-over in China and the subsequent invasion of Tibet in 1949 leading to the exile of the Dalai Lama in 1959—has been portrayed in the popular film Kundun and in the book My Land and My People by the Dalai Lama (1962).  It is now possible, through this new work by Shakya, to get a closer look at the events leading up to the “Lhasa Uprising” that instigated the Dalai Lama’s escape and the subsequent intensification of repression by the Chinese. 

What happened in Tibet after these events has not been depicted in the historical literature until now.  A number of books have appeared in the past that were based on personal experiences and observations, such as Return To Tibet (2) by Heinrich Harrer (based on a 1982 visit) and Sky Burial (3) by Blake Kerr (based on visits in 1987 and 1991).  The later books revealed some of the terrors imposed by the Chinese, especially during the Cultural Revolution of the 1960’s and early 1970’s, and then in Tibetan revolts that took place in the late 1980’s.  But this new book is a carefully researched and documented text that reveals the overall social, political, economic, and religious situation in Tibet during the period 1959–1989, ending with the massive anti-Chinese demonstrations in Lhasa in which many Tibetans were killed and hundreds more were arrested.  Earlier that same year, the Tiananmen Square incident took place, which dominated the media attention, leaving the Tibetan situation of less importance to most of the world.  Still, the Western world took some notice of the worsening situation in Tibet and recognized the Dalai Lama in the least political fashion possible, by awarding him the Nobel Peace Prize in 1989. 

Information is also provided in this book about the situation the Tibetan refugees have faced in India.  During the first three years of exile, the Indians grudgingly allowed the Tibetans in, not wanting to worsen relations with China by doing anything to support the refugees (especially the Dalai Lama, as their leader).  At times, Tibetan refugees were refused entrance to India and had to camp at the border, where many succumbed to the weather, until pleadings by the Dalai Lama led to their release (4).  It was only after the India-China war over the border between India and Tibet that India—having lost the war—became a willing host to the Tibetan refugees.  The Indian government came to realize that foreign assistance for its struggle with China (from the U.S., who had been supportive, though not openly, of Tibetan claims against the Communists) was easier to get if the Indians were seen as aiding the Tibetans.  As a result of this effort, India allowed more freedom for the Dalai Lama to operate in Dharamsala; the government then set aside some unused land, most of it in a climatically harsh portion of southern India (Karnataka State), far away from the border, as a refugee center.  Tsering Shakya relays:

The Indian policy towards the Dalai Lama and the Tibetans underwent a dramatic change as India came to realize the potential benefit of the presence of Tibetans in their country.  They began to adopt a more supportive policy and encouraged the Tibetans to organize themselves, eventually leading to the Dalai Lama’s setting up of a de facto ‘government in exile’ based in Himachal Pradesh in Dharamsala.  The Indian Government began to allocate substantial aid for the rehabilitation of refugees and, as Indian public sympathy naturally moved towards the Tibetans, the different state governments began to allocate land for the resettlement of Tibetan refugees.

At first, many of the Tibetans were used as laborers to build roads in the Himalayan region.  Later, each of the monastic groups received a few dozen acres of land to use for setting up living quarters and some cultivation of food, an amount which seemed adequate for the few hundred refugees at each of the sites.  The Government of India also provided a small annual stipend for each refugee to help in gaining the minimal requirements of food, clothing, and shelter.

I first encountered a Tibetan while he was monk visiting the West in 1975.  He had come as a representative of the exile community to try and educate Westerners about Tibetan culture.  In small meetings with limited attendance, mostly by people who had studied yoga and other aspects of Indian culture, he and a few other Tibetans described Buddhism, but not what had happened in Tibet.  During the next few years, I was able to study with Tibetan monks and Tibetan doctors and learn about the culture; but little was said about Tibet or the situation in India, other than that Dharamsala had become the new residence of the Dalai Lama and the new Tibetan medical school (see Tibetan medicine, below).  Interest in Tibet grew throughout the Western world; a student of ITM attended the Kalachakra Ceremony conducted by the Dalai Lama and 26 other lamas in Switzerland in 1985, where it was reported that 5,000 people from 37 countries attended.  In 1982, Heinrich Harrer (best known for his book Seven Years in Tibet, later made into a popular film) visited the Dalai Lama who explained that “Tibet has a great cultural heritage to preserve, and it is that which gives meaning to the people’s lives and gives them courage to face their existence.  That is why it is important for us to concern ourselves with Tibetan culture and religion; even in exile we have done everything possible to preserve them. I have traveled a great deal over the past 24 years: I have been to North America, Europe, Australia, and Japan.  We have set up a great many new Buddhist centers and, by participating in major exhibitions, have acquainted the world with our culture.”

I visited Tibet in 1986.  The conditions there were appalling and reflected the damage done by the Cultural Revolution during the 1970’s, more than ten years before my arrival.  Despite a liberalization of the Chinese policy towards Tibet allowed by Deng Xiaoping during the early 1980’s (that made it possible for me and several thousand other tourists to enter the country), Tibet was a very troubled nation.  The monasteries, which had been the center of Tibetan culture, were in ruins; the Potala had been retained as a historical site only, and a small portion of it was available for viewing by visitors.  A handful of monks were living at the major religious sites to maintain what was left of them (compared to earlier populations of several thousands).  At what remained of Drepung Monastery at the edge of the city, I was shown the central prayer hall which had been painted with beautiful Buddhist images.  The lower half of the images were worn away; I was told that the Chinese army, after closing down the monastery and destroying most of the buildings, had converted this hall to a grain storage depot.  It has been reported that of 6,000 monasteries that were destroyed; less than a dozen have been partly or fully reconstructed.

During his return visit to Lhasa, Heinrich Harrer visited Drepung Monastery, where he had been able to spend time prior to the Chinese invasion.  He asked plaintively:

What had become of the beautifully carved wooden tables, or the silver jugs and teacups chased with good-luck ornaments?  What had become of the heavy brocade-framed thangkas, what of the abbots and ministers who had such an air of power and severity in their magnificent garments?  I was keeping my eyes open for the three novices who were allegedly to be found there, the first since the occupation.  But, all I saw were small clusters of tourists, sightseeing like myself.  Men and women from all over the world, all talking excitedly and at the same time: ‘Frightful, this destruction, how beautiful these stones are....’  Not even a shadow of doubt or misgiving crossing their faces.  Had they no idea of what had stood here in the past?

Central Lhasa outside the Potala Palace had been transformed into an ugly city of grey cement block buildings.  These apartment buildings dominated the scene, where one could still see just a few of the brightly-colored traditional-style Tibetan homes.  The structures had been rapidly built to house huge numbers of Chinese who were forced to live in this remote area that was of no interest to them.  Harrer commented: “Lhasa, whose name means ‘place of the gods,’ no longer bears any relation to that lovely name; looking at the ugly hutments and tin roofs, at the new buildings and their alien architecture, as they choke the few old quarters of the city, it is hard to believe that the gods would choose this spot for their seat on earth.”  By the time I had arrived in Lhasa, six years later, thousands more Chinese had poured into Lhasa, all requiring quick housing solutions.

Starting in 1984, some Chinese came there voluntarily to Tibet, especially Lhasa, to find work among the thousands of other Chinese, receiving financial incentives from the Beijing government, and escaping the “one family, one child” policy that was enforced in China but largely ignored in Tibet at that time.  A greater Chinese presence was desired by the Party and that was eventually accomplished.  From a population of just a handful of Chinese in 1949, there were 30,000 Chinese living in Lhasa by 1959 and an estimated 200,000 by the end of 1999, now making up more than 60% of the city’s population.  These high figures for the current Chinese immigrant population do not include the huge army presence (which resides in separate barracks at the edge of the city) nor an increasing number of unregistered Chinese migrant workers seeking employment wherever they can find it.  In other words, Tibet has been converted to a Chinese Province by moving in more Chinese than Tibetans in the major population centers.  There are about 8 million Chinese now living in the lands that once were Tibet, versus 6 million Tibetans. 

During my visit I could see that the Tibetans were clearly unhappy about their situation and, from time to time, they got into scuffles with the Chinese (which, in later years, rose to the level of protest demonstrations and riots; two of the best known ones taking place in 1987 and 1989).  There was little food, with the commune system destroying the natural productivity of both the land and the people.  The Chinese tended to be more wealthy than the Tibetans, despite the economic ideology of Communism that should assure equality, so the best food often went to the Chinese dinner table.  The Chinese leaders I spoke with regarded the Tibetans as lazy, not realizing that they were talking about a hard working people who were being forced to do things that were entirely unnatural for them.  One of the stories relayed in The Dragon in the Land of Snows has the Chinese taking away the traditional plow the Tibetans used effectively to till their fields, replacing it with another that the Chinese deemed more efficient.  Eventually, the old way was restored when it was realized that it actually worked better, at least in the hands of the Tibetans.  Most of the fruits of Tibetan labor were taken away by the Chinese, reducing the incentive for any hard work.

There was a small tolerance for religious observation at this time which one could see by the presence of a few elderly persons making the traditional circumambulation of the Potala and the flying of some prayer flags (which had all been torn down during the Cultural Revolution), but the overt practice of religion had largely been eliminated.  A few years earlier, during a brief attempt to normalize relations between China and Tibet, the Chinese Communist Party had allowed a few delegations from exiled Tibetans representing the Dalai Lama (including a brother and sister on separate visits) to tour portions of Tibet.  Huge crowds came to greet them, nearly causing a riot in Lhasa (merely from the crush of well-wishers trying to get to the visiting tour bus).  The Chinese were amazed and embarrassed to see that the decades of imposing the Communist way of life had obviously failed to diminish the Tibetan interest in their native leaders and culture.  Future visits of the exile group that had already been planned were canceled.  Negotiations between the Chinese and the Dalai Lama (via intermediaries) eventually broke down completely.

Further attempts at opening Tibet and relaxing strict Communist rule were undertaken by order of Deng Xiaoping during the year of my visit.  This is the story as relayed by Tsering Shakya in his new book (pages 402–404):

In 1986, the [Chinese Communist] Party allowed the celebration of the Monlam ceremony [the major Buddhist celebration in Tibet] for the first time since it was banned in 1967.  This had a major social and psychological impact among Tibetan people, not only in the TAR [Tibet Autonomous Region] but throughout the ethnic Tibetan areas [such as Amdo and Kham, which had been absorbed into Sichuan and Qinghai Provinces].  When the news was released that the authorities would allow the monks to hold the ceremony, thousands of pilgrims flocked to Lhasa from every corner of the country.  More than anything that the Party had done over the past five years, the decision to allow the Monlam ceremony convinced the Tibetans that the Chinese were prepared to allow the Tibetans to define what type of reforms they wanted.

The Tibetans took full advantage of Wu Jinghua’s [newly elected First Party Secretary in Tibet] liberal policy towards religion.  For the first time they began publicly to display photos of the Dalai Lama and to defy Chinese laws restricting the rebuilding of monasteries and temples [that had been destroyed during the Cultural Revolution].  The state law forbade anyone under eighteen years of age to become a monk [in the past, children as young as 12 years old were sent to monasteries to become monks], but no one paid any attention to the restriction and hundreds of young boys were sent to the monasteries.  In some remote areas like Dagyab, there were more students entering the monasteries than local schools [that had been set up by the Chinese for modern education].  The Chinese authorities wanted to restrict the numbers of monasteries and temples rebuilt, and the local people were supposed to seek permission from the Religious Affairs Bureau for such projects, but since the people were able to raise funds privately, there was very little the Chinese could do to prevent increasing construction.  The new phase of reform also served to heighten the Tibetans’ political awareness and awaken deep-seated grievances.  This pushed the reforms in a direction over which the Chinese authorities had no control.

The Communists had hoped to promote a limited but controlled revival or Tibetan culture and religion [in order to better manage the “Tibet problem”].  But people were simply not prepared to accept officially defined limits to the new freedom of religion. The Communists had always known that there was an inherent danger in arousing the Tibetans’ latent aspirations, which were naturally linked to the question of religion.  While the Chinese had granted some privileges to the former secular elite, namely the aristocracy, they hesitated in promoting many of the Tibetan lamas and Rinpoches and tried to draw a clear distinction between what they regarded as the legitimate expression of religion and its illegal use.  It was stressed that the authorities would not tolerate the use of religion to undermine the ‘unity of the motherland’ or to impede economic development [for example, by having many people spend their lives pursuing religious activities instead of laboring to reach the Communist goals].  Religious institutions approved by the Chinese, such as the Buddhist Association, commanded little or no respect from the Tibetans; neither did officially promoted Rinpoches such as Phagpa Gelek Mangyal, the head lama of the Chamdo region.  The Communists were cynical about such high-ranking lamas and Rinpoches, who were used to convey the Party’s message of economic progress and modernization.  While in public the Party promoted Phagpa Gelek Namgyal as a prominent religious leader, it was commonly known in Lhasa that an internal Communist Party document had described him as a ‘hooligan’ and that he was held in contempt.  The officially promoted Rinpoches and lamas were consequently not seen by the Tibetans as natural leaders.

By the middle of 1986 the Chinese were encountering difficulties in limiting the growing number of monks and related religious institutions.  As we shall see later, this was to present a major challenge to the authorities.  The revival of religion as the center of Tibetan life was seen by the Chinese as a step backwards both in terms of ideology and of the modernization of the region.  This view was also shared by many Tibetans [who grew up under the Chinese system and adopted the Chinese view] who say the revival of monasticism as an obstacle to modernization.  More importantly, the awakening of religious feelings brought to the fore the question of the Dalai Lama’s return.  It was evident that there was universal devotion and loyalty to the exiled leader.  The Chinese tried to separate the Dalai Lama’s spiritual and political authority, but in the minds of the Tibetans, the two were fused.  There was no doubt that the Tibetans saw the Dalai Lama quite simply as their savior, Kyabgon.

One of the main contradictions that emerged during Wu Jinghua’s period was that while the Party was prepared to make limited concessions to local conditions, it was not willing either to endorse social pluralism or to accept the emergence of social institutions [e.g., monasteries] independent of the Party. The demand for change stemmed mostly from religious institutions and the central question was whether the Chinese authorities would be able to contain the growing demand for greater religious freedom in Tibet, which it had hoped to satisfy by the readoption of the United Front [i.e., the principle of having a united effort of China and the minorities, especially Tibet, rather than simple imposition of Chinese rule over the minorities] and the extension of patronage to religious figures.  However, it was apparent that the Chinese authorities would do their utmost to resist any demands that advocated independence.  This was reflected in the imprisonment of Geshe Lobsant Wangchuck, a scholarly monk who had openly argued that Tibet not only had the right to independence but that she had never been a part of China.  In February 1983, when wall posters appeared in Lhasa advocating Tibetan independence, the Chinese authorities quickly arrested a number of monks from Drepung monastery.  In August a monk named Palden Gyatso was found guilty of spreading ‘counter revolutionary propaganda’ and was sentenced to eight years imprisonment.  The Tibetans were painfully aware of the limits of Chinese tolerance and knew that they would have to work within the restrictions imposed by the Chinese.

In 1987, the Dalai Lama visited the U.S. and made an address to Congress.  He described the aspirations of the Tibetan people and made a proposal for resolution that was entirely unacceptable to the Chinese.  This engendered a harsh criticism by Beijing against the U.S. government for allowing the Dalai Lama to have this forum.  Shakya relays:

Had it not been for the subsequent developments in Lhasa, the events in Washington would have passed as a minor diplomatic discord between Beijing and Washington.  The Chinese would simply have ignored the Dalai Lama’s proposal.  But on September 27, at 10 A.M., 21 monks from Drepung monastery marched to Lhasa and staged the first pro-independence demonstration since the fact-finding delegations of 1981.  The monks circled around the Barkor (the center of Lhasa), carrying the Tibetan national flag, and shouted demands for Tibetan independence.  The demonstrations were immediately suppressed by the Chinese police, and most of the monks were beaten and arrested.

Several demonstrators were shot and killed; the demonstrations and the violent police reaction, were observed for the first time by some of the Western visitors.  These visitors learned that many of the Tibetans that were taken prisoner were severely tortured; the events stimulated one of those visitors, Blake Kerr (Sky Burial), a young medical doctor, to investigate Chinese medical activities in Tibet.


The partial revival of monastic life in China during the 1980’s, followed by worsening repression by the Communists following the 1987 demonstrations, is what has led to the huge increase in refugee monks from Tibet entering India.  Drepung Monastery, one of three large monasteries that had existed in Lhasa (the other major institutions being Sera and Gaden), has been the source of about 2,000 new refugees arriving during the 1990’s, greatly adding to the population that had begun arriving since 1959.  Most of Drepung monks end up at the Drepung Gomang (current population 1,500) and the Drepung Loseling (current population: 2,500) refugee camps in Karnataka State (southern India, near Bangalore and Goa).  The refugees must exit Tibet over high mountain passes, usually during the winter to avoid detection, risking death by exposure (frostbite leading to amputation, and blindness are common problems of those who survive).  They risk being shot by Chinese border patrols, some of whom will shoot at refugees even after they have crossed the border.  There is a “welcoming” site at Dharamsala (where about 5,000 Tibetan refugees reside), and then the refugees are transferred to the barren land in Karnataka.  Recently, the monks from these monastic sites in India have been visiting the U.S. where they perform traditional ceremonies and try to raise money to support the refugee camps which are now receiving little help from the Indian government (see: Drepung Gomang).  The Dalai Lama has provided funds from his own international fund-raising efforts to help the Drepung monks build new facilities to house the huge number of refugees.  The Gaden and Sera Monasteries in India face similar situations of overcrowding.

In addition to the thousands of lay people and monks, several important Tibetan Buddhist leaders have escaped at great personal risk.  These include Agya Rinpoche, abbot of Kumbum Monastery in Qinghai Province, and the Karmapa, head of the Kargyu sect of Buddhism.  Both of them cited, among other reasons for their escape, demands from the Chinese that they give formal public approval of Chinese policies and that they denounce the Dalai Lama.  In addition, the Karmapa was apparently the target of an assassination attempt by Chinese operatives of unknown background.  For more information about events in Tibet, see the Tibet Information Network (


Along with the repression of Tibetan religion, Tibetan traditional medicine was also repressed in Tibet.  This medical system is tightly linked to Buddhism, and has been opposed by China on this basis.  Most of the Tibetan doctors in Tibet were working in the monasteries and had been first trained as monks.  According to the doctrine of Mao Zedong, traditional Chinese medicine (of which he considered Tibetan medicine a part, based on the premise that Tibet was part of China) had to be purged of its superstitious elements and subjected to modern scientific rigor.  Religious components of medicine, such as found in the Taoist aspects of Han medicine and Buddhist aspects of Tibetan medicine, were to be eliminated entirely.

The Chinese then imported their own medical system into Tibet, providing a combination of limited Western medicine (which they considered valid, but was practiced under unsanitary conditions and with lack of the ethical framework that is important to Western medicine) and traditional Chinese medicine (the new TCM).  The growing Chinese population relied on the Chinese medical clinics, and most Tibetans had no choice but to do the same.  One of the major medical efforts of the Chinese during the past twenty years has been to enforce a strict birth-control policy, using the medical facilities to perform abortions and sterilizations, procedures that previously had been completely a secret and based on voluntary participation in Tibetan medicine..

During my visit to Lhasa, I was able to visit the newly refurbished Tibetan medical school.  The original Tibetan medical school, which had been located on a small peak (Chagpori also spelled Chakpori: Iron Mountain) near the Potala Palace, had been reduced to rubble by mortar fire during the 1959 uprising.  The Chagpori school had been sponsored by the 5th Dalai Lama (his long reign lasted from 1617–1682); he had already established small medical centers at several monasteries and responded to needs for a central facility.  A second medical school, Mentseekang (spelling usually used for transliteration), was established by the 13th Dalai Lama (his reign was from 1895–1933).  This was built under the auspices of Kyanrab Norbu, the most famous Tibetan physician of the 20th century.  His knowledge was more extensive than any other scholar in Tibet, and his abilities were commended everywhere.  In 1915, he began the medical school, which functioned until 1959.  The college had received one student from every major monastery in Tibet (altogether about 150), so that the returning graduate could provide medical services at each institution.  Mentseekang has been re-established under the authority of the 14th Dalai Lama in Dharamsala, India. 

Chagpori was never rebuilt in Tibet, but the Chagpori Tibetan Medical Institute was set up in Darjeeling by Dr. Trogawa Rinpoche.  The Mentseekang, which I was able to visit in Lhasa, was staffed by a few remaining Tibetan doctors (who had not fled or been killed).  They had the traditional style training; there were also some younger doctors who had studied Chinese medicine as well as the fundamentals of Tibetan medicine.  The doctors readily admitted that under the new conditions, most Tibetan doctors received very limited training and the application of traditional Tibetan medicine was not really practical.  They commented that the traditional pills required new research to understand their uses, since the traditional style information was of limited value under the new system.

Medical training before the Chinese incursion was intensive and unique (5).  Students resided at the medical college and were awakened at 3 A.M. to recite prayers.  They then learned medical and astronomical texts by heart and recited them until 6 A.M.  At 6 A.M., they began physical exercises, like gymnastics and running.  At 8 A.M. they went back to have breakfast and to perform more prayers.  Students were then divided into advanced and less-advanced groups; the former received training direct from Kenrab Norbu or his assistant on the Four Tantras; the latter received basic theoretical training in medicine and astronomy (new students first learned grammar, reading, writing, and poetry).  After lunch, at 1 P.M. the students had to learn anatomy, physiology, and herbal identification; new students had to learn mathematics, geometry, and history of medicine.  Lectures were finished at 5 P.M., and then there was a break for tea and dinner.  At 7 P.M. all students would gather for discussion and debate; prayers ended their session at 9 P.M. 

Nowadays, the studies in Lhasa fit a more standard modern-style schedule and are largely devoid of the prayers and other traditional aspects, though the Tibetans try to retain as much of the basic course as possible.  Mentseekang (Tibetan Medical and Astrological Institute) in Dharamsala has the freedom to pursue the classic approach.  The facility was founded in 1962 and now graduates 30–40 doctors after every five years; these graduates operate clinics throughout India and a few of them travel to the West to promote traditional Tibetan medicine. Three seats are also available to Westerners who are fluent in the Tibetan language used in all the medical texts and teachings; short English-language courses are sometimes presented for visiting medical tour groups.

Some Chinese scholars and researchers have undertaken an academic study of traditional Tibetan medicine, mainly examining the herbal substances and formulas that were being used, as well as methods of herbal processing and general instructions for health care. In 1992, the Chinese Journal of Ethnomedicine and Ethnopharmacy was established, which carries most of the articles.  In the introductory issue of the journal, an article, Survey of Tibetan medicine (6), began:

Tibetan medicine is a traditional medicine of the Tibetan people, which possesses an integrated and complete theoretical system with rich practical experience over a long time.  It is a splendid jewel in the Chinese medical treasurehouse, and a precious practical conclusion of struggling against diseases for over 2000 years by the Tibetan nationality living at the roof of the world.  Tibetan medicine is widely practiced in Tibet, Qinghai, Gansu, Sichuan, and Yunnan Provinces.

The reference to “Chinese medical treasurehouse” is based on a phrase of Mao Zedong, in which he justified continued use of traditional medicine within the Communist doctrine that would otherwise condemn it (as belonging to the superstitious tradition and the feudal period).  This was necessary because of the dearth of modern medical practitioners and modern medical equipment and drugs in China at the time.  Modern medicine had been introduced in the latter half of the 19th century and was given a big boost after the establishment of the Republic, headed by a medical doctor (Sun Yatsen).  Traditional medicine had been repressed, though hardly eliminated, during the subsequent decades.

In this introduction, it is mentioned that Tibetan medicine, implied to be part of Chinese medicine, is widely practiced in several Chinese provinces, of which Tibet is just one.  Indeed, portions of what the Tibetans would regard as Tibet have been absorbed into these Provinces.  There are also Tibetan people who live in areas that have long recognized to belong to the Chinese. 

In a later article, Tibetan medicine: history of development and theoretical system (7), it is stated that “Han national medicine had given a strong influence on Tibetan medicine.”  While the Tibetans are quick to acknowledge the international character of their medical system, the fact is that most of its influences are not from Han medicine (the Chinese tradition).  The principle influences were the local shamanistic medicine that was present during the pre-Buddhist era of Tibet, the Ayurvedic system, brought along with Buddhism from India, as well as the subsequent work by the Tibetans with these earlier systems. 

Chinese medicine had introduced into Tibet a very limited acumoxa therapy (with moxibustion already performed in Tibet mainly by application of heated metal rods to certain points, attributed to the Mongolian tradition) and some herbs that came from the regions adjacent to the Tibetan plateau.  The three-finger pulse diagnosis used in China was adopted in Tibet, but modified considerably, so that the method of feeling the pulse and determination of its indications are different.  The pulse system naturally incorporated some of the Chinese Five Element and Six Organ System theory, but only to a limited extent; it is rarely referenced beyond the pulse taking connection.  Although the Tibetan system has a Five Element underlying framework, it is the Ayurvedic version (involving earth water, fire, air, and space) and not the Chinese system.  Still, in linking the internal organs to their external counterparts (e.g., lung to nose, liver to eye, kidney to ear), the Tibetan system followed the Chinese model.  Almost none of the traditional Chinese system of yin/yang and other base theories, and little of the meridian system and physical therapies were adopted by the Tibetans.

The somewhat limited influence of Chinese medicine (Han medicine) occurred mainly because the dominant feature of Tibetan medicine, as has been practiced for over a thousand years, had already been formulated from Indian Buddhist principles prior to the arrival of influential Chinese visitors.  Although some Indian medicine had been introduced as early as the 4th Century A.D., the key to Tibetan medicine was the Four Tantras that were written in India during the 4th Century and brought to Tibet (there translated to Tibetan) at the end of the 8th Century.  A group of Tibetan medical texts that just predated the Four Tantras was unearthed at the Dunhuang Grottoes and taken to museums in Paris and France (8).  These manuscripts mentioned 180 kinds of drugs, 69 prescriptions, and moxibustion, which was applied to hot-type diseases as well as cold-type diseases.  There was no description of acupuncture. 

The influence of other foreign medical systems, including Greek, Iranian, and Chinese, came largely during an international medical conference at Samye Monastery during the 11th century.  These aspects were incorporated into a revision of the Four Tantras by the younger Yuthog Yontan Gonpo (1112–1203 A.D.), considered the leading historical authority on Tibetan Medicine.  As an example of the foreign influence, the Tibetan emphasis on urine diagnosis, which is not utilized in either India or China, is attributed by the Tibetans to the influence of Greek medicine.

In the conclusion to the Survey of Tibetan medicine, the author states: “In a word, Tibetan medicine and pharmacy are one component of the Chinese traditional medicine treasures, and have a long-standing history and abundant implications for application to therapy.  We should therefore undertake to earnestly excavate, investigate, systematize, carry forward, and further improve it.”

Unfortunately, a great wealth of knowledge of Tibetan medicine was destroyed by the Chinese.  As mentioned by T.J. Tsarong in his book Fundamentals of Tibetan Medicine (9): “If it had not been for the ruthless and senseless destruction of Samye Monastery during the Cultural Revolution, we would still have found the original [Sanskrit] and the translation [Tibetan] of the Four Tantras.”  Tsarong dedicated his book to “The people of Tibet who must preserve their cultural heritage and identity at all costs.”

Among the Tibetans escaping to India in 1959 was doctor Lobsang Dolma.  She was one of the few female traditional doctors to come out of the otherwise male profession and was regarded as an incarnation of Yitrogma, the goddess of medicine.  As a chief physician at the Mentsekang in Dharamsala, the Dalai Lama sent her to give talks in Europe and the U.S. during the 1970’s in response to requests for information about this aspect of the Tibetan tradition.  She became the first Tibetan doctor to give extensive lectures in the West (the lectures were in Tibetan and translated to English); others followed soon after, including Dr. Yeshe Donden (who had been the Dalai Lama’s personal physician at that time).  The teachings of Dolma and Donden led to publication of several books on Tibetan medicine.

ITM has obtained some translated articles on the Chinese investigations of Tibetan medicine, with plans for disseminating the information in future articles.  Although there is some general academic interest in this field of study in China, the main reason for the investigation is to determine if some of Tibet’s natural resources can be utilized in the manufacture of new herb-based drugs, which can then be used as a source of economic development, both through sales within China and for foreign exchange as the products are promoted internationally.

During my visit to Lhasa, I inquired about the possible export of Tibetan raw materials to the U.S. as a means of economic cooperation.  While the Tibetans had some medicinal materials to offer (they were all items commonly used in traditional Chinese medicine, such as bupleurum and fritillaria), they really had no mechanism for establishing trade. Also, there was no means in place for providing information about the botanical identity of the products (different species can be expected in the isolated Tibetan environment, compared to those obtained in the Chinese lowlands).  Since then, some small factories in Tibet have been set-up (under direction of the Chinese Communist Party) to trade in raw materials and some finished products.  One of the main herbal exports is rhodiola, an adaptogenic herb (see: Tibetan herbal medicine: with examples of treating lung diseases using rhodiola and hippophae) which had been promoted by both Russian and Chinese proponents of herbal health products. 

The medical school in Dharamsala established more 30 years ago is helping to perpetuate Tibetan medicine.  A number of Tibetan physicians who had escaped from Tibet work and teach there as well as traveling in the West to present background information about Tibetan medicine.  Several interested individuals in America and Europe have sponsored visits of Tibetan physicians and have established small organizations to promote interest and study of the medical system (see: Resource guide to Tibetan medicine; also, visit the website Western students have also been able to attend short medical training sessions in Dharamsala.  At Drepung Gomang in India, a medical facility has been built where a young Tibetan doctor (from Tibet) is in charge.  He had studied both Tibetan and Chinese medicine in Lhasa and now offers treatments to the refugee community in Karnataka.  Thus, attempts are underway to maintain Tibetan medicine under difficult circumstances; continued efforts are essential given the enormity of the task at hand.


1.      Tsering Shakya, The Dragon in the Land of the Snows: A History of Modern Tibet Since 1947, 1999 Columbia Press, New York.

2.      Harrer H, Return to Tibet, 1984 Butler and Tanner Ltd., London.

3.      Kerr B, Sky Burial: An Eyewitness Account of China’s Brutal Crackdown in Tibet, 1993 Noble Press, Chicago, IL.

4.      Lobsang Dolma, printed interview (booklet), ca. 1978 Vajrapani Institute, Boulder Creek, CA.

5.      Rechung Rinpoche, Tibetan Medicine, 1976 University of California Press, Berkeley, CA.

6.      Qinghai Provincial Hospital of Tibetan Medicine and the Research Institute of Tibetan Medicine, Survey of Tibetan medicine, Chinese Journal of Ethnomedicine and Ethnopharmacy, 1992; (1): 40–41.

7.      Guo Jiening, et al., Tibetan medicine: history of development and theoretical system, Chinese Journal of Ethnomedicine and Ethnopharmacy, 1995; (14): 1–5.

8.      Hong Wuli, Ancient Tibetan medical scrolls unearthed in Dunhuang Grottoes, Chinese Journal of Integrated Traditional and Western Medicine 1999; 5(4): 296–299.

9.      Tsarong TJ (translator and editor), Fundamentals of Tibetan Medicine, 1981 Tibetan Medical Center, Dharamsala, India.


14th Dalai Lama teaching Kalachakra,
1985 Switzerland.

Exiled Tibetan physician, Lobsang Dolma,
1976, California.

Potala Palace, 1986, Lhasa.

Tibetan medical staff at Mentseekang (hospital section, below), 1986 Lhasa.

Herbal Medicine Page from Traditional Tibetan Medical Text,
1986 Lhasa.

May 2000