Bhutanese Traditional Medicine

1. Traditional Medicine in Bhutan  

Traditional medicine in Bhutan is known as gSo-ba Rig-pa and is one of the oldest surviving medical traditions in the world. Other medical systems, such as Chinese medicine, Indian Ayurvedic medicine, Unani medicine, Greco-Roman medicine and the country’s rich cultures and traditions have greatly influenced the way traditional Bhutanese medicine evolved. However, Buddhist philosophy remains the mainstream of this medical system. gSo-ba Rig-pa’s principles are based on the perception the human body is composed of three main elements: rLung (‘Air’), mKhris-pa (‘Bile’) and Bad-kan (‘Phlegm’). When these three elements are balanced in the body a person is said to be healthy. The pathophysiology is also different from other medical systems, and the close link to Buddhism is reflected in the spiritual dimensions and the perception that all suffering is caused by ignorance. The treatment of diseases includes behavioral modification, physiotherapy, herbal medicines, minor surgery and spiritual healing. This makes the traditional medicine a unique and holistic health care system. The traditional medicine is an integrated and recognized part of the formal health care services in Bhutan under the auspices of the Ministry of Health.

2. History of Traditional Medicine in Bhutan

Traditional medicine was introduced as a part of the national healthcare system in 1968 under the Royal Command of His late Majesty Jigme Dorji Wangchuck, the third King of Bhutan. Recognizing the benefits and importance of traditional medicine, the Royal Government of Bhutan has accorded high priority in the development of traditional medicine as an alternative choice of treatment for the people of Bhutan. Today, traditional medicine services are integrated with modern medicine and available in all Districts Hospitals and Basic Health Units in the country. The traditional medicine is known as gSo-ba Rig-pa, and it has originated from Tibet in the 17th century. Traditional medical practice also takes into consideration the idea that some unexplained illnesses may ultimately be caused by someone’s karmic forces or even by evil spirits. 

Environmental sustainability of medicinal plants

Medicinal plants and traditional medicine play an important role in the health care system of most developing countries. The traditional health care practice is mainly dependent on medicinal plants collected from the wild. In spite of this, the medicinal plant biodiversity is being depleted due to man-made and natural calamities. Moreover, the indigenous knowledge associated with the conservation and use of medicinal plants is also disappearing at an alarming rate. 

The goal of conservation is to support sustainable development by protecting and using biological resources in ways that do not diminish the world’s variety of genes and species or destroy important habitats and ecosystems. In general, it involves activities such as collection, propagation, characterization, evaluation, disease indexing and elimination, storage and distribution. The conservation of plant genetic resources has long been realised as an integral part of biodiversity conservation.

Body In Balance

Traditional medical theory ascribes disease to an imbalance of three bodily “humors” or vital essences: bad-kan (the water humor, associated with bodily cohesion and support); mkhris-pa (the fire humor, responsible for heat and digestion); and rlung (the wind humor, producing breath and mobility). The humors, blood and other fluids are thought to circulate through a network of channels that intersect at various important points within the body called chakras.

Unhealthy behavior (including sexual indiscretions), toxins and improper diet are thought to cause humoral imbalances, as are unfriendly spirits or evil deeds performed in past lives. Treatment often includes traditional mixtures of Traditional herbs – sometimes as many as 165 plant species in a single pill – which traditional physicians are taught to identify, collect and prepare.

To diagnose illness, traditional physicians talk to and keenly observe the patient. They also check the color, smell and other characteristics of urine and perform a detailed and subtle evaluation of the patient’s pulse, which they examine with several fingers placed on the wrist.

Traditional medicine is not like Western medicine. A lot of Western medicine, you take it and you expect immediate results within a day, or two days at most. Traditional medicine is rarely that way, and so generally speaking, Westerners should not take Traditional medicine with any expectation that it’s going to give immediate results. In many cases, after maybe 25 or 30 days, they might start to see some results. 

What is of primary importance is that the patient follows the appropriate diet, abstain from certain types of injurious foods, and follow the appropriate behavior. Traditional medicine practice is based on the ancient science of healing based on Buddhist philosophy and psychology.

3. External Therapies in Traditional Medicine

The traditional medicine also uses numerous techniques of external therapies such as the bloodletting, golden-needle and moxibustion, acupuncture, massage, cupping, herbal ball compression, oil compression, nasal cleansing and steam treatments as explained in the sections below.

Sometimes it becomes necessary to prescribe additional therapies like bloodletting, golden-needle, and moxibustion. Once again, the physician not only has to know precisely when to perform the therapy, but also on which exact location of the patient’s body. Here it becomes very important to understand the concept of Bla (vital energy). It is that element which supports our vitality or life itself. It is a form of energy located predominantly at the heart and yet it circulates around the body in a 30-day lunar cycle. While performing such external therapies, one has to avoid treating the point on the body where the Bla resides on that particular day. Moreover, there are certain dates which are not suitable for performing such therapies, and the patient’s astrological Adversarial Days are also taken into consideration. Therefore, choosing the perfect day, date and hour for the therapy to be performed becomes really important for the physician. This is possible only if the physician has an understanding of the interpretation of astrological calculations elaborated in the almanac.

Acupuncture

Acupuncture is designed to re-establish the body’s natural flow of energy, relieve emotional and physical blocks and stimulate the immune and hormonal systems. Hair thin needles are applied to specific points on the body which effectively remove blocks and boost the body’s inherent ability to heal itself.

Traditional Massage Treatment 

Based on the type of sickness, different oils such as rancid butter, sesame oil, and animal fats and herbal substances are used to apply during the traditional massage treatment. Generally, the massage therapy is recommended for stiff joints and muscles; eye disorder; skin diseases; stress; old age; insomnia; and especially for those patients having wind as predominant humor.

The benefits of this massage treatment are that it prolongs one’s life, helps in clearing of senses; cures depression; balances emotional upheavals; fainting; and cures wind related diseases.

Cupping

In this treatment method, cups made from copper, brass or glass with round bottom and opening is used. A small piece of paper is lighted and put inside the cup and it is placed over the target area of treatment. This treatment is used for treating diseases such as back and breast pain; body pain due to accidents; food poisoning; shortness of breath; lower back tissue disorder; tumor, boils, blood and pus. There is also a cupping treatment technique in which the sucked portion of that particular area is split open using a surgical blade and the bad blood and pus are let out of the body.  

Gold Needle Treatment

According to the four Tantras (rGyud-zhi), gold is astringent in taste and has a cool potency. It is ascribed with several therapeutic efficacies. It is an antidote and promotes longevity. Moreover, cauterization with golden needle is less painful compared to other cauterizing agents like iron rod therefore reassuring patient compliance. It is accredited with multitude of healing capability like rejuvenation of cut vessels, diseases of brain matter and etc.

Golden needle is about two and half inches in the length and about one and half mm in diameter (on an average). It’s of pure gold with few coils at one end and pointed on the other apex. Both needle and the précised areas of the application are the deciding factor. The point’s on the channel corresponds to a particular organ. Acupuncture points are specific in locations on the channel that may be needled to affect the balance of its energy and thereby regulate the function of its corresponding organ too.

Conditions due to Bile, Blood, Jaundice and those conditions which are hot in nature and pregnant ladies are not advisable. Application near the orifice and right after having the food should be restricted.

For the following conditions, the golden needle therapy is useful and recommended:

1. Respiratory: Sinusitis and Synocytises, Asthma and Chest pain etc. 
2. Orthopaedic: Arthritis, Gout, Rheumatism, Lower backache, Oedema, Cervical spondylosis, Periathritis etc. 
3. Neurological: Paralysis and fibrositis, Neuritis, Neurosis, Necrotic, varicose veins, Colic and Sciatica, Anagesia, Vertigo, Headache, Migraines, Hay fever etc. 
4. Other: Vitilogo, Warts, Insomnia, Obstinate skin diseases, Anxiety, Chronic Gastritis and tumors etc.

Herbal Ball Compression

The herbal compress ball (Herbal Ball) made from various dried medicinal herbs wrapped in cotton is used for traditional medicine treatment. There are two types of Herbal ball Compression used for relaxation therapies known as hot compression and the cold compression. Hot ball compression is performed by packing some hot herbal in a clean cloth (muslin cloth) and it’s done on the desired body parts of the clients. Cold compression therapy is performed by packing some cold herbal in a clean cloth (muslin cloth) and it’s done on the desired body parts of the clients.

Back pain; indigestion; pain due to accidents; pain due to broken tissues, bones and muscles; swollen body parts.

Hot Oil Compression

In this traditional treatment method, the medicinal herbs are wrapped in a clean cotton cloth and made into appropriate balls and then it’s heated in sesame oil for about five minutes or so. Once it’s heated then the balls are squeezed to let the oil out and then the balls are pressed/applied onto the target area of the sick person.

It helps in insomnia, giddiness, and Stress, especially old aged people. For patients with dominant wind element (Lung), this method is also very effective. It is also effective for skin rejuvenation, anti-anxiety and tinnitus.

Herbal Steam Treatment

In this method of treatment, medicinal herbs are boiled in a air-tight container and the vapor emitting from the container is channeled and applied onto the appropriate treatment area. It helps in curing the back pain; pain due to accidents; pain due to broken tissues, bones and muscles; swollen body parts.

Nasal Cleansing

The method of treatment in which the medicinal herbs are boiled in an airtight container and the vapor emitting from the container is channeled and applied onto the nasal area and after that a specific herbal medicine droplets are applied on the nose which is known as nasal cleansing. 

This treatment is helpful in curing the sinuses, head-related diseases, and other five senses.

Blood Letting

Those diseases related to blood and bile combination are treated through a process called blood letting. The point of application has to be clearly identified and the bad blood is removed by letting out the blood by cutting with a surgical blade.

This method of treatment helps in curing the swellings caused due to bad blood and pus; traumatic fever (grams-tshed), disturbed fever (khrugs-tshed) injections, swelling, wounds, gout, rounded red rash on the skin associated with sores on specific organs, erysipelas, abscesses, leprosy, disorders of liver, pancreas, eye, head and in general, all the hot diseases caused by imbalance of blood and phlegm (mkhripas).