Medicine, Science, and the Everyday in Tibetan Art

The colorful and unique set of seventy-nine medical paintings from late seventeenth-century Lhasa depict in vivid detail and innovative form the core ideas of Sowa Rigpa, the Tibetan “science of healing,” or Tibetan medicine. The mastermind behind it was Desi Sanggye Gyatso (1653–1705), the regent to the Fifth Dalai Lama (1617–1682), who unified the Tibetan regions and established Lhasa as the new capital. The painting set illustrates Desi Sanggye Gyatso’s medical work Blue Beryl, which is his own commentary on the Four Tantras (Gyu zhi), Tibetan medicine’s foundational twelfth-century text comprising overall 156 chapters in four volumes.

Both the Fifth Dalai Lama and Desi Sanggye Gyatso took a keen interest in developing academic medicine as a novel means to define, classify, and control knowledge about the body, and by extension their Tibetan subjects, in support of their political pursuits and ambitions, another example being The White Beryl, a comprehensive work on the related field of divination and astrology. On a practical level, the medical set served as an indigenous mind map in aid of the memorizing of the Four Tantras (and the Blue Beryl) for ready recall in exams and during clinical and pharmacological work. For this purpose, the set was first displayed for students at Lhasa Chakpori Medical College, which opened in 1696 (fig. 2). The college, located opposite the Potala Palace, was built around the same time the medical paintings were created. The set also helped settle medical disputes of the time.

Content and Structure of the Painting Set and Relationship to Medical Texts

The painting set maps closely onto the structure and the content of the Blue Beryl commentary by Desi Sanggye Gyatso on the Four Tantras. The Root Tantra, the name given to the first volume of both texts, has six chapters that cover the origins of the Tibetan medical teachings and the foundational ideas of Tibetan medicine. In the painting set, the first six paintings of the total seventy-nine illustrate the Root Tantra: the first plate shows an image of the Medicine Buddha in a palace teaching the Four Tantras; Paintings 2–4 depict the “unfolded trees” with overall nine trunks (fig. 3), forty-seven branches, two hundred and twenty-four leaves, and five flowers and fruits. Small paintings on each branch, leaf, and flower visually illustrate core Tibetan medical ideas—for example, related to the digestion process—or particular kinds of behaviors that are considered wholesome or unwholesome. The tree paintings in particular acted as a summary of major aspects of the medical system and a visual mind map for memorization. Painting 5 shows in descending horizontal rows the development of the fetus during pregnancy, concluding in two birthing scenes at the bottom right corner. Painting 6 describes metaphors and measurements of the body, essentially likening anatomical aspects to a Tibetan house and to elite members and functions within the Tibetan government, including a queen, a king, and their ministers.

The Explanatory Tantra, the name given to the second volume of the texts, has thirty-one chapters covering eleven broad themes, including the anatomy of the body, diseases, behaviors, diet, pharmacology, diagnosis, methods of healing, and medical ethics. The illustration of this volume begins with Painting 7. Paintings 7–15 show large-scale abstractions of human anatomy and physiology. Paintings 16–22 detail prognoses as well as adjustment to personal conduct and diet. The large subject of materia medica is covered in Paintings 23–33, including detailed drawings of stones and minerals and of primary and supplementary medicinal plants (fig. 4), as well as information on their pharmacological compounding. Plates 34–36 depict the external therapies of bloodletting, moxibustion, and golden-needle acupuncture, with the Explanatory Tantra concluding on the qualities of a physician and medical ethics in Painting 37.

The Instructional Tantra, the name given to the third volume, is the largest, with ninety-two chapters, and covers in great depth the treatment of hundreds of conditions within fifteen broad categories of diseases, for example, fevers, children’s diseases, and women’s diseases, including the use of elixirs for rejuvenation and long life. Illustrations of the Instructional Tantra are found on Paintings 38–67 and characterized by detailed drawings of varied pathology (Paintings 38–52), of the topic of virility and fertility (Painting 53), and of diagnostic methods, including tongue, pulse, and urine diagnosis (Paintings 54–67) (fig. 5).

The Last Tantra and fourth volume, with twenty-seven chapters, covers the four broad divisions of pulse and urine diagnosis, pacifying medications, eliminative therapies, and external therapies (including large-scale drawings of the body with bloodletting points), illustrated on Plates 68–79. Aligned with the last two chapters of the last volume of the Four Tantras and the Blue Beryl are Plates 77 and 78, which conclude the set with a depiction of the “entrustment” of the medical tradition, that is how Tibetan medicine should be protected and safeguarded for future generations. In one early twentieth-century set, Painting 80 was added, portraying several key scholars and sponsors of medicine into the early twentieth century (fig. 6).

The Everyday

The detail in the paintings was unprecedented in Tibet at the time and remained unique even centuries later and across Asian scholarly medical traditions.1 One special feature was the depiction of people not just as patients in medical consultations, but in a wide range of contexts. Seeing ordinary folk going about their lives in these paintings is delightful and also opens a unique window onto the social history of certain groups of Tibetan society in the seventeenth century not well represented in religious art. For example, on the dietetics thangka (Painting 22) (fig. 1), we see depictions of farmers and pastoralists milking their animals, collaborative food preparations, and sources of drinking water in the high Himalayas.

Artistically, the paintings added substantially to the range of expression possible for Tibetan and Himalayan artists, who had previously focused almost entirely on the representation of extraordinary beings such as buddhas, deities, and religious teachers. Here, only few such depictions creep in. Instead we see several thousand individual paintings of people, animals, plants, concepts, and objects, many of them shown in a new format: often small and in cartoon-style, the paintings are lined up on horizontal panels. Sometimes as many as one hundred smaller paintings are found on one thangka, each with a caption. Although in a close relationship to the Blue Beryl text, the often lively renderings go beyond what the texts could achieve or would have required in order to conform to scholarly standards.

The content, style, and format of the paintings effectively convey original expressions of newly gained and alternative forms of authoritative visual knowledge about the world, life, and the body. While the medical scholars and artists involved in the project (including the Desi himself) operated within the cultural and religious constraints of the Buddhist religion, the medical paintings express their empirical observations, in some cases, also the result of vivid debates. For example, to settle questions about the number and exact form of bones in the human body, empirical evidence was gathered from corpses and the results were drawn on Painting 49, taking such inquiry to the greatest lengths possible. As seminal work by the scholar Janet Gyatso has shown, the team behind the medical paintings was not content simply to follow prevailing scriptural authority in medicine and religion.2 An intriguing question remains: to what extent are these medical paintings evidence of an early scientific revolution in Tibet?

Beyond the Text

The paintings explicitly illustrate textual information of the Blue Beryl, yet there was also the concurrent creation of text and paintings—with a painting in the Potala Palace to prove this.3 The influences went both ways, from texts to paintings and paintings to texts, elucidating and enhancing understanding of many aspects of medicine. However, beyond sharing and explaining visually enhanced medical information, as well as feeding back new knowledge to the texts, the paintings also do something entirely new: with a sense of humor and delight in the vividness and idiosyncrasies of life, the artists provide realistic impressions of Tibetan society at the time. In addition to the already mentioned examples on the dietetics thangkas, we see aspects of disability and sexuality quite freely and seemingly nonjudgmentally (and nonreligiously) explored, a mind-boggling array of Tibetan hairstyles, animals takings thrones from human kings to explain concepts of medical lineage, and women both depicted and discredited in favor of male norms.

The sumptuous execution of the paintings, the coproduction of Desi Sanggye Gyatso’s Blue Beryl medical work and the medical paintings by a group of artists, also shines important light on the broader political concerns of the time. Building the foundations of a more modern state, by exerting power through knowledge, and particularly by new knowledge about the body, seemed to offer an alternative to the use of brute force in geographically expanding the unified theocratic state.

The Original and Copies

Many copies have been made from the original late seventeenth-century set, the first by students and visitors to the college. Over time, the entire set and also individual paintings have been copied in a variety of media (including canvas and paper) and sizes, for use across the Himalayas and Tibetan Plateau, as well as in Buryatia and Mongolia, where Tibetan medicine also spread.4 Copies of the set’s materia medica drawings are often found in more portable forms, such as illustrated manuscripts and woodblock-printed books.5 Anatomical drawings and those detailing the application of external therapies such as moxibustion and bloodletting, meanwhile, were also copied on larger sheets of paper and used to instruct students even in remote regions.6

A particularly beautiful set of all seventy-nine paintings was produced in Lhasa in the early twentieth century and is preserved in Buryatia.7 As the global interest in Tibetan medicine and Himalayan art has risen steadily since the 1990s, many copies of this particular set and its individual paintings have been made, mainly in Tibetan and Nepalese thangka studios, at relatively affordable prices. They have been shipped across the world and are now displayed in diverse settings.