In one of the sessions at an ITTM workshop in September 1996 documentation of case reports of patients that are treated with traditional Tibetan Medicine was discussed. Views among the participants differed on finding methods that would document the traditional mode of diagnosis (pulse and urine) and on using allopathic investigations, such as blood tests, etc., in the context of the effectiveness of Tibetan medicine.

The following report of the noted Tibetan physician Dr. S. Wangdu Changbhar presents a case study of a patient with chronic aplastic anaemia. The patient was diagnosed and successfully treated with Tibetan medicine. The entire process of treatment was however monitored and documented through regular blood tests, not for the purpose of diagnosis but for noting the progress in treatment as per allopathic parameters. Such investigative tests are not used for diagnosis in traditional Tibetan treatment but are applied by a number of Tibetan practitioners today.

During a recent interview with Dr. Changbhar on the subject it became clear that he, as a practising Tibetan physician in India as well as abroad, has been facing continuous questioning and scepticism by patients as well as biomedical practitioners. His attempt to improve communication and understanding between the different medical cultures has led him to explain Tibetan diseases, diagnostic and therapeutic methods with modern medical terms. His 30,000 odd patient records - most of them allopathically rejected cases with files of biomedical reports - include therefore BP and blood test results. His Tibetan pulse readings are recorded in a Tibetan handwritten script for his own reference, of which mainly the conclusions to which they lead him are being communicated to the patient and that again mainly in modern medial terms. This situation has led to an interesting amalgamation of a traditional method that is communicated and documented with modern medical parameters for the sake of being understood in a daily clinical situation where the cosmological concept of the five elements, rlung, mkhris pa and bad kan remain incomprehensible and foreign.

 
The Case Report

 Aetiology (abridged)

 The patient (male, 63) came to our clinic in April 1994 after various hospital treatments. His biomedical diagnosis was stated as chronic aplastic anaemia. Besides he was suffering from angina pectoris (grade III), chronic colitis, amoebic ulcers and bleeding piles. Laboratory tests showed a very low haemoglobin (4.1.gm/dl: normal range varies between 10 gm/dl to 16 gm/dl), the ESR was 80mm/1st hour (normal: less than 10mm), RBC Hypochromia (++), platelets appeared to be reduced. Six bottles of blood had been transfused within two months without showing any improvement in his condition. The patient, after various hospital treatments, was advised to undergo a bone marrow transplantation in Europe since a bone marrow test confirmed his diagnosis. It was beyond his capacities to follow the doctor's advice and he was finally treated with three bottles of blood transfused every month and steroid injections (Decaduraboline 50 1/m) every ten days. Within two weeks after each blood transfusion the Hb went again down to 3.1 gm/dl. His Haemoglobin at the time of reporting to our clinic was 3.1 gm/dl, his BP 120/40mmHg.

 Tibetan Medical Diagnosis

1. Observation and Questioning
The patient appears thin and pale, with swollen face and legs, lethargic and with breathing difficulties, reporting constipation and loss of appetite, giddiness and disbalance of the body, virtually at the stage of collapsing.

2. Pulse Diagnosis
The pulse reading shows a very slow and low pulse. From its specific characteristics it is understood by the physician as a sign of a disease in Tibetan called chong chen.

3. Urine Diagnosis
(because of technical problems this technique is not applied)

The disease is diagnosed in the Tibetan system as a combined disorder with the main diagnosis being chong chen, meaning "great wasting". It is characterised by the loss of haemoglobin. (In the Tibetan tradition six types of chong chen are known and explained in chapter 11 of the third Tantra in the rgyud bzhi.)

The aim of the Tibetan treatment is to restore a balance between the five elements and three humours. For this the following medicines are prescribed:

Tibetan Medical Treatment

 rin chen yu snying 25 special (Old Turquoise 25 sp.) 1 pill at 6 AM every second day, to support the liver functions.
zhi ru (Pacifying Saussurea) 2 Pills at 6 AM every second day, together with No.1, against constipation.
gur gum 8 special (Saffron 8 sp.); 4 Pills 10 AM daily, to treat the bleeding piles and to support the liver function}.
se ‘bru kun bde (Continuously Comforting Pomegranate); 3 pills at 3 PM daily, to increase the digestive heat. This medication was at times changed to da li 16 (Rhododendron 16) to treat the swellings.
a gar 8 (Eaglewood 8) 4 pills at night, daily; to treat angina pectoris.

Diet plays an important part in the treatment. The following advice was given to the patient: to avoid sour and fermented food, to take high protein food, such as mutton, beef or liver, green and bitter leaf vegetables.

Effect of the Tibetan Medical Treatment

 After one month of taking Tibetan herbal medicines there was a remarkable improvement. The patient had gained his appetite, constipation eased, swellings considerable reduced. His Hb had raised from 3.1. gm/dl (April 1994) to 7.4 gm/dl (May 1994). He had stopped all blood transfusions and steroid injections. Other complications like chronic colitis and bleeding piles were cured. After eight month of treatment his haemoglobin was 9 gm/dl. By July 1995 his Hb was 10.44 gm/dl. Since May 1995 he has been leading a normal life without any medicines.

The patient himself expressed his improvement in excerpts of the following letter, dated 9.3.1995:

" ...I have been under your treatment since April 1994 as a patient suffering from aplastic anaemia. Prior to your treatment my blood level went down to 3 point every month after the transmission of blood within a fortnight or so. So every month I had blood transmitted into my body at least three bottles and thus in all 31 bottles of blood had been transfused to my body. But your herbal medicine within three months did miracles for me. Gradually my blood level showed signs of getting higher and after eight months it stands at 9 point. This gives me strength for doing normal works even at the age of 64. My words fail to express my gratitude to you for doing a God like deed to a dying man. ..."

* Sonam Wangdu Changbhar, graduated from the Tibetan Medical and Astro Institute in Dharamsala in 1977 and in 1978 received the Menrampa Degree (M.D.). He has served at TMAI branch clinic at Bylakuppe, Mysore, as a chief physician till 1988, and since then has been working as a private physician in two clinics in Calcutta. He was awarded (F.I.C.A.) by the International Council of Ayurveda and is a Honorary advisor to the Indian Board of Alternative Medicines. A Gold Medallist in Tibetan Medicine he has been teaching and practising in many countries in Europe and Asia. In 1997 he was honoured D.Sc. (Honoris Causa) by the Open International University for Complementary Medicines, Colombo.

 For Details Contact: