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The Fundamental Treatise rgyud-bzhi

The fundamental medical treatise, the rgyud-bzhi, is comprised of four sections, usually known as the Four Tantras:
  1. the RCTA Tantra
  2. the Explanatory Tantra
  3. the Oral Tradition Tantra and
  4. the Last Tantra.
    The Fundamental Treatise rgyud-bzhi
The complete test encompasses 5900 verses which are grouped in 156 chapters.

The following is a short description of the contents of this treatise, which lists the different topics treated in Tibetan medicine and illustrates the lucid and systematic presentation of the teachings.

The RCTA Tantra
The first section, the RCTA Tantra, is comprised of six chapters giving a brief outline of the whole text and comparing the medical system with a tree. Three rCTAs sprout into nine stems, which branch out into 47 branches bearing 224 leaves. The nine stems represent the nine sections of medical science, the branches stand for general information and the leaves illustrate the details.

The First RCTA (Figure-I)
The first rCTA explains the human organism and its functioning and encompasses two stems, which stand for the healthy and the sick body. The healthy body is represented by three branches and 25 leaves, the sick body by nine branches and 63 leaves. The first stem, the healthy body, bears three branches. One of the branches represents the three humours, another the - bodily constituents (nutritional essence, blood, muscle tissue, fat or fatty tissue, bones, marrow and regenerative fluid) and the third branch the three excretions of the body (feces, urine and perspiration).

Furthermore, the first stem bears two flowers standing for health and long life and three fruits representing religion, wealth and happiness.

The second stem represents the sick organism. This section deals with the causes and the conditions of diseases, the six - doorteays by which diseases may enter the body, the locations of the humoral diseases and the pathways where they circulate. Information is provided about the promotion of humoral diseases by the patient's age, the season, time of day and the dwelling place. Furthermore, incurable diseases, side effects due to inappropriate treatment and the classification of all diseases as either cold or hot disorders are discussed.

Figure - I: The RCTA of Physiology and Pathology
This picture describes the Tibetan concepts of health and disease illustrated as a tree with two stems. The first stem deals with the healthy body. It has three branches, 25 leaves, two flowers and three fruits. The first branch bears 15 leaves representing the three humours and their five types. These are depicted in the three different colours blue, yellow and white signify-ing the humours riung, mkhris pa and bad kan, respec-tively.

The second branch has seven leaves representing the seven bodily constituents.

The third branch bears three leaves, which stand for the three bodily excre-tions. The two flowers stand for a healthy and long life and ultimately serve as the basis for attaining the three fruits: spiritual accomplishment, wealth and happiness.

The second stem deals with the diseased body. It com-prises nine branches and 63 leaves. The first branch has three leaves, which stand for the three specific distant causes of disorder: attactment, hatred and closed - mindedness. The second branch bears four leaves de-picting the four conditions that trigger disorders: sea-sonal changes, demons, diet and behaviour. The third branch has six leaves representing the six areas of in-ception of diseases. The fourth branch possesses three leaves showing the main locations of the three hu-mours. The fifth branch has 15 leaves, which illustrate the pathways of the humours. The sixth branch has nine leaves representinq the humoral diseases in rela-tion to age, places of occurrence, maturation period and seasonal changes. The seventh branch has nine leaves signifying the nine incurable cases. The eighth branch shows 12 leaves depicting the side effects of in-appropriate treatment. The ninth and last branch has two leaves, which illustrates the fact that all diseases can be either hot or cold disorders.

In the upper left corner one can see the picture of the Medicine Buddha. According to the main Tibetan med-ical text, i.e. tgyud bzhi, drang srong rig pa'iye shes emanated from the heart of the Medi-cine Buddha as the expounder of rgyud bzhi, and drang srong yid las skyes emanated as the recipient of rgyud bzhi. Thus,the main Tibetan text is written in the form of questions and answers between these two emanations, which are portrayed in the upper left corner. It is also stated that when the Medicine Buddha unfolded this medical system, he was surrounded by various disciples, gods, sages, Buddhists and non-Buddhists. Some of whom are portyed in the uppermost part of the picture.

The Second RCTA (Figure-II)
The second rCTA informs about the methods of diagnosis, the examination of the tongue and urine, the pulse diagnosis and the questioning of the patient regarding the symptoms of the disease, the way of living, etc.

Figure-II: The RCTA of Diagnosis
This illustration displays three stems and depicts the three main diagnostic techniques used by Tibetan phy-sicians: pulse reading, urine analysis and interrogation. The first stem deals with visual observation methods. it is divided into two branches; the first branch stands for observation of the tongue and the other branch for ur-ine analysis.

These branches possess three leaves each, showing that each of the three humours has a differ-ent effect on the patient's tongue and urine, which can be visually detected by the physician.

The second stem depicts the pulse analysis in three branches. each comprised of a single leaf symbolising the different pulse nature of each of the three humours.

The third stem deals with the method of interrogation. It consists of three branches with 11 blue leaves relat-ing to rlung disorders, seven yellow leaves relating to mkhris pa disorders and 11 white leaves to bad kan dis-orders. These colours stand for the different ways of in-quiring used to identify the humoral diseases and their symptoms as well as to determine their remedies. Several sages and non-Buddhists are depicted In the uppermost part of the picture.

The Third RCTA (Figure-III)
This rCTA deals with therapeutical methods, diet, behaviour, medical preparations and external treatments.

Figure-III: The RCTA of Treatment
This picture shows the methods of treatment used in the Tibetan system of medicine. The rCTA of treatment develops into four stems symbolising diet, behaviour, medication and external therapy. These treatments are generally used in combination depending on the nat-ure of the person and the disease involved.

The first stem stands for diet treatment, which has six branches. The first two branches with ten and four blue leaves, respectively, show the diet and the drink best suited to treat rlung disorders. The third and fourth branches with seven and five yellow leaves, respectively, stand for the diet and drink suitable for mkhtis pa disorders and the fifth and sixth branches with six and three white leaves, respectively, stand for the diet and drink recommended for bad kan disor-ders.

The second stem illustrates behavioural treatment. It has three branches with two leaves each representing the behaviours beneficial for the three humours.

The third stem depicts the different medications. It has a total of 15 branches and 50 leaves. The first six branches each bear three leaves. These refer to the tastes and medicinal qualities favourable for treating rlung, inkliris pa and bad kan disorders, which are shown as blue, yellow and white leaves, respectively.

The seventh to the twelfth branches bear a total of 23 leaves representing different medicinal preparations: broth and medicinal butter, decoctions and powders, pills and specific medicinal powders. The type of pre-paration prescribed depends on the afflicted humour. In addition to the above medications, there are three different branches symbolising medicinal preparations with a cleansing effect: enemas, purgatives and eme-tics used respectively for rlung, mkhrispa and badkan disorders. They are represented by three blue leaves on the thirteenth branch, four yellow leaves on the four-teenth and two white leaves on the fifteenth branch. The fourth stein stands for external therapies, which are generally used as a list resort after all other treatments fail. It consists of three branches. The two blue leaves on the first branch portray the external therapy used to treat rlung disorders. The three yellow leaves on the second branch stand for external therapies used to f iqiit fight mkhris pa disorders and the two white leaves on the third branch signify external therapies used on bad kan disorders.

In the lower right corner one can see a picture of the Medicine Buddha. Some of Buddha's disciples, Buddhists and important scholars of Tibetan medicine are depicted in the uppermost part of the picture.

The Explanatory Tantra
The second tantra, the Explanatory Tantra, en-compasses 31 chapters and is concerned with the life cycle (conception, childbirth, function-ing of the three humours and signs of death), causes, conditions and classification of the dis-eases. It specifies the properties of medicinal in-gredients and explain in detail diet, behaviour and the rules for maintaining health, etc. It also contains a code which the physician should up-hold in conducting his profession.

The Oral Tradition Tantra
The third tantra, the Oral Tradition Tantra, consists of 92 chapters which mainly teach the 101 disorders of the three humours indicating their causes, conditions, symptoms and meth-ods of therapy.

The Last Tantra
The fourth tantra, the Last Tantra, is comprised of 27 chapters, which deal with diagnosis (such as urine analysis and pulse reading), medicinal ingredients and their preparations (pills, powders, syrups, medicinal butters, etc.) pacifying medicaiton (purgatives and emetics) and additional treatments (moxibustion, golden-needle therapy) which are applied when all other medicinal preparations have failed to cure the patient.

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