"Bhutan is a small country of 750,000 people in the Himalayan range between India (Assam and West Bengal) and Tibet, to the east of Sikkim and Nepal. It has been largely isolated from the rest of the world, until recently; today, only about 5,000 tourists per year venture to this kingdom. Bhutan shares many cultural aspects with Tibet, including the Buddhist religion as the dominant influence (the Kagyu sect of Tibetan Buddhism, with emphasis on Tantric Buddhism), and Tibetan traditional medicine as the basis for much of its health care until the introduction of modern medicine in the 1970s. As with Tibetan medicine, the main methods of diagnosis are feeling the pulse, checking urine, and examining the eyes and tongue, as well as interviewing the patient. Therapeutically, the Bhutanese rely on herbal combinations, limited acupuncture therapy (including use of the golden needle), applications of heat (usually with metal rods), and minor surgical interventions, all done in the context of Buddhist ritual. There is a hospital for modern medicine relied upon mainly for treatment of acute and severe diseases. Bhutanese herbal medicine is also similar to that of Tibet. Originally, herbal powders were swallowed down with warm water, but with the introduction of modern equipment, the herb mixtures are now produced as pills. The specific formulas used in Bhutan differ somewhat from their Tibetan counterparts in that there are local influences on the selection of herbs, but most of the key herbs are the same, as the altitude and climate conditions are similar to that of Tibet. A substantial amount of herbal materials-perhaps 30% of the total used-are imported from India and Nepal "--The author's introduction.