This chapter sets out two arguments. My argument in relation to the fi rst issue is that while there are subtle aspects in Tibetan medical concepts of the body, we need to be careful in talking about a separate entity of a ‘subtle body’ as such. My second argument is more preliminary in nature and suggests that Tibetan medical ‘circulatory systems’ or ‘circulatory channels’ do not necessarily move in circulation in the Western sense of the term, and therefore such terms, both in themselves or as translations of Tibetan medical terms, should be used more cautiously.
The western adaptation of non-western medical systems and traditions is a complex process that takes place at a variety of different levels. In many practical medical contexts, epistemological issues receive little attention. Both patients and practitioners may switch frameworks relatively freely, without much concern about underlying theoretical assumptions. Epistemological issues may be more central elsewhere, for example in regard to the licensing and approval of practitioners and medicinal substances, or in terms of the rethinking of western models of knowledge to include new insights from these non-western sources. I suggest in this paper that the major learned medical traditions of Asia, such as āyurveda and traditional Chinese medicine and traditional Tibetan medicine, for all their differences from biomedicine and among each other, are in some respects relatively compatible with western biomedical understandings. They can be read in physiological terms, as referring to a vocabulary of bodily processes that underlie health and disease. Such approaches, however, marginalise or exclude elements that disrupt this compatibility (e.g. references to divinatory procedures, spirit attack or flows of subtle 'energies'). Other non-western healing practices, such as those in which spirit attack, 'soul loss' or 'shamanic' procedures are more central, are less easily assimilated to biomedical models, and may simply be dismissed as incompatible with modern scientific understandings. Rather than assenting to physiological reduction in the one case, and dismissal as pre-scientific in the other, we should look for a wider context of understanding within which both kinds of approach can be seen as part of a coherent view of human beings and human existence.
Much of what Western medicine classifies as psychiatric illness is understood by Tibetan thought as associated with imbalance of rlung (wind, breath). Rlung has a dual origin in Indian thought, combining elements from Ayurvedic medicine and Tantric Buddhism. Tibetan theories of rlung seem to correspond in significant ways with Western concepts of the autonomic nervous system (ANS), and Western medicine too has associated psychiatric issues with ANS problems. But what is involved in relating Tibetan ideas of rlung to Western ideas of the emotions and the ANS? The article presents elements of the two systems and then explores similarities and differences between them. It asks whether the similarities could be the basis for a productive encounter between Tibetan and Western modes of understanding and treating psychiatric illness. What could Western psychiatry learn from Tibetan approaches in this area?
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