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Several letters to the editor are presented in response to the article on the research on collaborative event ethnography (CEE).
In the last ten years, there has been a dramatic reduction in medicinal plants in Tibet. This situation has attracted the attention of many researchers from different professional backgrounds, yet very few documents have been published on the general theoretical context and the actual process of herb collection as it occurs at different levels in clinics in Tibet. This article begins with a systematic review of the general principles of medicinal plant collection methods as set out in the ancient traditional medical system. Because the demand for plants is generated by the need to make Tibetan medicines, it is necessary to consider the original context of Tibetan medicine to understand pharmacological needs and the principles behind collecting medicinal plants to develop a strategy that might guarantee sustainable development of the plant supply. After considering the wider context of this study, the article presents research mainly based on case studies with the intention of understanding different stakeholders' experiences and social relationships in the contemporary herb collection process in order to discover behavioral patterns within the dynamic social roles involved in this process as these inform policy formation and to seek to promote appropriate methods in the future.
Introduction Hypertension is a leading cause of cardiovascular disease, which is the cause of one-third of global deaths and is a primary and rising contributor to the global disease burden. The objective of this systematic review was to determine the prevalence and awareness of hypertension among the inhabitants of Tibet and its association with altitude, using the data from published observational studies. Methods We conducted electronic searches in Medline, Embase, ISI Web of Science and Global Health. No gender or language restrictions were imposed. We assessed the methodological characteristics of included studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Two reviewers independently determined the eligibility of studies, assessed the methodology of included studies and extracted the data. We used meta-regression to estimate the degree of change in hypertension prevalence with increasing altitude. Results We identified 22 eligible articles of which eight cross-sectional studies with a total of 16 913 participants were included. The prevalence of hypertension ranged between 23% and 56%. A scatter plot of altitude against overall prevalence revealed a statistically significant correlation (r=0.68; p=0.04). Meta-regression analysis revealed a 2% increase in the prevalence of hypertension with every 100 m increase in altitude (p=0.06). The locations and socioeconomic status of subjects affected the awareness and subsequent treatment and control of hypertension. Conclusions The results from cross-sectional studies suggest that there is a significant correlation between altitude and the prevalence of hypertension among inhabitants of Tibet. The socioeconomic status of the inhabitants can influence awareness and management of hypertension. Very little research into hypertension has been conducted in other prefectures of Tibet where the altitude is much higher. Further research examining the impact of altitude on blood pressure is warranted.
Classical Tibetan medicine is closely related to Buddhist philosophy. This article describes how the study and meaning of sexual differentiation in Tibetan medicine is deeply rooted in Buddhist texts and philosophy. The article pays particular attention to the Buddhist theory of mutual dependence of birth and death and on the medical ways of explaining the determining of sex. While Tibetan medicine approaches sexual differentiation by examining its various determinant factors, thus aiming to improve understanding of the human body and diseases, which manifest differently in men and women, in Buddhist philosophy sexual differentiation is perceived as a fundamental, natural phenomenon of human life that forms a key in Tantric practices to comprehend the nature of mind and thence attaining the highest state of mind. The article consists of a translation of the first chapter of a Tibetan medical book on obstetrics, including a newly written introduction to the Buddhist interpretive frame employed in the chapter.
It is widely known that aetiology is an essential but difficult topic in the subject of pathology for all medical systems. There are distinctive issues with respect to aetiology in Tibetan medical theory, where initial causation of diseases is
Objective. To explore evidence for the traditional Tibetan medicine, Zhi Byed 11 (ZB11), for use as a uterotonic. Methods. The eleven ingredients in ZB11 were chemically analyzed by mass spectroscopy. A review was conducted of Western allopathic literature for scientific studies on ZB11's individual components. Literature from Tibetan and other traditional paradigms were reviewed. Results. Potential mechanisms of action for ZB11 as a uterotonic include laxative effects, a dose-dependant increase in smooth muscle tissue peristalsis that may also affect the uterus smooth muscle, and chemical components that are prostaglandin precursors and/or increase prostaglandin synthesis. A recent RCT demonstrated comparable efficacy to misoprostol in reducing severe postpartum hemorrhage (PPH) (>1000 mL) and greater effect than placebo. Historical and anecdotal evidence for ZB11 and its ingredients for childbirth provide further support. Discussion. ZB11 and its ingredients are candidates for potentially effective uterotonics, especially in low-resource settings. Further research is warranted to understand the mechanisms of action and synergy between ingredients.
This article advances the hypothesis that “traditional” Asian pharmaceutical industries are rapidly growing in size and prominence in contemporary Asia, and identifies a lack of empirical data on the phenomenon. Addressing this gap, the article provides a quantitative outline and analysis of the Sowa Rigpa (Tibetan, Mongolian and Himalayan medicine) pharmaceutical industry in China, India, Mongolia and Bhutan. Using original data gathered through multi-sited ethnographic and textual research between 2014 and 2019, involving 232 industry representatives, policy makers, researchers, pharmacists and physicians, it assembles a bigger picture on this industry's structure, size and dynamics. Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations. The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.