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    82. Angela Sumegi Dorje, G. (trans) (2006) The Tibetan Book ofthe Dead. New York: Viking, umey to Realms Beyond Death, trans. R, Barron. Junction ldhahood Without Meditation: A Visionary Account Known as fans. R. Barron. Junction City, CA: Padma Refining One's Perception (Nang:ja Publishing, (208 imanng se Cows of Lif: Sa Tronfermaion ne Shan But Humphrey, C. and Onon, U. (1996) Shamans and Elders: Experience, Knowledge, and Power Among the Daur Mongols, Oxford: Clarendon Press. 1. MT, (2004) “The strange de The Presence of Light: Divine Radiance and Rel wersity of Chicago Pre vigins of Yopa and Tantra: Indic Religions to the Thirtoenth Century ambridge: Cambridge University res. of Dharmakaya, rans. Lopon Tenzin Namdak, 2nd ick and Yellow shamans among the Mongols’, Jounal of the -Anglo-Mongolian Society 9: 19-24, 5 On the ‘subtle body’ and ‘circulation’ in Tibetan medicine Barbara Gerke Subtleties or ‘subtle body’? In recent years, the term ‘subtle body’ has appeared inthe discussion of Tibetan ‘medicine in both academic and popular literature by Tibetan and. Westem wluded (e.g. Asshauer 2005: 52; Clifford 1994: 71; Drungtso the ‘subtle body’ in relation to the channels of the body (risa), the movement of wind essence (b/a). Although discussed in medical contexts, the term “oe body” remains medically largely undefined, and its understanding is linked to Tibetan Buddhist tantric body concepts. Without discrediting the contributions of these individual authors and thei scholarship, in this chapter! I want to reflect critically on two issues arising from use of the term ‘subtle body" in a Tibetan medical context. First, body” and what ‘ibetan medicine, Second, ors, I want to question the ideas of circulation when talking about risa for example “circulatory channel (Garrett and Adams 2008: 92; Garrett 2008: 9) or ‘circulatory system’ (Clark 1995: 56; Garett 2008: 64), This chapter sets out wo arguments. My argument in relation tothe first issue Ives or as translations of Tibetan medical terms, should be used more cautiously Risa in Tibetan me: lated as ‘channel (Millard 2007: 265). Rtsa mainly transport blood (Krag), wind/respiration (rlung), and water (chu; chu’i risa are often translated as ‘nerves’), but also the ‘mind (sems), nutrients and waste products. Inthe eighth to tenth century Tibetan the term has been trans 84. Barbara Gerke texts from Dunhuang — the first documented mi f risa in a medical of blood: (Yan 2007: 302) the Ryyud bzhi? mentions four main types of channels ‘with sub-channels and a wide variety of functions. They can only be briefly summarized here: medi context — risa relate mai 1 The ‘channels of formation” (chags pa't risa) are three channels generate (a) the brain and its white channels (rsa dha), (b) the black channel (rtsa nag) and its vessel, and (c) the genitals. The second of these three channels the black channel ~ isthe disputed lfe-channe (srog fs, farther discussed below. 2 The ‘channels of existence” (srid pu’ rsa) are situated in the brain, heart, navel and genitals and are responsible for sensory experience, memory and clarity of mind, body growth, and the continuation of the family lineage respectively. 3. The ‘channels of connections’ ‘bre! bu’i risa) are black (blood) and white (ovater) channels that each diffuse from the right and left main channel 4 The ‘Vitality channels” (tshe’ isa). also called ‘channels where life abides" (ishe gnas pa’i risa) form the basis of life as such’ (Parfi 1992: 39-40), They are discussed in the last section of tl All ofthese four main types of channels have been the cause for debate for centuries in terms of their functions and categories, their link to Buddhist tantric body concepts, as well as the hundreds of auxiliary channels surrounding them (Gyatso 2004: 87-90). ‘contexts, the first group of the above listed four main types iked to the three myes pa in the sense that each of the chann iddle and lower areas of the body respectively, each of which isthe predominant seat of one of the three nyes pa.* ~ the term has often erroneously been translated as “humour” — are ey that are embedded within the fire, earth, wind and space. The lement dominates), mkhris pa (in ich the elements of earth and is connected to a specific thoughts: the five process and for regulating body temperat views of the body. Here are two examples of how trained in Buddhism — consolidated tantric Bud jews of the channels in the body. Zurkar Lodo Gyalpo (zur mkhar (On the ‘subtle body’ and ‘circulation’ in Tibetan medicine 85 century scholar Tsultrim Gyalts ked the three ‘channels of forma ious and tantric knowledge systems, Increasingly after the fourteenth century, medicine in Tibet was deeply inked with Buddhism,’ and also state control (Schaeffer 2003). Therefore, \we often find medical texts referring to advanced Buddhist practices, and bound- aries between what is considered medicine and what belongs to religious realms become blurred. ‘The ideas of the Indian tantric body channels eame to Tibet along with tantric Buddhist knowledge, particularly through the Kalacakra Tantra in the eleventh ‘century. In the Indian Tantric traditions, the channels are called nis and in their subtle form are understood as inner pathways forthe motile wind. The K@lacakra Tantra mentions 72,000 nddis — some of which are presided over by deities in the form of consonants. This alludes to a view of the body ‘as a tantric text, consisting ‘of mantras and letters that provide a blueprint of the mind-body complex’ (Wallace 2008: 179, 184). Cakras (lit. wheel’) are the nexus centres inthe body where many nadis come together. There are many different traditions, but the main cakras are generally shown vert the three tantric channels ~ the “cent susumnd, pingala, ida); in Tibetan they are known as dbw ma, ro ma and rky ‘ma; cakras are known as ‘khor lo Among the Tibetan tantric body concepts ofthe Kalacakra Tantra the ‘vajra body" (sku rdo rje or rdo rje lus) comes probably closest to an idea of a ‘subtle body’, body” that Tibetan doctors refer to when asked about ian physicians apologize, saying isnot really part oftheir medical do and linked to 86 Barbara Gerke f the body as described in Tibetan medical texts, specifically the Reyud bzhi the Baidarya sgnon po by Desi Sangye n to ‘coarse’ (rags pa). le’ (phra ba) is primarily associated with something debate about when discussing tantric He thought that if there is anything the embryology section and describe the early when the human body is still very small in si body’ would have much connection to the channels, perhaps more to the bla and thig le. | mentioned to him Western esoteric concepts ofa ‘subtle body” in terms of ‘energy bodies” or ‘auras’ that appeared transparent but were about the size of the adult body or even larger. He had heard about the aura, but thought that noth- ing similar existed in Tibetan medicine, especially not that size. When we discussed suitable Tibetan terms for ‘subtle body" he suggested gzugs phra ba He said not to use lus phra ba, since Tibetans would imme- diately associate this with the poetic term lus phra mo: a beautiful woman with a slender body. "* Gzugs phra ba or phra ba’t gzugs as possible translations for ‘subtle body’ do not appear in the Rayud bzhi. The tantric ‘vajra body” (sku rdo rje or rdo rje lus) and the ‘illusory body" (sgyw lus), which also consists of cakras and nadis (Samuel 1993: 237), also do not feature in the Reyud bzhi. I also cannot find any Tibetan medical technical term for ‘subtle body’ in the Tibetan medical dictionaries at hand (Drungtso and Drungtso 2005; Wangdue 1982).'S What we find in the ‘medical texts are certain subtle aspects of the body that are explained in relation © nyes pa, embryology (chags pai tshul), and of the channels. Some of these topics have strong ‘twenty characteristics (mishan nyid) that describe the qu: pa, particularly rlung. As a technical term rlung serves to denote forces in the . a On the ‘subtle body’ and ‘circulation’ in Tibetan medicine 87 ‘organism that manifest themselves physically with a characteristic of the element ‘wind, Rlung is used to translate both the Tantric prdna and the Ayurvedic ditions can probably be seen as a very early notion that , experience and perceive more subtle aspects of the human body. lassical Tibetan medicine, the meaning of rlung cannot be confined to the physical sensation of wind, such as gas tines or breath ‘the organism — inclu of everything od to thoughts, all nerve activity, and the movement of the muscles and bowels are governed by rung. According to the Rgyud bzhi, the six qualities of rlung are subtl rough (risub pa), light (yang b (grang ba), hard (sra ba) and mobil (gvo ba). These six functional qualities describe the nature of rlung and refer to aspects of the body, mind, food, the environment and climate. is context denotes the capacity of rlung ‘Phra ba does teristics of medicinal ingredients. The discussion cine thus centres more on physiology and ‘anat ‘Since subtlety in Tibetan medicine is intrinsical ‘through which rlung travels give further insight into the subtle aspects of the body. The Reyud bzhi (third chapter, first treatise) describes fifteen pathways for the three nyes pa, among which bones (rus pa), ears (rma ba), the skin as a sensory organ (reg bya), the heart (snying), the life-channel (srog rtsa), and the large intestine (Jong) are mentioned as the pathways of rlung. At first they seem arbitrary and unlinked, but they follow a set framewor that each pathway of a nyes pa is related to at constituents, the lus zungs bdun’® (in the case of rlung, ise. the bones), a waste product (ie. ear wax), a sensory organ (je. the ski (ie. the heart and the “ a vital organ fe-channel’) and a vessel organ (ie. the large intestine). (srog risa), which is not one of the five ted here ‘in addition to the heart’2” It is one of the most important pathways for rlung, but does not fit neatly into the pathway categories provided for the three nyes pa. ‘The ‘Tife-channel’ has an unusual, often contested place among the channels.”" In the Rgyud bel (Men-Tsee-Khang 2008: 5 of the “channels of formation’. In the ‘anatomy’ chapter (Men-Tsee-Khang 2008: 61 inked to the tantric central channel, and to the two main *connect- 88 Barbara Gerke ‘The subtleness of riung's mobility is evident from some of the names of the five types of rlung that indicate the direction of its flow in the body. The “all-pervading rlung’ (khvab byed rlung) moves throughout the body, whereas the “downwards-mo\ (gyen rgyu rlung) life-sustaining rlung’ (srog “dzin rlung), which moves throughout the body. Again, some of these rlung movements follow solid pathways, such as the intestines, and others, such as the ‘life-sustaining rlung’, are linked to finer channel low for their flow throughout the body. Within this physiology, there are so far no clear demarcations in the subtleties of rlung or risa that could be singled out as a ‘subtle body’. Several the five types of rlung influence emotional and mental processes (see lard 2007: 270-1), which is the reason why rlung Inesses. In this. context, very subtle rlung supports the very subtle mind in the transmigration between lives (2007: 266). This mind-body link, however, is not articulated in terms of a “subtle body’ The ‘root’ nature of Rtsa To better situate the issues surrounding risa in the Tibetan channel debate, further the Tibetan medical understanding of isa. The Sanskrit term nad? means ‘river’ or ‘stream’: this meaning is not found ‘the Tibetan translation of nad as risa, which literally means “root. The ‘root nature of risa can be interpreted in at least two ways. First, the image of a root resembles a well-branched system of organized, harmonious pathways, which are well connected but not necessarily circular in nature. ‘The healthy channels should be like the nerves of the leaves.?? well branched and not disconnected,” says the Tibetan doctor Dr Passang Yontan Arya (Beguin 2009), of the person’ (Beguin 2009). These of the medical paintings (see Parfionovitch ef al. 1992: thang ka nos, 9-15 pp. 33-46, and nos. 47-8, pp. 109-12): at least on a visual level, seem to give lus some indication that the channels in Tibetan medicine are largely perceived as open-ended ducts or fine networks, but not necessarily as closed circular On the ‘subtle body’ and ‘circulation’ in Tibetan medicine 89 Consolidating disparate body concepts in Tibet When analysing subtle aspects in Tibetan ‘anatomy’, we need to take into account that ideas surrounding Tibetan medical channels developed at different times in history, drawing from different, unrelated medical and philosophical systems, While bla is a non-Buddhist idea of vitality prevalent in many imalayan and Asian communities (see Gerke 2007), the three tantric channels derive from Indian tantric material (see Samu long with Buddhism and was incorporat thang ka no. nels wit channels, debating their visibility body, Medicine in Tibet struggled with classical Buddhist doctrine throughout its history, and some of these struggles are based simply on a discrepancy between different systems that Tibetan authors tried to reconcile (Gyatso 2004: 87). it contemporary Tibetan doctors in Lhasa, who have been exposed 546). Remarkably, both sides have labelled t ga ‘exemplifies how Tibetan physicians today deal with the subtleties of th that do not always fit neatly into their changing medical views ier days of Tibetan medicine, the channels, their s through a method of dividing bodies according to the Buddhis could be reconciled without having to cri nis found in the common triad of ‘outer’ ip of various theories, in physical realities. In the process, India reworked ‘workable Tibetan medical body. For example, as already mentioned, the ‘main channels ofthe Indian tantric system were seen by some authors as equivalent tantric ideologies 90 Barbara Gerke 1" (Garrett 2008: 68). Others moved the tantric jon, so that they only possessed valid ‘reality’ puted by, among others, (orian and former director the tantric channel debate in ly translated into English (Garrett of the Lhasa Mentsikhang Jampa Thi an essay in the late 1990s. This essay was re and Adams 2008). and author Zurkar Lodo there are invisible things in the body that prove their existence through their effect on the body. This means that the three tantric channels must exist since otherwise meditation could not have the effect it has (Garrett and Adams 2008: 94), even though in terms of visibility, the channels might be so subtle that only spiritual advanced meditators ccan actually see them (2008: 112). They also must exist, since otherwise there “would be a contradictory relationship within the Tibetan scholastic tradition’, ‘and ‘a thesis that invalidates the scriptures would be established’ (2008: 100, 110), something unthinkable for most Tibetan scholars, where ~ in Tsultrim Gyaltsen’s words — invalidating the scriptures is indicative of ‘personal arrogance’, and the best choice is considered to ‘follow the experts’ (Gyaltsen in Garrett and ‘Adams 2008: 110). Limited by such scholarly constraints, Gyaltsen does not ‘solve’ the debate, but shows what is at stake. In the remaining section, I want to analyse the notion of circularity with respect to various channels and their subtleties. On the circularity of Tibetan channels Resa are often talked about in terms of a ‘circulatory system’, which i either used asa general umbrella term for the rsa system oF a a loose transtation of “rel : latory system’ is a Western notion now primarily known as fe eighteenth and early shed in popular thought f the heart’s pumping t blood was created in the liver and flowed one way, ing the body nutrition, but not back to the liver (Gregory away from the liver, 2001: 4), Duden points to the diffi ‘we are pinned down by our own Wes ‘granted as an unchanging biologi ing the body; how take “the body for ity’ (Duden 1991: 3). Acknowledging a On the ‘subtle body’ and ‘circulation’ in Tibetan medicine 91 now possible to admit that bodies in mind, we might be better able flows are synonymous of th in the susumnd channel (White 1996: 227). This adds an interesting perspect to the discussion on culture-specific constructions of body perception, since it reveals how what is perceived as natural movement in a particular environment is projected into similar movements within the body by people influenced by this, In the analysis of subtle aspects of the body in Tibetan medicine, I want to follow Duden’s advice that “if we start from the assumption that the imaginations and perceptions of a given period have the power to generate reality, we can approach phenomena that are usually rendered invisible because of some a priori axiom of what is natural’ (1991: 6). If we look at the different types of ‘circulation’ of subtle substances in the Tibetan medical body, we might understand why Westemers tend to talk about them in terms of a “subtle body’. We seem to have difficulties conceiving of a solid body with subtle substances, such as ‘winds’ or ‘life essences’ that move beyond the boundaries of visible pathways. The four major types of channels ‘mentioned in the Rgyud bzhi and described above do not directly or implicitly reveal a medical perception of ‘circulation’; they were classified according to their function, While the seventeenth-century medical paintings do not give ‘proof of the ‘actual medical perception at the time, they might provide a visual representation of certain patterns in medical thought. In the Tibetan medical paintings under . most channels appear to be open-ended, not circular. Some run ing the breath even begins de the body, namely sixteen fingers away from the tip ofthe nose (thang ka that old blood and converge ka no. 47, central drawing, p In terms of their nature and function, some channels ‘pulsate’ phar risa, often ed as ‘arteries') or ‘stay’ (sdod risa, often translated as ‘veins'); other 92 Barbara Gerke channels “pervade’ (Khyab pa) the section on risa ‘Khor indicates the wheels of citeulation in ccakras. is not used themselves ~ The three main tantric channels move from top to bottom and are connected at the nexus of each eukra, from which several channels branch off like flower petals (thang ka no. 12, p. 40). The central cl self appears like an open- ‘ended empty tube, opening above the crown cakra into the sky and below the root cakra towards the ground, The so-called ‘seven hundred minor channels’ (risa phran bdun braya) cover the body like a net. On the shang ka, they have ‘been painted in the form of fine waves that exit from various vertebrae of the spine, and then take their own course across the entire body, finely meshed, reaching out to the extremities where they end in the tips of fingers and toes, (thang ka no. 12, p. 40). This topographic net of the subtle channels does not have circular features. Moreover. the very subtle channels on the right body side are painted in ted, ‘while the ones on the left body side are painted in blue, showing a clear partition t side of the body. This partition seems to link up w the waxing and waning moon cycle and the movement of the bla. The bla moves in 30 days around the body in a set fashion, fo the moon cycle through 30 reading of the Reyud bzhi seems to be variable in terms of direction and circular and permeating movements of vital forces in all sta concept of jon’ in the biomedical sense A very careful and po, and other commentaries, Nowadays, a shift in Tibetan m of the ‘channels where life abides ‘The channels where life abides One sect ‘anatomy’ chapter of the Rgyud bzhi deals w led ‘the channels where life abides’ (tshe gnas pa rts On the ‘subtle body’ and ‘circulation’ in Tibetan medicine 93 the issues of circularity discussed above, and what is section in the Reyud bhi itself is brief: (Garrett and Adams 2008: ‘het al. 1992: 39). They differ mainly in levels of the debate described above in that they reflect an cism. One expression of this debate is Baidiirya sngon po and the r thang ka (no. 12, p. 40). The captions of the ‘medical paintings deseribe the ‘vitality channels’ referring ex ing given to these channels in accordance with either the ‘m “tantric tradition’ or both (Parfionovitch etal. 1992: 195, $-9).® In the “anatomy” chapter of the Baidirrya sngon po, Sangye Gyatso also makes a point of st the different views of each tradition and clarifies which tradition he i about (1982: 89-115). Tsultrim Gyaltsen argues (following Lodo Gyalpo) that the ‘vitality channels? are not real (dngos) but ‘they refer to forces within the body that m (Garrett and Adams 2008: 90). What becomes clear from these i tions is thatthe the movement of vital forces, which appear to have the most vary Sangye Gyatso concludes the section on the channels as follows: All the winds, the blood, the nutrients, the waste products, all move through the subtle and coarse pathways. connecting the entire outer and inner body. 94 Barbara Gerke ‘channel debate. The extent to which he might have assumed a concept of circulation in the channels needs further investigation. Summary and conclusions Rece aspects of the body been translated into notions of a ‘subtle body’ tan medicine have frequ chapter has focused on two of the five types of wind (rlung) and their direction of mover syud bzhi and the oot’), showing the ‘ of the coarse nature in the topography and subtle channels (risa; and function of risa. T think one reason why the debate on Tibetan channels has been so vigorous in knowledge and influenced Tibetan medical practice only indirect times in history, however, subtle body concepts had to be debated theoretical because of issues of authority and the Buddhist state control of insttutionalized (mostly monastic) medical practice (Gyatso 2004). We can therefore understand the Tibetan channel debate as a reworking of Indian tantric ideas into Tibetan ‘medical texts in the context of Buddhist hegemony in Tibet. Moreover, authors of medical works in Tibet also had to account for popular ideas of vitality, such as the bla, which was in some ways linked to the ‘anatomy’ of the channels. In the second part of the chapter I suggested that Tibetan channels are not necessarily circulatory in nature, Risa are often talked about in termns of a ‘cireu- latory system’, probably because of our Eurocentric internalization that bodily channels follow a circulatory fashion, but — even though Tibetans might have had an idea of blood circulating in the body ~ the classical Tibetan medical presenta- tions of rtsa are much more ‘root-like’, open-ended, or diffuse in nature. I suggest that the terms ‘circulatory system’ and ‘circulatory channel’ both in general and “connecting channels’) should be used with they give the impression that the Tibetan channel system consists question of the circular- Tibetan channels certainly warrants further research. The clas- (eg. Men-Tsee-Khang n.d. Tibetan medi of rtsa incorporate both subtle and coarse pathways for various visible ar ible substances that flow in numerous ways in and out of | the body. Some of chan some of the key Tibetan medical texts and ate depi ‘medical paintings, On the ‘subtle body' and ‘circulation’ in Tibetan medicine 95 Ik about a unified Tibetan me ns subtle aspects ofthe body. ‘The variety of subtle-body concepts and practices might get confusing in terms of medical practice. On a theoretical and textual level, Buddhist and me ‘were easier to conflate. Due to oty of coarse and s disparate body concepts cou ion of the body” that emphasizes promotion of good health and long life. sisting of four main a5 ~ with regional variations ~ remained text among Tibetans today. lescription ofthese four types of channels can be found, fr example, 1995: 56-8; Garrett 2008: 64-70; Garrett and Adams 2008: 88-92; Men-Tsee- Khang 2008: 61-4; 5 The ‘white chant third channel is associated with desire and extends into the pelvis, i. these DDebatably, the three mes pahave often been rendered as "wind the fourteenth to fifteenth centuries isa sign ofthe (Garret 2007: 422), at the Men-Tsee-Khang in Dharamsala, commented in February 2012 that a draft version ofthis p conference among Tibetan doctors with a few Geshes on wi subtle body in Tibetan medicine or not. He remarked that inthe intermediate bar do state between death and rebirth there was a subtle body thet consisted of the very subtle forms ofthe five elements (shin tu ‘phra ba’i “byung ba Inga). This would also ‘amedical context, especially in embryology. Without the very subtle five would not have a bass to take form and process of death and rebirth, rather than with the functioning of the normal body. 96 Barbara Gerke ‘dot’ isa polysemous tantric tem that indicates, among other thi; 12e ofthe body (white and red seminal fluids) oF the nucleus of the e ‘ened mind, often linked tothe ‘vajra body’ 13 Tsultrim Gyaltsen lists pra ba’ geugs as one of the synonyms for the tantric central channel (Garren and Adams 2008: 105). 14 Personal communication, Dr Tsering Wangdue, Dharamsala, $ August 2010. 15. Drungiso and Drungtso mention the “illusory body’, but without any medical explana ‘the natural condition omy" derives from the the Tibetan view ofthe ‘natural conditions ofthe body’ aspects that have not been detected through dissection (see also Garret and Adams 2008: 98, n.17), 17 Foran example of notions of ‘wind’ in the Chinese tradition see Kuriyama 1994; and Indian Ayurveda see Zysk 1993, 2008, od in continuous pracess from food nutri- cents through the stages of nutritional essence (dvangs ma), blood (Khrag), flesh (sha), (ku ba), eventu- the secretion of skin pores as waste congan(Men

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