A review of Tibetan Medicine on the Margins: Twentieth Century Transformations of the Traditions of Sowa Rigpa in Central Tibet, by Theresia Hofer.
Reflecting Tibetan medicine’s own recent emergence as a modern “traditional medicine” with much clinical and economic potential, modern scholarship on Tibetan medicine (also known as “Sowa Rigpa”) is a relatively recent phenomenon, marked as much by its small size as by its consistently high academic quality that is anything but limited to its first proponents, such as Fernand Meyer, Vincanne Adams and Craig Janes. Theresia Hofer’s dissertation is a fine example of a new generation of outstanding scholarly work that pushes the boundaries of this growing field.
While most previous scholarship on Tibetan medicine — especially inside Tibet — has focused on institutional centers as its prime historical, ethnographic and archival sites, Hofer’s dissertation makes a strong argument for de-centering Sowa Rigpa through a focus on the subaltern histories of practitioners (“amchi”) operating outside of Lhasa or state institutions. As Hofer compellingly shows, these histories reveal — by their voices and by their silences — the crucial agency of individual Tibetan amchi in preserving, reviving and transforming Sowa Rigpa throughout the Communist reforms imposed on Tibet. This postcolonial/subaltern approach is an important and timely contribution to scholarship not only on Tibetan medicine but also on Tibet in general.
This clearly written and well-structured dissertation contains eight chapters, an extensive bibliography of Tibetan, Chinese and European-language sources, and seven appendices containing lists of medical students, medical texts, and drugs of different schools and doctors. Each chapter is supplemented with photographs either taken by the author herself or by her brother (a professional photographer), or acquired from archives. While the Chapters 1 to 4 provide the dissertation’s theoretical, methodological and historical framework, Chapters 5 to 7 contain its ethnographic core, with Chapter 8 concluding the thesis.
Introducing the study’s research question, Chapter 1 begins by asking how amchi in rural areas of Central Tibet (especially Tsang), outside of large state institutions, negotiated the Communist reforms between 1951 and 2007 in order to preserve, adapt and transform Tibetan medicine. Aiming to show that these amchi were far from mere recipients of reforms and policies but rather took an active role in shaping and implementing them, Hofer then outlines the study’s key concepts and theoretical framework, revolving around Bourdieu’s practice theory and the “temporalities” and “socio-political geographies” of amchi agency (pp. 8, 35ff.).
Chapter 2 discusses the research methodology as well as the particular limitations of conducting fieldwork in rural Tibet. Thus, interviews, participant observation and archival work were carried out at different sites in Central Tibet for one year (2006-07), supplemented by additional material from an earlier visit in 2003. While Hofer spent most of her time as a language student in Lhasa, she managed to conduct a total of three months of fieldwork in Shigatse Prefecture and especially Ngamring County. Considering the difficult political circumstances especially in Central Tibet, this is a remarkable achievement that not many other Tibet scholars have been able to make, with the exception of Melvyn Goldstein and Heidi Fjeld. She was thus able to collect substantial new historical and ethnographic material.
Chapter 3 provides a historical outline of Sowa Rigpa and its practitioners in the study area before the beginning of the Communist occupation in 1951. Focusing especially on Tibetan medicine in Shigatse, Ngamring and Sakya, Hofer argues that Tsang had its own regional centers and lineages, leaving the Tibetan medical establishment in Lhasa with very little influence there.
Chapter 4 proceeds with a summary of Central Tibet’s political history since 1951, before analyzing three different strands of texts on Tibetan medicine during that period: Tibetan and Chinese sources; exile-Tibetan sources; and Western scholarship. Here, we learn how from the Chinese perspective, Tibetan medicine’s perception shifted from “feudal garbage” to a “minority nationality medicine” to an “ethnic medicine” (p. 124); how Tibetan accounts from both within Tibet and in exile are marked by different kinds of silences; and how in Western scholarship, amchi agency is often overshadowed by a strong focus on the overwhelming power of the Chinese state.
Chapter 5 is devoted to the life and work of one key informant, amchi Rinzin Norbu. In contrast to most of his peers, he managed to continue his medical practice throughout the Communist reforms by creatively negotiating and adapting his practice and discourse to the prevailing socio-political circumstances. Hofer argues that it is precisely accounts such as his that are missing in Western and exile-Tibetan writings on Tibetan medicine, and that most effectively de-center prevailing histories of Tibetan medicine after 1951. After all, it was amchi like Rinzin Norbu who enabled the revival of Tibetan medicine after the Cultural Revolution, thus providing the basis for Sowa Rigpa’s more recent national and international success.
Chapter 6 focuses on the Pelshung Tibetan Medical School that operated with the support of the Swiss Red Cross (SRC) just outside Shigatse town between 1991 and 2003, and its graduates’ activities since then. Despite — or because of — numerous difficulties as graduates from a private rather than a government school, these amchi integrated Tibetan medicine with biomedical methods, thus actively participating in reviving and transforming Tibetan medicine in Tsang.
Chapter 7 takes up two cases of contemporary medicine production that fall outside the seemingly pervasive large-scale industrialization and commercialization of Sowa Rigpa pharmacy. Neither following modern guidelines nor the classical Tibetan medical texts, these amchi creatively apply their own personal “art of compounding” gained through many years of experience (p. 256). In particular, the reinstatement of pharmaceutical production at Tashilunpo Monastery — one of the two cases discussed here — was a milestone in the revival of Tibetan medicine in a monastic context.
Chapter 8 concludes the dissertation by returning to its central argument about the crucial, active role of amchi in Shigatse and Ngamring in preserving and innovating Sowa Rigpa from 1951 until today. Although their agency was often heavily restricted, they creatively engaged with the Communist reforms rather than becoming their passive victims. It is precisely by driving this point home through excellent ethnographic and historical work that this dissertation contributes to a more nuanced understanding of contemporary Sowa Rigpa and the socio-cultural and medical changes that occurred in modern Tibet.
Since (for obvious political reasons) the experience and memories of Communism in Central Tibet have not yet been analyzed in any great depth, this dissertation also makes a welcome contribution in this regard to the anthropology and modern history of Tibet in general.
Institute for Social Anthropology
Austrian Academy of Sciences
Ethnographic fieldwork with Sowa Rigpa practitioners in Lhasa, Shigatse and Ngamring
Medical texts and unpublished archival sources in Tibetan language
Modern Chinese scholarly texts on Tibetan medicine
English-language information/promotion material on Tibetan medicine, published in China
University College London. 2011. 366 pages. Primary Advisors: Vivienne Lo and Hildegard Diemberger.
Image: Photograph by Theresia Hofer.