For many, answering the question “What does yoga mean to you?” leads to the response that it is a physical practice designed to maintain the body by making it more flexible and stronger, all while focusing attention on the breath—thus allowing body and mind to unite. This is true, but I believe it is important to go beyond this approach, which is in fact a simplified Western view of a spiritual practice that is part of a greater whole.
In the Tibetan system, yogas are very diverse practices. They include movement-based practices such as Lu Jong, Kum Nyé, Yantra Yoga, or Tsa-Lung, reclining practices such as dream and sleep yoga, and numerous meditative practices without movement such as Tummo, meditations with Yidams (visualization and self-generation in the form of a deity), mantra recitations, and more.
Because of the way our society is structured, we tend to compartmentalize and separate each of these practices. In contrast, the Tibetan system is meant to be understood and integrated as a whole, since all of these practices work on the same foundation: our subtle body—and more specifically, our life force energy.
Sowa Rigpa, or "Science of Healing", an Internal Part of Spiritual Practices
Within this system is also included Tibetan Medicine, Sowa Rigpa, or “the science of healing.” It is important to understand that in the Tibetan system there is no separation between yogic practices and Tibetan medicine. Buddha Shakyamuni was the first physician. He is considered one of the Eight Medicine Buddhas, and he gave the teaching of the Medicine Buddha in the form of the Gyud Zhi treatise.
“Because health is of primary importance,
In all understanding, everyone who wants to meditate
And attain nirvana, and who wants wealth and happiness,
Must learn the science of medicine.”
(translated from Tibetan Medicine by Rechung Rinpoche)
Gyud Zhi, or the Four Medical Tantras, sets forth the general theory of medical science and lists more than 1,600 diseases, providing explanations for all the related methods of care. This medical treatise contains 5,900 verses that every Tibetan physician must memorize in order to refer to them daily in their practice.
The methods of healing used in Tibetan Medicine combine the essence of the finest ancient Indian, Chinese, Greek, and Persian healing methods, associated with Buddhist Tantric science.
Tibetan Medicine is today one of the rare traditional medicines to have survived the centuries totally preserved and intact, offering modern societies a science of healing whose positive results are now beginning to gain validation and interest from Western science. It is also interesting to know that Chinese Medicine was heavily inspired by Tibetan Medicine, and that Tibetan pills are often found marketed under the name of Chinese medicine.
Tsog-Lung, the Pillar of Tibetan Medicine
One of the two pillars of Tibetan Medicine is based on the knowledge of “tsog-lung,” vital breath or life force. It is known as prana in India, chi in China, pneuma in ancient Greece… Interestingly, no fewer than 95 cultures worldwide have built their healing systems on this same concept.
This vital breath circulates through the body via a network of channels or tsa (three main channels, 72,000 secondary ones), in relation to the cycle of the moon. When there are blockages in these channels, energy can no longer circulate freely and cannot reach all parts of the body evenly. It is in these energy-deficient spaces that disease can manifest.
Illnesses are seen in the Tibetan system as the opposite of tsog-lung. When energy circulates, disease can leave the body through the same door it entered, with tsog-lung expelling the negative energy. The body’s energetic vibration, or energetic charge, is then transformed from a state of imbalance to a state of health and vitality.
The Three Humors, the Three Internal Energies
The second pillar of Tibetan Medicine is the concept of the three humors. These are the three energies of health. Imbalance in these humors constitutes the deeper nature of poor health, giving rise to 404 diseases.
The Four Medical Tantras (Gyud Zhi) explain how the effects of food interact with the three humors, our vital energies. Dietetics therefore plays a central role in treating the causes of disease. The Gyud Zhi also describes how the five elements contained in food—earth, air, water, fire, and space—give rise to the five elements within the body, which are connected to each of the three humors.
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The humor Lung (Wind), linked to the element Air, represents the energy of movement. This concerns all movements, from walking to muscular action, as well as movements within physical channels (vascular, lymphatic…) and subtle energy channels (tsa).
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The humor Tripa (Bile), linked to Fire, is the energy of metabolism. It represents body heat, digestive fire, and all transformations related to assimilation and metabolism.
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The humor Bekan (Phlegm), linked to Water and Earth, is fluid by nature. It manages all bodily fluids, lubricates joints, brings flexibility and softness to the body, and plays an important role in concentration and memory.
The Causes of Illness in the Tibetan System: The Influence of Mental States on Well-Being
Tibetan Medicine defines poor health in terms of both cause and nature. There are four causes of illness: diet, behavior, seasons, and karma. These aspects, including emotions, are known as “conditions.” Every negative emotion or thought is a contraction; their accumulation creates blockages in the channels. Energy circulation becomes unbalanced, with over-stimulation in some areas and undernourishment in others.
Thus, the spiritual understanding is that physical illnesses arise from our mental attitudes. The three main poisons are attachment, anger, and ignorance. These mental aspects interfere with the vital energies of the three humors: Lung (wind), Tripa (fire), Bekan (phlegm). The result is illness.
Hence the importance of walking a spiritual path in order to establish a positive, luminous mind, creating the conditions for a healthy body. Tibetan Medicine works on the causes, but nothing will change unless the conditions are also transformed.
The root condition to work on is ignorance (marigpa), our mistaken perception of reality. Through this mistaken view, we live in duality, where emotions weave the fabric of our thoughts and lives. By freeing ourselves from this error, we can transform negative emotions into positive ones, strengthen our subtle body, and establish self-sustaining well-being.
Diagnosis
Tibetan doctors begin with diagnosis, using several tools. One of the most subtle and refined is pulse diagnosis. Unlike the West, where pulse is simply measured, Tibetan physicians “listen” to the pulse. This requires great openness and takes a year to learn, and at least a decade to master. A pulse reading can last more than 20 minutes, during which the physician enters a meditative state and emerges with astonishingly precise diagnoses.
Other diagnostic tools include urine analysis (unique to Tibetan Medicine), tongue examination, and astrological diagnosis based on the Kalachakra Tantra. Tibetan doctors also study both medicine and astrology; medication preparation is coordinated with astrologers according to lunar and solar cycles.
They may also use eye diagnosis, dream analysis, and anamnesis.
Methods of Treatment
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Internal Therapy: Diet is fundamental. Food should be natural, fresh, and free of chemicals. Digestion is seen as an energetic process. Medicines are prescribed in the form of pills, decoctions, powders, or medicated butters, combining multiple plants and minerals.
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External Therapy: Includes massage, poultices, medicinal baths, cupping, moxibustion, and bloodletting.
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Spiritual Therapy: Since illness stems from ignorance (marigpa), healing also involves spiritual practice. This includes mantra recitation (not prayers but positive affirmations), and visualization of the Eight Medicine Buddhas.
Maintaining Health
Health is primarily about prevention. Tibetan doctors encourage patients to adapt diet to seasons, practice Tibetan yogas such as Lu Jong, receive therapeutic massages, and do meditations like Tonglen or fasting practices such as Nyoung-né.
What’s the Link with Yogas?
Both yogis and Tibetan doctors work with the subtle body (phra-bailus). Doctors treat subtle points with acupuncture, moxibustion, or cupping, while yogis use pressure points, breath, and visualization to guide subtle winds.
Thus, Tibetan doctors are not only physicians but meditators, cultivating compassion and accessing diagnostic insight through their own subtle body. Yogis, as Buddha taught, must maintain health to advance on their path, which is why the study of Tibetan Medicine is considered essential for serious practitioners.
And in the West?
For most of us, it is not possible to dedicate our entire lives to yogic or medical study. Yet these practices can still be integrated gently into daily life to bring real benefits.
This article is an introduction to a series of posts that will provide practical tips on lifestyle, diet, breathwork, and movements, to help those interested in Tibetan yogas understand that these practices are part of a vast puzzle whose ultimate purpose is to free us—and all beings—from suffering and its causes.
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