Thinking about Contagion and Epidemic Disease in Tibetan and Himalayan Medical Contexts: Introducing the “Pandemic Narrative” Research Project

contributed by Barbara Gerke, Jan M. A. van der Valk, and William A. McGrath, 15 January 2023

Figure 1. Detail of Yutok Yönten Gönpo (20th c.; HAR #77181), edited by the “Last Classical Man” (最后的古典人). Seen on WeChat (February 2020)

The COVID-19 pandemic has offered an opportunity to revisit Asian medical ideas of contagion from fresh perspectives, textually, as well as through ethnographic research in societies in which pre-modern ideas of contagion are still part of lived medical practices. During the ARI workshop on religion, COVID-19 vaccines, and structures of trust, it became clear that issues of “faith in immunity” in Asian medical contexts cannot fully be understood without first researching underlying conceptions of contagion and epidemic disease that might affect trust in vaccines. This research poses several challenges, which we will address in an interdisciplinary project introduced below.

The Fluidity of Contagion

First, “contagion” remains a contested and fluid concept, not only in pre-modern societies (as Angela Ki Che Leung describes in Leprosy in China), but also in contemporary ethnographic encounters. Translations and new interpretations of classical epistemologies need careful textual and ethnographic contextualization. Especially when working with living medical traditions, such as Sowa Rigpa (Tibetan medicine), that rely on texts dating as far back as the 12th century and earlier, this poses a continuing methodological challenge.

The malleability of traditional widespread disease etiologies is visible in new interpretations of classical epidemiological terms. For example, contemporary Sowa Rigpa practitioners are frequently translating classical terms for types of disease-causing “pathogens” as “viruses” or “microbes,” and have integrated these paradigms into their pandemic responses (Tidwell and Gyamtso 2021). One could argue that the use of biomedical terminology is inappropriate to accurately represent premodern Tibetan sources (for example, translating the Tibetan term sinbu [srin bu] as “virus” privileges a modern biomedical etiology over the historical and cultural contexts in which this term first emerged). However, in our anthropological fieldwork it is crucial to explore and analyze how and why such presentist translations (e.g. sinbu = virus) occur, and how and to what extent they have impacted evolving Sowa Rigpa ideas of “immunity” (see Fig. 1). Volker Scheid (2016) has suggested in Chinese medical contexts to understand such developments as “rewriting the past to imagine the future.”

Sowa Rigpa’s Heterogeneity

When analyzing the changing meaning of medical terms and concepts, we have to take into account that what is now called Sowa Rigpa is not a homogenous medical system, but rather a dynamic corpus of trans-local ideas and practices that have accumulated, changed, been transmitted and reinterpreted through locale-specific sensibilities in vast geographical areas across Central and South Asia over long periods of time. They have been transmitted orally and textually through lineages mainly in Tibetan Buddhist (often monastic) contexts, and are documented in an enormous body of largely untranslated Tibetan medical texts. Any analysis thus requires historically and geographically nuanced interpretations, which frequently question the suitability of categories such as “medicine,” “science,” and “religion.”

Existing scholarship (e.g. Conrad and Wujastyk 2000) emphasizes that classical medical systems (Vedic, Ayurvedic, Chinese, and Galenic) did not develop a coherent theory of contagion separate from their established etiologies of humors, elements, spirits, poisons, or environmental miasmas. Similarly, in the most representative Tibetan medical work, the Four Tantras (Rgyud bzhi) from the 12th/13th century, which is still partially memorized by Sowa Rigpa students today, “contagiousness” is clearly based on cosmologies where non-human actors play a major role in disease transmission.

In the Tibetan language, “widespread disease” or rimné (rims nad) includes many subcategories. Nyenrim (gnyan rims), in particular, are virulent diseases that early on in Tibet were linked to nyen (gnyan; a type of non-human agent, variedly translated as spirits/entities/demons) that have protective relationships with the environment (Karmay 1998, 253–55). Key to this nyen-related “contagion” complex are poisons, vapors, pollution, and their embeddedness in landscapes. Humans are not passively exposed to contagiousness; they are able to ritually and medically interact with these infectious agents (Arya and van der Valk 2020; Gerke 2020a; McGrath 2020a,b).

Figure 2. Nakpo Gujor or “9-Compound Black Pills,” which were distributed in Dharamsala, India, in 2020. While they contain medicinal substances, they are generally not ingested but worn around the neck. They are said to protect through the strong odorous effects of around seven to nine ingredients, such as garlic (sgog), sulfur (mu zi), types of aconite (sman chen), types of myrrh (gu gul), and traditionally also musk (gla rtsi). Photo: B. Gerke

Over time, Sowa Rigpa widespread disease etiologies have been interwoven with Vajrayāna Buddhist ideas around protection, resulting in an array of rituals, amulets, and therapeutic pills, which were used during epidemics in the past and came to the forefront yet again during the early phases of the COVID-19 pandemic (Gerke 2020a,b; see Fig. 2).

 The Pandemic Narratives Project

A shared sense of seeking protection from epidemic disease has often translated into a resourceful co-existence of different ritual and medical epistemologies among Buddhist communities in Tibet and across the Himalayas. Recognizing the importance of this research, we (Gerke, van der Valk, and McGrath) considered and discussed such issues during the winter of 2021/22 in preparation for a grant application. Together we developed the project “Pandemic Narratives of Tibet and the Himalayas: Prophecies, Contagion, and Protection—From the Black Death to COVID-19.” In October 2022, we received funding from the Austrian Science Fund (FWF) to carry out the project at the University of Vienna, Department of South Asian, Tibetan and Buddhist Studies, where the current FWF research project (by Gerke and van der Valk) “Potent Substances in Sowa Rigpa and Buddhist Ritual” is also based.

In the new project, we will explore Tibetan pandemic narratives, past and present, with a particular focus on Tibetan medical theories of widespread disease, protective pills, therapeutic recipes, Buddhist rituals, as well as related end-time prophecies (Nattier 1991). Prophecies of degenerate times—a central feature of Mahāyāna Buddhism—are recalled and reimagined by contemporary Tibetan and Himalayan voices in these times of environmental disasters (Childs et al. 2021) and in reference to COVID-19, demonstrating the contextual versatility of pandemic narratives.

We seek to investigate Himalayan and Tibetan pandemic narratives from religious, medical, and ecological viewpoints, with specific attention to spirits, deities and disease-causing agents. We will trace the history of Tibetan Buddhist and medical responses to epidemics and assess contemporary (re)interpretations of Buddhist scriptures, medical therapies, and Himalayan ecologies. Our aim is to place the past in conversation with the present through a narrative approach that helps contextualize and illuminate Tibetan and Himalayan responses to the COVID-19 pandemic.

Figure 3. Folio 1a of a manuscript edition of the Vase of Ambrosia (BDRC: W2PD17503), once held at Pelpung monastery and marked with the seal of an official “physician” (lha rje; lit. “lord of the gods”): “The complete Great Vase of Ambrosia, including the mother, children, and additional branches … .”

The 13th-century Buddhist text titled Vase of Ambrosia (’Chi med bdud rtsi bum pa) contains instructions for the creation of anti-epidemic powders and pills, among many other medical and ritual protections (McGrath 2021; Fig. 3). Such pills are now being used in Sowa Rigpa globally to prevent and treat COVID-19. Starting from this observation, our project has two hypotheses: (1) The Vase of Ambrosia emerged as a direct response to outbreaks of widespread disease in 13th-century Tibet; and (2) The end-times prophecies, disease categories, protective pills, medical recipes, and ritual engagements with pathogenic agents that developed during these earlier periods have informed Tibetan and Himalayan responses to widespread disease down to the present.

To test these hypotheses, the team will philologically and ethnographically analyze prophetic narratives, related ritual and medical instructions, evolving ideas of contagion, and the active roles of nonhuman forces in current end-time narratives in India, Nepal, and Bhutan, as well as online. Building on recent research about the history of the Black Death in Central Eurasia (Cui et al. 2013; Green 2020; Spyrou et al. 2022), our textual analysis of Tibetan accounts of widespread disease from this period will help redefine current understandings of the Black Death and its global history.

Through online ethnography and participatory ethnographic methods, we will analyze pandemic narratives documented in “COVID-19 Diaries” by Tibetan and Himalayan communities in New York, in collaboration with Sienna Craig and her colleagues. We will also further explore the therapeutic approaches documented in the NACTMOS North American COVID-19 Tibetan Medicine Observational Study of 15 Tibetan medical practitioners treating 140 patients with mild to medium COVID-19 symptoms in the USA and Canada. For this research component, we collaborate with the NACTMOS principal investigators Tawni Tidwell and Tenzin Namdul, who designed and carried out the study with their colleagues in 2020. We aim to more deeply understand the underlying pandemic narratives in these projects and trace the way Tibetan medical knowledge of widespread disease, contagion, prevention, and treatment traveled globally in response to the pandemic.

In sum, this project will present the first nuanced study of Sowa Rigpa theories of widespread disease and will reveal how past narratives have informed present-day outbreak responses.

 


Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the position of the blog editorial team or the Asia Research Institute.

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Barbara Gerke (M.Sc. Medical Anthropology and D.Phil. Social Anthropology, University of Oxford) is the PI of the Austrian Science Fund research projects “Potent Substances in Sowa Rigpa and Buddhist Rituals” and “Pandemic Narratives of Tibet and the Himalayas” at the University of Vienna. Together with Jan v.d.Valk and Sienna Craig (2020) she co-edited a Hot Spots issue on Asian medical responses to COVID-19. Her open-access monograph Taming the Poisonous: Mercury, Toxicity, and Safety in Tibetan Medical Practice (Heidelberg University Publishing, 2021) examines the use of refined mercury in Tibetan medicines. Her first monograph Long Lives and Untimely Deaths (Brill, 2012) analyzes long-life rituals, as well as vitality and life-span concepts among Tibetans in the Darjeeling Hills.

Jan M. A. van der Valk (PhD, University of Kent) is a scholar-practitioner specializing in Sowa Rigpa. Drawing on a multidisciplinary training in anthropology, ethnobotany, and biology, his interests revolve around Eurasian medicinal plants and other potent substances, traditional pharmaceutical processes, more-than-human ecologies, and knowledge transmission. He mainly conducts ethnographic fieldwork in the Himalayan valleys of Ladakh (India) and Kathmandu (Nepal). Besides working as a postdoctoral researcher at the Institute of South Asian, Tibetan and Buddhist Studies (University of Vienna), he has a private Tibetan medical practice in Belgium, while also collaborating with his teacher Gen. Pasang Yonten Arya as the editor in chief of Bedurya Publications.

William A. McGrath (PhD, University of Virginia) is Robert H. N. Ho Family Foundation Assistant Professor of Buddhist Studies at New York University, where he teaches in the Department of Religious Studies. His research primarily concerns the historical intersections of religion and medicine in Tibet. He recently edited the volume Knowledge and Context in Tibetan Medicine (2019) and, with Kurtis R. Schaeffer and Jue Liang, Histories of Tibet: Essays in Honor of Leonard W. J. van der Kuijp (2023).