|A Tibetan traditional doctor evaluates the taste of ‘dzin pa zla bral (pronounced: zin pa da drel), Aconitum gymnandrum, in the mountains surrounding the town of Litang, Litang County (Sichuan, China), 4090 meters altitude, July 2000. Photo 2006 © Alessandro Boesi.|
by Alessandro Boesi, PhD, and Francesca Cardi, PhD
Several studies on Tibetan civilization have been carried out up to now, yet some aspects of Tibetan traditional knowledge are still not well-known, such as the way local people conceive the environment, plants, and animals, and the way of practicing Tibetan medicine and exploiting medicinal substances. Previous research on Tibetan medicine has mainly provided information on theoretical aspects. Only recently have some scholars started to document the ongoing transformations of this science.1,2,3,4,5
|A medicament formula before the crushing, Dhorpatan Tibetan settlement (Central Nepal), June 1998. Photo 2006 ©Alessandro Boesi.|
Between 1998 and 2004, a research project on Tibetan ethnobiology and pharmacopeia of traditional medicine was carried out by the authors in the context of a doctoral program in Biological Anthropology. The aim of the research was to study plant conception, classification, and exploitation among Tibetan populations, as well as to assess the Tibetan materia medica and medical practice, from the gathering of medicinal substances to the processing and administration of medicaments. Particular attention has been given to the evaluation of the knowledge of traditional doctors and to the contemporary evolutions of medical activities in Tibetan regions.
This study is interdisciplinary, involving several specialities such as anthropology, botany, ethnobotany, and tibetology. To obtain exhaustive information, the fieldwork was carried out for a period of 16 months in collaboration with traditional doctors of different educational levels who were located in different Tibetan regions: east Tibet (Litang County, Sichuan, China), Ladakh (India), and different areas of Nepal (Dhorpatan and Baragaon). The following anthropological methods were the most commonly used during the investigation: participant observation, open-ended conversations, and to a lesser extent, semi-structured interviews.
Excerpts of classical texts of Tibetan medicine6,7,8 and of some traditional and modern treatises of Tibetan materia medica9,10 were translated to analyze medicinal plant conception, classification, and identification systems. Comparisons with the field data were made. Plant and mineral specimens (approximately 350) were gathered and identified, their traditional classification and use documented. Medicinal plants were deposited at the Herbarium of the Muséum National d'Histoire Naturelle de Paris, France, and mineral samples were deposited at the Museo di Storia Naturale di Milano, Italy.
Field data have shown that the traditional doctor's individual knowledge is crucial, influencing classification, identification, and use of the materia medica, and that the recent political, demographic, and socio-economic transformations of Tibetan societies directly affect medical knowledge and practice.11 At the popular level, traditional botanical knowledge is unevenly spread according to profession and education and is rapidly disappearing.12 Some of the research findings on the classification and identification of the materia medica are reported in this article.
Tibetan medicine is practiced over a vast area, which covers all the regions inhabited by populations of Tibetan language and culture, as well as other areas: the northern states of India (Jammu & Kashmir, Himachal Pradesh, West Bengal, and Sikkim), Bhutan, a large part of the northern regions of Nepal, and the Chinese Provinces of Tibet (Xizang), Qinghai, Gansu, Sichuan and Yunnan. It is also practiced in Mongolia, Buryat (Russia), and many other countries where Tibetans have settled.
The medical system is the result of the blending of different medical traditions and practices that come from the most important Asian medical sciences: Ayurveda, traditional Chinese medicine, and the middle-east tradition. These kinds of medical knowledge, introduced into Tibet from the 7th century onwards, were superimposed and integrated with the pre-existing medical tradition of Tibetan regions, which at first were probably scarcely developed and gave particular weight to magic and religious rituals. Gradually, a distinct system of medical theories and practices developed, rational and homogeneous, which gave origin to a new medical science, Tibetan medicine, completely independent from the traditions which had influenced its evolution. That entire various medical learning was gathered, probably between the 8th and the 12th centuries, in a text composed of 4 volumes, The Four Tantras (Gyushi, rGyud bzhi),6 nowadays still the fundamental reference for all students and practitioners of Tibetan medicine along with its famous commentary The Blue Beryl (Vaidurya sngon po),7 produced in the 17th century by the Regent Sangye Gyatso (1653-1705).13 Tibetan medicine is currently practiced in several forms such as private clinics, medical institutes, and dispensaries. It is taught at medical schools or transmitted by masters through a lineage of disciples and family lineages.
It is worth noting that, although practitioners employ the same Tibetan classical and modern texts devoted to theory and practice, Tibetan medicine is a complex and heterogeneous system of thought whose presentation and practice is not standardized and uniform. Our fieldwork has shown that the way to practice this medical tradition is subject to variations according to several factors, e.g., environmental conditions, family medical lineages, local traditions, medical schools, medical centers, the influence of religious institutions, and foreign influences both from other medical traditions and from modern western medicine.
|One of the areas where the research fieldwork was carried out. The so-called Gompa easternmost camp of the Nordzinling Tibetan settlement of Dhorpatan Baglung District (Central Nepal), 2900 meters altitude, April 1995. Photo ©2006 Alessandro Boesi.|
Tibetan Materia Medica
According to the Tibetan "science of healing," sowa rigpa (gso ba rig pa), medicinal substances, along with diet, behavioral rules, and external treatments, represent a means to eliminate sickness and re-establish the humoral balance of the body. In Tibetan medicine, most medicinal agents are not used separately, but are mixed and processed into complex medicines. Ingredients are chosen according to their individual therapeutic properties and to their capacity of performing a coordinate and synergetic action.
Tibetan materia medica, influenced mainly by Ayurveda after the translation of several treatises of Indian origin, has been enriched and modified during the centuries according to the needs of the Tibetan population and has been adapted to local environmental conditions. Even during the present time, in relation to recent transformations of the society and environmental changes, the materia medica is evolving.14
The most important traditional pharmacopeias employed today are the Crystal Block (Shel gong) and the complementary text of it, the Crystal Rosary (Shel phreng),8 both written in the first half of the 18th century. The general texts of Tibetan medicine, The Four Tantras and The Blue Beryl, also have a section devoted to describing the potency (nus pa) of medicinal substances. Although the above texts usually play a basic role in the education of doctors, our research has shown that oral information is crucial, in particular as far as practical activities and the use of medicinal substances are concerned.
Medicinal substances, man dza (sman rdzas), include drugs of plant, mineral, and animal origin. They are gathered directly on the Tibetan plateau or are imported from the lower regions of India, Nepal, and China. Several medicinal plants grow in tropical and sub-tropical regions. Nowadays, these substances are available on local markets. The gathering of plants may be influenced by their availability and other factors, and practitioners organize them according to specific rules and timings. Medicinal substances may be classified on the basis of different criteria, e.g., their "hot" or "cold" properties, other therapeutic properties, as well as morphological, biological, and environmental features. One of the most common classifications of the materia medica reported by the informants (and also described in medical texts) points out the 9 categories shown in Table 1.
Medicinal substances may be assembled according to various criteria. The category of the woody medicines is worked out on the basis of the presence of woody organs. The categories of herbaceous medicines and medicines of the plains are worked out on the basis of several criteria: morphological, biological, and environmental. A single criterion, the healing properties of the medicines, is employed for the category of essence medicines. We emphasize that regarding the category of precious medicines, its construction is also inspired by religious beliefs.
Medicinal substances are commonly named according to Tibetan standard designations that are also reported in written sources, but practitioners may use regional names and synonyms. Several substances are designated with names of Sanskrit origin, in particular the ones imported from India and Nepal, which are also employed in Ayurvedic medicine.
Table 1: Categories of Tibetan Materia Medica
|Medicinal Substances||Tibetan Names|
|precious medicines||rin po che'i sman|
|stone medicines||rdo'i sman|
|earth medicines (soils)||sa'i sman|
|salt medicines||tshwa sman|
|essence medicines||rtsi sman|
|woody medicines||shing sman|
|medicines of the plains||thang sman|
|herbaceous medicines||sngo sman|
|medicines coming from living beings||srog chags sman|
Categories of Tibetan Materia Medica
Precious medicines include precious and semiprecious stones, such as emerald, diamond, and lapis lazuli; metals (gold, silver, iron); and mineral substances of animal origin such as coral, pearls, and conches. These substances are considered doubly precious according to their economic value and to their symbolic and religious importance, since Buddhism and medicine are interrelated. Although Tibetan doctors affirm that every element of the materia medica is equally important in the preparation of remedies, this category of medicines is generally considered to be very powerful. In fact, a type of medicament named Precious Pill, the therapeutic effect of which is particularly renowned, is mainly composed of substances that are included in this special category. The category of stone medicines includes several kinds of minerals, e.g., calcium carbonate, pyrite, and magnetite. Earth medicines and salt medicines are small categories: drugs such as Vermiculitum are included in the former, and sulphur in the latter. Both categories present a similar internal division in 2 sub-groups: natural (rang byung ba) and artificial (bcos pa).
The categories of stones and earths mentioned above include only elements of mineral origin, except one. Curiously, practitioners consider a particular lichen as an herbaceous plant, i.e., the one designated dodreg (rdo dreg, Parmelia spp., Parmeliaceae); the Tibetan name means "incrusted on the stone." However, the majority of practitioners put this lichen in the group of medicinal stones because it appears to be growing directly on the rocks, while others place it among the medicinal earths category.
The category of essence medicines includes drugs apparently very dissimilar coming from plants, minerals, and animals, e.g., camphor (ga bur, Cinammomum camphora [L.] Nees & Eberm., Lauraceae), cardamom (sug smel, Elettaria cardamomum Maton, Zingiberaceae), saffron (gur gum, Crocus sativus L., Liliaceae), musk, bear bile, and bitumen. Why do Tibetan doctors classify them together? According to practitioners, the main characteristics they share are their strong potency and their particular fragrance. Due to this strength of potency and fragrance, they are employed in small amounts.
The woody medicines, the medicines of the plains, and the herbaceous medicines include only drugs of plant origin. The woody medicines include drugs coming from trees and shrubs. Among the few of them gathered directly on the Tibetan plateau, the most common are shug pa (Juniperus spp., Cupressus spp., Platycladus orientalis (L.) Franco, Cupressaceae); dali (da lis, Rhododendron spp., Ericaceae); and several types of honeysuckle such as kishin (khyi shing, Lonicera thibetica Bur. & Franch., Caprifoliaceae) and tarbu (star bu, commonly called sea buckthorn in the West, Hippophae spp., Elaeagnaceae). Many come from tropical and sub-tropical regions, such as the Indian sandalwood tsendenmarpo (tsan dan dmar po, Pterocarpus santalinus L. Papilionaceae), different types of myrobalam (a ru ra, Terminalia chebula Retz., Combretaceae), and ba ru ra (T. bellerica C.B. Clarke, Combretaceae). The category is structured in 7 sub-groups; they correspond to the anatomical parts of plants used in medicine: seeds and fruits, flowers, leaves, stems, branches, barks, and resins.
The following 2 categories, medicines of the plains and herbaceous medicines, have a similar internal organization. While some informants report this classification, many of them do not differentiate the 2 groups, recognizing only a single category designated tsa man (rtswasman, "herbaceous medicines"). Others, influenced by modern texts, name it by joining the 2 terms sngo (herbaceous) and thang (plains). However, many informants throughout different Tibetan regions affirm that the distinction of these 2 groups has no practical utility. The majority of the informants have little or no knowledge of the 2 categories or of the features that differentiate them. They generally report that the medicines of the plains grow in the area of the Tibetan plateau at lower and medium altitudes and that herbaceous medicines grow on high mountains.
In Tibetan traditional medicine, the term thang sman has 2 distinct meanings and utilizations. It is employed either to indicate the category of medicinal plants, as reported above, or to designate a kind of medicinal preparation, notably decoctions. In the first case the meaning of thang is "flat area"; in the second case it is "soup." It comes from the Chinese language and particularly from the thang preparation employed in Chinese medicine. Several Tibetan informants mistakenly report that the term thang sman only designates medicinal plants that are used to prepare decoctions.
|ug chos dmar po (pronounced: ugchö marpo) Incarvillea grandiflora. Xiangcheng County (Sichuan, China), 4120 meters altitude, May 1999. Photo 2006 © Alessandro Boesi.|
Detailed descriptions of the botanical characteristics of the plants included in the 2 categories are seldom reported. In this case, they correspond nearly to the ones reported in traditional texts such as the Crystal Rosary. The informants affirm that the medicines of the plains may be bulky herbaceous or sometimes tiny woody plants, whose stems and roots are more developed than those of the herbaceous medicines, such as pashaka (ba sha ka, Adhatoda vasica Nees, Acanthaceae), thangdromnagpo (thang phrom nag po, Anisodus tanguticus Pasher, Solanaceae), and chum (lcum, Rheum palmatum L., Polygonaceae). Conversely, plants belonging to the herbaceous medicines have an herbaceous aspect, with a slender stem and tiny underground organs such as ugch? marpo (ug chos dmar po, Incarvillea grandiflora Bur. Et Franch., Bignoniaceae) (see photo on left) and tser n?n (tsher sngon, Meconopsis horridula Hook. F. & Thoms., Papaveraceae).
The last category reported by the informants is the one of medicinal substances coming from living beings. It includes substances that belong to the animal kingdom. Hence, the medicinal substances previously described, plants included, are not considered as living beings. Tibetans regard as living beings only the substances that have a conscious principle (sems).
|thang khrom nag po (pronounced: tan drom nag po) Anisodus tanguticus. Litang County (Sichuan, China), 3930 meters altitude, July 1999. Photo ©2006 Alessandro Boesi.|
Drugs are listed by anatomical parts and organs and are divided into numerous sub-groups such as horns, eyes, tongues, teeth, hearts, and lungs. Some insects and other small invertebrates may be included in another sub-group. The same living being may be repeatedly listed according to its different anatomical parts; for example, the stag, which appears both in the horn and in the blood sections. Although many substances of animal origin are included in the materia medica, Tibetan doctors do not frequently use them. Some possible reasons are their rarity, high cost, and the recent promulgation of regulations protecting the fauna.
The Identification of Medicinal Plants
Owing to the great extension of the area over which Tibetan medicine is practiced, the materia medica shows differences according to the region, climate and vegetation, local traditions, the activities of medical institutes, and foreign influences. All these factors may influence plant identification. Hence, different plants (i.e., from different genera and species from the botanical perspective) may be designated by the same Tibetan name.
The ability to accurately identify medicinal plants can be acquired only after several years of study and practice with the guidance of a learned master. It involves not only the identification of plants from their morphological features and the recognition of the subtle differences between plant varieties, but also the ability of evaluating their therapeutic properties through the analysis of various plant and environmental features.
Two systems may be distinguished in the identification process employed by Tibetan practitioners: "prototypical" and "componential-conceptual."15,16 The former allows the practitioner to recognize the plant and to attribute a name to it after the observation of its general features, employing an ideal model, which evokes and supports the botanical nomenclature. The latter is based on the evaluation of the presence of one or several characteristics, which represent the necessary condition to recognize the plant. Thus, this identification process implies the attentive analysis of specific features of the plant.
|dwa ba (pronounced: da wa) Arisaema nepenthoides. Dhorpatan (Central Nepal), 3120 meters altitude, May 1998. Photo ©2006 Alessandro Boesi.|
Many Tibetan doctors examine the general aspect of a plant without considering its minute features, and recognize it almost instantaneously, as in the case of rechagpa (re lcag pa, Stellera chamaejasme L., Thymelaeaceae) and dawa (dwa ba, Arisaema nepenthoides [Wallich] Martius ex Schott, Araceae) (see photo on left). The practitioner bears in his/her mind one ideal model, which allows the immediate recognition of all the plants included in the same class. This model, based on his/her experience and region of origin, usually constitutes the most typical specimen of the category. Yet, in Tibetan medicine, the "prototypical" system seldom allows the precise recognition of medicinal plants, representing only the first stage of the identification process, i.e., the examination of the plant's general aspect. Actually, the "componential-conceptual" identification system is essential to recognize and exactly designate medicinal plants. Identification is complete only when specific features evaluated for each plant correspond to the ones known by the doctor, on the basis of his/her experience and education, and to the ones described in the treatises of Tibetan materia medica. Only then can the plant be gathered and employed in medicine. A practitioner's experience and education, along with text information, represent concurrent aspects of this task. Morphological features, taste, scent, and the environment where the plant grows—the most important plant characteristics examined—are analyzed below.
To describe the importance of the analysis of minute morphological features in plant identification, we take as an example 2 categories of medicinal plants: lug ru (lug ru, sheep's horn, Pedicularis spp., Scrophulariaceae) and lang na (glang sna, elephant's trunk, Pedicularis spp.). Pedicularis (lousewort) is a genus of semi-parasitic plants, often conspicuous in the alpine zone all over the Tibetan plateau and the Himalayan Mountains. According to the recent Flora of China,17 among the 352 species of Pedicularis present in China, 271 are endemic, and many thrive on the Tibetan plateau. The flower of the lousewort has a corolla, which is two-lipped. The upper lip is hooded and often prolonged into a beak, which may be slightly circular or trunk-shaped.
Tibetan practitioners of Litang County (East Tibet) and other Tibetan areas identify louseworts in the following manner. After a rapid evaluation of the general aspect of the plant, they attentively examine the morphology of the flower and in particular its beak, which may be called horn or nose, according to its shape. When the beak is slightly circular, it is called horn, and the plant is identified as lug ru. In this case, the beak of the flower is associated with the horn of a sheep. When the beak of the flower doesn't bend on one side, but it bends directly forward, looking like an elephant's trunk, the plant is called lang na, meaning "elephant's trunk." The plants included in the group called lug ru are mainly identified according to the color of their flowers (and to the features of the environment of growth), while the ones belonging to lang na are identified according to flower size and position, and leaf position.
|chu skyur (pronounced: ciu ghiur) Rheum alexandrae. Litang County (Sichuan, China), 4100 meters altitude, July 2000. Photo ©2006 Alessandro Boesi.|
Sometimes, the morphological identification parameters of the same plant may vary as in this example concerning the identification of cha rkan (bya rkang). The specimens of this plant that we gathered in Tibetan regions belong to the genus Delphinium: Delphinium cashmerianum Royle, Ranunculaceae in Ladakh; D. caeruleum in the Litang County (Sichuan, China); and D. grandiflorum L. in Baragaon. According to the majority of practitioners and texts,8 the flower of the cha rkan must be similar to the head of the hoopoe (Upupa epops), and they affirm that one of the Delphinium exhibits that characteristic. Conversely, a traditional doctor from Khyungbo, a region located in East Tibet, names cha rkan as a totally different plant, which has been identified by us as a fern (Pteridium aquilinum [L.] Kuhn var. wightianum (J. Agardh) Tryon, Dennstaedtiaceae). That practitioner refers directly to the plant name cha rkan, meaning "bird's feet," for the identification. Actually, he showed us that the not-fully-opened buds of that fern have a striking similarity to bird feet and constitute the element, which allows him to identify the plant as cha rkan.18
An important plant feature, which has to be carefully examined, is its taste (ro), because taste allows the practitioner to both recognize the plant and to assess its potency. In Tibetan medicine the 6 tastes (sweet, acid, salty, bitter, hot, astringent) are considered curative properties. They are produced by the dominant 2 of the 5 elements (the fundamental constituents of matter) of which each plant is formed. The 5 elements are the fundamental constituents of all substances and are responsible for all their features and qualities. Thus, most practitioners, as in the case of dzinpa dadrel ('dzin pa zla bral, Aconitum gymnandrum Maxim, Ranunculaceae), after observing plant morphology, crush with the teeth a portion of the plant and keep it for a while on the tongue (see photo on cover page). The taste has to correspond to the one indicated in the texts for that plant or according to the experience of the doctor.
A situation which took place on the field in East Tibet confirms the importance of the evaluation of scent for the identification of medicinal plants. We showed a Tibetan doctor a specimen of Nardostachys grandiflora DC., Valerianaceae that had been gathered a few hours previously on the mountains. The doctor, after examining the morphological features and taste of that specimen, identified it as pang p? (spang spos)—the Tibetan name of the plant mentioned above as N. grandiflora—but after evaluating the scent of its underground part, changed his mind, because the scent did not correspond to the one proper to that plant. Therefore, he concluded that, as concerned the morphology and the taste, that plant was very similar to pang p?, but as to its scent, it was different. Hence, that plant could not be identified as pang p? and could not be used in medicine. After a few days, we climbed with the same informant to the place where we had gathered that plant. This time the practitioner, after analyzing the scent of a fresh specimen, identified it as pang p?. All the above is to demonstrate that without its scent this plant can't be exactly identified. We note that plant potency (i.e., as a medicine) may also be ascertained through the evaluation of its fragrance, which is also dependent upon the 5 elements: certain plants without their proper fragrance cannot be employed as medicines, since they would be deemed to be lacking in therapeutic properties.
Table 2: Traditional Tibetan Medicinal Plants Mentioned in this Article
|Parmelia spp.||Parmeliaceae||rdo dreg|
|Platycladus orientalis (L.) Franco||Cupressaceae||shug pa|
|Juniperus spp.||Cupressaceae||shug pa|
|Cupressus spp.||Cupressaceae||shug pa|
|Elettaria cardamomum Maton||Zingiberaceae||sug smel|
|Crocus sativus L.||Liliaceae||gur gum|
|Cinammomum camphora (L.) Nees & Eberm.||Lauraceae||ga bur|
|Rhododendron spp.||Ericaceae||da lis|
|Lonicera thibetica Bur. & Franch.||Caprifoliaceae||khyi shing|
|Hippophae spp.||Elaeagnaceae||star bu|
|Pterocarpus santalinus L.||Papilionaceae||tsan dan dmar po|
|Terminalia chebula Retz.||Combretaceae||a ru ra|
|Terminalia bellerica C.B. Clarke||Combretaceae||ba ru ra|
|Anisodus tanguticus Pasher||Solanaceae||thang khrom nag po|
|Rheum palmatum L.||Polygonaceae||lcum|
|Adhatoda vasica Nees||Acanthaceae||ba sha ka|
|Incarvillea grandiflora Bur. Et Franch.||Bignoniaceae||ug chos dmar po|
|Meconopsis horridula Hook. F. & Thoms.||Papaveraceae||a byag tsher sngon|
|Arisaema nepenthoides (Wallich) Martius ex Schott||Araceae||dwa ba|
|Stellera chamaejasme L.||Thymelaeaceae||re lcag pa|
|Pedicularis spp.||Scrophulariaceae||lug ru|
|Pedicularis spp.||Scrophulariaceae||glang sna|
|Delphinium cashmerianum Royle||Ranunculaceae||bya rkang|
|Delphinium caeruleum||Ranunculaceae||bya rkang|
|Delphinium grandiflorum L.||Ranunculaceae||bya rkang|
|Pteridium aquilinum (L.) Kuhn var. wightianum (J. Agardh) Tryon||Dennstaedtiaceae||bya rkang|
|Aconitum gymnandrum Maxim.||Ranunculaceae||'dzin pa zla bral|
|Nardostachys grandiflora DC.||Valerianaceae||spang spos|
|Aconitum violaceum Jacquem. ex Stapf.||Ranunculaceae||bong nga nag po|
In the identification process, the observation of the environment where the plant grows is important, because it allows the practitioners to make a selection. Certain plants thrive only in particular ecological settings. The distinction between the shady side (srib) and the sunny side (nyin) of the mountains is fundamental. In fact, in the Tibetan perception of the environment in general and, in particular, in plant identification, that differentiation is a crucial factor because it denotes different growing areas, each one with specific characteristics, where only particular plants can grow.
|a byag tsher sngon (pronounced: a ciag tser nön) Meconopsis horridula. Litang County (Sichuan, China), 3920 meters altitude, June 2000. Photo ©2006 Alessandro Boesi.|
Furthermore, in Tibetan medicine, examining the environment where the plant grows is crucial because it affects its potency: the hot power of the sun prevails on the sunny slopes, whereas the cold power of the moon prevails on the shady ones. In the same way, the altitude influences the cold nature or the hot nature of the plant, increasing or decreasing its potency. That is the case of a plant with a cold potency such as the bon na nagpo (bong nga nag po, Aconitum violaceum Jacquem. ex Stapf., Ranunculaceae).12,18 The informants do not pluck the individuals growing on the sunny side of the mountains because the hot nature of the sun dissipates their cold potency. On the contrary, the ones that grow in the highest places of the shady slopes are the most appreciated because the cold power of the spot is very strong. There are also plants whose properties are not particularly influenced by environmental features such as the tsern?n (Meconopsis horridula Hook. F. & Thoms., Papaveraceae) (see photo at left), a type of Himalayan blue poppy. Interestingly, the doctor may decide to pluck the same plant in a different site according to the therapeutic properties required.
The role of literary sources in the identification process
Many traditional6,7,8 and modern texts9,10 describe and illustrate the materia medica of Tibetan medicine. They give general information about plant categories and very concise descriptions of plant morphology and of their environment of growth. The authors often use comparisons with other plants or metaphors, which describe the plant organ, using an animal or its organ as a model of similarity. These descriptions certainly cannot be employed to carry out the identification a priori, because they imply subjective interpretations. Actually, plant identification is not carried out employing these texts, but on the basis of the individual experience of the practitioner.
These treatises are used by practitioners who are already able to recognize medicinal plants and may use the information to distinguish the different varieties of a single plant. This may be very important because each type of plant often has distinct healing properties or a distinct technique of use. In this way written information in Tibetan texts and the oral information received by the teachers allow the practitioner to recognize the plant. The modern treatises of Tibetan materia medica published in Chinese Tibet in the last decades have been spreading increasingly all over Tibetan regions. We noticed the rapid diffusion all over Tibetan cultural regions of a recent text of Tibetan pharmacopeia,9 which also presents numerous illustrations of plants and other medicinal substances. During gathering trips or at drug markets, many doctors employ it to identify plants using the illustrations.
The knowledge of the materia medica is moderately diffused throughout Tibetan regions, and the disparity of competence among practitioners is significant. Modern generations of practitioners are principally skilled in the diagnosis and administration of the remedies. Only a limited number of highly educated and well-experienced Tibetan doctors have a deep knowledge of medicinal plant classification and identification criteria. One of the reasons explaining that phenomenon may be related to a recent trend, which is becoming increasingly important in the last decades—the recent standardization and industrialization of drug processing in Tibetan medical institutes, and the specialization of practitioners.11
Medicinal substances are similarly conceived in the regions studied. Traditional doctors seem to attribute little importance to their classification in categories (as shown in Table 1) and prefer distinguishing drugs on the basis of their qualities and therapeutic properties. A general tendency consists in simplifying the traditional classification according to practical evaluations. The same happens with modern Tibetan pharmacopeias (edited in Chinese Tibet), some of which may also include additional substances, probably under Chinese influence, that do not appear in classical Tibetan treatises.
As far as the identification of medicinal plants is concerned, it is not only based on the analysis of the morphology of the plant, but also takes into account other properties such as its taste and smell, and the features of the environment where it grows. Taste, smell, and environment are important features, which are employed both to recognize the plant and to assess its healing properties and quality at the same time.
Although based on the same medical texts, the knowledge related to the many substances of mineral, animal, and plant origin of the Tibetan pharmacopeia may vary according to the region, climate and vegetation, medical schools, local traditions, and foreign influences. Owing to the socio-economic, cultural, and political transformations of Tibetan societies, and to the standardization of medical knowledge and practice, it is important to document this unique local knowledge that may disappear in the near future.
Alessandro Boesi obtained his PhD in Biological Anthropology in 2004 at the Université de la Méditerranée, Marseille, France. His thesis is titled "Le savoir botanique des Tibétains: conception, classification et exploitation des plantes sauvages." Alessandro has conducted fieldwork in Ladakh (India), Nepal, and Tibet (China) since 1994, focusing on Tibetan ethnobotany and the materia medica of Tibetan medicine. He is affiliated with Shangdril (www.shangdril.org), a research center at the Museo di Storia Naturale di Milano (Italy) and works as a lecturer for Italian universities.
Francesca Cardi obtained her PhD in Anthropology in 2004 at the Université de la Méditerranée, Marseille, France. For the last 10 years she has carried out extensive research in several Tibetan regions, focusing on Tibetan pharmacopoeia, medicament production, and the practice of traditional doctors. She is a member of the research center Shangdril (Italy) and collaborates with Italian universities and institutions such as Université di Pavia and Museo di Etnomedicina di Genova, and also with scientific publishers and pharmaceutical companies.
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