by John Avedon
A related specialty known as chu-len or “Extracting the Essence” dealt with rejuvenation. By using its medicines, religious practitioners on three-, nine- or twelve-year retreats were able to survive, it was believed, on a single seed or flower a day. For lay people chu-len could restore hair and teeth while increasing lifespan by many decades. As Dr. Dhonden explained, “Each of us breathes 21,000 times a day; 500 of these breaths are associated with lifespan. Chu-len medicines, taken in conjunction with the correct meditation practices, increase the number of these breaths. From my own experience I can definitely say they work. I’ve known people in their hundreds who have undergone the full course of treatment, beginning at the age of fifty, and been restored to a state of middle age. I met one lama when he was 170 years old. He had gray hair but the face of a forty-year-old.”
Having administered rejuvenation treatment for two millennia, Tibetan physicians considered it a normal component of their medical practice. However, one group of drugs, as venerable as those of chu-len, excited particular interest—rinchen ribus or “Precious Pills.” Whenever Dr. Dhonden returned to Mendzekhang to replenish his professor’s medicines, he made sure to inquire which Precious Pills had most recently been manufactured in the college’s pharmacy. Seven types existed, the weakest composed of eighteen ingredients, the strongest, known as the King of Medicines, of one hundred sixty-five. Wrapped in colored cotton, tied with rainbow-hued thread and sealed with wax, the Precious Pills received their name for two reasons: for their contents—gold, silver, mercury, pearl, ruby, sapphire and diamond, specially treated and then mixed with various medicinal plants—and for their function—as panaceas for the entire body. Precious Pills, it was believed, could cure the most intractable ailments. As their manufacture sometimes took up to three months of around-the-clock labor by a team of twenty druggists, they were extremely potent and administered only under strict conditions. The stronger ones often incapacitated the patient for a day, while toxins were eliminated and imbalances in the body corrected. Though Yeshi Dhonden was familiar with their ingredients, his internship was primarily geared toward expanding his knowledge of Tibetan medicine’s vast pharmacopoeia. To check his progress, Kenrab Norbu required Dr. Dhonden to accompany the college each year on its annual outing to pick herbs in the mountains.
The journey commenced at the start of July and was attended by those who had completed memorization, generally 300 students and faculty in all. As a rule, each traveler brought three changes of clothing, the Buddha having stressed the importance of cleanliness while collecting medicinal substances. With one pack animal and a groom serving every two students, the caravan left Mendzekhang and, skirting Lhasa, proceeded a day north to Dhakyaba, a region of peaks and alpine meadows considered ideal for herb gathering. A large tent camp provided by the government, staffed with cooks and fully provisioned, already awaited the college. For seven weeks, changing location every three days, small groups of students and teachers set off at eight o’clock each morning to collect herbs just below the snow line. While harvesting, they recited prayers to the Medicine Buddha, intent on keeping the mind as well as the body pure. Thirty classes of plants, subdivided into fifty-nine categories, with each plant having nine divisions, were initially sought. Hundreds of herbs with less universal value were also taken. With the waxing of vegetative processes and the onset of pollination, barks and plant secretions received less attention; flowers, fruits, seeds and leaves, more.
Halfway through the summer, large wooden crates began arriving from Lhasa. Ordered from district governors months in advance, the crates contained dozens of medicinal plants that were unavailable in Central Tibet. They had been carefully picked with earth still around their roots and immediately packed in snow and ice. By the end of August, when all had arrived, the students had completed their own collections and were ready to take the year-end test on the identification of plants.
The exam took place inside a large tent surrounded by a high cloth wall. Within, stacks of wood covered with white cotton lined the enclosure, two hundred selected plants laid out haphazardly on top. With Kenrab Norbu presiding from a high seat at the far end, three faculty members, each assisted by a secretary, escorted students past the tables. While the secretaries recorded their replies, the students were asked to describe each specimen by type, species and the medicinal power of the active part. Guided out the tent’s rear, they were separated from those yet to be examined, and the next group of three took their places. While they did, the scores were tabulated and given to the Master, who had them announced to the whole gathering—a procedure guaranteed to increase the tremendous tension the students already felt. The test completed, students once more were taken around, this time to have their mistakes pointed out.
Most of Mendzekhang’s aspiring physicians took up to five exams before they could correctly identify a majority of each year’s plants. In his first and second attempts, Yeshi Dhonden placed sixty-second, then forty-fifth in the ranking. By the age of twenty, though, with his internship completed, he captured third place. By coincidence his old roommates took first and second, giving the three friends a clean sweep of the top positions. Because their scores were so close, Kenrab Norbu ordered a retest. This time the young men were taken around the tables blindfolded. One by one their examiners held up plants, requesting that they be identified by odor and taste alone. As Yeshi Dhonden recalled, “This was very difficult, but fortunately all of us were able to answer correctly. When the test was over, it was announced that I had come in number one. Later, though,” he added, laughing, “I found out there had been a catch. Because I was graduating, my friends had pretended to make little mistakes. In reality I was number three, but thanks to their trick I was chosen as the best student in the college.”
Following the exam, a large celebration, equivalent to graduation day, was held. Hundreds of people came from Lhasa and the surrounding villages to watch as the students were publicly ranked. Those who took first and second places received long silk scarves embroidered with the words “Luck in the Day. Luck in the Night.” Those who came in last didn’t fare so well. The fifth from last was pronounced “Carrier of the Medicines”—a barb equivalent to “nurse”—and given a blue doctor’s bag to hold, of the kind used by every physician’s assistant. The fourth from last, called “The Doorman,” was dressed in the black robes of a government servant and placed at the entrance to the tent; the third from last, costumed as a muleteer, escorted the second from last and the last—banished not just from the race of physicians but that of men—known, respectively, as the “White” and “Black Donkeys.” With bells, reins and halters on their necks and medicines loaded across their backs, the “donkeys” were driven around the camp, bellowing and braying, to the great amusement of the crowd, after which a picnic was shared by all. The next day the college returned to Lhasa, where a ceremony at the Central Cathedral took place and the year ended for a week’s vacation.
After graduating, Dr. Dhonden served as Kenrab Norbu’s special assistant for three years. In the evenings he continued to debate with Mendzekhang’s senior students and faculty members. Once a month he went to the Lingkhor, Lhasa’s Holy Walk, to treat the hundreds of poor pilgrims and beggars who rarely came on their own for help. In conjunction with this, he paid special attention to cultivating the eleven vows of the physicians’ code which attempted to instill an altruistic motive as the basis of a doctor’s practice. As Yeshi Dhonden commented, concerning his own application of the ancient code, “I am just an ordinary person afflicted by desire, hatred and ignorance. But through contemplating the suffering I see in my work, I have tried to increase my compassion. As doctors we are expected to put kindness before all else.” Out of his own curiosity, Dr. Dhonden also went, two hours a day, to the British Legation, to acquaint himself with Western medicine. Finally, in 1951, Kenrab Norbu sent Yeshi Dhonden’s diploma to the office of the Cabinet, where it was officially confirmed. The Kashag then dispatched letters to district offi
cials in Lhoka, as well as the government transport center, from which Yeshi Dhonden received free passage home. Thirteen years after his education began, Dr. Dhonden left Lhasa, looking forward to taking up practice on his own.
He didn’t have long to wait. An epidemic had broken out along the Bhutanese border, imported—along with chocolate, batteries, silks and the beloved fedora hats—by traders returning from India. In Tibet’s high, germ-scarce environment, those who contracted the disease—a form of intestinal influenza—died quickly. Scores of doctors had already flocked to the area.
Traveling to a monastery called Sungroling Gonpa, Dr. Dhonden joined three physicians who had been attempting, unsuccessfully, to check the epidemic. Nine of the monastery’s 300 monks had already died, as well as many of the inhabitants of the village below its walls. Arriving just before nightfall, Dr. Dhonden was shown to a private room, where, after his regular evening meditation session, he went to sleep, expecting to see his first patients in the morning. During the night, however, he experienced an unusual dream, one which, though seemingly inexplicable by Western standards, demonstrated the close relationship of religion to science in Tibetan medicine. “In the night I dreamt that a naked woman came before me, a khadroma,” said Dr. Dhonden, referring to a spiritual being believed, in a manner similar to that of an angel, to aid practitioners in meditation. “In her right hand she held a tantric drum; in her left hand she held a skull. She carried a bag of medicine under her left arm. A white tin cup with a red design and a slight crack on its rim, filled with urine, appeared before her. Then the woman asked me, ‘After examining this urine can you tell me the disease of the patient? What is your diagnosis?’ In the dream I looked at the urine and replied, ‘This is today’s epidemic, one of sixty-five types of the eighteen new diseases predicted in the tantras for this era.’ ‘What is its cause?’ she asked. I responded that it was due, as the tantras state, to environmental pollution and that it was a hot disease. ‘You said that externally it is a fever, but are you sure that internally it’s not cold?’ she said. At that time, because my memory was fresh from constant study, I recalled that the thirteenth and fourteenth chapters of the third Tantra address the topic of cold and hot diseases together. I answered her in debate form, quoting the text as proof, stating that there was no hidden cold fever, but that the ailment was hot both inside and out. We debated back and forth for some time and finally she said, ‘What treatment will you give?’ I replied, ‘Because the bacteria causing the disease have mixed the blood and bile, medicine should be given to separate them.’ Then she asked what the patient’s behavior and diet should be—two aspects of treatment that always accompany medicine. I answered and she said, ‘Tell me again. How will you cut the tail of this disease?’ Once more we debated vigorously and then she laughed and suddenly disappeared. There was complete silence and I woke up.”
In a short while, as the day began, Dr. Dhonden was brought tea. Afterwards he was asked to visit his first patient, a twenty-three-year-old monk, infected by the illness, languishing in his room. “I went to see the young man,” continued Dr. Dhonden. “It was a very serious case. The room he lay in stank. Diarrhea mixed with blood was pouring from him onto the bed and he was semi-comatose; he couldn’t talk. I asked for his urine specimen and it was brought to me in a tin cup. All of a sudden I remembered my dream. It was the exact cup, even with the crack on the rim. ‘Oh, I have already examined this before,’ I thought. I was amazed. Then the whole dream came back. I recalled the debate and the treatment and immediately I prepared the correct medicines. The man recovered and after that, the epidemic in the village was completely stopped. Now when I look back on it,” Dr. Dhonden said, “I feel that whoever came to me in the form of a khadroma that night was actually administering my true final examination.”
As Dr. Dhonden’s reputation spread, he spent the remainder of the 1950s traveling from one district to another. “Each day I rode from village to village, returning periodically to Lhasa to obtain medicines,” he recounted. “I was able to cure three quarters of my patients. And because I gave penicillin injections for skin disease—a great novelty among Tibetans—my reputation continued to increase. I never had a free day.” A group of young relations began to study with him, but before long the uprising against the nine-year-old Chinese occupation broke out in Lhasa and the Dalai Lama fled. “I saw His Holiness when his party came through my area,” recalled Dr. Dhonden. “Those who weren’t following him had joined the guerrillas to put up a last fight for our freedom. My students all had family members whom they couldn’t leave. My own mother’s legs were too poor for her to walk out and my father had said that he was too old to cross the high passes into Bhutan. As a monk, I wouldn’t fight. So I felt that I had no other choice but to leave. I borrowed a horse, said farewell and set off.”
Though Namro was only a few days from the border, the presence of Chinese troops forced Dr. Dhonden to hide for over a month before finally, in the company of eighty other refugees, he descended a steep snow-covered slope, trekked through a valley and crossed a glacial stream into the forests of Bhutan. With only a few texts, instruments and medicines in his possession, he then walked across Bhutan begging day to day. “After I was forced to flee my homeland, I was overwhelmed by a deep sense of renunciation,” reflected Dr. Dhonden. “I saw life as essenceless, without real stability. I only wanted to practice religion.” Arriving at Buxa, Yeshi Dhonden requested permission to remain with the monks there while the rest of his group was transferred to road work. The Tibetan government official in charge replied, “You have the right to practice religion and you are also young and fit to work on the roads. However, if the Kashag asks me, ‘Has any doctor come out of Tibet?’ and I’ve sent you elsewhere, what will I say? Therefore, you studied medicine at the government’s expense, and now the time has come for you to help us.”
Dr. Dhonden was sent to Dalhousie, where 3,000 refugees, including the elite monks of Lhasa’s two Tantric colleges, Gyudto and Gyudme, were camped in squalid conditions. Tuberculosis, hepatitis and amoebic dysentery were rampant. Preparing what medicines he could from the few herbs available in Indian stores, he set up a clinic and went to work. “One day a sweeper in my clinic was bitten by a poisonous snake,” he related. “Just as I was applying a Tibetan tourniquet, an Indian doctor arrived. He examined the bite and declared that unless his leg was amputated immediately the man would die in half an hour. I told him this was unnecessary; I had already given the man Tibetan medicine effective for poison. The doctor turned to the sweeper and said, ‘You will die within minutes unless I operate, but this Tibetan’—indicating me—‘thinks otherwise.’ He asked him whose diagnosis he wished to accept. The sweeper had seen my work and so he replied mine. The doctor then compelled me to sign a paper releasing him from all responsibility in the case. There were many aspects to my treatment, but after ten days the sweeper could move about and in a month he was completely cured.”
Despite the man’s recovery, the episode proved to be the start of a serious conflict. Once a week Indian doctors came to inspect the refugees, in the course of which they dropped by Dr. Dhonden’s clinic to demand that, as he was not certified in India, he discontinue practice. “During one of their visits I was examining a patient with skin disease,” continued Dr. Dhonden. “The physicians saw this woman and together announced that she had chicken pox. They claimed that unless she was isolated an epidemic would sweep over all the refugees. I said bluntly that they were wrong. It was a minor heat disorder and no more. They departed, leaving medicine for her to take. I forbade her to. In a short while they came back and tried to remove her to an isolated house in the forest. I refused to let her go. They asked if I was willing to have an outbreak of chicken pox on my hands and I replied, ‘The Tibetans are my own people. How could I ever harm them?’ I then demanded that now they sign a paper, just as I had been made to, certifying that indeed this woman had chicken pox. They stalled and within a few days the woman was cured.” D
espite this minor victory, more battles ensued, until, in mid-1960, Yeshi Dhonden was unexpectedly summoned to Dharamsala. Word had reached the government-in-exile that a Mendzekhang-trained physician had escaped. Apprised of his existence, the Dalai Lama had called for Dr. Dhonden personally.
“I arrived in Dharamsala just before sunset,” Dr. Dhonden remembered. “The hills were covered with tents. People were living in very poor conditions. They had refused to leave His Holiness and were going wherever he went.” Directed to the kitchen area of the Secretariat compound at Mortimer Hall, Yeshi Dhonden sat and waited. He was finishing his tea when the Dalai Lama arrived. “Suddenly I heard His Holiness in the other room. ‘Where is the doctor?’ he said. I stood up, folding my hands in prayer, praying for his long life. I had a very strong mind of faith. But when he entered the room I began to weep. I had never wept upon meeting someone before. I must have been thinking of Tibet …”
The Dalai Lama questioned Dr. Dhonden on his escape and then requested him to treat those camped around Dharamsala. Working out of the Nursery at Conium House, Dr. Dhonden began seeing patients under the observation of Tibetan government officials. Having met with their approval, he was summoned to the Dalai Lama once more, this time in the capacity of examining physician. After curing the Dalai Lama of a skin disorder, he was asked to see Kyabjé Ling Rinpoché, the Dalai Lama’s senior tutor and head of the Gelugpa sect, who was bedridden in a hospital in Calcutta suffering from a severe case of pericarditis, an inflammation and swelling around the heart. In little over a year Ling Rinpoché was cured and Dr. Dhonden was officially appointed to be the Dalai Lama’s personal physician, a post normally filled by up to four doctors in Tibet. His enthusiasm for his practice now fully recovered, he set about the monumental task of preserving Tibetan medicine in exile.
