China’s Other Medical Systems: Recognizing Uyghur, Tibetan, and Mongolian Traditional Medicines

Elaine Yu, MScorresponding author and Hakima Amri, PhDcorresponding author

Abstract

Background:

Traditional Chinese medicine, as it is understood and adopted by those with a growing interest in complementary and alternative practices to biomedicine, is often used as an umbrella term for traditional medical practices from regions within and bordering the People’s Republic of China. However, there are multiple distinct medical traditions in China, including that of the Uyghurs, Tibetans, and Mongolians.

Objective:

It is important to recognize the commonalities and differences of these unique systems of medicine practiced by the 3 different cultures among China’s borders.

Methods:

Through an in-depth analysis of the individual beliefs and theories that form the foundation of each system, we trace the origins of the concepts that were synthesized into the Uyghur, Tibetan, and Mongolian medical systems. Furthermore, we compare diagnostic techniques and contrast treatment modalities among the 3 systems.

Discussion:

We discuss humoral theory, constitution theory, elemental theory, organ theory, and yin and yang theory. We find that imbalance is the common cause of disease or illness, but the conditions and external factors that explain such imbalances differ among the Uyghur, Tibetan, and Mongolian systems. Through these comparisons, we seek to highlight the unique beliefs, practices, and treatments utilized by these cultures.

Conclusion:

The features and attributes, while not exclusive to each population, are nonetheless uniquely synthesized by each system and thus demonstrate the distinct nature of Uyghur, Tibetan, and Mongolian medical systems.

Key Words: Uyghur medicine, Tibetan medicine, Mongolian medicine, traditional Chinese medicine, humoral medicine

摘要

背景:传统中药为越来越多的人们所理解,并将其作为生物医学的补充和替代医疗,它通常涵盖中华人民共和国境内各地区的传统医疗实践。然而,中国有许多独特的医学传统,其中包括维吾尔族、藏族和蒙古族。

目的:了解中国境内三种不同文化践行的独特医疗体系之共性与差异非常重要。

方法:我们通过深度分析形成各个体系之基础的各种信念与理论,追踪了融入维吾尔族、藏族和蒙古族医疗体系的概念之根源。此外,我们比较了这三种体系之间的诊断技术和对照治疗模式。

讨论:我们讨论了体液学说、体质学说、元素学说、器官学说和阴阳学说。我们发现,失衡是疾病的常见病因,但在维吾尔族、藏族和蒙古族体系中,解释此类失衡的条件和外部因素不尽相同。通过这些比较,我们力求突出这些文化使用的独特信念、实践和治疗。

结论:这些特点与属性尽管并非每个人群所专属,但却独特地融入到每一个体系,因此展现出维吾尔族、藏族和蒙古族医疗体系的独特性质。

SINOPSIS

Antecedentes:

La medicina tradicional china, tal y como está entendida y adoptada por un interés creciente en prácticas complementarias y alternativas a la biomedicina, se usa a menudo como un término paraguas para las prácticas médicas tradicionales procedentes de las regiones internas y limítrofes a la República Popular China. Sin embargo, hay muchas tradiciones médicas distintas en China, incluidas las de los uygures, tibetanos y mongoles.

Objetivo:

Es importante reconocer las semejanzas y diferencias de estos sistemas únicos de medicina que practican tres culturas diferentes entre las fronteras de China.

Métodos:

Mediante un análisis en profundidad de las creencias y teorías de los individuos que forman la base de cada sistema, realizamos un seguimiento de los orígenes de los conceptos que se sintetizaron en los sistema médicos uygures, tibetanos y mongoles. Además, comparamos técnicas diagnósticas y contrastamos modalidades de tratamiento entre los tres sistemas.

Debate:

Estudiamos la teoría de los humores, la teoría de la constitución, la teoría elemental, la teoría de órganos y la teoría del yin y el yang. Averiguamos que el desequilibrio es la causa más común de enfermedad o trastorno, pero las condiciones y los factores externos que explican dichos desequilibrios difieren entre los sistemas uygur, tibetano y mongol. Mediante estas comparaciones, queremos destacar las creencias, prácticas y tratamiento únicos que utilizan estas culturas.

Conclusión:

Los rasgos y atributos, aunque no son exclusivos de cada población, están, sin embargo, sintetizados en cada sistema y, por consiguiente, muestran la distinta naturaleza de los sistemas médicos uygur, tibetano y mongol.

INTRODUCTION

The Chinese are known to have one of the oldest and distinct medical systems in the world, spanning a written history of nearly 3000 years. While the system as a whole is still practiced throughout China, traditional Chinese medicine (TCM) has been modified throughout history. Over the course of time, its theories, treatments, and medicines have spread worldwide. In the United States, the fields of complementary and alternative medicine (CAM) and integrative medicine (IM) promote TCM ideals such as holistic wellness and balance, noninvasive treatments such as acupuncture and massage therapy, and medicines such as herbal decoctions and medicinal foods. CAM and IM also recognize medical theories and practices originating from regions that are now part of the People’s Republic of China. As a consequence, these are often attributed to the Chinese system of TCM. However, there are many medical traditions practiced by the diverse peoples of China that differ in theory and in practice from TCM.

This paper focuses on the 3 most prominent medical systems practiced by ethnic minorities in China living in autonomous regions—Uyghur, Tibetan, and Mongolian medicines. Autonomous regions are similar to provinces in China but hold greater legislative rights and are governed by local administrations. Xinjiang, Tibet, and Inner Mongolia are China’s largest provincial-level regions and comprise most of their border between other countries (Figure 1).

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Map of China’s autonomous regions and Mongolia.

Due to its close proximity to Central Asia, Xinjiang and the early Uyghur medical tradition drew much from the Greco-Arabic practices coming out of the Eastern Mediterranean. Strong influences from the Indian Ayurvedic tradition made it to Xinjiang along the Silk Road, creating a mixture of theories and practices that are unique to Uyghur Medicine today. Central to Uyghur Medicine is humoral theory which originated from the teachings of the Greek physician Hippocrates and Roman physician Galen and was subsequently modernized by Arab physicians Avicenna and Razes. In Uyghur Medicine, the 4 humors (blood, phlegm, yellow bile, and black bile) are closely related to the 4 component elements (earth, water, air, and fire) that guide the traditional practitioner in determining the nature of disorder and prescribing the proper treatment.

South of Xinjiang lies Tibet, an isolated plateau whose people selectively drew medical knowledge from their neighbors to the north, south, and east. Greco-Arabic medicine was known as “upper Tibetan medicine” and Galeno, a follower of the teaching of Galen (129-199), served as the court physician under King Songtsan Gampo (617-650). King Gampo also had two queens, Brikuti Devi from Nepal and Wenchen Kongjo (628-680) from China. Through these relationships, Ayurveda and Chinese medical practices were brought to Tibet. The focus of Tibetan Medicine has always revolved around Buddhist theories and practices. Their ancient synthesized medical system, known as Sowa Rigpa, was thus intrinsically tied to Buddhism.

Inner Mongolia is found east of Xinjiang, forming most of China’s northern border. For much of history, medicine in this region was not well established due to the nomadic lifestyle of most Mongolians. However, Tibetan medicine fit in well with historical shamanistic practices and later became standard practice under Manchu rule. Mongolians also adopted medical practices from the Chinese, most prominently implementing especially yin and yang theory into the heart of their diagnosis and treatment. They synthesized this and other Chinese theories with the teachings of Tibetan Buddhism to create a medical system unique to their culture.

The migration of peoples throughout China has allowed for the spread of medical knowledge and the varying influences in China’s border regions have allowed them to develop unique medical traditions (Figure 2). Therefore, we argue that the medicines of these 3 regions are a cultural treasure of these minority populations and should be regarded as different from TCM. In this study, we aim to explain the commonalities and differences among of Uyghur, Tibetan, and Mongolian medical traditions and further describe their respective theories and practices. Comparisons between the 3 medical systems are drawn in order to illustrate the unique components that distinguish each tradition.

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Transmission of medical knowledge from ancient and global medical systems to the 3 types of medicines described (arrows indicate influence).

MEDICAL SYSTEMS

History has shown that medical systems constantly evolve in response to religious, political, and social forces. While many modern medical theories and practices can be traced back to ancient medical systems, the exchange of medical knowledge is difficult to trace. The medicines of today’s Uyghurs, Tibetans, and Mongolians share common characteristics but are also distinct. Most importantly, they are different from TCM, which is commonly used as a general term for all medical practices throughout China.

Of the 35 ethnic medical traditions recognized by the Chinese government, the most prominent are Uyghur, Tibetan, and Mongolian medicines. Although other hospitals may provide traditional medical care, the government recognizes 39 Uyghur, 70 Tibetan, and 51 Mongolian medical hospitals. The National Qualification Examination for Doctors certifies physicians of Uyghur, Tibetan, and Mongolian medicines separately. Each practitioner of Uyghur, Tibetan, or Mongolian medicine must be thoroughly trained in the theories, treatments, and medications unique to each system. What follows is a description of each of these 3 systems of medicine as it is practiced today.

The Uyghur Medical Model

The central concept in Uyghur Medicine is that of mizagyi (derived from the Arabic and Urdu word mizaj) or temperament. An individual’s mizagyi is expressed in facial appearance, skin color, body shape, personality, habits, and mental state. Temperament is determined by a balance between the 4 properties of heat, moisture, coldness, and dryness that correspond to qualities of the tot mizaj (4 elements) of fire, air, water, and earth (or soil). Mizagyi follows the idea that these elements are in a constant struggle for dominance and are affected by climate, geographical location, heredity, seasons, food, herbs, fluids, and air. The 4 temperaments can be combined into a total of 8 conditions: heat, coldness, moisture, dryness, dry heat, moist heat, moist coldness, and dry coldness. When these properties are unbalanced with some in excess and others insufficient, people fall ill.

Temperament can be used to characterize each organ as well as the whole individual. The Uyghurs subscribe to the notion that each organ has its particular temperament that is related to its function (Table 1). This is the foundation of azha (derived from the Arabic word A’ada’) theory or organ theory. Organs are categorized as controlling, dominant, and controlled according to their function. They are organized in a hierarchical manner based on a system of control (Figure 3). The 3 controlling organs are the brain, heart, and liver, which correspond to an individual’s vitality, spirit, and natural force. Vitality manifests as survival and reproductive ability, spirit refers to control over mental and physical activities, and natural force manifests as regulation, enrichment, and control of other organs. The controlling organs directly affect the 6 dominant organs. They in turn affect the remaining controlled organs. All other organs are considered controlled organs., It is important to note that Unani medicine, the origin of Uyghur medicine, was the first to report the brain as a major controlling organ.

Table 1

Uyghur Medicine Organs and Temperaments

Element Temperament Organs
Fire Dry heat gallbladder
Air Moist heat liver, heart, muscle, lung, esophagus, duodenum, small intestine
Water Moist coldness minimum-unit (cell), body fat, stomach, brain, kidney, spinal marrow
Earth Dry coldness spleen, bone, hair, nail, cartilage, ligament, membrane, large intestine, bladder
Moderatea fingers, palm, back of hand, skin

Adapted from Yu and Ren7 with modifications.

aNo associated element.

Uyghur medicine organ hierarchy as practiced today (arrows indicate control).

In the same way the 4 temperaments correspond to the 4 elements (fire, air, water, and earth), Uyghur medicine’s 4 bodily fluids correspond to the 4 elements (Table 2). This is described by teliti theory or body fluid theory. The 4 hilits (fluids)—bile (or yellow bile), blood, phlegm, and atrabiliary (or black bile)—are created by the liver and help the body maintain a balanced state of health. Each individual is born with an inherent balance of his or her hilits, and this balance can be affected by food, climate, season, and medication. Any change in quantity or quality of these hilits will contribute to a state of disease.

Table 2

Uyghur Medicine Body Fluids and Functions

Element Fluid Temperament Functions
Fire Bile (yellow bile) Dry heat Helps peristalsis in large intestine and stomach
Aids in the digestion of fat
Causes growth and strength
Air Blood Moist heat Stabilizes metabolism and fluid
Balances kidney and lung
Transfers the energy of fire
Nourishes spaces
Responsible for metabolism and growth
Water Phlegm Moist coldness Controls bile
Supplies fluid to blood
Circulates products necessary for life
Hampers fading and coming of death
Slows down invading substances
Prevents energy from being redundant and chaotic
Excretes metabolites
Earth Atrabiliary (black bile) Dry coldness Maintains organ form and quality
Balances bile and blood
Strengthens spleen, stomach, intestines, bone, muscles
Regulates force and influence of phlegm
Regulates the synthesis and decay of substances

Adapted from Lapham with modifications.

Similar to Unani medicine, there exist 6 principles in Uyghur medicine that can aid an individual in maintaining health. These sayat (conditions) are as follows:

  1. people struggle in order to live

  2. foods that one eats should be taken in balance of quantity and quality

  3. rest and activity must be kept in balance

  4. a good mood is important to long life

  5. the body must be kept clean

  6. energetic characteristics of body fluid deserve special tracking after age 60

To diagnose illness, Uyghur physicians, called beletibabets, use their senses of smell, sound, sight, and touch to examine a patient. Once they determine the cause of illness, they will prescribe a combination of herbal medicines and treatments, such as massage, hydrotherapy, the external application of animal products, or smoking animal bones, hooves, and horns. In some cases, the calendar is consulted to determine the best day to apply the treatment or perform a treatment ritual. Treatment rituals can involve prayers or readings from the Quran. While most Uyghur are Muslim and the Quran is used in many healing prayer rituals, it is important to note that Uyghur medicine is not based on Islam the way Tibetan medicine and Mongolian medicine were based on Buddhist teachings.

The Tibetan Medical Model

Balance is essential to Tibetan medicine, as a healthy individual is defined by a state of balance. Imbalances are a result of either the ignorance of the mind, mental afflictions, or direct influences. In order to determine the cause of disease, physicians diagnose through questioning, visual observations, and palpation. Once the disease state is known, the correct combination of diet therapy, herbal products, and external treatments can be applied to return the patient to the balanced state.

Tibetan medicine considers a psychosomatic link in the body that regulates an individual’s processes, functions, and structures. According to theory, the individual is divided into the 3 nays (humors) of rLung (activity, wind), mKhrispa (vitality, bile), and Badken (stability, phlegm). Activity is regulated by the nervous system and divided into vital-conscious, respiratory-expressive, digestive-metabolic, excretory-reproductive, and motor-proprioceptive sub-activities. All of these comprise rLung. Vitality is a result of the functions of the digestive system and metabolism; stability results from the structure of connective tissues and the musculoskeletal system. These 3 humors make up the 3 of the 7 total constitutions (Table 3), which determines an individual’s body type and personality. Tibetans believe that the constitution is developed from the parents’ constitutions as well as a past karmic blueprint.

Table 3

Tibetan Medicine Body Constitutions

rLung (Wind) Thin
Dark, rough, dry skin
Dark, small, sharp eyes
Big joints
Dry hair
Fragile nails
Talkative
Doesn’t sleep much
Emotional
Short lifespan
mKhrispa (Bile) Medium size
Yellow, red skin
Red, yellow, brown eyes
Thin, oily hair
Fast digestion
Sweaty, smelly
Sharp memory
Strong ego
Formal, diplomatic
Medium lifespan
Badken (Phlegm) Large, tall
Smooth, white, moist skin
Green, gray, blue, large eyes
Black, straight, strong hair
Slow digestion
Thinker
Heavy sleeper
rLung-mKrispa (Wind and Bile) Cold extremities Fearful, anxious
rLung-Badken (Wind and Phlegm) Cold sweats
Obesity
Confused mind
mKrispa-Badken (Bile and Phlegm) Hot upper body
Cold lower body
Conflicted mind
riung-mKrispa-Badken (Wind, Bile and Phlegm) Well-balanced body Well-balanced state of mind

Adapted from Arya with modifications.

The 3 humors that comprise the body constitutions are connected to 5 main organs that correspond with the 5 elements of earth, water, fire, air, and space (similar to 5 Ayurvedic elements). They and other organs are described in a 3-part structure with a root, fruit, and flower that work together to transport and distribute the 3 humors throughout the body (Figure 4). Root organs are responsible for absorbing nutrients and transforming them into the essential humor. Fruit organs use the humor to govern major bodily functions and flower organs are facial components that reflect the state of the other organs. This is important for diagnosis, where the face is often examined to determine the cause of disease. These are observations that are extrapolated directly from nature and the surrounding environment.

Tibetan medicine 3-part organ structure as practiced today (arrows indicate movement).

Another way of thinking about the humors is in terms of 3 channels on the body. Tibetan medical theory divides the body into 3 channels—u-ma (middle, black), ro-ma (right, red), and rkyang-ma (left, white). These tantric channels are thought to determine the natural quality and quantity of the body’s 3 humors. The father contributes the white channel, which corresponds to the lymphatic and endocrine systems that regulate Badken (stability). The mother contributes to the red channel, which corresponds to the blood circulation that distributes mKrispa (bile). Lastly, the black channel is thought to originate from past lives and karma; this channel controls the nervous system and consciousness that distributes rLung (wind).,

Diseases are broken down into 3 main causes. The first, Ringu (distant cause), refers to the ignorance of the mind, which manifests as an ego. It is this ego that gives rise to the second cause, nye-gyu (near cause), or mental poisons of attachment, hatred, and close-mindedness. Attachment is the cause of wind disorders, hatred the root of fire disorders, and close-mindedness prevents the action of phlegm and leads to negative karma, which leads to suffering. These mental poisons are stimulated by unwholesome diet, behavior, and psychology to disturb the humors and produce disease. Lastly, imbalances are attributed to the third cause, kyenl (immediate cause), or direct threats such as climate change, strong negative emotions, unwholesome diet, and negative behavior. Imbalances can manifest in one or a combination of organs, thus affecting the humoral balance that is maintained by the flow of rLung, mKrispa, and Badken energies among them. In order to regain balance, the origin of the disorder must be determined.

Diagnosis is accomplished in a series of 3 steps. The first step is driwa (questioning), which is used to determine which humor is responsible for the disorder. Next, physicians conduct mig-gi-tawa (visual diagnosis) by examining the tongue, ear veins, eye veins, urine, and constitution or complexion. The tongue shows what specific part of the body is afflicted by a humoral imbalance. By looking at the ear veins, a physician can determine which organ is afflicted. Through the eyes, an individual’s flow of psychic energy can be isolated. Urine analysis is important to distinguish superficial from hidden diseases. The constitution is considered since people of specific constitutions are prone to certain humoral disorders. Finally, physicians use tsa-latak-pa (pulse diagnosis) to find information about the state of the organs and energies.

According to Tibetan medical theory, there is a cure for each type of disorder. Treatment usually involves a combination of diet, herbs, and external therapies. Diets restricting and recommending certain foods are prescribed according to which humor(s) are imbalanced. Foods are linked to the 5 elements which give rise to the 3 humors. Therefore, avoiding or eating certain foods is believed to help bring the humors back into balance through control of the elements. Herbal remedies are divided into 2 types—pacifying and purifying—and are categorized by taste. Formulas of multiple herbs are used to simultaneously treat disorders, restore balance, and control side effects. Pacifying therapies target specific disorders while purifying therapies generally cleanse the body and organs. Physicians will also apply external therapies such as moxibustion, massage, and medicinal baths. In some disorders, behavioral treatment is also required in the form of yoga and meditative techniques. It is the responsibility of the physician to educate the patient about adopting the proper lifestyle and mindset in order to prevent disease, especially if an individual’s constitution predisposes one to a certain type of disorder.,

The Mongolian Medical Model

Many of the basic theories in Mongolian medicine are taken directly from Tibetan medicine. Health is defined as a balance between the 3 life-sustaining principles of hii (wind), sar (bile), and badgan (phlegm). In addition to their relationship to the 5 elements, these 3 principles are also given hot and cold attributes in accordance with arga and bilig (yang/hot and yin/cold) theory as practiced in TCM (Table 4). Arga and bilig play an important role in diagnosis and are often used interchangeably with hot and cold. Since most diseases are described by excessive heat or coldness, Mongolian medicine holds that arga and bilig imbalances are the cause of illness.,

Table 4

Three Principles in Mongolian Medicine

Principle Elements Attribute Description
Hii (Wind) Wind Body movement, speech, breathing
Sar (Bile) Fire Arga (Yang) Heat generation, blood production, digestion
Badgan (Phlegm) Earth Water Bilig (Yin) Body fluid production, keep skin/joints supple (soft), taste, smell

Adapted from Donegan with modifications.

aWind has no Yin/Yang attribute.

Mongolian medicine practitioners diagnose imbalances through observation, palpation, and questioning. Observation is the first step of a diagnosis, and includes examination of the tongue, complexion, sclera, demeanor, posture, skin tone, vocal strength, and emotional state. Often, urine is collected for analysis over time in a separate laboratory, where its color, vapor, odor, and sediments are recorded at the hot, cooling, and cold time periods following collection. While such analysis can determine the hot or cold nature of disease, this is most easily found through pulse-taking.

According to Mongolian medicine, pulse-taking is considered the most sophisticated diagnostic tool and also the primary method of determining a state of disorder. Therefore, there is a very specific methodology that must be applied. Male patients should have the pulse of their left hand taken with the physician’s right hand, and female patients will have their right hand pulse taken by the practitioner’s left hand. Pulses are taken on 3 levels—skin, meat (muscle), and bone—and the quality of the pulse at each location is indicative of a different heat or cold disorder.

When it comes to treatment, emphasis is placed on changing the patient’s diet and behavior. To supplement the changes, a physician may also prescribe medications or external therapies. Medications come in the form of decoctions, powders, pills, and ointments made from natural plant, animal, and mineral products. The taste of each ingredient serves important functions to cure the disease, support the main ingredient in its efficacy, or manage side effects of other ingredients. Usually, medicines are placed in 1 of 2 categories: relieving or evacuating. Relieving medicines such as decoctions, pills, herbal extracts, precious elements, powders, pastes, ash, alcohol, and herbs are more common. Less commonly found oils, emetics, oral or anal purgatives, nasal inhalants, and suppositories are considered evacuating medicines. It is important that certain medicines are blessed according to the ritual of reciting mantras of the medicine Buddha.

There are a variety of external treatments employed in Mongolian medicine. They are divided into 2 categories: mild and rough. Mild therapies that are noninvasive consist of mineral mud, herbal infusion, or medicinal baths made from animal products. Included is also the Mongolian style of moxibustion, which differs from TCM moxibustion in its use of bundled herbs heated in butter. The Mongolian practitioners apply the bundle by pressing on a different system of moxibustion points that do not correspond to TCM acupuncture points. Rough therapies in contrast are more invasive. Needle therapy in Mongolian medicine uses large, thick, heated gold or silver needles in a therapy called khatgah emchinlee (golden needle therapy). Lastly, khanuur (blood-letting) is popular in relieving excess heat disorders. Blood is drained in large quantities until colors change from dark to bright red at 19 commonly used incision points.

In some cases, it is appropriate for medical practitioners to provide religious services such as healing rituals and astrology readings. However, such services are only offered at institutions that identify as both religious and medical. This is more common in Mongolia than in China. It is important to note that many practitioners of Mongolian medicine are also trained in biomedicine and do not strictly adhere to the rules of traditional practice. Often, the diagnosis and prescription follows the patient’s request for either a traditional or biomedical approach to curing disease.

DISCUSSION

It is evident that the theories and practices of medicine differ between the Uyghurs, Tibetans, and Mongolians of China. While each system is distinct on its own, there is much that is shared among these and other known traditional medical systems. The transmission of medical knowledge between cultures over past millennia has greatly influenced the modern practice of medicine. This section aims to highlight the similarities and differences between the ethnic medicines of China’s border minorities (Table 5).

Table 5

Direct Comparison of Uyghur, Tibetan, and Mongolian Medicine (Empty boxes have no attributes)

Uyghur Medicine Tibetan Medicine Mongolian Medicine
Health Balance 4 properties (humors) Balance 3 humors Balance 3 humors and hot/cold
Elements Fire, air, water, earth Earth, water, fire, air, space
Humors Heat, moisture, dryness, coldness Wind, bile, phlegm
Constitutions Heat, coldness, moisture, dryness, dry heat, moist heat, moist coldness, and dry coldness Wind, bile, phlegm, wind-bile, wind-phlegm, bile-phlegm, wind-bile-phlegm
Causes of disease Food, climate, season, medication, condition Constitution, ignorance/ego, attachment, hatred, close-mindedness, climate, emotions, diet, behavior Diet, behavior, climate, external factors
Diagnosis Smell
Sound
Sight
Touch
Questioning
Observation
Pulse-taking
Observation
Palpation
Questioning
Main organs Brain, heart, liver Heart, liver, kidney, spleen lungs
Secondary organs Kidney, lung, gallbladder, spleen, nervous system, ovaries, and testicles Bladder, gallbladder, stomach, small intestine, large intestine
Tertiary organs Fat, spinal cord, stomach, muscle, esophagus, small intestine, duodenum, intestine, bladder, large intestine, bone, tendons, ligaments, hair Tongue, lips, eyes, nose, ears
Herbal medicine Pacifying and purifying Leading and supporting ingredients
Behavioral therapy Prayer Yoga, meditation, diet, lifestyle Diet, lifestyle
Unique external treatments Animal excrement, smoking animal bones Moxibustion, massage, medicinal baths, diet therapy, herbal products Mud baths, moxibustion, blood-letting, bone-setting
Center of learning Mentsikhang Manba Datsan
Important figure(s) Yuthok Yonten Gonpo Hu Sihui
Religious connection Islam Buddhism Buddhism and shamanism

Balance is a key principle across the 3 systems of Uyghur, Tibetan, and Mongolian medicine. In all 3, illness or disease is caused by imbalance. The 4 humors of Uyghur medicine correspond with the 4 elements and therefore the 4 fluids of yellow bile, blood, phlegm, and black bile. Both in Tibetan and Mongolian medical theory, imbalance affects the 3 humors of wind, bile, and phlegm that correspond to 5 elements. For Mongolian medicine in particular, imbalances are further divided into hot and cold (TCM yin and yang) causes that warrant different treatments. In each case, a combination of visual, verbal, and physical diagnosis is conducted in order to determine the nature of the imbalance. Observation, questioning, pulse-taking, and urine analysis are common across the 3 systems.

In all 3 systems, herbal treatments based on a specific formula are prescribed to address the particular imbalances that are causing disease. Most herbs are recognized for qualities of taste that determine the healing or supporting effect. However, the plants, animals, and minerals used in each system vary according to the flora and fauna of each region. Herbal medications, while a commonly prescribed form of treatment, are used in conjunction with other modalities and therapies across Uyghur, Tibetan, and Mongolian medicine.

Dietary and lifestyle changes are common prescriptions in all 3 medical systems. However, the historical influences are most prevalent in the variety of external treatments offered in each region. Uyghur medicine relies more heavily on animal parts for their use in cupping and smoking as treatment, while Tibetan medicine focuses on behavioral treatments that affect the mind-body connection. Mongolian medicine employs the widest range of physical therapies from Mongolian mud baths to Tibetan golden needle therapy to Chinese massage.

While Mongolian medicine practitioners are the only ones allowed to administer religious healing practices, both traditional Uyghur and Tibetan physicians are arguably more religious than the biomedically-trained Mongolian medicine physicians. Most Uyghur doctors are Muslim and serve the primarily Muslim Uyghur population. Tibetan Medicine practitioners are encouraged to seek a career in medicine, as it is favored for its intrinsic practice of Buddhist dharmas. However, both Uyghur medicine and Tibetan medicine are careful to identify as scientific medical systems that are separate from religion in accordance with current government policies, while Mongolian medicine is subject to no such restriction, as it is still strongly rooted in shamanistic traditions and Tibetan Buddhist teachings.

CONCLUSION

In analyzing the individual beliefs and practices of the Uyghurs, Tibetans, and Mongolians, it is clear that these systems are uniquely different. While all emphasize the importance of balance in health maintenance and utilize natural resources from the surrounding environment in treating disease, they each employ theories and modalities exclusive to their own medical traditions. Similar diagnostic and therapeutic techniques affirm the transmission of medical knowledge among these and likely other cultures. Trademark beliefs and practices mark the separation of each into its own medical system. Therefore, it is valuable for scholars of Asian cultures and patrons of traditional medical therapies to acknowledge the distinction between these 3 medical systems and that of traditional Chinese medicine.

Notes

Disclosures The authors completed the ICMJE Form for Disclosure of Potential Conflicts of Interest and had no conflicts to disclose.

Contributor Information

Elaine Yu, Department of Biochemistry and Cellular and Maolecular Biology, Georgetown University Medical Center Washington, DC, United States.

Hakima Amri, Department of Biochemistry and Cellular and Maolecular Biology, Georgetown University Medical Center Washington, DC, United States.

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