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Understanding Ideas of Toxicity in Tibetan Medical Processing of Mercury

In: Asian Medicine
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Sonam Dolma Men-Tsee-Khang Dharamsala India drsodon@hotmail.com

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Duk (dug) in Tibetan language means ‘poison’ and has the connotation of a substance being harmful. In the Tibetan medical tradition, anything which adversely affects our system and causes suffering and pain can be referred to as a poison; for example, the afflictive emotions are labelled ‘mental poisons’. The term duk is coined based on its harmful effects, just like medicine is called men (sman) because of it being beneficial. Tibetan medical practitioners know that mercury is highly toxic. Nevertheless, Tibetan medicine still uses it in the particular form of mercury sulphide as an important ingredient in some multi-compound medicines to treat severe diseases. This is possible because Tibetan pharmacology describes detailed methods of processing mercury, which are complex and long and demand the involvement of highly skilled people and a particular environment. The ability to transform a virtual toxin into a tonic is an invaluable skill based on the in-depth understanding of the characteristics of the various types of duk contained in unprocessed mercury as this article will explore.

Abstract

Duk (dug) in Tibetan language means ‘poison’ and has the connotation of a substance being harmful. In the Tibetan medical tradition, anything which adversely affects our system and causes suffering and pain can be referred to as a poison; for example, the afflictive emotions are labelled ‘mental poisons’. The term duk is coined based on its harmful effects, just like medicine is called men (sman) because of it being beneficial. Tibetan medical practitioners know that mercury is highly toxic. Nevertheless, Tibetan medicine still uses it in the particular form of mercury sulphide as an important ingredient in some multi-compound medicines to treat severe diseases. This is possible because Tibetan pharmacology describes detailed methods of processing mercury, which are complex and long and demand the involvement of highly skilled people and a particular environment. The ability to transform a virtual toxin into a tonic is an invaluable skill based on the in-depth understanding of the characteristics of the various types of duk contained in unprocessed mercury as this article will explore.

The deadliest of the poisons, such as mercury, can be transformed into medicine if one knows the secret of its transformation.

The best of medicines, such as sandalwood, can become a life-taking poison if one does not know how to use it properly.1

Introduction

Tibetan medicine or Sowa Rigpa (gso ba rig pa) is a system of medicine that has been practised in Tibet for centuries. Sowa Rigpa also developed pharmacological practices that process mercury into a purified mercury sulphide formulation called tsotel (btso thal).2 This paper discusses Tibetan concepts of poisons and their purification in the context of mercury formulations described in specific Tibetan medical texts. Tibetan medical practitioners know that mercury is highly toxic. Nevertheless, Tibetan medicine still uses it in some compounds, yet only in the specific form of mercury sulphide. It is, for example, an important ingredient in some multi-compound precious pills and is used against severe diseases. Tibetan pharmacology describes detailed methods of processing mercury, in Tibetan called dülwa (’dul ba). In this article, dülwa is translated as ‘purifying’ raw or unprocessed mercury. Dülwa is also translated as ‘taming’ or ‘controlling’, such as to control afflicting emotions, or to tame a person’s rough nature while yielding the good qualities. More generally, it is used in the sense of controlling or refining the harmful while augmenting the beneficial effects.

As a Tibetan medical practitioner practising in India and as a refugee, I consider it to be my responsibility to explicitly state the Tibetan medical view on the therapeutic use of mercury to a Western audience. I will explain the methods that we employ in order to transform toxic mercury into a medicinal substance. To substantiate the authenticity of this practice, this article presents literary sources, some historical aspects of its practice, and present research conducted at the Men-Tsee-Khang in India.

The ‘healing from poisoning’ (dug nad gso ba’i skabs) is one of 15 main categories of healing described in Tibetan medical texts. It is explained in three elaborate chapters in the Oral Instruction Tantra of the Gyüshi (Rgyud bzhi) or the Four Tantras,3 the seminal standard text of Tibetan medicine. This article shows that mercury is one of many toxic substances that are known to Tibetan pharmacologists and demonstrates the rationale based on empirical knowledge behind the detoxification process mentioned in Tibetan pharmacological texts.

The Gyüshi became the fundamental text for the practice of Tibetan medicine some time after the twelfth century ce, and many commentaries on this text were written by Tibetan scholars at various points in time. It is simply known as the Four Tantras because it contains four treatises, in Tibetan briefly called gyü shi (rgyud bzhi). The Gyüshi is written in 5,900 verses, covering the entire four tantras in 156 chapters. The first part, called Tsagyü (Rtsa rgyud) or Root Tantra, contains the introduction and briefly outlines the various subjects that are covered in the subsequent three tantras. The second part, known as Shégyü (Bshad rgyud) or the Explanatory Tantra, contains 31 chapters, which are classified in 11 sections, covering subjects such as anatomy, physiology, pathology, lifestyle and dietary advices, diagnostic and therapeutic principles, classifications of disorders, the healthy body, surgical instruments, and the ethics of physicians. The third part, called Menakgyü (Man ngag rgyud) or Oral Instruction Tantra, contains 92 chapters and elaborately describes the causes, conditions, classifications, signs, symptoms, and the treatment of numerous diseases. The latter tantra is divided into 15 categories based on different classes of disorders which need to be healed. The fourth part, known as Chimégyü (Phyi ma’i rgyud) or the Subsequent Tantra, contains 27 chapters that cover detailed explanations of diagnostic methods, pharmacopoeias, and some forms of therapies ranging from mild to drastic interventions, including surgery. This tantra is divided into four main compendiums of diagnosis, medicine, eliminative, and external therapies.

The objective of Tibetan medicine is to maintain the dynamic equilibrium of body, speech, and mind. It emphasises the point that the primordial cause of all suffering is understood as the fundamental ignorance that obscures the relative nature of phenomena, resulting in the three ‘mental poisons’ (dug gsum) arising from the three afflictive emotions of desire, hatred, and delusion. In a pursuit to attain happiness and to avoid suffering when the mind is tainted with these three afflicting emotions and indulges in any resulting action of body, speech, and mind, it further gives rise to three corresponding forces of lung (rlung), tripa (mkhris pa), and béken (bad kan). These forces act as principle energies in our body, which when in a balanced state, give good health and when disturbed result in disease and suffering. The key to understand how to handle these afflicting emotions and their by-products lung, tripa, and béken is to maintain a positive attitude to health and the wisdom to apply the appropriate diet, lifestyle, medicines, and therapies.

In Tibetan language, the terms men and duk, which literally mean ‘medicine’ and ‘poison’ respectively, have multiple applications. Generally speaking, anything that is beneficial is called men, and anything that is harmful is called duk. Therefore, also the three afflictive emotions are called ‘mental poisons’. How the concept of duk relates to the compounding of medicines will be explained in the next section.

Understanding Poison in Tibetan Medicine

In order to understand the ideas of poison in Tibetan medicine it is important to outline some basic principles of Tibetan pharmacology. The main principles of compounding medicines are the ‘six basic tastes’ (ro drug), the ‘three post-digestive tastes’ (these are the tastes after digestion, called zhu rjes gsum), the ‘eight potencies’ (nus pa brgyad), and ‘17 attributes’ (yon tan bcu bdun). The six basic tastes are sweet, sour, salty, bitter, hot, and astringent, and the three post-digestive tastes are sweet, sour, and bitter. The eight potencies of medicines are heavy, oily, cool, blunt, light, coarse, hot, and sharp. The 17 attributes are smooth, heavy, warm, oily, firm, cold, blunt, cool, flexible, fluid, dry, parched, hot, light, sharp, coarse, and mobile. When the six basic tastes come in contact with the three different types of digestive heat4 in the alimentary system, they produce the three post-digestive tastes. Each of the six basic tastes is a composite of two of the five elements (earth, water, fire, air, and space) that define the characteristics of each taste, resulting in a particular potency of each taste and its subsequent attributes. Sweet taste is a composite of earth and water, sour taste of fire and earth, salty taste of water and fire, bitter taste of water and air, hot taste of fire and air, and astringent taste of earth and air elements. Formulations of medicines are mostly done by combining ingredients having similar tastes, post-digestive tastes, potencies or attributes, together counteracting the opposite characteristics of the diseases. Therefore, it is imperative to understand the characteristics of particular medicinal ingredients and their compounded formulation to be applied against a particular disease in order to have the best effects.

The ‘seven essential limbs’ (yan lag bdun) as explained in Tibetan pharmacology consider that all raw medicinal ingredients contain some toxic parts that need to be avoided or removed, and therefore it is imperative to practise these seven limbs. These seven limbs offer precise instructions from the time of harvest or collection to the final product. Accordingly, medicinal ingredients should be (1) ‘found in the right habitat’ (skyes gsar skyes pa), (2) ‘collected at the right time’ (dus su btus ba), (3) ‘dried and stored properly’ (skam gsed legs pa), (4) ‘utilised at the right time’ (so ma rnyings pa), (5) ‘removed from all poisons’ (dug ’don pa), (6) ‘appropriately compounded’ (’jam btsal ba; lit. ‘smoothening’), and (7) ‘made suitable for consumption’ (’phrod par sbyar ba).5

The fifth of these seven limbs deals with the removal of poisons from raw ingredients. This is based on the pharmacological knowledge that all substances contain a toxic part. For example, the major ingredients of Tibetan medical formulations are herbs. The removal of their toxic parts might include removing the bark of a root, the pith of a stem, the node of a branch, the petiole of a leaf, the sepal of a flower, the endocarp of a fruit, the dirt from the bark, and the vascular cylinder of a cortex. In the case of metals, gems, rocks, and soils, the removal of toxins includes treating them with different ingredients through various methods of washing, boiling, burning or frying, dipping them in different liquids, or fermenting them. In the case of mercury, first the ‘oxide’ or ‘tarnish’ (g.ya’) needs to be removed by kneading it with various ingredients, followed by washing it with different liquids, cooking it by subjecting it to different intensities of heat, and then mixing it with various ingredients, which is further explained below.

Thus, in Tibetan medicine the meaning of the term poison is multi-dimensional, ranging from a distorted psychological mindset to the physical innate toxic nature of substances. Before fully understanding the toxicology of unprocessed mercury in Tibetan medicine, it is imperative that we first grasp the general meaning of the term poison or duk. The management of poisoning is explained in three chapters of the Oral Instruction Tantra, where poisons are classified into three types: (1) ‘compounded poisons’ (sbyar dug), (2) ‘transformed poisons’ (gyur dug), and (3) ‘natural poisons’ (dngos dug). Of these, the first two are man-made poisons, while the third one refers to naturally existing poisons.

‘Compounded poisons’ are made with malicious intent to explicitly cause harm to others or to gain something by unfair means. There is the prophecy that during the time of a degenerated era, people with great intelligence yet with bad intentions would indulge in the misuse of nature and handle poisonous substances, thereby giving rise to various compounded poisons in the form of ‘air pollution’ (rdzi dug), ‘solar poisons’ (ser dug; what we might now call ultra-violet rays), ‘soil contamination’ (sa yi rlangs, lit. ‘soil vapour’), ‘external application of oily poisons’ (dug reg pa snum gyi dug), and ‘food contamination’ (zes dug).6 The appearance of such a degenerated era is linked to Buddhist understandings of certain periods of time during which the teachings of the Buddha will prevail. It appears to me that this has some relevance to our present time, because many kinds of modern scientific knowledge are used for short-term gains, posing the possibility of complete annihilation of this planet. In the Gyüshi it is said that nature, which is the basis of our existence, can become the agent of such poisons.7 The text also elaborates on the various gateways for the entry of poisons into the body through the nose, mouth, skin pores, as well as genitals.8 The chapter also mentions two countries (India and China) and two geographical regions where poisoning is practised (Dolpo and Monyul), different poisonous substances, times, pathways, how to identify poisons, signs and symptoms, progression periods, treatments, post-treatment therapies, and guarding factors pertaining to the prevalence and practices of introducing such poisons.

‘Transformed poisons’ are the poisons resulting mainly from eating certain foods, which when taken together do not agree with each other and result in incompatibilities, or from contracting meat poisoning after ingesting undercooked or rotten meat. Some kind of food poisoning comes from substances which in themselves do not contain any innate toxins, but can result in poisoning when consumed together. It generally occurs due to a lack of understanding of our body and of food qualities, as well as due to a missing sensibility of how and when to take them. Any food substances used inappropriately—even though devoid of any innate toxic properties—might have adverse effects on the metabolism, thus having a kind of toxic effect on the body. Tibetan doctors would classify food poisoning as a ‘transformed poison’ since it can be caused by eating incompatible food, unsafe food, or taking food at an unsuitable time, or under conditions that do not agree with the individual constitution of the person.

‘Natural poisons’ are those poisons that have a toxic nature in their innate state. They are of two types, animate and inanimate. ‘Animate poisons’ (rgyu ba’i dug) are poisons from animals, such as canine rabies, snake venom, crab poison, insect poison, cow poison, etc. The ‘inanimate poisons’ (mi rgyu ba’i dug) are again of two types, ‘hot’ poisons and ‘cold’ poisons. ‘Hot’ poisons are plant poisons, such as certain resins, trees, seeds, fruits, roots, etc., whereas the ‘cold’ poisons are the poisons from precious metals, gems, rocks, and soil. Accordingly, mercury or ngülchu is classified under ‘inanimate cold poisons’.

Mercury, the Silver Water

In this section, the origins, categorisation, and toxic properties of mercury according to Tibetan medical texts will be outlined. Major sources of ingredients used in Tibetan pharmacology are precious medicines, rocks, soils, aromatic medicines, trees, shrubs, herbs, salts, and animal products. Having said this, the use of animal ingredients in Tibetan medicines that are produced in India has become obsolete, partly due to their unavailability, but mainly because of growing environmental awareness and legal obligations.

According to the popular materia medica text Shelgong sheltreng (Shel gong shel phreng), ‘precious medicines’ (rin po che sman) are classified into two varieties of meltable and non-meltable substances.9 Metals of all types come under the meltable category whereas precious stones and gems are included in the non-meltable category. Metals recognised in the Tibetan materia medica include gold, silver, mercury, copper, iron, brass, bronze, tin, lead, and zinc.

Mercury is known by 30 different names in Tibetan materia medica texts, such as ‘supreme of all liquids’ (khu ba’i dbang po), ‘great essence’ (khams chen po), ‘swan’s feet’ (ngang pa’i rkang pa), ‘king of penetration’ (’bigs byed rgyal po), and ‘moon shape’ (zla ba’i gzugs can).10 The story of how mercury first appeared on this earth is narrated in different sources, mainly folk tales, many of them of Indian origin. The Tibetan understanding of the medicinal values of mercury has been influenced by these tales.

The earliest known story of mercury purification in Tibetan medicine goes back to the time of the Yutok Yöntan Gönpo the Elder (G.yu thog Yon tan mgon po), who is believed to have lived in the eighth century.11One story tells of the Muslim King Zun Haram (’Dzun Ha ram), who was suffering from a dreadful ‘lymph disorder’ (’bam nad) and requested Yutok for treatment. Yutok sent two of his disciples to Kongpo to procure mercury. The disciples returned with 50 loaded horses. Yutok purified the mercury and successfully treated the king. The king in return rewarded Yutok with 20 bags of pearls.12

Mercury is known as ngülchu in Tibetan, which literally means ‘silver water’. As mentioned above, mercury as a type of ‘precious medicine’ is classified under ‘inanimate cold poisons’. Ngülchu is not only sourced from metal-containing rocks, such as ‘cinnabar’ (mtshal) and ‘silver rocks’ (dngul rdo), but can also be derived from animals, humans, and plants.13 Black scorpions, pigeons, human sweat, and corpses are believed to be some of the animal and human sources of ngülchu. Chenopodiun album, commonly known as ‘fat hen’ and in Tibetan as neu (sne’u) is the plant source of ngülchu. None of these sources are used in today’s practice.

Mercury itself is classified into two types: ‘wild’ and ‘mild’. The ‘wild’ type (rgod pa) is whitish and has a highly fluid nature, and the ‘mild’ type (gyung ba) is a little bluish and less fluid.14Mercury has been traditionally collected by breaking the rock sources into small pieces and putting them in a wok or a pot that is covered with a lid and sealed with mud to avoid the fumes from escaping. The pot is slowly heated and the lid is constantly sprinkled with cold water to allow the mercury to distil. Thereafter, the fire is extinguished and the container unsealed. Ultimately, the extract is gently removed with a piece of cotton and kept in a separate container.15

Just like the medicinal value of any given substance is recognised by its taste, potency, and attributes, as described above, in Tibetan medicine the toxicity of mercury in its raw form is also expressed in terms of its characteristics, which are known as the ‘poison of heaviness’ (lci ba’i dug), ‘penetrative/mobile poison’ (’bigs pa’i dug) and ‘adherent poison’ (rtsi’i dug). How would these characteristics affect the body if unprocessed mercury would be taken internally? The heavy characteristics would increase the elements earth and water in the body thereby accumulating béken disproportionately. The ‘heavy’ nature of mercury would extinguish the digestive heat, thereby slowing down the metabolism and causing hindrances in the synthesis of food and its subsequent benefits for mind and body. In Tibetan medicine, metabolism is more easily understood as a digestive process. The term for ‘digestion’ in Tibetan medicine is jujé (’ju byed). Jujé is not solely confined to the physical absorption of food particles in the stomach and intestines. It is more widely understood as a process of synthesising and refining bodily constituents in many stages. Every food, while passing through the various stages of this synthesis, is segregated into a ‘refined’ and a ‘waste’ part, which further undergoes various levels of digestive synthesis. In sum, Tibetan medicine maintains that a lot of chronic abdominal and thoracic disorders result from indigestion or the improper metabolic synthesis at any of these levels. Accordingly, ingesting unprocessed mercury would virtually stop the functioning of metabolism due to the ‘heavy’ nature of mercury, thus bringing the body functions to a complete halt, which according to Tibetan medicine would be the reason for toxic complications.

The ‘penetrative’ or ‘mobile’ characteristics are better understood in lay language as ‘fast’ (myur ba) and ‘unhindered’ (mi gtong ba). It means that mercury passes through the passages and immediately disseminates into the entire system of the body, making it vulnerable. Due to it being ‘fast’, which also has the connotation of being ‘sharp’ (rno ba) in nature, there would be no time to apply any methods against its detrimental effect. The toxic effect of unprocessed mercury is therefore also a time-bound factor, which hinders the physician from counteracting its poison once it has been ingested.

The ‘adherent’ nature of mercury is explained in the form of a metaphor of oil being absorbed by a cloth.16 In this metaphor, the body is described as a piece of cloth which, once it comes in contact with the toxicity of unprocessed mercury, cannot be purged from the stain of the oil. Like the oil clinging to the piece of cloth, the ‘adherent poison’ of the mercury stays with the body. The cloth wastes away on trying to wash off the oil stain; similarly the body literally gets tormented and wastes away in the process of cleansing and purging the toxic mercury.

How to Process Mercury

Unprocessed mercury is recognised as the most dangerous poison in Tibetan pharmacology; however, it is equally revered as the highest potent medicine after subjecting it to a standardised and complex purification method called dülwa in Tibetan, which literally means ‘to tame’ or ‘to subdue’, as already explained above. In Tibetan medicine dülwa means to overpower, or to eliminate the harmful effects of a substance, thereby subduing the negativity of the substance and generating and reinforcing its positive side. In this context, dülwa stands for the purification of ‘raw’ or unprocessed mercury.

Tibetan pharmacology texts describe methods of how to process mercury at great length. This process is very complex and long and demands the involvement of highly skilled people and a particular environment. The processing requires long preliminary preparations, including rituals to bless the substances used for medicine and to invoke the compassionate heart of the Medicine Buddha in oneself, as well as to assemble and prepare numerous ingredients, which are used during the actual process of dülwa. The processing involves long-term and short-term preliminaries and immediate activities.17Long-term preliminaries involve gathering the numerous ingredients needed for the processing, which in some cases can take many years. Short-term preliminaries include the preparation and processing of those ingredients, which will then be used for the actual purification of mercury. This can take many months. Immediate activities include the necessary steps taken to avoid the contamination of humans and the surroundings with mercury vapours.

During the immediate activities the people involved in the practice need to drink Tibetan barley wine, called chang (chang), keep a piece of raw meat in their mouths, and apply sheep fat on their faces, hands, and the body, as well as cover up their eyes, ears, noses, and mouths to avoid direct contact with unprocessed mercury. They also should be in optimum health.

Generally, 14 different methods of purifying mercury are mentioned in the texts:18 (1) ‘wild purification’ (rgod ’dul), (2) ‘mild purification’ (g.yung ’dul), (3) ‘heat purification’ (tsha ’dul), (4) ‘cold purification’ (grang ’dul), (5) ‘pacifying purification’ (zhi ’dul), (6) ‘specific purification’ (khyad par ’dul), (7) ‘strong purification’ (drag ’dul), (8) ‘mantra purification’ (sngags ’dul), (9) ‘the consuming of unpurified mercury in meditative equipoise’ (rjen pa thung ba’i thabs), (10) ‘quick purification’ (mgyogs ’dul), (11) ‘purification with rocks’ (rdo ’dul),19 (12) the practice of Dzaki Kiti Nath (Dza ki ki rti na tha),20 (13) the practice of Nāgārjuna, who in Tibetan is known as Gönpo Ludrup (Mgon po Klu sgrub),21and (14) the practice of Khédrup Orgyenpa Rinchenpel (Mkhas grub O rgyan pa Rin chen dpal, 1230–1309).22

Of these, the most popular purification method is the last one, which comprises the three processes of (1) ‘cleansing’ (bkru ba), (2) ‘cooking’ (btso ba), and (3) ‘confrontation’ (dgra sprad pa, lit. ‘meeting the enemy’). These are briefly described as follows:

  1. ‘Cleansing’ involves repeatedly cleaning the unprocessed mercury with different ingredients through different methods. ‘Cleansing’ removes the ‘oxide’ or ‘tarnish’ (g.ya’) and the ‘adherent’ nature of mercury.

  2. ‘Cooking’ the unprocessed mercury has three different stages, which differ in the length of the cooking time, the intensity of the fire, and the ingredients added at each stage. ‘Cooking’ removes the characteristics of ‘heavy’ and ‘penetrative’.

  3. ‘Confrontation’ involves mixing the semi-processed mercury, which was already subjected to cleansing and cooking, with various ingredients, including sulphur (mu zi). ‘Confrontation’ transforms the liquid matter into a solid powder state, thus virtually transforming the original nature of mercury.

For a Tibetan pharmacologist, the physical transformation of mercury during this purification process is evident from the change of the nature of mercury. The ‘adherent’ nature of unprocessed mercury is removed completely during this transformation stage. After the cleansing process the colour of mercury looks like a transparent mirror. The ‘heavy’ nature of mercury is transformed into a ‘light’ matter. This can be proven by putting the ash of purified mercury on a glass of water where one can see it easily floating on the surface rather than sinking to the bottom. Mercury’s ‘penetrative’ and ‘mobile’ nature, which is characterised by its mobility and its ability to form globules, is transformed into a curd-like matter, which can be easily held between one’s fingers.

Benefits of Processed Mercury

There are multitudes of health benefits from processed mercury, which is never used singly but generally only in combination with other ingredients in compounded precious medicines, also known as ‘precious pills’ or ‘jewel pills’ (rin chen ril bu). Some of these benefits are mentioned in the eleventh chapter of the Subsequent Tantra of the Gyüshi. For example, purified mercury in the precious pill Rinchen Drangjor Chenmo (rin chen grang sbyor chen mo) is said to act as a tonic due to its smoothness and lightness. It is supposed to disintegrate and dissolve ‘tumours’ (skran), control ‘diphtheria’ (gag pa), ‘inflammations of the muscles’ (lhog pa), and ‘leprosy’ (mdze nad). It treats contagious diseases by inhibiting the growth of ‘parasites and harmful micro-organisms’ (srin nad), and it is known to act as an antidote against any form of ‘poisoning’ (dug nad).23

Research on Mercury at the Men-Tsee-Khang, Dharamsala

The Men-Tsee-Khang, the first institute of Tibetan medicine in Indian exile, established in 1961 in Dharamsala, Himachal Pradesh, co-initiated a small pilot study with foreign researchers to evaluate the toxicity and safety of tsotel in Tibetan medicine.24 This open retrospective, non-randomised, controlled study conducted in 2003 constituted an initial feasibility study, which was followed up by a larger clinical study in 2009. The first study revealed that even after prolonged consumption of mercury sulphide containing multi-compound Tibetan medicines, there was no evidence of neurotoxic symptoms or of inorganic mercury in the blood, and there were no red blood cells or protein in the urine.25 There were no clinically relevant abnormal changes in kidney or liver function. However, higher levels of mercury were present in three out of six urine samples.26Group I, which took mercury sulphide containing Tibetan medicines, had more loose teeth,27which could be a non-specific sign of mercury toxicity or due to age, since it is a sign of poor dental hygiene prevalent among older Tibetans (subjects in Group I were significantly older).

The second study with 120 patients in three groups apparently did not show any inorganic mercury in blood and urine samples and also no clinical symptoms of toxicity.28 With a very positive attitude, I am hopeful that one day modern scientists will come up with a device that will help to prove the subtle characteristics of the various forms of processed mercury through different parameters other than those currently in existence.

Conclusion

Yutok Yöntan Gönpo and many other outstanding Tibetan physicians have been passing on the practice of processing mercury, which is one of the important legacies of Tibetan medicine. There are numerous great scholars who have mastered this tradition with perfection, and some of their texts still exist.29 At the Men-Tsee-Khang, numerous doctors have received the traditional lineage transmission of this practice and have long-term practical experience.

Tibetan medicinal compounds containing processed mercury are considered highly potent and have been used for centuries on humans. They have been based and developed through long-established theory and practical experience. The elimination of many severe diseases, for example, lymph diseases and some types of tumours and cancers, after carefully diagnosing the condition and administering some of these compounds individually and according to the constitution of the patient, are to us Tibetan medical physicians a proof in itself. We observe in our patients that the use of processed mercury in medicines does not lead to the harmful effects that are described when taking unprocessed mercury. We also find that the medicinal value of the compound is augmented when processed mercury is added. Some of the precious pills are taken as a prophylactic before setting off on a long journey, travelling to a new place, or when there is an outbreak of an epidemic. According to my own estimate, more than 80 per cent of my patients in India use precious pills, and I see many senior citizens in our Tibetan community who are still alive and going strong despite taking these purified mercurial compounds for many years. I myself have been using these Tibetan medicinal compounds containing processed mercury since 1987 as regular tonics and have not noticed any health hazards. Furthermore, I have experienced them as being very helpful for alleviating certain ailments, such as migraine, vomiting and diarrhoea due to indigestion, food poisoning, fever, high blood pressure, hepatic pain, nerve problems, eye disorders, and arthritis. I wish that one day the wisdom to understand and respect the knowledge of the medicinal value of processed mercury in Tibetan medicine will prevail and that biomedical experts will be able to understand and culturally translate the ideas of toxicity and Tibetan medical processes of purification and transformation of mercury, and its positive effects.

1 This is a popular saying among Tibetan medical practitioners.

2 See the articles by Czaja and by Gerke, this issue.

3 The full title reads Bdud rtsi snying po yan lag brgyad pa gsang ba man ngag gi rgyud (Yutok Yöntan Gönpo 2006).

4 The three different types of ‘digestive heat’ (me drod) are the functional properties of the ‘decomposing’ béken (myag gi bad kan), ‘digestive’ tripa (’ju byed kyi mkhris pa), and the ‘fire-accompanying’ lung (me mnyam rlung).

5 Ridak 2003, p. iv. See also Dawa 2009.

6 Yutok Yöntan Gönpo 2006, p. 590.

7 Ibid.

8 Ibid.

9 For example, Deumar Tendzin Püntsok 2009, p. 4.

10 For example, ibid., p. 106.

11 I am aware that this position in Tibetan history is contested from a Western academic point of view and refer here to highly acknowledged and authoritative Tibetan scholars who take Yuthok the Elder as the legitimate primary source of knowledge of the Gyüshi. See, for example, Deumar Tendzin Püntsok 2009, p. 106; Ridak 2003, p. 403.

12 Desi Sangyé Gyatso 2008, pp. 129–42; Ridak 2003, p. 403; Jampa Trinlé 1991, pp. 72–7.

13 Ridak 2003, p. 414.

14 Jampa Trinlé 2006, p. 186.

15 Deumar Tendzin Püntsok 2009, p. 576.

16 This metaphor was mentioned in class by our teacher, the late Lozang Chöpel Pakri (Blo bzang chos ’phel Phag ri).

17 Yutok Yöntan Gönpo 2006, pp. 691–5; Desi Sangyé Gyatso 1982, pp. 1288–95.

18 Ridak 2003, p. 399.

19 Purification 1 to 11 are mentioned in Ridak 2003, pp. 399–401.

20 Deumar Tendzin Püntsok 2009, p. 577. Details of this tradition and its proponents are unknown.

21 Ibid., p. 579. Nāgārjuna, the Indian philosopher and alchemist, whose dates are unknown, is said to have authored texts on mercury, such as the Rasendramaṅgala. See Wujastyk 1984.

22 Ridak 2003, p. 403. See Czaja and Simioli, this issue, for details on Orgyenpa Rinchenpel.

23 Yutok Yöntan Gönpo 2006, p. 692.

24 Sallon et al. 2006.

25 Ibid., p. 409.

26 Ibid., p. 410.

27 Ibid.

28 Results have not yet been published, but preliminary results were presented by Sarah Sallon during the Second International Conference of Tibetan Medicine in Dharamsala, 27–29 October 2012.

29 Full references of these texts are not available in most cases. Czaja and Simioli, this issue, mention some of these texts.

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  • Trinlé Jampa Byams pa ’phrin las Gangs ljongs gso rig bstan pa’i nyin byed rim byon gyi rnam thar phyogs bsgrigs 1991 Dharamsala Men-Tsee-Khang

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  • Trinlé Jampa Bod lugs gso rig tshig mdzod chen mo 2006 Pe cin Mi rigs dpe skrun khang (Byams pa ’phrin las) and Bod rang skyong ljongs sman rtsis khang (eds)

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  • Ridak Dawa Bod kyi gso ba rig pa las sman rdzas sbyor bzo’i lag len gsang sgo ’byed pa’i lde mig 2003 Delhi Rig Drag Publications

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  • Sallon S., Namdul T., Dolma S. & Dorjee P. et al. ‘Mercury in Tibetan Medicine—Panacea or Problem?’ Human Experimental Toxicology 2006 25 405 412

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  • Wujastyk D. ‘An Alchemical Ghost: The Rasaratnākara by Nāgārjuna’ Ambix 1984 31 70 83

  • 5

    Ridak 2003, p. iv. See also Dawa 2009.

  • 6

    Yutok Yöntan Gönpo 2006, p. 590.

  • 10

    For example, ibid., p. 106.

  • 12

    Desi Sangyé Gyatso 2008, pp. 129–42; Ridak 2003, p. 403; Jampa Trinlé 1991, pp. 72–7.

  • 13

    Ridak 2003, p. 414.

  • 14

    Jampa Trinlé 2006, p. 186.

  • 15

    Deumar Tendzin Püntsok 2009, p. 576.

  • 17

    Yutok Yöntan Gönpo 2006, pp. 691–5; Desi Sangyé Gyatso 1982, pp. 1288–95.

  • 18

    Ridak 2003, p. 399.

  • 20

    Deumar Tendzin Püntsok 2009, p. 577. Details of this tradition and its proponents are unknown.

  • 21

    Ibid., p. 579. Nāgārjuna, the Indian philosopher and alchemist, whose dates are unknown, is said to have authored texts on mercury, such as the Rasendramaṅgala. See Wujastyk 1984.

  • 22

    Ridak 2003, p. 403. See Czaja and Simioli, this issue, for details on Orgyenpa Rinchenpel.

  • 23

    Yutok Yöntan Gönpo 2006, p. 692.

  • 24

    Sallon et al. 2006.

  • 25

    Ibid., p. 409.

  • 26

    Ibid., p. 410.

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