The Four Medical Tantras—excerpted from the Chinese Medical Encyclopedia—Tibetan Medicine

　　"The Four Medical Tantras" is the foundational text of Tibetan medicine. Completed at the end of the 8th century, it was compiled by the renowned Tibetan medical scholar Yuthok Yontan Gonpo, who synthesized traditional Tibetan medical theories and therapeutic practices while drawing upon the rich insights of Chinese medicine, ancient Indian medicine, and the medicine of the Abbasid Caliphate. Over subsequent generations, numerous Tibetan medical scholars further refined, supplemented, annotated, and organized the text, making it increasingly detailed and comprehensive—especially during the 12th century, when the new Yuthok Yontan Gonpo (the 13th-generation descendant of the original Yuthok Yontan Gonpo) undertook a thorough revision and addition to the text. In the 16th century, Sukha Lozang Gyatso had the Zhatang edition of "The Four Medical Tantras" engraved and printed. By the late 17th century, the Fifth Dalai Lama and Desi Sangye Gyatso reexamined and revised the Zhatang edition, producing the version of "The Four Medical Tantras" that is currently in use. The Tibetan name for "The Four Medical Tantras" is "De Shi," and its full title is "The Eight Branches of the Nectar Essence: A Series of Secrets." The term "nectar essence" refers to how "The Four Medical Tantras" is like butter extracted from milk—concentrating the very essence of all medical knowledge and surpassing all other medical systems in excellence and superiority. It treats physical and mental illnesses as well as life-threatening conditions through four primary therapeutic approaches: medicine, surgical instruments, diet, and lifestyle adjustments. Thus, it serves as a nectar that ensures both physical and mental well-being and long life. The "eight branches" refer to the main categories of medical practice: physicians themselves, who are the core of medical treatment; the diseases they treat, which are categorized into eight branches—general diseases, pediatric diseases, gynecological and obstetric diseases, mental disorders, trauma and ulcers, poisoning, geriatrics, and tonics for strengthening vitality. The "secret" aspect means that physicians keep their medical knowledge confidential and do not disclose it to those with various defects or illnesses. The "诀" (key) represents a method of quickly grasping profound truths without excessive effort. The "串" (series) signifies a linking together of three interrelated elements: body, disease, and treatment, known as the "cause series"; linking body, disease, symptoms, and therapies, known as the "method series"; and linking the elimination of pain, attainment of perfect health, and fulfillment of meritorious deeds, known as the "result series." Alternatively, the "series" can also refer to systematically organizing profound content according to general outlines, specific locations, detailed items, and comprehensive gatherings. As we can see from the above, clearly articulating a series of profound principles depends on exquisite language;When this language is expressed in writing and linked together through words and text, it becomes a “series.” “The Four Medical Tantras” is precisely such a complete medical work—a unified whole, seamlessly connected from beginning to end, encompassing every aspect of medicine without any redundancy or contradiction. As stated in the “Subsequent Section”: “This is the life-saving thread without blemish, the magical treasure that vanquishes death, the heroic force that subdues illness, the fair steward that balances yin and yang, the sharp sword that cuts through the rope of fate, the hammer that smashes pain, the iron hook that rescues one from the mire of suffering, the fearless benefactor who saves lives, and the nectar bottle that brings the dead back to life.” Similarly, the Fifth Dalai Lama remarked: “(The Four Medical Tantras) will endure forever, becoming an inexhaustible treasury of life-saving nectar.” “The Four Medical Tantras” boasts eleven major virtues: it stands at the pinnacle of all medical theories, reigns supreme over all medicines and medical instruments, provides the most comprehensive interpretation of all medical practices, forms the foundation of all medicine, serves as the source of all medical knowledge, offers a precious mirror for understanding all diseases, gathers the ocean of all medical essences, dispenses the nectar that relieves pain, performs acts of charity that save lives, fulfills patients’ wishes as a public good, and is the wish-fulfilling jewel for longevity and health preservation.

　　As its name suggests, the "Four Medical Tantras" consists of four parts, namely the "Fundamental Section," the "Discourse Section," the "Secret Section," and the "Subsequent Section." The "Fundamental Section" serves as the general outline of the entire work; like a seed, it embodies the essence of Tibetan medicine in its entirety. Concise and succinct, it is intended for those endowed with keen intelligence and quick wit. Its content comprises six chapters: "Origins," "Outline," "Physiology," "Pathology," "Diagnosis," and "Tree Metaphor," which systematically introduce the core contents of Tibetan medicine. The "Discourse Section" contains 31 chapters across 11 sections. The first section is the general outline, featuring one chapter that provides an overview of the Discourse Section's contents. The second section focuses on human physiological anatomy, covering six chapters: embryology, anatomical comparisons of the human body, tissue structure, bodily functions, classification and roles of the human body, and signs of death. The third section deals with pathology, including five chapters on causes, external factors, disease onset, disease characteristics, and disease classification. The fourth section addresses daily life and behavior, comprising three chapters on routine daily activities, seasonal routines, and temporary behavioral practices. The fifth section covers diet, including three chapters on dietary common sense, dietary taboos, and dietary restrictions. The sixth section is dedicated to medicinal substances, with three chapters on drug properties, therapeutic effects, drug categories, and preparation principles. The seventh section is on medical instruments, consisting of one chapter. The eighth section is on health preservation, with one chapter. The ninth section is on diagnosis, including three chapters on direct diagnostic methods, indirect diagnostic approaches, and the four-corner selection method. The tenth section outlines treatment principles, encompassing four chapters on general treatment guidelines, specific therapies, tonifying and weight-loss methods, and special treatments. The eleventh section is devoted to physicians, containing only one chapter. The "Discourse Section" represents the foundational theoretical part of Tibetan medicine, covering topics such as the formation of the human body, anatomical structure, physiology, pathology, etiology and pathogenesis, preventive healthcare, medicinal substances, diagnosis, treatment, and medical ethics and professional conduct. It expounds all the fundamental theories of Tibetan medicine and constitutes the core of Tibetan medical knowledge. As stated in the essence of the "Four Medical Tantras": "The 'Discourse Section' is like the sun and moon suspended high in the sky, illuminating medical principles so clearly that they are as bright as a mirror." The "Secret Section" comprises 92 chapters across 15 sections. The first section focuses on the treatment of the Three Disorders—Lung disorders, Tripa disorders, and Bkra-gyud disorders—as well as Mu-bu diseases (the combined syndrome of Lung, Tripa, and Bkra-gyud)—covering five chapters. The second section deals with diseases of the body cavities, including six chapters on indigestion, tumors, gray edema, descending edema, ascites, and wasting diseases. The third section addresses febrile and epidemic diseases, covering 16 chapters on general fever treatment, key points in distinguishing between cold and heat, critical conditions at the cold-heat boundary, immature fever, exacerbated fever, deficient fever, latent fever, chronic fever, turbid fever, injury-induced fever, disordered fever, plague, smallpox, dysentery, diphtheria and anthrax, and influenza. The fourth section covers diseases of the upper body, including six chapters on head ailments, eye diseases, nasal diseases, ear diseases, oral diseases, and goiter. The fifth section addresses diseases of the internal organs, including eight chapters on heart, lung, liver, spleen, kidney, stomach, small intestine, and large intestine diseases. The sixth section covers two chapters on diseases of the male and female genitalia. The seventh section deals with miscellaneous ailments, including 19 chapters on voicelessness, loss of appetite, thirst, hiccups, asthma, acute abdominal pain, parasitic infections, vomiting, diarrhea, constipation, urinary retention, frequent urination, hot diarrhea, gout, rheumatism, yellow water disease, white pulse disease, skin diseases, and surgical complications. The eighth section focuses on skin lesions and ulcers, including eight chapters on carbuncles, hemorrhoids, erysipelas, sun-induced abscesses, flesh tumors, hernias, green leg sores, and perineal fistulas. The ninth section covers pediatric diseases, including three chapters on newborn care, childhood illnesses, and mental disorders in children. The tenth section addresses gynecological and obstetric diseases, including three chapters on general gynecological conditions, specific gynecological diseases, and obstetric conditions. The eleventh section deals with mental disorders, including five chapters on epilepsy, stroke, mania, psychosis, and leprosy. The twelfth section covers trauma treatment, including five chapters on general trauma management, head injuries, neck injuries, trunk injuries, and limb injuries. The thirteenth section addresses poisoning, including three chapters on synthetic toxins, transformed toxins, and natural toxins. The fourteenth section is dedicated to nourishment and elderly care, with one chapter. The fifteenth section focuses on enhancing virility and treating female infertility, with two chapters. The "Secret Section" primarily discusses the causes, symptoms, and treatments of various diseases across different specialties, forming the clinical component of Tibetan medicine—a treasure trove from which all clinical needs can be drawn. The "Subsequent Section" consists of four sessions totaling 27 chapters. Each session brings together practical operational methods and treatment approaches. The first session includes two chapters on pulse diagnosis and urine analysis. The second session is devoted to preparing remedies, covering ten chapters on decoctions, powders, pills, elixirs, medicinal oils, calcined preparations, plasters, medicinal wines, precious herbal formulas, and herbal formulas—totaling ten chapters. The third session focuses on purgative remedies, including seven chapters on oil therapy, laxatives, emetics, nasal drops, mild laxatives, strong laxatives, and venesection methods. The fourth session covers external treatments, including six chapters on bloodletting, moxibustion, poultices, medicinal baths, topical applications, and acupuncture—plus two chapters summarizing the essential points and providing an overview of the Four Sections. The "Subsequent Section" mainly elaborates on specific diagnostic and therapeutic methods, constituting the practical and operational aspect of Tibetan medicine—a diamond hammer that leaves no obstacle in the way of healing. In summary, the "Four Medical Tantras" is the encyclopedic compendium of Tibetan medicine, encompassing both the theoretical and practical aspects of the Tibetan medical system in their entirety.

　　(Compiled by Luo Sang Nianzhe, edited by Xing Quanzhang)