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Demon Diseases and Tibetan Medicine: The Interface between Religion and Science

Ivette Vargas

 

The philosopher and environmentalist Max Oelschlaeger, in his Caring for Creation: An Ecumenical Approach to the Environmental Crisis, writes, “Religion, more than anything else, confirms for believers their place in a meaningful cosmos, a telos that is an ultimate guide, a reality that legitimates existence.”¹ He also notes in regard to the environmental crisis he sees worldwide, “My claim is not that religion alone can solve the environmental crisis but that it has an irreplaceable function in the larger process.”² When we speak of the Tibetan medical tradition, we must keep in mind that we are also referring to complex religious traditions that are linked with the natural environment. And within this complicated web of interrelationships, we have a healing system transforming itself with the times, adopting new and foreign methods, as it must, and maintaining its foundational, yet contested, identity. There are entities that make up part of this contested identity—spirits, or what others might call reified obstacles or demons as such— which create disharmony within the body and in the environment. For example, early Tibetan chronicles envisioned Lhasa and its surroundings as the domain of a primeval serpent king named Maldrozichen who was held accountable for several floods. In stories surrounding Khri srong lde btsan and Padmasambhava, klu are said to govern the four districts of Tibet and were appeased in order to complete the monastery Bsam yas. A variety of klu are present in the Gtsang ma klu ’bum text and protect the various directions as well as inflict red and gray leprosy (mdze dmar, mdze skya).³ Even among the Sherpas in Nepal, we have the connection of klu and pollution of the environment.⁴ Finally, small klu khang shrines in monasteries, temples, and corners of homes throughout Tibetan areas, and in archaeological sites in Western Tibet, are erected in order to appease and honor klu because of their potential to inflict disease and other calamities.⁵ Although they are known to protect the Dharma and provide wealth, one wrong move on the environment—pollute a sacred site, cut a tree that is inhabited by a klu, or forget to honor a klu—could cause a person to be inflicted with dementia, rashes, and even leprosy, or disrupt the environment. Hence, for their good and negative aspects, these spirits form the “embedded ecology of everyday Tibetan life.”⁶

But what exactly are these entities? What is their relevance in Tibetan medical texts? Why are illnesses related to these entities still significant categories today for treatment purposes? Do beliefs in these entities reflect a preoccupation about the ecological and medical crisis in modern Tibetan society in the Tibetan Autonomous Region (TAR)? This paper will briefly focus on the role of a specific type of spirit called klu, and in general, gdon, in the Tibetan medical tradition and how diagnosis and treatment of their illnesses traverse the often tenuous crossroads among religion, politics, and medicine in the modern context. Preliminary textual and some ethnographic work in Lhasa, Tibet, and interviews with physicians from the U.S., Tibet, and Dharamsala, India, from 2004-06 reveal a complex complementary relationship between medical and religious communities.

Klu Identity in Select Buddhist and Bon Texts

What klu signifies is, of course, a very complex question, often dependent on religious and historical contexts. What is consistent is that klu, or nāgas, are considered one of the most ambivalent figures to appear throughout Asian literature. Closely linked with the environment; the monastic, royal, and political institutions; and the well-being of individuals, klu as wrathful and protective deities have often been at the center of religious traditions and their transmissions. They were, on the one hand, the Buddha’s staunchest adversaries, and on the other, guardians of the Dharma (once they were pacified).⁷ Klu have been prevalent in Tibetan religious traditions prior to the advent of Buddhism and throughout its transmissions. Klu were identified with the well-known nāgas from the Indian context perhaps around the time of the eighth century as indicated in the Abhidharmakośa.⁸

In Bon po texts like Bon sgo gsal byed and the Gzer mig, klu are classified as both lha ma yin (asura) and yi dwags (preta), while in Buddhist texts like the Abhidharmakośa-bhāṣya, the two categories of klu (nāga) such as nāga rājas (nāgādhipataḥ, klu bdag) and ordinary nāgas (klu phal pa’i ming la) are classified differently. The first are considered animals (dud ’gro) (because of their serpent-like form and their apparitional birth like the garuda and the kinnara), while the second are considered pretas.⁹ In the Chinese context, klu is often equated with the dragon, klung. These theriomorphic snake-human or completely snakelike entities are often believed to inhabit the environment, embodying the forces of nature like trees and water sources as well as inhabiting and possessing humans’ bodies or controlling a whole society.

What makes these figures particularly “demonic” is that, in possessing or attacking individuals, they cause diseases that affect sensory perception, nervous system (like in the case of leprosy), common sense (like insanity), and sense of discernment (as discussed in Buddhist and Bon traditions)—in the end, impairing the ability for spiritual advancement. In the rnam thars of Dge slong ma Dpal mo, an eleventh-century Buddhist nun, klu obstructed her development as a practitioner and even led to her contraction of leprosy. These figures are therefore considered real entities that appear to obstruct practice and biological functions because of karma, some offense, or lack of reverence due to them. They are, however, also conceived of as “psychological” entities in the Buddhist sense (as mental projections based on one’s deluded view of reality). Therefore, these texts reflect complex psychological, biological, and environmental concerns.

Klu Identity in Tibetan Medical Texts

In medical texts like the twelfth-century Rgyud bzhi, klu are subsumed under the larger category of bgegs (literally meaning “obstacles”). In Buddhist texts, 84,000 bgegs in the sutras are said to correspond to the 84,000 mental defilements. Out of these arises the complex category of gdon.¹⁰ Gdon includes a pantheon of figures like asuras, pretas, gandarvas, rakshasas, or others known as the eight classes (lha srin sde brgyad) that include klu, sa bdag, rgyal po, bdud, mamo, yaksha, lha, and others coming from Bon and Buddhist traditions.¹¹ As in religious texts, they retain their theriomorphic and other forms as described earlier. Some, when they are linked with gdon, increase their harmful effects on individuals, especially when offended, in the form of a kind of sgrib (pollution).

Illness Caused by Klu in Medical Texts

In the Rgyud bzhi, the descriptions of illnesses caused by klu or gdon (klu nad/ gdon nad) reflect a number of textual sources, one significantly being the well-known Sanskrit medical treatise on Āyurveda, the Aṣṭāṇgahṛdayasaṃhitā of Vāgbhaṭa and others that seem to have arisen from Tibetan sources.¹² The third and longest of the four parts of the Rgyud bzhi is the Man ngag rgyud or Instructional Tantra whose five chapters, chapters 77 to 81, deal primarily with gdon nad (illness caused by spirits), although these diseases are present in other chapters as well.

In the Rgyud bzhi, klu nad is described as klu “possessing,” attacking, or inhabiting a human being, controlling his senses due to some poisons (mental obscurations) which they embody or help to agitate. Past karmic relations, low accumulation of virtuous actions, in addition to bad diet that affects the nyes pas (humors, that form the three principles of physiologic regulation, rlung, mkhris pa, bad kan), provide gdon/klu an opportunity to inflict mental and physical harm.

The first chapter describes the connections of these entities to the environment within and outside of the body and their impairment of the senses. Demons are explained in five groups: elemental demons (’byung po’i gdon), madness-causing demons (smyo byed kyi gdon), epilepsy-causing demons (brjed¹³ byed kyi gdon), planetary-demons (gza’ yi gdon), and serpent demons (klu’i gdon).¹⁴

Chapters 77 and 81 give a broad view of the effects of klu spirits. In chapter 77, klu is said to belong to one of the eighteen elemental spirits (’byung po gdon’) that embody both protective qualities and on the negative side, are prone to anger and dangerous behavior (classified as klu’i gdon). The klu are also distinguished from the asuras and the pretas which have their own categories and sets of symptoms they inflict. Those affected by klu’i gdon or klu’i nad exhibit radiant faces, red bloodshot eyes with piercing stares, unclear vision, flickering tongues, blistered skin, unregulated voices, their hearts feel empty, and they sleep backwards with a straight body in the manner of snakes. In chapter 81, there are eighteen different locations for the eighteen types of klu, the first being the epidermal and other parts of the body, including the muscles, fat, ligaments, blood, yellow water, bone, and so forth.¹⁵ The onset of klu’i nad is often preceded by a dream of a bull or some other animal ready to attack, indicating an offence has been committed.

Chapters 77, 78, and 81 also focus on two major diseases that affect sensory perceptions, dementia and leprosy, thus linking the mind with the skin and to Buddhist philosophical concepts. Because these entities have an undisciplined nature, klu manifest in exaggerated ways in the individual—increasing mental obscurations to a near frenzy and obsession or blocking sensations altogether as with neuropathies, rashes, and leprosy.

In chapter 77, the eighteen different gdon (demons) appear in the form of figures from the Buddhist and Hindu pantheon and such spiritually advanced figures as gods (lha), asuras (lha min), gandharvas (dri za), Brahmins (tshangs pa), lamas, sages, hungry ghosts (yi dags), nāgas (klu), and others. Curiously, five listed reflect the negative attributes of beings with advanced spiritual attainments especially lamas, sages, elders, and siddhas such as the lha gdon, lama demon (bla ma’i gdon), the sage demon (drang srong gi gdon), the respected elder demon (rgan po’i gdon), and the accomplishment emanation (grub pa’i gdon). The text also emphasizes that these five are known as the five highest elementals and are described as seeds for future insanity, whereas they would otherwise be the seeds for enlightenment. Terms like ’byung po, these figures, and their enumeration into eighteen and five types, correspond with some basic Buddhist philosophical ideas regarding experience and sensory perception. These analyses are aimed at showing: (1) a relationship between human personality and the external world, and (2) that relationship is in fact a conditioned process or function of consciousness or sense experience. In terms of the elemental demon disease, the demons disrupt an individual’s perception of the outside world through a distortion of sensation and a resulting aberrant excessive behavior.¹⁶

Next, the five ’byung po that are attributed with future insanity correspond in the Buddhist sense with the five great elements (’byung ba lnga): earth, water, fire, air/wind, and space which make up matter. In terms of Tibetan medical ideas, these elements form the three principles of physiologic regulation, the nyes pa gsum. Possession or attack by ’byung po’i gdon results in an imbalance on the physiological and spiritual levels; not only are the nyes pas (humors) in disequilibrium but also attainments in spiritual advancement are taken in a negative direction (through excess of one type or another, like the angry nāgas, hungry ghosts, and egotistical sages exemplify). Another way of phrasing this is that the person is not possessed by the gods but by a negative force or attachment that causes him to behave in a manner reminiscent of these figures. These demons make people operate in the world of the senses as described by the standard Buddhist mental obscurations (kleśas, nyong mongs) and poisons.

According to the brief chapter 78 on smyo byed kyi gdon, madness-causing demons distort the senses through the interaction of the emotions and humors (nyes pas). For example, arising from rlung, one becomes emaciated. Arising from phlegm, one sleeps a lot. Arising from mental distress, one is obsessively thinking of sadness. And finally, the mind is confused and can act in a harmful manner if it arises from poisons or demons. These conditions are said to lead to a confused mind (dementia) which is defined as consciousness staying in the path of the mind.¹⁷ With dementia-causing demons, the path of the mind is blocked and perverted at the crucial center of the heart where all the veins meet. As Terry Clifford makes note in her work, Tibetan Buddhist Medicine and Psychiatry, gdon enter the body from the eastern and downward direction which dominates thought and ear consciousness; they come in with confused and agitated thinking and block the path of the mind by staying in the heart center.¹⁸ As in the case of Kaśyapa’s story in the Āyurvedic tradition, the actions of individuals cause openings for demons to enter into vital points in the body that eventually afflict the mind and consciousness.¹⁹

A well-known effect of klu, leprosy exemplifies the Tibetan preoccupation with the mind and its link with the skin. In the case of leprosy, the major locus (and most obvious one) of the disease is the skin (the largest sense organ of the body) indicating that the life-extending rlung (wind element) is impaired. Rlung is the central element that acts as a medium between the mind and the body. The five rlung (life-sustaining, ascending, pervasive, fire-like, downward-voiding) are responsible for physical and mental activities, including the clarity of the sense organs and life sustenance. Therefore the condition of the skin (rashes, neuropathies, leprosy) indicates that the demons are creating mental obscurations and impairment of the senses. In the religious context, this reflects a person’s inner moral state.²⁰ In the story of the Buddhist Nun Dge slong ma Dpal mo who contracted leprosy, not only was her practice disrupted but there was a sense of decentralization and disintegration of her mind as well as her connection with the environment and society. She had to appease and transform these entities:

In the saga month

[at the time of the constellation] sa ri nam mthongs,

the interfering demons were placed in the state of bodhicitta.

[Nun Palmo’s] illness, sins, and defilements were purified

and she saw the truth of the first bhūmi.

On the first day of sa ga zla ba,

she witnessed the countenance of the Holy Tārā

and [Tārā] prophesized,

“Buddha activities of all the Buddhas

of the three times are consolidated in you.”

On the eighth day,

she witnessed the majority of the kriyā tantra deities

such as five Amoghapaśa deities and so forth.

On the fifteenth day,

she witnessed the countenance of the Eleven-faced One

endowed with a thousand hands

and a thousand eyes and furthermore,

countless Buddhas in all the pores of the body,

the hands also being the quintessence of Buddhahood.

On the eyes on the palms of the hands,

she witnessed a host of tantric deities.

Since the holy one talked about the Dharma,

inconceivable samādhi arose in [her].

She saw the truth of the eighth bhūmi.

Then moreover she practiced the fasting ritual

for three months more for the sake of all sentient beings.²¹

The leper’s skin is therefore a reflection of the broken mind and body. As the medical text indicates, only whole bodies are capable of spiritual cultivation because their minds are intact and their senses are focused.

Demons and the Modern Body Politic

These klu and gdon diseases have often been encased in social and cultural constructs, also revealing tensions and rivalries. The occurrence of disease also reveals a culture’s urgency to retain some semblance of its so-called traditional identity amidst political and economic pressures. There are many times in Tibetan history that point to this. One is the case of smallpox in the royal period when Buddhism was accused of bringing the curse of the disease upon the Tibetan royal court. Mat-thew Kapstein, in his work The Tibetan Assimilation of Buddhism: Conversion, Contestation, and Memory, draws attention to a manuscript found by Pelliot, one of a number of sources which points to a Buddhist persecution that occurred during an outbreak of illness in the eighth century:

At about the time [during the events in Khotan described earlier in the text] the divine Tsenpo of Tibet and the lord of China formed [the relationship of] nephew and uncle, at which the Chinese princess, too, became the divine Tsenpo’s bride. The Chinese princess built one great temple in Tibet and established the provisions. The whole saṃgha went there, whereupon the princess also provided rations. The doctrine of the Mahāyāna having thus blossomed in Tibet, for a period of twelve years both the saṃgha and ordinary layfolk practiced the doctrine and so were exceedingly happy. But even there Mārā’s host became agitated, and Mārā sent forth the black pox and many other sorts of disease. As for the princess, she died after the black pox appeared at her heart. After that the laity lost faith and said that the occurrence of the black pox and many sorts of disease was an evil due to an arrival in Tibet of the host of the saṃgha. It was ordained that not even one member of the saṃgha be permitted to remain in Tibet. After they were banished, one and all, the entire saṃgha traveled to Gandhāra in India.²²

In the modern context, despite the continuing secularization and scientization of Tibetan medicine in the Tibetan Autonomous Region and other areas of China, the diagnosis of diseases as caused by demons (with modification in treatment in urban areas) still remain the same. A diversity of opinions about klu and gdon nad was shared by physicians, instructors at medical schools, administrators, and lamas in Lhasa, Tibet in 2005-06. As is expected of an increasingly secularized and/or “biomedical” Tibetan environment as the Mentsikhang and the Tibetan Medical College in Lhasa, gdon and klu diseases are mostly described in empirical and psychological terms, often focused on symptomotology. At the medical college, students are taught that klu and gdon either do not really exist or are mental projections of some kind (instead of focusing on what the medical texts state and their underlying religious ideas). Therefore training at the college is focused on being “scientific” and secular in its theoretical and practical content; there is either no knowledge and/or interest in incorporating the religious aspects of the Tibetan texts in the curriculum. What students learn about gdon and klu diseases is that they must treat them physiologically, and not spiritually. This means that they learn how to prescribe certain medicine for symptoms they observe, and this includes a change in diet since the condition is considered a disease which does not concern religion. There is also a contrast with traditional understandings of treating klu diseases as discussed in the Rgyud bzhi and even Bon po texts like the Klu ’bum, which is to treat the klu first (since it is the klu that is ill), and then to treat the patient. This requires both ritual and medicine. Thus there is a major disjuncture between what is taught at the medical school level, on the one hand, and what is literally stated in the medical texts and believed in many sectors of Tibetan culture.

Informants in Lhasa indicated that there are several ways medical students tackle the ideas about these diseases in their training. One way was talking about these diseases in different ways—as mdze nad instead of klu nad, for example. In addition, they also refer to these diseases as environmental diseases.²³ This notion, that there is a secularization of the environment, is unlike what Tibetan culture traditionally understands it. As an administrator at the college noted, young Tibetan medical students take pride in thinking that they have inherited an “environmentalist” tradition, a long history of concern about nature.²⁴ This view, however, is not taken further to the realm of the spiritual, to the nonhuman realm of the hindering spirits who get offended and inflict disease. Thus medical students come out with a superficial sense of their environment and an understanding of klu and gdon nad at least according to literary Rgyud bzhi standards and historical cultural views. But several informants at the medical school noted that it was not harmony with the environment but “harmony with the nonhuman” that we should foster.²⁵ This, however, cannot be openly discussed in the current political climate. This is reminiscent of a remark given by Dr. Tsering Dorjee from Dharamsala’s Mentsikhang, who noted klu diseases are not “spiritual” but known to be caused by spirits. This seems to indicate the need to go beyond the discourse of spirituality or religion in the modern Tibetan medical context and think of these beings as actual or “real” entities (and deal with them as such in treatment). In Lhasa, there was also a reticence on the part of some Tibetan physicians, administrators, and medical college professors to talk about klu and gdon nad, often because the disease was described as a “spiritual disease,” and “the Chinese government separated religion from medicine.” Often questions directed toward klu or gdon had to be phrased as “medical questions” and not have any semblance of religion per se. Although texts on Gdon nad gso ba were made available to me and were available at the local bookstore in the Barkhor, the content and treatment were not readily discussed in public.

Another reaction encountered during fieldwork was a much more flexible attitude in terms of treatment including religious ideas, to integrate the discourse of religion and medicine as mentioned above. For example, two physicians in two specializations unrelated to gdon nad were said to be “experts” in diagnosing and providing some treatment to patients with this disease. In addition, some physicians were even fostering a relationship between institutions like the Mentsikhang and the Klu khang behind the Potala Palace. What was observed was that physicians not only treated patients with suspected gdon and klu diseases with “conventional” Tibetan and Western biomedicine, but also referred them to the local lama for further “spiritual treatment,” i.e., mantra recitation, prayers, and offerings. If patients exhibited mental disturbances, they were also immediately sent to a lama.²⁶ This is reminiscent of the biography of the elder gyu thog Yon tan Mgon po who received the help of the royal king nāgas to heal terrible diseases in the nāga realm caused by immoral behavior.²⁷ According to fieldwork observations at the Klu khang in 2005, numerous patients and others exhibiting symptoms and dream experiences associated with klu nad were found requesting prayers from lamas and making offerings. Not only was the klu khang a site of healing or complementary treatment, it also represented a continuity of tradition surrounding beliefs regarding the klu. An example closely associated with this behavior related to farmers’ visits to the temple. As prior to the 1950s, farmers in the Lhasa valley still bring segments of their fields to the shores of the Klu khang lake in hopes of ensuring good harvests.²⁸ Both of these actions—physicians referring their patients to the klu khang for “alternative or complementary treatment” and the farmers’ visits—represent a continuity of traditional beliefs about the klu’s connection to the environment.

So what may be called on the surface a “pluralistic or complementary” medical approach regarding gdon and klu on the part of some physicians was surprising in view of the restrictions concerning religion. Some younger physicians who did not have much knowledge or interest in the religious tradition or its rituals to combat these diseases saw no contradiction whatsoever about sending patients to lamas. For some patients, unlike psychological or psychiatric resources that are readily available and accepted in the West, such “treatment” provided options.

Benefits of klu nad in Modern TAR

Overall, based on the observations made in TAR, the benefits of klu nad diagnoses are that they maintain traditional associations between medical and religious institutions and an awareness of the environmental conditions. In addition, Tibetan concerns over the demonic nature of klu and gdon nad were coupled with frustrations about treatments of conditions like increasing infectious diseases as AIDS and HIV (with leprosy still prevalent) and the ecological and cultural crises caused by development projects.

Outside of Lhasa in Qinghai province, glu rol rituals might be taken as a parallel case in terms of the recognition of the power of the spirits of the environment and the maintenance of the health of the Tibetan community as a whole.²⁹ In terms of purification and healing, lay people are invited to bathe in a river beside a sanctuary dedicated to white klu who reside there in order for the lay people to recover from skin and eye diseases or mental imbalances.³⁰ Many who have gone to local physicians also take part in this ceremony. Klu are therefore beings to entertain and to appease in the rituals of agriculture, reproduction, order, and health. Thus, what is evident in the modern Tibetan context in China is a practical response to very difficult illness conditions and a continued recognition of maintaining good relations with the environment, using all one’s resources, secular and religious, at one’s disposal. Klu disease therefore reflects a rather complex situation incorporating the psycho-physical, the cultural, and the ecological dimensions.

Even further, the treatment of these diseases also accentuates the current Tibetan medical tradition’s way of dealing with challenges within and without. The process of appeasement and negotiation regarding these entities often has to do with the recognition of their negative and uncontrollable aspects as described in the Rgyu bzhi, especially their association with creating obstacles in the body and the environment. Strong rituals, often accompanied by prayers, concentrate on appeasing the klu by offering whites (curds, milk, and butter),³¹ and by burning juniper and equal portions of diverse herbs, peacock feathers, various fruits, snakeskin, gems like white aconite, lavender, urine, and a mixture of scatological substances used alongside Tibetan medicine in order to combat the wrath of the hindering spirits.

Conclusions

In the end, are the klu relevant at all in the Tibetan religious and medical contexts today? This study indicates, among other things, that the diseases associated with klu are needed as a way of dealing with situations of vulnerability and inferiority. They serve as a reminder of Tibetans’ association with an environment that they cannot fully control but of which they must constantly maintain awareness. Another significant issue is that religion is yet to be erased out of Tibetan medical practice, a body of knowledge that is constantly undergoing dissection from diverse parties: religious, political, and medical. What is evident from these few examples is that klu cannot be divorced from medical theories, religion, politics, or the environment as a whole (natural, social, and cultural). This creates a dilemma in modern medical practice in TAR where politics, modernization, and Westernization are dictating what is learned and what is practiced. This draws attention to much broader issues of modernity and agency. Ming-Chen M. Lo, in the work Doctors Within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan, draws attention to the case of Taiwan during Japanese occupation of the complex role of agents of modernity and the negotiation between “universalistic narratives of science and the concrete sociopolitical relationships through which science is being delivered, developed, and received.”³² As Lo notes, modernity cannot exist outside of the “culturally specific plans of its deliverers and the culturally specific evaluations of its receivers.”³³ Thus there is no modernity that is not localized or a nonrelational process. In terms of the case of klu nad, we can see the complex relationships fostered between Tibetan physicians trained in a secularized environment, religious practitioners, and a combination of religious and secular views that permeates the culture, all having a hand in the process of modernity in the medical sense. Even more so, the underlying Tibetan identity is somehow thrust forward through the disease process and its treatment amongst a rapidly changing cultural environment. Klu nad therefore expresses underlying tensions and accommodations between the religious and medical dimensions of Tibetan society, a disease that reflects its environment and all that that entails.

Acknowledgments

I am grateful to physicians at the Tibetan Medical College and the Mentsikhang in Lhasa. Textual and fieldwork in 2004-06 was supported by Austin College Richardson Funding. Ethnographic work in Lhasa, Tibet in 2005 was made possible through a generous grant from the Wabash Center for Teaching and Learning. This study is dedicated to my husband, Eric, and my abuela.

Endnotes

1. Max Oelschlaeger, Caring for Creation: An Ecumenical Approach to the Environmental Crisis (CT: Yale University Press, 1994): 219. See Sherry Ortner, “The White-Black Ones: The Sherpa View of Human Nature,” in J. F. Fisher, ed., Himayalan Anthropology: The Indo-Tibetan Interface (The Hague: Mouton, 1978): 263-86.

2. Ibid.

3. Réne De Nebesky-Wojkowitz, Oracles and Demons of Tibet: The Cult and Iconography of the Tibetan Protective Deities (Delhi: Book Faith India, 1996): 291.

4. Ortner, “The White-Black Ones,” 263-86.

5. Jakob Winkler, “The Rdzogs chen Murals of the Klu Khang in Lhasa,” in Henk Blezer, ed., Religion and Secular Culture in Tibet, Tibetan Studies 2 (Leiden: Brill, 2002): 321-44.

6. V. Nagarajan, “Rituals of Embedded Ecologies: Drawing Kolams, Marrying Trees, and Generating Auspiciousness,” in C. K. Chapple and M. E. Tucker, eds., Hinduism and Ecology: The Intersection of Earth, Sky, and Water (Reprint, New Delhi: Oxford University Press, 2001): 453-68.

7. In Indian mythology, nāgas (Tibetan, klu) are the serpent spirits who inhabit what could be labelled as the “underworld,” Lanka, or water sources like lakes, rivers, ponds, and trees. In many respects, the Buddhist nāgas inherited much of the early Indian Hindu symbolism. In Buddhist cosmology, they are assigned to the lowest level of Mt. Meru with their garuḍa (mythical birds) enemies on the level above. See Richard S. Cohen, “Nāga, Yakṣiṇī, Buddha: Local Deities and Local Buddhism at Ajanta,” in History of Religions 37, no. 4 (May, 1998): 360-400.

8. I thank Geoffrey Samuel for this reference.

9. As these entities, they exhibit hallucinations and fear (pretas) and negative emotions (aggression, anger, and inflict disease and poison) (animals and asuras). In such Bon po texts, these pretas-klu move through space (mkha’ la rgyu ba), and inhabit the underworld (gnas na ’dug pa) accompanied by snakes or water sources (described as chu bdag klu). Pretas (like other beings as tsen, gyelpo, shindre, jungpo, mamo, theurang, etc.) in Buddhist texts live their lives in constant terror and hallucination, often afflicted by diseases. As animals according to the Buddhist tradition, klu are constantly tortured by garuda (khyung) and kept in their beaks symbolizing the negative emotions, swamped with rains of burning sand, and are stupid, aggressive, and poisonous. As asuras, the Bon po text indicates that klu fall under one of the three classes, one of the eleven che bas who are g-yen of the ground. In Buddhist cosmology, asuras live in constant quarrels and aggression, full of envy toward the gods whose desires are completely taken care of. See Katsumi Mimaki, “A preliminary Comparison of Bonpo and Buddhist Cosmology,” in New Horizons in Bonpo Studies (Osaka, Japan: National Museum of Ethnology, 2000): 99-101; K. Mimaki and Samten Karmay, “Bon sgo gsal byed, Two Tibetan Manuscripts in Facsimile Edition of a Fourteenth Century Encyclopedia of Bonpo Doxography,” in Bibliotheca Codicum Asiaticorum 13 (Tokyo: The Centre for East Asian Cultural Studies for Unesco, The Toyo Bunko, 1997).

10. Although according to Tibetan dictionaries, the nominal form is taken to mean “evil spirits or demons,” the term itself literally derives from the future tense of the verb ’don meaning “to cause to come out or come forth, to drive forth”; in modern usage it means “to take out.”

11. Geoffrey Samuel, Civilized Shamans: Buddhism in Tibetan Societies (Washington, DC: Smithsonian Institution Press, 1993): 161-63.

12. I thank Geoffrey Samuel for directing me to the sources here.

13. Ronald E. Emmerick, “Epilepsy According to the Rgyud-bźi,” in G. Jan Meulenbeld and Dominik Wujastyk, eds., Studies on Indian Medical History (Groningen: Egbert Forsten, 1987): 63-90.

14. Bdud rtsi snying po yang lag brgyud pa gsang ba man ngag gi rgyud (Lhasa, Tibet: Bod ljongs mi dmangs pe skrun khang, 2002). See also Rgyud bzhi: A Reproduction of a Set of Prints from the 18^th century Zung-cu-ze blocks from the Collection of Professor Raghu Vira, reproduction by Orgyan Namgyal (Leh, Ladakh: S. W. Tashigangpa, 1975). See Terry Clifford, Tibetan Buddhist Medicine and Psychiatry: The Diamond Healing (Maine: Samuel Weiser, 1984): 179.

15. The major locus of the disease is the skin indicating that the life-extending rlung (wind element) is impaired. Rlung is the central element of the body that acts as a medium between the mind and the body. The five rlung (life-sustaining, ascending, pervasive, fire-like, downward-voiding) are responsible for physical and mental activities including the clarity of the sense organs and sustaining life. Therefore the condition of the skin indicates that the klu are creating mental obscurations and impairment of the senses and is a reflection of a broken mind and body. Bdud rtsi snying po yang lag brgyud pa gsang ba man ngag gi rgyud (Lhasa, Tibet: Bod ljongs mi dmangs pe skrun khang, 2002): 392-401. See Terry Clifford, Tibetan Buddhist Medicine and Psychiatry: The Diamond Healing (Maine: Samuel Weiser, 1984): 179-81.

16. For example, Buddhist philosophy, particularly the Abhidharma, analyzes experience into various elements—physico-psychological combination (nāmarūpa), the most basic of these being the five skandhas or aggregates, i.e., form, feeling, perception, mental formation or volition, and consciousness and then the six elements (cha-dhātu). The five aggregates and six elements in turn can be analyzed into the eighteen elements, which can be further analyzed into seventy-two elements. Buddhism also utilizes the method of twelve bases/ spheres/loci (āyatana) of meeting between the six sense-organs and their corresponding objects that are also related to the eighteen elements to refute an eternal self (ātman). These are the gateway of sense experience or the ground for bringing about consciousness.

17. According to the Lapis Lazuli commentary on the Rgyud bzhi, the path of the mind is the normal flowing of the energies of the five skandhas through the five veins of consciousness according to Tantric physiology. See Bai Dur sNgon po (The Lapis Lazuli Commentary on the Rgyud bzhi) of Sangs-rgyas rGya mtsho, vol. 3 (Leh: T.Y. Tashigangpa, 1973).

18. Clifford, Tibetan Buddhist Medicine and Psychiatry: The Diamond Healing (Maine: Samuel Weiser, 1984).

19. Dominik Wujastyk, The Roots of Ayurveda: Selections from Sanskrit Medical Texts (London: Penguin, 2003): 210-38.

20. From the eleventh to thirteenth century, many Tibetan practitioners and teachers contract illnesses (like leprosy) and keep the company of lepers, such as Ras chung pa, Ma gcig Lab sgron (1055-1145), and Chad kha ba Ye shes rdo rje (1102-1176). See Jérôme Edou, Machig Labdrön and the Foundations of Chöd (Ithaca, NY: Snow Lion Publications, 1996), 133; a translation of and commentary on ’Chad kha ba’s Blo sbyong don bdun ma’i khrid yig mdor bsdus don bzang bdud rtsi’i snying po and a brief synopsis of his life are provided by Geshe Kelsang Gyatso, Universal Compassion: Transforming Your Life Through Love and Compassion (New York: Tharpa Publications, 2002); Ivette M. Vargas, “Falling to Pieces, Emerging Whole: Suffering, Illness and Healing Renunciation in the Life of Gelongma Palmo,” (Ph.D. diss., Harvard University, 2003); “The Life of dGe slong ma dPal mo: The Experiences of a Leper, Founder of a Fasting Ritual, and Transmitter of Buddhist Teachings on Suffering and Renunciation in Tibetan Religious History,” Journal for the International Association of Buddhist Studies 24.2 (2001): 157-85.

21. My translation of the Tibetan text: sa ga sa ri nam mthongs kyi zla ba la bar du gcod pa’i bgegs rnams byang chub kyi sems la bkod/ nad dang sdig sgrib rnams byang ste/ sa dang po’i bden pa mthong/ sa ga zla ba’i tshes gcig la rje btsun sgrol ma’i zhal gzigs te/ dus gsum sangs rgyas thams cad kyi phrin las nyid la ‘dus so zhes lung bstan/ tshes brgyad la don zhags lha lnga la sogs kri ya’i lha phal che ba’i zhal gzigs/ bco lnga la zhal bcu gcig pa phyag stong spyan stong dang ldan pa’i zhal gzigs shing/ de yang ba spu’i bu ga thams cad na sangs rgyas dpag tu med pa gnas pa/ phyag rnams kyang sang rgyas kyi ngo bo la/ phyag mthil gyi spyan rnams ni gsang sngags kyi lha tshogs su gzigs/ ‘phags pas chos gsungs pas ting nge ‘dzin bsam gyis mi khyab pa rgyud la skyes/ sa brgyad pa’i bden pa mthong ngo// de nas yang sems can thams cad kyi don du smyung gnas zla ba gsum mdzad de/Jo gdan Bsod nams bzang po, Smyung gnas bla ma brgyud pa’i rnam thar, blockprint. (Lhasa: Dpal ldan Par khang, n.d.): 6a.6-7a.2.

22. Matthew Kapstein, The Tibetan Assimilation of Buddhism: Conversion, Contestation, and Memory (Oxford: Oxford University Press, 2000), 41-42. See also Ronald E. Emmerick, Tibetan Texts Concerning Khotan (London: Oxford University Press, 1967), 84-85, lines 57-61. Tibetans themselves in sacred literature also account for the presence of leprosy or illness in general in their vicinity.

23. I thank Dr. Tashi, Dr. Namgyal, and others (I am unable to reveal identities) for this remark.

24. Dr. Tashi and Dr. Tsering from the Mentsikhang.

25. Dr. Tashi noted in September 15, 2006.

26. Tibetan temples like the klu khang (short for Rdzong rgyab klu’i pho drang meaning “the water spirit house behind the fortress”) in Lhasa are a reminder of the relationship between the religious and medical institutions forged by the klu. This structure was built around the time of the Sixth Dalai Lama (Tshangs dbyangs rgya mtsho, 1683-1706?) to appease and honor klu because of their potential to create havoc and calamity. Klu images abound in this temple, mostly half human and half serpent—one has a serpent head and lower body with a human chest and arms. The two lower floors are dedicated to the klu. Some areas depict nāgarājas with a retinue of nāgas; others are holding jewels or other offerings and scepters, mostly emerging or immersed in water, on some pedestal or small temple. The ground floor enshrines a gold-plated image of the nāgarāja, Maldrozichen, whose female partner, klu mo, was said to have visited the Fifth Dalai Lama during his meditations. The floor above houses a large gilded statue of Nāgendrarāja, the form taken by Śakyamuni to tame the Nāgas’ realm. The surrounding walls of the middle floor depict episodes of Pema Obar, where an earlier form of Padmasambhava reclaims the wish-fulfilling jewel from the Nāgarāja. There are three images of Padmasambhava on the east wall of the top floor that depict him subduing the nāgas. See Winkler, “The Rdzogs chen Murals of the Klu Khang in Lhasa.”

27. As in the biography of the elder Gyu thog Yon tan Mgon po, because of immoral actions (not keeping tantric and vinaya vows, women losing their morals, yogis talking nonsense), the protector guardian gods became angry and inflicted diseases like phol-hbras (bubonic plague), swelling of the throat (diphtheria), lumbago, dropsy, ha-la lchog hgyal (falling disease?), and a fatal disease. It was not until a Tibetan physician—with the help of the royal nāgas—interceded that were they able to heal everyone in the nāga realm. See Ven. Rechung Rinpoche and Jampal Kunzang, Tibetan Medicine (Berkeley: University of California Press, 1976): 254.

28. Ian Baker, The Dalai Lama’s Secret Temple: Tantric Wall Paintings from Tibet (London: Thames and Hudson, 2000): 14.

29. Aside from the blatant Buddhist and Bon po affiliations, rituals like glu rol point to the secular qua religious character of klu in Tibetan communities. In festivals performed in present-day Reb skong (Ch. Tongren), Huangnan Tibetan Autonomous State, Qinghai Province, sedentary farmers and other laity perform rituals relating to klu. Rituals like klu rtsed and lha chu kha, and worship of klu mo reflect a preoccupation with protection of the village from disease, and a need for purification and reproduction, fertility, and prosperity, and order in terms of borders. The focus on reproduction, fertility, and prosperity is evident in the rituals associated with assisting barren women. In glu rol festivals, one of the elder male performers possessed by the mountain god puts a wooden image of klu mo into the bosom of these women and carries out the ceremony. In klu rtsed, there are unmarried girls no older than twenty-five that perform an offering dance (gar ma) in slow rhythmic movements said to imitate the movements of the klu.

See Sadako Nagano, “Sacrifice and Lha pa in the Glu rol Festival of Reb-skong,” in New Horizons in Bonpo Studies (Osaka, Japan: National Museum of Ethnology 2000): 567-649. The word, glu rol, can be interpreted in two ways since glu and klu are homonymous. Glu means a song, especially one sung only on a mountain. The mountain gods are said to be fond of mountain songs (ri glu). Klu, on the other hand, stands for dragon. Nagano notes that among these etymologies, glu is much more accurate as a general term for this ritual. Next, rol means (1) playing a traditional musical instrument, and (2) amusement (rsted mo). The word glu rol signifies a festival with singing and the playing of musical instruments. This word connotes also a mountain and height, and the play between gods and men.

Klu rol can also be interpreted as “playing with the klu deity.” Klu is an important deity of sedentary farmers, in association with water. In fact, Gling rgyal villagers belonging to the Rnying ma pa perform only klu rtsed and worship klu mo as well in the glu rol. These interpretations reflect an expansion of the worship objects from the main mountain gods to watery deities, klu, or the more agricultural development of glu rol festivals.

30. Lawrence Epstein and P. Wenbin, “Ritual, Ethnicity, and Generational Identity,” in M. C. Goldstein, Buddhism in Contemporary Tibet (Berkeley: University of California Press, 1998): 120-38. In terms of order, studies by Epstein and Wenbin point out that in a village called Sog ri, the origins of glu rol marks the treaty of Gansu in 822 between Tang China and the Tibetan Empire. Klu were invited and celebrated as part of the ritual.

Finally, burning rituals associated with klu rta (or klu gtad) are used to pacify any evil or disruptive spirits. This ritual is reflected in local practices to the klu at shrines in Western Tibet where lay practitioners who dream of being attacked by an animal exhibit skin eruptions and seek the help of lamas who pray over them.

31. Clifford, Tibetan Buddhist Medicine and Psychiatry, 180.

32. Ming-Cheng M. Lo, Doctors Within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan (Berkeley: University of California, 2002): 197.

33. Ibid.

Bibliography

Adams, Vincanne. “Particularizing Modernity: Tibetan Medical Theorizing of Women’s Health in Lhasa, Tibet. In L. Connor and G. Samuel, eds. Healing Powers and Modernity: Traditional Medicine, Shamanism, and Science in Asian Societies. Westport, CT: Bergen and Garvey, 2001.

———. “The Sacred in the Scientific: Ambiguous Practices of Science in Tibetan Medicine.” Cultural Anthropology 16 (2001): 542-75.

Arnold, David. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California, 1993.

Bai Dur sNgon po (The Lapis Lazuli Commentary on the Rgyud bzhi) of Sangs-rgyas rGya mtsho. Vol. 3. Leh: T.Y. Tashigangpa, 1973.

Baker, Ian. The Dalai Lama’s Secret Temple. London: Thomas and Hudson, 2000.

Bdud rtsi snying po yang lag brgyud pa gsang ba man ngag gi rgyud. Bod ljongs mi dmangs pe skrun khang, 2002.

Chen, Nancy N. Breathing Spaces: Qigong, Psychiatry, and Healing in China. New York: Columbia University Press, 2003.

Clifford, Terry. Tibetan Medicine and Psychiatry: The Diamond Healing. Maine: Samuel Weiser, 1984.

Cohen, Richard. “Nāga, Yakṣiṇī, Buddha: Local Deities and Local Buddhism at Ajanta.” History of Religions 37, no. 4 (May, 1998): 360-400.

De Nebesky-Wojkowitz, Réne. Oracles and Demons of Tibet: The Cult and Iconography of the Tibetan Protective Deities. Delhi: Book Faith India, 1996.

Donden, Yeshi. Health Through Balance: An Introduction to Tibetan Medicine. Ithaca, NY: Snow Lion Publications, 1986.

Dpal-ldan-bkra-shis and Kevin Stuart. “Perilous Novelties: The A-mdo Tibetan klu-rol Festival in Gling-rgyal Village.” Anthropos 93 (1998): 31-53.

Edou, Jérôme. Machig Labrön and the Foundations of Chöd. Ithaca, NY: Snow Lion Publications, 1996.

Emmerick, Ronald E. “A Chapter from the Rgyud-bźi.” Asia Major 19 (1975): 141-62.

———. “Epilepsy According to the Rgyud-bźi.” In G. Jan Meulenbeld and Dominik Wujastyk, eds. Studies on Indian Medical History. Groningen: Egbert Forsten, 1987: 63-90.

———. Tibetan Texts Concerning Khotan. London: Oxford University Press, 1967.

Epstein, Lawrence, and P. Wenbin. “Ritual, Ethnicity, and Generational Identity.” In M. C. Goldstein. Buddhism in Contemporary Tibet. Berkeley: University of California Press, 1998: 120-38.

Farkas, Janos, and Tibor Szabo. The Pictorial World of the Tibeto-Mongolian Demons. Budapest: Mandala and LibroTrade, 2002.

Freund, P. E. S., M. B. McGuire, and L. S. Podhurst. Health, Illness, and the Social Body: A Critical Sociology. Upper Saddle River, NJ: Prentiss Hall, 2003.

Gso rig rgyud bzhi’i dka’‘grel. Bod ljongs mi dmangs dpe skrun khang, 1996.

Gyatso, Janet. “The Authority of Empiricism and the Empiricism of Authority: Medicine and Buddhism in Tibet on the Eve of Modernity.” Comparative Studies of South Asia, Africa and the Middle East 24.2 (2004): 83-96.

Gyatso, Geshe Kelsang. Universal Compassion: Transforming Your Life Through Love and Compassion. New York: Tharpa Publications, 2002.

Gyu thog cha lag bco brgya. Vol 1 and 2. Dolanji: Tibetan Bonpo Monastic Center, 1976.

Janes, Craig. “Buddhism, Science, and Market: The Globalization of Tibetan Medicine.” Anthropology and Medicine 9, no. 3 (2002) 267-89.

———. “Imagined Lives, Suffering, and the Work of Culture: the Embodied Discourses of Conflict in Modern Tibet.” Medical Anthropology Quarterly 13 (1999): 391-412.

Jo gdan Bsod nams bzang po, Smyung gnas bla ma brgyud pa’i rnam thar, blockprint. Lhasa: Dpal ldan Par khang, n.d.: 6a.6-7a.2.

Kapferer, Bruce. “Mind, Self and Other in Demonic Illness: The Negation and Reconstruction of Self.” American Ethnologist 6 (1979): 110-33.

Kapstein, Matthew. The Tibetan Assimilation of Buddhism: Conversion, Contestation, and Memory. Oxford: Oxford University Press, 2000.

Kelsang, Jhampa. Ambrosia Heart Tantra. Dharamsala: Library of Tibetan Works and Archives, 1977.

Kleinman, Arthur. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. Berkeley: University of California., 1980.

Leslie, Charles, and Allan Young. Paths to Asian Medical Knowledge. Berkeley: University of California., 1992.

Lo, Ming-Cheng M. Doctors Within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan. Berkeley: University of California, 2002.

Martin, Dan. Unearthing Bon Treasures. London: Brill, 2001.

Mimaki, Katsumi. “A Preliminary Comparison of Bonpo and Buddhist Cosmology.” In New Horizons in Bonpo Studies. Osaka, Japan: National Museum of Ethnology, 2000: 89-115.

——— and Samten Karmay. “Bon sgo gsal byed, Two Tibetan Manuscripts in Facsimile Edition of a Fourteenth Century Encyclopedia of Bonpo Doxography.” In Bibliotheca Codicum Asiaticorum 13. Tokyo: The Centre for East Asian Cultural Studies for Unesco, The Toyo Bunko, 1997.

Nagano, Sadako. “Sacrifice and Lha pa in the Glu rol Festival of Reb-skong.” In New Horizons in Bonpo Studies. Osaka, Japan: National Museum of Ethnology, 2000: 567-649.

Nagarajan, V. “Rituals of embedded ecologies: Drawing Kolams, Marrying Trees, and Generating Auspiciousness.” In C. K. Chapple and M. E. Tucker, eds. Hinduism and Ecology: The Intersection of Earth, Sky, and Water. Reprint, New Delhi: Oxford University Press, 2001: 453-68.

Norbu, Namkhai. Drung, Deu and Bon: Narrations, Symbolic Languages and the Bon Tradition in Ancient Tibet. Dharamsala, India: Library of Tibetan Works and Archives, 1995.

Oelschlaeger, Max. Caring for Creation: An Ecumenical Approach to the Environmental Crisis. New Haven, CT: Yale University Press, 1994.

Ortner, Sherry. “The White-Black Ones: The Sherpa View of Human Nature.” In J. F. Fisher, ed. Himayalan Anthropology: The Indo-Tibetan Interface. The Hague: Mouton, 1978: 263-86.

Pati, Biswamoy, and Mark Harrison. Health, Medicine and Empire: Perspectives on Colonial India. New Delhi: Orient Longman, 2001.

Pordié, Laurent. The Expression of Religion in Tibetan Medicine: Ideal Conceptions, Contemporary Practices and Political Use. Pondy Papers in Social Sciences 29. Pondicherry, India: French Institute of Pondicherry, 2003.

Rgyud bzhi’i rnam bshad. Mtsho sngon mi rigs dpe skrun khang, 1999.

Rechung Rinpoche, Ven., and Jampal Kunzang. Tibetan Medicine. Berkeley: University of California Press, 1976.

Samuel, Geoffrey. Civilized Shamans: Buddhism in Tibetan Societies. Washington: Smithsonian Institution Press, 1993.

———. “Religion, Health and Suffering Among Contemporary Tibetans.” In J. R. Hinnells and R. Porter, eds. Religion, Health and Suffering. London: Kegan Paul International, 1999: 85-110.

Strickmann, Michel. Chinese Magical Medicine. Stanford: Stanford University Press, 2002.

Vāgbhaṭa. Aṣṭāngahṛdayasaṃhitā. Wiesbaden: Franz Steiner GMBH, 1965.

Vargas, Ivette M. “Falling to Pieces, Emerging Whole: Suffering, Illness and Healing Renunciation in the Life of Gelongma Palmo.” Ph.D. diss., Harvard University, 2003.

———. “The Life of dGe slong ma dPal mo: The Experiences of a Leper, Founder of a Fasting Ritual, and Transmitter of Buddhist Teachings on Suffering and Renunciation in Tibetan Religious History.” Journal for the International Association of Buddhist Studies 24.2 (2001): 157-85.

Winkler, Jakob. “The Rdzogs chen Murals of the Klu Khang in Lhasa.” In Henk Blezer, ed. Religion and Secular Culture in Tibet, Tibetan Studies 2. Leiden: Brill, 2002: 321-44.

Wujastyk, Dominik. The Roots of Ayurveda: Selections from Sanskrit Medical Texts. London: Penguin, 2003.