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Balancing Health - Tibetan Medicine

by Lisa Llewellyn(more info)

listed in ayurveda, originally published in issue 67 - August 2001

In October 2000, I participated in a ten-day Tibetan medicine course at the Tibetan Medical and Astrological Institute, Dharamsala, India. The decision to uproot myself and investigate a different interpretation of health to the West came about soon after completing an MSc in Health Psychology.

The Western understanding of health and illness is primarily based on implementing theoretical knowledge and empirical research. I feel that, although we have adopted a more Eastern approach, greater emphasis needs to be placed on personal responsibility and discipline of self-care, which are ultimately required to achieve a positive and balanced state of health.

Tibetan medicine is an ancient medical system that has its foundations embedded in the teachings of Buddhistic philosophy. The Tibetans believe that the human mind embodies and combines the qualities of five universal elements to form the many different aspects of the physical body: Earth is the basis of all experience and makes up the solids of the body such as bone; Water represents the adaptability of the mind to different situations and the body's fluids and cohesion; Fire represents the mind's unlimited ability to perceive and provides biological warmth to the body; Wind represents the characteristic state of flux of the contents of the mind and is also connected to the respiratory process; and Space signifies the unlimited characteristics of the mind, the orifices of the body and the spatial separation of organs.[1] Tibetan doctors follow a traditional theory of physiology that aims to heal human suffering by balancing the relationship between the universal elements and the three bodily energy systems.

Table 1: Characteristics of three energy systems
(adapted from[3]

rLung: Disorder – Wind Tripa: Disorder –
Badkan: – Disorder Phlegm
Element: Air (cold) Element: Fire (hot) Element: Earth and Water (cold)
Potency (nupa): Cold, light, rough, subtle, hard and mobile Potency (nupa): Hot, oily, sharp,light, dry and coarse Potency (nupa): Cool, oily, firm, blunt, smooth and sticky
Location: Head, breastbone, heart, lower stomach and genitals Location: Middle stomach, liver, heart, eyes and skin Location: Breastbone, upper stomach, tongue, brain, joints

Function: Physical and mental activity, cardiac and gastro-intestinal movement, respiration, motor and sensory nerve function, expulsion of urine, faeces, menstruation and foetus. Assists in the swallowing of food, sneezing, burping and inhalation. Gives clarity to sense organs and acts as a medium between mind and body.

Function: Promotes bodily heat, responsible for hunger, thirst, indigestion, skin tone and complexion. Provides bodily strength, eyesight, self-confidence and determination and regulates colour and function of: nutritional essence, blood, flesh, fat, bone, marrow and regenerative fluid. Function: Mixes and decomposes ingested food and provides physical and mental strength. Lubricates the body, connects the joints and enables flexion and extension. Induces sleep and provides the capacity for the elemental six tastes: sweet, sour, salty, bitter, hot and astringent

Energy Systems

Three bodily energy systems (Nypeas) – rLung, Tripa and Badkan (Table 1) – represent physical and mental attributes that characterize health status. Existing in a kinetic state, they constantly adjust and combine with the mind and body. Human suffering is based on levels of psychological and physical experiences that can be understood and controlled by assessing mental attitude and actions. The arising of delusional mental states is considered to result from our ignorance of the true nature of phenomena and how things in our external world actually exist. This is blamed on our attachment to impermanent situations, such as, material conditions or other people, which manifests as three negative states of mind: desire, anger and obscurity. These negative states ripen into physical disease according to their nature: desire disturbs and captivates the mind, inducing wind disorders; hatred induces bile disorders by generating bodily heat, and obscurity induces phlegm disorders due to a bewildered and heavy mental state.[2] Ignorance is the principal cause of all suffering, but considered a distant cause of disease as it lies at the root of our cyclic existence. Although sickness may not be apparent, it lies dormant until our energies are disrupted.

In the Western world, research examining the effects of both psychological stress on the immune system, and behavioural patterns related to coronary heart disease, suggests that we are integrating an Eastern psycho-physiological perspective. In addition, treatment methods in the West employ psychological strategies that influence physiological states. These include biofeedback, meditation and autogenic training. Psychology is therefore widely acknowledged as being intrinsically linked to the diagnostic-therapeutic practice of medicine with regard to the interdependence of mind and body and their role in the development and treatment of illness.

The first of the energy systems, rLung (Table 1), is related to the neurological system and is chiefly responsible for mental and physical activity. The light and mobile characteristics of Wind enable it to pervade the whole body and disturb the subtle energies of Tripa and Badkan by generating bile/hot disorders and phlegm/cold disorders respectively. This makes rLung (wind) the cause of all disease. Illness results from abnormal changes in energy balance due to actions (karma) of a past life and/or the result of causative factors in this lifetime. The irregularities of the energies are stabilized, and health restored, through holistically considering one's diet, personal disposition, age, behaviour regimes and the seasons. The immediate cause of imbalance is improper diet and this is therefore given precedence over detrimental behavioural patterns.

Diet: Accumulation and Manifestation of Disorders

The universal elements are present within our food in the form of six tastes: sweet, sour, salty, bitter, hot and astringent (Table 2). These have the ability both to harm and to heal the body depending on individual physical constitution and dietary intake. The unwholesome, excessive or inadequate consumption of food or drink of a particular taste and potency can conflict with the characteristic properties of either one or a combination of the three bodily energies. Individual constitution is determined by a pulse reading that is taken when a patient is healthy. When a patient does fall ill, the physician can then detect the site and exact energy imbalance in the body.

Table 2: Elemental tastes and potencies

Dominant Earth Fire Water Water Fire Earth
Element Water Earth Fire Air Air Air
Taste Sweet Sour Salty Bitter Hot Astringent
Heavy Hot Heavy Cool Hot Heavy
Cool Oily Oily Blunt Sharp Cool
Blunt Light Sharp Light Light Blunt
Oily Sharp Hot Coarse Coarse  

Accumulation of a particular energy is a natural process of digestion that occurs when dietary intake corresponds to the elemental and characteristic properties of that energy. Disorders occur when food intake exceeds the amount of nutrition that the body and energy site can hold. rLung (wind), for example, may manifest into a disorder if an excess of food and drink that share the same potencies as the air element is consumed (Table 1). This also applies to taste: an excess of something bitter, such as beer, can result in wind disorders due to the dominant elements of bitter being water and air (Table 2). Restoration of the three energies to their right proportions can be achieved by adjusting the diet to balance the necessary elements and potencies. To treat the cold disorders of rLung (wind), opposing elemental properties need to be given. For example, food or drink that is hot and heavy in potency and sweet and sour in taste (Table 3). Balancing the natural form of the three energies will prevent disease and maintain a healthy physical and psychological state.

Tibetan medicine, as a dietary therapy, suggests that a good diet consists of the right combination of grains (podded beans and non-podded rice), meat, vegetables (assorted and cooked) and oils (butter, grain oils, marrow and fats).[4] These foods contain all the balancing tastes and potencies needed to stabilize the energies. Rice is a particularly important food as it contains a blend of cool, oily, and light properties.[5] It can therefore eliminate the faults of the three energy disorders, but still needs to be eaten in combination with other foods.

If diet and behaviour modification alone proves ineffective to alleviate an ailment, herbal medication and other accessory therapies may be applied. These include: warm sesame oil massage to treat rLung/cold disorders; a cool bath and blood-letting for Tripa/hot disorder; and moxibustion (burning herbs on different points of the body) to treat the phlegm/cold disorders of Badkan.

Tibetan medical practice has proved to be beneficial for chronic problems such as indigestion, arthritis, blood pressure, depression, insomnia and disorders of the nervous system.

The philosophical lifestyle of Tibetan culture suggests that at times of ill health they are receptive to suffering and the delicacy of the body's balance. The Tibetan understanding of illness and its remedial factors concentrates primarily on the causes and not just the symptoms of ill health. Although diet is seen to be the main causative and immediate factor of illness, optimal health can only be obtained through psychological transformation. This requires the unravelling of complex mental attitudes and lifestyle patterns.

The majority of health problems in the West, such as heart disease, lung cancer, immune deficiency and respiratory disease, are directly or indirectly related to diet and behaviour.

Our energy seems to be exhausted by the repulsion of illness, mainly because a healthy life is so natural to the majority of us that we only pay attention to it when we fall ill. As a result, when we do become ill, our being is threatened with uncertainty, day-to-day life is disrupted, and to add to the distress, medical-based knowledge can sometimes appear to be incompatible with our health needs and daily life management. We do embrace alternative and holistic health care, along with the growing awareness that health is more than the absence of disease, and anticipate that this alone will alleviate our ill health and need for further concern. However, it is imperative that we do not treat the holistic consultation as a special treat, but as an invitation to a new way of self-management. It doesn't really matter who attends to our ailments if we ourselves fail to examine how to maintain and improve our own health. It is from this approach that a better understanding of the cause and effect of our actions will be attained, along with the opinion that each one of us, including our illness, is unique. Thus, the patient is responsible for the causes of disease and restoring/maintaining health, and the doctor is responsible for giving advice and curing illness.

Tibetan medicine is an ancient and complex medical system that has only been marginally outlined here. Its depth and intricacies can only be fully understood by exploring the elemental basis to all life, astronomy, Tibetan language, religion and Buddhist practice.

While it is unreasonable to expect ill health to be rectified through incorporating the teachings of Buddha into our hectic Western lifestyles, an important message can be extracted from their approach to health care. We need a more honest and motivated self-analysis of mental attitude, diet and behavioural patterns. This in turn, would offer a different means to understanding and managing health and illness whilst improving our quality of life. Ultimately, despite our preference in health consultations, we the patients are at the forefront of the healing process, holding the controls to balance our health.


1. Rinpoche Kalu. The Five Elements and the Nature of Mind and Physical Body. bardotea/bardotea.html. 1982.
2. Donden Yeshi. Health Through Balance: An Introduction to Tibetan Medicine. Motilal Banarsidass. Delhi. India. p38. ISBN 81-208-1519X. 1986.
3. Tibetan medicine and astrological Institute. Tibetan medicine: The three principle energies. 2001.
4. Hollifield Steven C. Tibetan Dietary Therapy. Calmspirit Magazine. 2000.
5. Donden Yeshi. Health Through Balance: An Introduction to Tibetan Medicine. Motilal Banarsidass. Delhi. India. p155. ISBN 81-208-1519X. 1986.

Further Information

For details of the Tibetan Medical and Astrological Institute, India and informantion on Buddhist philosophy, healing practices and courses contact: The Tibetan Medical and Astrological Institute, Men-Tsee Khang, Gangchen Kyishong, Dharamsala, Dist. Kangra (HP) 176215, India; tel: (91) 1892-23113/22618/23222; fax: (91) 1892-24116;;


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