Medicine and Memory in Tibet

Theresia Hofer’s Medicine and Memory in Tibet is a captivating ethnographic and historical exploration of medical practitioners, amchi, in the region of Tsang. It examines their personal and professional trajectories within the political landscape of Tibet from the 1950s to the 21st century. Through rich narratives, detailed descriptions, and critical analysis, Hofer brings to light the struggles and hardships of medical practitioners on the socio-political margins of Tibet. She shows eloquently how medicine and health in the context of Tibet have been—and still are—embedded in politics, ideology, and power relations. By giving voice to amchi’s memories and perspectives, the reader is offered an insight into their personal and professional losses and gains, but also their adaptions and navigations during the massive political transitions that have taken place throughout the years. With analytical attention to social, economic, and political realities during the socialist transformation and the following reforms, Hofer describes how amchi in Tsang—in the west-central part of Central Tibet and far from the medical center of Lhasa—have managed to navigate the sea of political waves that have swept over Tibet for years, characterized by forceful oppression and the rise of socialist development. At the heart of this book lies Hofer’s novel insights about the significant roles that male and female amchi of rural areas of Tsang have played in the continuation and revitalization of Tibetan medicine in Tibet and beyond. 

This book is divided into six chapters following an introduction and ending with a conclusion. The introduction provides an overview of the basic elements of Tibetan medicine, Sowa Rigpa, its transformation in the 20th century, and the dynamics between the centers and margins of Tibetan medical institutions and medical practices. It introduces the reader to the analytical dialogue that runs throughout the book between anthropological approaches and historical perspectives.

Chapter 1 focuses on “Medical Houses” as a conceptual framework for describing and analyzing the continuity and transmission of medical knowledge and practices. The historical narratives presented and the analysis of named medical houses in rural Tsang bring to light how the social and medical authority of these houses have endured on the basis of flexibility in the modes of transmission of medical knowledge from older to younger generations. This flexibility, as well as the houses’ social, economic, ritual, and moral authority, served to secure their endurance and their position as a nexus for medical knowledge and healing practices in Tsang rural villages.

Chapter 2 traces the historical intersections between religion and medicine as they came to be embedded in narratives of the nation and in public health campaigns of the Tibetan state until 1959. Through the voices of male and female medical practitioners, Hofer describes how Buddhist medical knowledge and teachings were imparted to students, emphasizing in particular how, through ordination, women in rural Tsang were able to access medical knowledge and be trained to become amchi.Considering the dearth of research on female amchi in Tibet, these narratives and the analysis presented contribute to a more nuanced and gendered understanding of the interrelations between gender, economy, and religion within the medical landscape at the time. 

Chapter 3, focusing on the issue of narration and narrative forms, revolves around how memories and narrations of the past have come to be moulded by a powerful state orchestration of the past, or what Hofer refers to as “state time.” Amchi narrative constructions of historical processes and successive state reforms show how memory came to be used as an imposed political tool through enforced public narratives of the past. Relative to the audience and the presence of the state, amchi balanced their narrations of memories between the strategically necessary and the deeply felt, highlighting “oppositional practices of time” (Eric Mueggler, The Age of Wild Ghosts, University of California Press, 2001, 7).

Chapters 4 and 5 together paint a detailed historical description of Tibetan medicine and the work of medical practitioners from 1966 and the beginning of the Cultural Revolution up to the present decade. The chapters focus on moments in time that have affected Tibetan medical practices and techniques, their institutions and practitioners, as well as their material objects and medical texts. Moreover, with sensitivity to detail, these chapters take us through moments of alignment—willing or forced—between Tibetan medicine and state-initiated public health campaigns as they manifested in both the center and at the margins of Tibetan society. The revitalization of Tibetan medicine in the 1970s, along with government policies on the integration of Tibetan and Western medicine, privatization of health care, and commodification of medicines is compellingly analyzed. As in the previous chapters the unique medical work and life-stories of rural amchi form the ethnographic nexus of the analysis. 

Chapter 6 elaborates on the moral economy of the Sowa Rigpa and the extent to which amchi in Tsang engage in this economy. It is argued that the insufficiency of government health care on the margins necessitates a medical practice that is morally informed. The chapter describes how rural amchi, in the midst of increasing commodification and the capitalist logic of medicine and health care, engage in a Sowa Rigpa moral economy where religious and medical values on spiritual, mental, and bodily health and wellbeing form its core. 

This study is a unique and well-crafted ethnography written in beautiful prose that will be of great interest to scholars and students of Tibetan medicine and minorities in China, social anthropologists, and historians alike.

Benedikte V. Lindskog is Associate Professor in Medical Anthropology at the University of Oslo.

Benedikte V. Lindskog

Date Of Review:

July 5, 2018