Tibetan Medicine and Biomedicine: Epistemological Conflicts, Practical Solutions

May combine two claims.

In that refugee practice, pulse analysis was carried out on all patients but often seemed perfunctory, and urine analysis was hardly used.

“While pulse analysis was carried out on all patients, it often seemed perfunctory.Urine analysis was hardly used at all.”

May combine two claims.

In the refugee Tibetan medical practice studied, the stethoscope and sphygmomanometer were prominent, the office resembled a western general practitioner's, focus was on the specific complaint, and holistic aspects such as diet received little concern.

“My co-researcher, Linda Connor, and I were initially quite surprised at the prominence of the stethoscope and the sphygmomanometer in the refugee Tibetan medical practice that we were studying.The ambience of the doctor's office was much like that of a western general practitioner, with a strong focus on the specific complaint, and little concern with 'holistic' aspects such as diet.”

May combine two claims.

In Yeshi Donden's Dharamsala clinic, which served largely westerners, the consulting room had a quasi-monastic ambience, the doctor wore full traditional monastic dress, and pulse and urine examination were meticulously observed.

“Thus in Yeshi Donden's Dharamsala clinic, which catered largely to westerners, the atmosphere of the consulting room was quasi-monastic in its ambience, with the doctor wearing full traditional monastic dress, and the arguably more 'exotic' aspects of Tibetan medical practice, such as pulse and urine examination, were meticulously observed.”

May combine two claims.

Tibetan practitioners working with Tibetan refugee patients in India operated differently, and similarities to biomedical practice were not a problem for these patients.

“Tibetan practitioners who were working with Tibetan refugee patients in India operated differently.For these patients, similarities to biomedical practice were not a problem, if anything the reverse.”

May combine two claims.

One Tibetan traditional doctor in India dealt with possible spirit-illness cases by neither rejecting nor explicitly confirming patients' understandings; he treated them with compounds appropriate for gza' attack but also effective against alternative diagnoses, and he saw spirit-attack as less common than his patients did and was not interested in pursuing it.

“He neither rejected these patients' understandings of their illness outright nor explicitly confirmed it.Instead, he treated them with medicinal compounds that were held to be appropriate in cases of g;::,a'-attack, but were also effective against alternative diagnoses which did not involve spirit-attack as such.As far as I could tell, he did not altogether reject the possibility of spirit-attack,”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

In many practical medical settings, epistemological disagreements between medical systems receive little attention, and patients and practitioners may switch between frameworks without much concern for underlying theoretical assumptions.

“In many practical medical contexts, epistemological issues receive little attention.Both patients and practitioners may switch frameworks relatively freely, without much concern about underlying theoretical assumptions.”

Probably not a substantial claim: may not pass S4 (based).

These Asian medical traditions can be interpreted in physiological terms as vocabularies of bodily processes that underlie health and disease.

“They can be read in physiological terms, as referring to a vocabulary of bodily processes that underlie health and disease.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The spirit-world is not amenable to physiological reduction and is in many ways the antithesis of physiological explanation.

“The spiritworld is not at all amenable to physiological reduction.In fact, it is in many ways the antithesis of physiological explanation, the dark other to the bright world of clinical illumination presented by modern biomedicine.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Without reconciliation of epistemological conflicts between biomedicine and Asian medical traditions, mind, consciousness, and emotion will remain a marginal add-on to a fundamentally biomedical paradigm, and the place of Asian traditions within western healthcare systems will always be vulnerable and insecure.

“Without such a reconcilia-tion, mind, consciousness and emotion will remain a marginal addon to a fundamentally biomedical paradigm, and the place of the Asian traditions within western healthcare systems will always be vulnerable and insecure.”

May combine two claims.

Subtle body concepts (cakras, nadi, prana in Indian traditions; meridians and qi in Chinese) reflect these sensitivities and are problematic for biomedical science, tending to be marginalized or explained away in modernist Asian and western discussions.

“The 'subtle body' concepts (cakras, nat/,'i and prarta in Indian traditions, meridians and qi in the Chinese) reflect these kinds of sensitivities.They represent aspects of these traditions that are problematic for biomedical science, and which again tend to be marginalised or explained away in biomedical terms in modernist Asian and western discussions.”

Probably not a substantial claim: may not pass S4 (based).

Trials carried out in more Tibetan terms, using complex compounds and variable treatment regimens, carry little credibility with the biomedical establishment.

“Those carried out in more 'Tibetan' terms (using complex compounds and variable treatment regimens, for example) carry little credibility with the biomedical establishment.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Acupuncture, with its internal anatomy of channels along which subtle energy is held to flow, can be relatively easily construed in physiological terms.

“Even acupuncture, with its internal anatomy of channels along which subtle energy is held to flow, can be relatively easily construed in physiological terms.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The ease with which these traditions can be assimilated to a materialist epistemology has greatly aided their acceptance in western societies.

“I suggest that the ease with which these traditions can be assimilated to a materialist epistemology has greatly aided their acceptance in western societies.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Non-western healing practices in which spirit attack, soul loss, or shamanic procedures are more central are less easily assimilated to biomedical models and may be dismissed as incompatible with modern scientific understandings.

“Other non-western healing practices, such as those in which spirit attack, 'soul loss' or 'shamanic' procedures are more central, are less easily assimilated to biomedical models, and may simply be dismissed as incompatible with modern scientific understandings.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Varela and Depraz discuss the relationship between neurophysiology and imagination based on recent work on brain functioning, pointing to upward causation by which mental imagery can be seen as large-scale synchronisation of neural processes.

“In this article, Varela and his colleague Natalie Depraz discuss the relationship between neurophysiology and imagination, on the basis of recent work on the functioning of the brain.They point to the process of 'upward causation', by which mental imagery can be seen as a system of large-scale synchronisation of neural processes, a 'transient coherency-generating process of the organism'.21”

• cites Varela and Depraz 2003Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Practitioners and patients are engaged in a pragmatic search for healing much more than in a quest for theoretical consistency.

“Practitioners and patients are engaged in a pragmatic search for healing much more than in a quest for theo-retical consistency.”

Classified as probably not a substantial claim. May combine two claims.

There are two basic choices in such situations: assert the dominance of conventional biomedical science, treating other factors as supplementary and external, or open to a wider frame of reference in which consciousness, the spirit world, and therapeutic interactions with that world can find a meaningful and scientific representation.

“We have two basic choices, though there are certainly plenty of attempts to seek a middle way between them.19 One is to assert the dominance of conventional biomedical science.According to this path, the basic paradigm is that of physiological processes within the physical body, and any other factors, if admissible at all, have to be treated as supplementary and external.The other choice is to”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The rhetoric of science is influential in contemporary western society, and most alternative treatment modalities make at least token gestures toward it, which may reflect looking scientific rather than being consistent with biomedical theory.

“The rhetoric of science is undoubtedly influential in contemporary western society, and most alternative treatment modalities make at least token gestures in its direction, but this may be more a question of looking scientific than being consistent with biomedical theory.”

Classified as probably not a substantial claim.

The expanded framework explored by Varela and Depraz provides space within which spirit-causation of illness, shamanic recovery of lost souls, and similar processes can be understood.

“Certainly, the kind of expanded framework which Varela and Depraz were exploring in their paper provides plenty of space within which processes of spirit-causation of illness, shamanic recovery of lost souls, and the like can be understood.”

Classified as probably not a substantial claim.

Both biomedicine and the mostly humorally-based traditions are perceived as learned, scholarly traditions with a theoretical basis.

“What is more significant than the historical connection, though, is that both biomedicine and these mostly humorally-based traditions are perceived as learned, scholarly traditions with a theoretical basis.”

May combine two claims.

By the seventeenth century, the activating soul or spirit was disappearing from western medical understanding, and the body was increasingly seen in purely mechanical terms.

“By the seventeenth century, the activating soul or spirit was disappearing from western medical understanding, and the body was increasingly seen in purely mechanical terms, but Kuriyarna's account reminds us that the physiology of western biomedicine cannot be detached from its specific history and the epistemological assumptions built into that history.”

• cites Kuriyama 2004Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Acupuncture and traditional Chinese medicine have been particularly successful and incorporated relatively easily into western models of medical training and certification.

“Acupuncture and traditional Chinese medicine have been particularly successful, and have been incorporated relatively easily into western models of medical training and certification.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Greek medicine increasingly saw the body as a hierarchical structure focused around the will, seeing muscles where the Chinese saw storehouses.

“Greek medicine increasingly saw the body as a hierarchical structure focussed around the will: they saw muscles where the Chinese saw storehouses.”

• cites Kuriyama 2004Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

One major real-world implication is that the extent to which non-biomedical treatment modalities are allowed or legitimated by contemporary western governments is at stake, with the biomedical establishment serving as gatekeeper and biomedically trained scientists weighing heavily in decisions.

“One major real-world implication regards the extent to which the practice of non-biomedical treatment modalities is allowed or legitimated by contemporary western governments.In such situations, the biomedical establishment inevitably serves as the gatekeeper, and the opinions of biomedically-trained scientists weigh heavily in the critical decisions as to what is allowed and in which contexts.”

May combine two claims.

Biomedical testing generally presupposes a substantial sample of patients with the same condition treated uniformly on a double-blind basis, whereas a competent Tibetan doctor will ideally prescribe an individual treatment regimen for each patient.

“Biomedical testing generally presupposes a substantial sample of patients with the same condition who can be treated uniformly on a double-blind basis, but a competent Tibetan doctor will ideally prescribe an individual treatment regimen for each patient.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Chinese conceptions of the body's interior emphasized storage and containment of qi as a key strategy for longevity and good health.

“Chinese conceptions of the interior of the body emphasised the storage and containment of qi, as a key strategy for longevity and good health.”

• cites Kuriyama 2004Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Western biomedical practitioners can be found who also employ homeopathy, acupuncture, or traditional Chinese medicine.

“Yet it is not difficult these days to find western biomedical practitioners who also employ homeopathy, acupuncture or traditional Chinese medicine.”

May combine two claims.

Trials closest to biomedical standards isolate and test single ingredients; this may identify useful substances for the western pharmacopoeia but does not evaluate the procedures of Tibetan medicine itself.

“Those that are closest to biomedical standards involve isolating and testing single ingredients, but while this may lead to the identification of useful substances for the western pharmacopoeia, it does nothing to evaluate the procedures of Tibetan medicine itself.”

Classified as probably not a substantial claim. May combine two claims.

Biomedicine assures that all, perhaps even consciousness, can be explained in terms of bodily processes, while spirit-doctors and shamanic healers take the opposite approach, treating consciousness as primary and open to interaction with other beings.

“While biomedicine assures us that all, even perhaps consciousness itself, can be explained in terms of bodily processes, the spirit-doctors and shamanic healers take an entirely opposite tack, both in terms of explanation and in terms of treatment.Within their framework, consciousness (in its widest sense, including emotions and bodily sensations as well as rational thought) is primary, and is”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Other areas of Tibetan healing premised on spirit-causation of illness involve assumptions fundamentally irreconcilable with the biomedical worldview.

“Other areas of Tibetan healing, such as those premised on the spiritcausation of illness, seem to involve assumptions that are fundamentally irreconcilable with the biomedical worldview.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Varela and Depraz insist that upward causation must be balanced by downward causation, in which the emergent self has direct efficacious action over local neural components.

“However, they insist that this process of 'upward causation' has to be balanced by a corresponding process of 'downwards causation': Many will accept that the self is an emergent property arising from a neural/bodily base.However [ ... ] the reverse statement is typically missed.If the neural components and circuits act as local agents that can emergently give rise to a self, then it follows that”

• cites Varela and Depraz 2003Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Returning to the learned traditional medical systems of Asia, there are possibilities of a fully scientific mode of understanding these systems that does not need to marginalize the subtle physiology of qi or prana or treat the spirit-world as an embarrassing survival of folk belief.

“If we return to the learned traditional medical systems of Asia, too, we can now see possibilities of a fully 'scientific' mode of understanding these systems that does not need to marginalise the subtle physiology of qi or praTJ,a, or to treat the spirit-world as an embarrassing survival of folk belie(”

Probably not a substantial claim: may not pass S3 (load-bearing).

Greek and Chinese medical traditions developed fundamentally different understandings of the body and its organs, grounded in radically different senses of the embodied self.

“Greek and Chinese medical traditions developed fundamentally different understandings of the nature of the body and its organs, which were grounded in radically different senses of the embodied self.”

• cites Kuriyama 2004Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

There are contrasts between the major scholarly humoral traditions (Islamic-Galenic, ayurvedic, Tibetan, Chinese) and biomedicine, but these systems are more assimilable by biomedicine than might appear.

“There are undeniably contrasts between the major scholarly traditions of humoral medicine, the Islamic-Galenic, ayurvedic, Tibetan and Chinese, and biomedicine, but there are also ways in which these systems are more assimilable by biomedicine than might appear on the surface.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

These traditions can easily be read in terms of a materialist physiology; they presuppose a discrete physical body with internal anatomy and substances or processes within that body that cause illness or health.

“These traditions can easily be read in terms of a materialist physiology.They presuppose a discrete physical body with an internal anatomy, and substances or processes within that body that cause illness or health.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Non-materialist elements in these traditions can be treated as marginal, as folk belief or superstition, which spoils the clean profiles of an essentially materialist system.

“Such matters can however be relatively easily treated as marginal, as regrettable elements of folk belief or superstition, which spoil the clean profiles of an essentially materialist system.”

May combine two claims.

In practice, it is not easy to reduce ayurvedic medicine to the balance of the three dosa or Tibetan traditional medicine to countering the three nyes pa; these traditions are more heterogeneous than their systematic presentation implies.

“In practice, it is not necessarily so easy to reduce ayurvedic medicine to the balance of the three dofa, or Tibetan traditional medicine to countering the activity of the corresponding three nyes pa.As, undoubtedly, is the case with biomedicine itself, these medical traditions have a considerably more heterogenous nature than their systematic presentation may imply.”

May combine two claims.

The holistic conceptual structure of these Asian traditions may be misleading if taken too literally, but it has a profound influence on how practitioners understand their patients' problems.

“The holistic conceptual structure of these traditions may be misleading if taken too literally, but it nevertheless does have a profound influence on the way in which practitioners understand their patients' problems.”