Treating Essence With Essence

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Asian Medicine 7 (2012) 196224

brill.com/asme

Treating Essence with Essence: Re-inventing bcud len


as Vitalising Dietary Supplements in Contemporary
Tibetan Medicine
Barbara Gerke

Abstract
Bcud len (pronounced chulen) or essence extraction practices have been described in classical
Tibetan medical and religious texts as an element of rejuvenation therapies and preventive antiageing methods. These practices include the ingestion of bcud len pills taken as a dietary supplement or as a substitute for food during meditation and fasting retreats. This paper1 discusses how
ideas of bcud len are interpreted by Men-Tsee-Khang-trained Tibetan doctors in India as health
tonics and dietary supplements. What underlies contemporary Tibetan medical ideas of an
essence extraction in relation to Tibetan rejuvenation therapies and pharmacological manufacturing practices of such tonics? I argue that not all bcud len are essence extractions and that
what constitutes an essence receives various interpretations by contemporary Tibetan doctors.
Ethnographic examples presented are based on postdoctoral fieldwork in Dharamsala, Himachal
Pradesh, India (20092010).
Keywords
Dietary supplements, essence extraction, bcud len, Tibetan medicine, Tibetan pharmacology,
Sorig products

Introduction
The prolongation of life has occupied peoples thoughts in a multitude of different cultural contexts. From myths and folk tales on the fountain of youth
to physiological-medical, alchemical, ritual and meditative long-life practices,
longevity has been of vital concern in many societies. It has also been an
important aspect of Asian medical systems, recently especially in the context
of the pharmaceutical manufacturing of rejuvenating and aphrodisiac products, largely marketed as dietary supplements. While a substantial amount of
research has been conducted on concepts of immortality and practices of
1
I am grateful to Stephan Kloos, Jamyang Oliphant, Florian Ploberger, Dr Namgyal Qusar,
Dr Lobsang Choejor and two anonymous reviewers for commenting on this paper at various
stages.

Koninklijke Brill NV, Leiden, 2013

DOI: 10.1163/15734218-12341248

B. Gerke / Asian Medicine 7 (2012) 196224

197

r ejuvenation and alchemy in the Indian and Chinese contexts, longevity practices in Tibetan societies have only recently begun to be explored.2
Among the large variety of Tibetan longevity practices, we also find the socalled essence extraction or bcud len practices. There is, however, no single
definition of bcud len as one distinct set of practices. The term bcud len is
polysemous, having a variety of meanings in different contexts as the examples
from the literature below will show. The Tibetan term bcud can be translated
as taste, essence, elixir, sap, moisture, potency, nutrition, extraction, good
substance, essential aspects, nutriment, nutritious, vital essence, quintessence,
distillation, distilled essence, or a drink.3 The verb bcud len pa, the Tibetan
equivalent of the Sanskrit term rasyana, means extracting the essence of
substances and subsisting on them, but is also used to indicate the preparation
of elixirs for the aged, and also the extraction of nutrients from food.
Bcud len involves the extraction of essences from substances, such as stones/
minerals (rdoi bcud len), soil (sai bcud len), roots (rtsa bai bcud len), flower
petals (me tog gi bcud len), but also from breath (rlung gi bcud len) and awareness (rig pai bcud len), which require contemplative meditation skills. Since
bcud also means to nourish, the term is used colloquially and as a technical
term in the context of tonics, aphrodisiacs and supplements in contemporary
Tibetan medical practice; for instance, as part of a product name (for example,
the tonic named rgas pa gso ba bcud len chen mo, lit. The great essence extraction for the aged, discussed later in this paper). Nourishing substances, such
as medicinal butters (sman mar), may also be considered a bcud len.
The main objective of this research project4 was to find out how bcud len is
interpreted by contemporary Tibetan medical practitioners in India and how
ideas of essence extraction are employed in the manufacturing process of
Tibetan medical tonics and supplements. Asking Tibetans physicians on how
they (re)interpret the bcud len of their classical medical texts in todays clinical
contexts involved two key questions: how do such (re)interpretations inform
pharmacological production, product design, and marketing? How do Tibetan
doctors explain the physiology of how a bcud len product works? This paper
presents ethnographic and some textual material on the development and production of institutionalised medical bcud len products from fieldwork with
Tibetan medical practitioners at the Men-Tsee-Khang in Dharamsala,
2
For ethnographies of Tibetan longevity practices, see Gerke 2010, 2012. Examples for
textual and anthropological studies of longevity rituals are Cantwell and Mayer, 2008, 2010;
Samuel 2010ac, 2012; Samuel and Cantwell, forthcoming.
3
THL 2010.
4
This project was kindly funded by a research grant from the Frederick Williamson Memorial Trust, Cambridge, UK.

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B. Gerke / Asian Medicine 7 (2012) 196224

Himachal Pradesh, India, in 2009 and 2010. A textual analysis of bcud len
ingredients in seminal Tibetan medical texts is presented in another paper.5
The term supplement, is defined in the Oxford English Dictionary as a
substance added to the diet to remedy a deficiency or to enhance (actually or
supposedly) growth, health, or well-being. It has been used in a Western
dietary context only since the late nineteenth century.6 Contemporary ethnographic research on supplement use in the US has revealed a significant disconnect between the official discourse surrounding dietary supplements and
supplement users actual practices.7 In the Tibetan context, none of these discourses has been studied as yet. Even though there is no technical Tibetan
medical term for a supplement as such,8 the idea of a supplement is not
unknown in classical Tibetan medical texts. The seminal Tibetan medical text
Gyushi (Rgyud bzhi) and its main seventeenth-century commentary Blue Beryl
(Bai dr sngon po) both make a clear distinction between individuals taking
bcud len (1) on a regular basis (gtso bor blangs) which will obtain benefits in
three, six, or twelve months, or (2) in addition, if one does not have the time
to practise this [long version].9 Taking bcud len in addition (zhar la spyad)
was explained to me by the senior Tibetan physician Dr Pema Dorjewho is
of course familiar with contemporary ideas of supplementsas taking bcud len
in addition to a normal diet. He argued that taking bcud len as a supplement is
nowadays more popular since only very few people have the time, money and
motivation to undergo the months-long bcud len fasting practices.10
To understand Tibetan versions of bcud len supplements, we also need to
look at the larger context in which strategies of manufacturing and marketing
Asian medicines in the form of supplements develop. This process is increasingly influenced by the legal constraints in marketing these products as
Gerke, forthcoming.
OED 2012.
7
Nichter and Thompson 2006, p. 175.
8
Tibetan terms of the Tibetan Sorig brochure (Ridak 2009, pp. 57, 59; see note 58) that
were paraphrased as dietary supplements in the English version are tsho ba zas (lit. dietary
regimes, which is one of the eleven sections of the Explanatory Tantra of the Gyushi) and lus
stobs skyed sman zas (lit. medicines and foods increasing physical strength). Tibetan colloquial
verbs for supplement or supplementing, such as cha tshang bar byed ba (lit. to make complete), kha gsab byed ba, kha skong, sur rgyen, and zur snon byed ba (Acharya 2000, p. 753; THL
2010) are apparently not used in this medical context.
9
zla ba gsum drug lo gcig bras bu grub / de ma lcogs na zhar la spyad byas pas (Gonpo 1982,
p. 81; Sangye Gyatso 1982, p. 362). This additional option only appears in the chapter on
Normal Health in the Gyushi. I analyse the chapters on bcud len in these two texts in another
paper (Gerke, forthcoming).
10
Dr Pema Dorje, personal communication, Dharamsala, 24.8.2009 (see also Gerke,
forthcoming).
5
6

B. Gerke / Asian Medicine 7 (2012) 196224

199

medicines.11 Developing herbal products as food supplements is usually the


easiest way to gain access to Western markets, since the legislation surrounding supplements is less restricted.12 Since there is no global definition of what
constitutes traditional herbal medicinal products (THMP), legislation of
supplements differs worldwide; in some countries they are considered food
supplements, in others they are seen as medicines;13 sometimes they are
camouflaged as cosmetics. Despite blurred boundaries between such
classifications,14 legal restrictions considerably influence the development of
supplements in Tibetan pharmacies in Asia. For example, in India the Sorig
products can only be licensed under the Indian Cosmetic Act if they do not
contain herbs. If they contain herbswhich most of them dothey cannot
be licensed and therefore can only be sold at the Men-Tsee-Khang outlets and
not in the open market.15
This paper presents one of the first anthropological studies on bcud len
supplements. Since the overlapping of medical and religious meanings in rejuvenation practices in Tibetan medicine is common,16 studies on bcud len have
been carried out in various disciplines (Tibetan Studies, Religious Studies,
Buddhist Studies, Anthropology). Ching-Hsuan Mei explains bcud len practices in the Nyingmapa tradition of Tibetan Buddhism, showing that bcud len
in these early sources has a variety of meanings beyond pills and decoctions
used for meditation retreats.17 Frances Garrett links bcud len practices to the
wider nectar (bdud rtsi) and accomplishing medicine (sman sgrub) practices,
mainly in Tibetan literature of the thirteenth century in the context of gastronomical ideas of food,18 but also in the context of the medical oriented Yuthok
Nyingthik (g.yu thog snying thig) practices.19 David Germano mentions bcud
len practices as part of Longchenpas (klong chen rab byams pa; 130863)
11
Since the European Directive 2004/24/EC took full effect on 30 April 2011, it is now
illegal for companies to sell manufactured unlicensed herbal medicines within Europe without
the appropriate license i.e. a Marketing Authorization (MA) or a Traditional Herbal Registration (THR). The UK differs slightly from the rest of Europe in that herbal practitioners are to
be regulated as from April 2012 allowing for unlicensed manufactured herbal medicines to be
prescribed following a face-to-face consultation (Fan et al. 2012, p. 569).
12
For example, in the USA, the classification of a product as dietary supplementa subcategory of foodallows the marketing of such supplements without submitting proof of safety or
efficacy to the US Food and Drug Administration (FDA) (Denham 2011).
13
See Fan et al. 2012.
14
See Quintus and Schweim 2012.
15
Personal communication, Dr Dawa Ridak, New York, 11.6.2010.
16
See Garrett 2010.
17
See Mei 2010. E-mail communication, Geoffrey Samuel, 15.6.2011.
18
See Garrett 2010.
19
See Garrett 2009a.

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B. Gerke / Asian Medicine 7 (2012) 196224

three principles of the yoga of food.20 Jamyang Oliphant is translating selected


bcud len texts.21 One account by a Western Buddhist bcud len practitioner
describes personal experiences during a bcud len retreat.22 Bcud len practices
are also mentioned in many biographies of Tibetan lamas.23 The composition
of a longevity sdhana or a bcud len text seems to have belonged to the religious obligations that almost every high lama in Tibet had to fulfil in his
lifetime, which makes them not easy to locate. Bcud len texts are often grouped
along with other longevity practices, pervading Buddhist collections.24 English translations of these numerous bcud len texts are almost non-existent.25
During this project, I came across a detailed description of a contemporary
meditative bcud len practice, including a list of bcud len pill ingredients in
English.26 These pills were prepared by Lama Thubten Yeshe for a bcud len
retreat in Dharamsala in 1982; some of the ingredients were purchased from
the Men-Tsee-Khang pharmacy at the time.27 This bcud len recipe, which
makes use of two Tibetan precious pills (rin chen ril bu) as well as numerous
blessed substances, exemplifies how bcud len practices are part of the wider
body of various nectar (bdud rtsi) and accomplishing medicine (sman sgrub)
consecration practices that also include empowered medicines.28 Another
example to support this point is that a number of bcud len ingredients mentioned in Dudjom Rinpoches commentary (bsNyen yig, Volume Pha, folio
449) are also used in longevity pills and other blessed Dharma nectar

Germano 1997, p. 296.


See Oliphant, forthcoming.
22
See Doelter 1983.
23
See, for example, Kongtrul and Barron 2003.
24
For example, the collected works of Mipham Gyatso (18461912), the Mi pham rgya
mtshoi gsung bum, comprise 27 volumes, seven of which contain about 25 texts or sections on
bcud len, Amityus and other long life practices (Karma Phuntsok, personal communication,
London, 5.6.2004). The Tibetan Buddhist Resource Centre (www.tbrc.org, last date of access:
14.9.2011) lists 106 works on bcud len. One has to take into account here that bcud len often
appears in the ornamental title of Buddhist works; so the search result is not a clear indication of
how many texts are actually on bcud len practices.
25
Oliphant, forthcoming, will fill parts of this gap. Mullin 1985 translated a flower bcud len
text by the second Dalai Lama (see also Gyatso and Rigzin 1982). Emmerick 1990 translated the
geriatric chapter of the Gyushi, which contains bcud len recipes. There is also an unpublished
translation of a bcud len text by Shardza Tashi Gyaltsen (18591934), who wrote The Nutrition
of Liberation: The Three Kya Quintessence-Extraction (Chulen) From The Dzogchen
Spontaneous Arising of the Three Kyas, translated by Peter Roberts on behalf of the Kalpa
Group (I am grateful to Charles Ramble for sharing this reference).
26
See Yeshe 2010.
27
Personal communication, Dr Tenzin Taye, Dharamsala, 24.9.2009.
28
See Garrett 2009a.
20
21

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edicines (bdud rtsi chos sman).29 As I show later in this paper, sman sgrub
m
rituals are also used to consecrate contemporary bcud len tonics.
It would require extensive research of hundreds of existing bcud len texts to
fully understand Tibetan categorisations of bcud len and their contexts. There
seems to be a large variety of categories. Here are three examples. The geriatric
chapter of the Gyushi distinguishes two types of bcud len: (1) bcud len as a
retreat practice and (2) bcud len taken in addition to a regular diet.30 Germano
distinguishes three types of food yoga, which embrace alchemical bcud len
practices, in a text by Longchenpa:31 (1) ingesting the extraction of substances,
such as meat, stones, herbs etc., (2) eating ones own energised breath, and
(3) eating ones excrements.32 Kongtrul Rinpoche lists his bcud len teachings
along with sman sgrub under Amrita (Principle of enlightened qualities) practices.33 These comprise almost 300 pages, which again exemplifies the strong
link between bcud len and meditative nectar practices.34 These examples show
that there are probably as many classifications as there are bcud len practices,
although one could identify recurring themes and characteristics in these
classifications, such as the following three types.
During my ethnographic and textual research on bcud len in contemporary
medical and pharmaceutical practices at the Men-Tsee-Khang in Dharamsala,
I identified three types of bcud len practices: (1) bcud len products that are
taken as supplements in addition to a normal diet; (2) rejuvenating bcud len,
i.e. pills and substances used as a substitute for food during ascetic fasting
practices and rejuvenation retreats; (3) meditative bcud len, where essences are
extracted from the five elements, sexual fluids, breath, awareness, or the surrounding Buddha fields through visualisation. All these types of bcud len can
overlap and intersect with each other in various practices, since medicine in
its widest sense involves not only the healing of illness but also the enhancing
of health, vitality, and power,35 for example, by extracting essences (bcud)
and lustre (mdangs) from surrounding elements through spiritual practices.
The entire process is alchemical in nature since it transforms not only the
substances, but also the person who is preparing, consecrating and consuming
the bcud len.
See Samuel and Cantwell, forthcoming.
Personal communication, Dr Pema Dorje, Dharamsala, 24.8.2009. See also Emmerick
1990.
31
Germano 1997, p. 296.
32
See Garrett 2009b and 2010 for details on such tantric nectar practices.
33
Kongtrul and Barron 2003, p. 522.
34
Garrett 2009a, p. 219.
35
Garrett 2010, pp. 3001.
29
30

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B. Gerke / Asian Medicine 7 (2012) 196224

As a case in point, bcud len practices might include deity visualisation or


sexual union practices to consecrate the bcud len pills used as elixirs for patients
or for subsistence during a retreat.36 During such retreats, the practitioner
undergoes a period of fasting and purification while living exclusively on bcud
len pills and performing meditative practices of absorbing energy from prn a
(rlung), thereby rejuvenating the body physically and spiritually.37 Considering the remoteness of Tibetan mountainous areas where food was difficult to
procure but which meditators preferred for such retreats, living on bcud len
also had a strong practical relevance.
Essence extractions as part of Tibetan nectar practices
The recent research by Garrett has highlighted Tibetan forms of taking all
kinds of substances in the form of transformed and consecrated nectar (bdud
rtsi).38 Garrett views these practices within the discourse of gastronomy and
consumption as an aspect of Tibetan culture and food and shows that these
practices are largely linked to the tantras of the Nyingmapa school of Tibetan
Buddhism. As those they influenced and cannot be clearly demarcated from
medical practices of accomplishing medicines and extracting essences.
Medicines that involve the purification of mercury and metals (btso thal) also
include some of these nectar substances.39 All these preparations are part and
parcel of a varied set of practices linking medicine to religion and vice versa.
A vast amount of literature on these preparations gives testimony of the popularity they held in Tibet.
With detailed studies (such as Garretts) emerging, we can slowly understand the range of ideas surrounding the consumption of numerous essences
or nectars, may it be in the form of medicines, blessing pills, elixirs, or visualised consecrated nectars, During the thirteenth century in Tibet, tantric
nectar practices occurred parallel in both medical and religious writings, and
were often written by the same authors.40 Also, the Gyushi, which became the
prominent medical text in Central Tibet from the thirteenth century onwards,41
Parfionovitch, Dorje and Meyer (eds) 1992, pp. 11922.
See, for example, Gyatso and Rigzin 1982, and Yeshe 2010. Some of these bcud len practices also involve taking other medicines. Namkhai Norbu Rinpoche mentions a mercury pill as
medicine to be used for overcoming hunger in the Dharmakya-style bcud len of Dzogchen
practice (White 1996, p. 385, note 127).
38
Garrett 2010.
39
Gyatso 1991.
40
Garrett 2010, p. 307.
41
Garrett 2010, p. 302.
36
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includes the use of elixir recipes for treating the aged as well as mercury recipes
for a variety of diseases. The geriatric chapter in the Gyushi (chapter 90, Oral
Instruction Treatise) offers a range of longevity elixir recipes.42 They involve
similar kinds of ideas and use a similar rhetoric of consecration as described by
Garrett for accomplishing medicines and other nectar practices. The nectars and essences of the bcud len recipes mentioned in the Gyushi, for example, are all based on the idea that certain substances contain bcud, which
can be extracted, concentrated into an elixir, and consumed in a consecrated
form to enhance vitality and prolong life. The geriatric chapter in the Gyushi
mentionsamong many other ingredients, which cannot be discussed here
a list of four nectars (rtsi bzhi)43 and five essences (dwangs ma lnga).44 The
four nectars and five essences also appear in Vajrayna longevity practices,
such as the Chi med srog thig of the Dudjom tradition.45 The four nectars are
used in bcud len recipes because of their vital, partly evergreen nature. As the
Men-Tsee-Khang pharmacist Dr Tenzin Taye explained, they are very strong
and their leaves feel sticky and juicy. Two of them (shug bru and ba lu) remain
green throughout the winter. They have potency (nus pa).46 He then referred
to a Tibetan medical dictionary, which states that the [four nectars] do not
dry in winter and therefore become the nourishment of the life-force.47 Their
appearance in both medical and ritual contexts supports the wide-spread belief
in Tibetan societies that vital essences can be extracted from the outer elements and made available for humans to support health and physical vitality.
In the following, I introduce some contemporary tonics, manufactured at the
Herbal Product Research Department at the Men-Tsee-Khang in Dharamsala
and sold under the trade name of Sorig,48 and analyse their related ideas to
bcud len.

See Gerke, forthcoming.


According to Parfionovitch, Dorje and Meyer (eds) 1992, p. 275, the four nectars are
juniper seeds (shug bru, Juniperus indica), rhododendron flower (bal u me tog bcas pa, Rhododendron Capitalum Maxim), ephedra (mtshe, Ephedra sp.), and tansy (mkhan pa, Artemisia sp./
Tanacetum sp.).
44
The five essences are: (1) mineral exudates/bitumen (brag zhun), (2) calcite (cong zhi),
(3) raw sugar (bu ram), (4) honey (sbrang rtsi) and (5) milk and butter (mar dkar). They are said
to carry the essential vitality of earth (sa), stones (rdo), wood/trees (shing), flowers (me tog), and
roots/grass (rtsa) respectively and in turn restore the flesh (sha), bones (rus), physical strength
(stobs), radiance/lustre (mdangs), and nutrition (bcud) (Gonpo 1982, p. 549).
45
See Samuel and Cantwell, forthcoming.
46
Personal communication, Dharamsala, 24.9.2009.
47
dgun mi skams pa tshe yi gsos su gyur (Wangdu 1982, p. 479).
48
Sorig is the abbreviation of gso ba rig pa, which means science of healing and is the common Tibetan term for Tibetan medicine.
42
43

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The field site and the Herbal Product Research Department


The fieldwork took place in the north-western Indian state of Himachal
Pradesh, which has large Tibetan communities, with 18,150 Tibetans living
in and around Dharamsala.49 Dharamsala, and especially the Tibetan enclave
of McLeod Ganj in upper Dharamsala, with about 9,500 Tibetans,50 is one of
the main centres of the Tibetan exile community in India and the home of the
Fourteenth Dalai Lama.
The Men-Tsee-Khang, with its famous Tibetan medical college, large pharmacy and clinics, is located on the hillside between McLeod Ganj and
Dharamsala. It is not only the largest medical institution in Tibetan exile,51 it
is increasingly catering to foreign and Indian patients52 not only through its
clinics, but also through their Sorig rejuvenating tonics, aphrodisiacs and wellness products.
The majority of Tibetan medical practitioners in India are trained at the
Men-Tsee-Khang. Today, Tibetan medical students are also taught Western
anatomy, chemistry and biology, and many of them have science backgrounds
from their higher secondary degrees. These Tibetan doctors speak English,
Tibetan and Hindi and are largely able to communicate with Tibetan, foreign
and Indian patients in all of these three languages and thus translate their
medical ideas not only between three languages but also within various cultural and medical belief systems.53 Many of them are sent abroad for short
periods of time on certain Men-Tsee-Khang projects to teach and see patients
and are thus familiar with Western culture to varying degrees. Tibetan medicine in Indian exile is remarkably homogenous...with the vast majority of its
practitioners, whether practicing privately or in an institution, having been
trained under the Men-Tsee-Khangs syllabus.54 During fieldwork, this general homogeneity of institutionalised education often led to Tibetan physicians referring to the same corpus of medical texts in response to my textual
questions. Nevertheless, in the context of medical practice, I found that MenTsee-Khang doctors themselves had their own personal views on the Sorig
bcud len products. While some prescribed them as supplements, others did
not. Some even disregarded them as commercial bcud len, arguing that real
See CTA, Planning Council 2000.
See Prost 2008.
51
For a history of the Men-Tsee-Khang, see Kloos 2008, 2010.
52
Kloos quotes from the Men-Tsee-Khang annual report that between 2007 and 2008, 92
per cent of all Men-Tsee-Khang patients were Indian (Kloos 2010, p. 82).
53
For an example of such cultural translations of medical terms, see Gerke 2011.
54
Kloos 2010, p. 16.
49
50

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essence extractions are too difficult to manufacture on such a large scale


of production.
In 1994, the Herbal Product Research Department was established by
Tsering Tashi, the Men-Tsee-Khang director at the time, as a subsection of
the Clinical Research Department. Under the guidance of the senior Dr Tenzin Choedrak and the two physicians, Dr Namgyal Qusar55 and Dr Lhawang,56
both of the Research and Development (R&D) Department, it began producing the first Tibetan Herbal Tea and beauty products (e.g. White Lotus
beauty cream). In 1995, Dr Namgyal Qusar was instrumental in developing
the first tonic called gso rig stobs sman (today sold under the name stobs sman
bcud dus rgya mtsho). Sorig Products were produced by the R&D Department
from 1994 to 1999 under the supervision of Dr Namgyal Qusar with the aim
to finance Men-Tsee-Khangs research projects.57 With the growing success of
these products, a separate unit under the name Herbal Product Research
Department was opened in 1999, and Dr Lhawang was appointed head of
this department. It is located on the hillside below the pharmacy, consisting
of a four-storied building with several work units. The department has a few
machines to fill the Sorig tea bags and make sachet packets for the tonics,
which are sold in the form of granules.
By the end of 2009 (Dr Dawa Ridak had been head of the department from
2003 to 2009), altogether 45 products had been developed and a detailed
90-page brochure, which Dr Ridak had designed, was published in Tibetan
and English.58 The products are sold at the over 50 Men-Tsee-Khang branch
clinics around India and Nepal, online via the official Men-Tsee-Khang
website, through an Export Department in Delhi,59 and various foreign
distributors.60 The distributor for Europe, Tibetan Therapeutics, based in
London, sells only eight of the supplements, among them all four products
introduced in this paper, which shows that these are popular products in the
Dr Namgyal Qusar was deputy director of the R&D department from 1994 to 1999.
Dr Lhawang was deputy director of the R&D department from 1998 to 2003.
57
Personal communication, Dr Namgyal Qusar, Dharamsala, 15.5.2012.
58
See Ridak 2009. The brochure can be accessed online in English and Tibetan at http://
www.men-tsee-khang.org/hprd/hprd-history.htm (last date of access: 22.2.2012). The Herbal
Product Research Department also distributes smaller information leaflets on the products in
English and Tibetan for distributors.
59
Their webpage http://www.tibetan-medicine.org is linked to the official Men-Tsee-Khang
website http://www.men-tsee-khang.org/index.htm. Last date of access: 1.3.2012.
60
As of 1.3.2012, the Sorig products had three official distributors in the West, for Europe
www.tibetan-therapeutics.com, for Estonia www.sorig.ee, and for Canada www.tibet-treasure.com.
Since April 2012, the Shang Shung Institute has also made Men-Tsee-Khang Sorig products
available in the United States via their online store. See: http://shangshung.org/store/index.
php?main_page=index&cPath=138 (last date of access: 31.8.2012).
55
56

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B. Gerke / Asian Medicine 7 (2012) 196224

West. The income generation for the Men-Tsee-Khang through the sale of
Sorig products is substantial. In 2008, the Herbal Product Research Department generated approx. 1 crore (10,000,000) Indian Rupees (approx. 154,000
Euro) turnover and 50 lakh (5,000,000) Indian rupees profit (approx. 78,000
Euro), which was about a fourth of the Men-Tsee-Khangs annual turnover
that year.61 In India, the products are sold for an affordable price, following
Men-Tsee-Khangs policy to serve the underprivileged sections of society.
At the beginning of this project (August 2009), Dr Dawa Ridak had just
left the Herbal Product Research Department for the USA and Dr Lobsang
Choejor, who had previously worked as a medical practitioner at a Men-TseeKhang branch clinic near Kathmandu, had taken over as the new head of
department. Fortunately, I was able to interview Dr Dawa Ridak later in New
York. In Dharamsala, I also spoke with the senior physicians Dr Pema Dorje,
Dr Namgyal Qusar (who established his independent clinic close to Dharamsala), the pharmacists Dr Tenzin Taye and Dr Ngawang Soepa, and informally with several other Men-Tsee-Khang-trained doctors.
I was not allowed to see the manufacturing process or take any photographs
inside the department and had to rely on the Sorig brochures, the packaging
descriptions, and interviews with Tibetan doctors. Unfortunately, I also did
not get access to official sales figures that would reveal who were the main
customers of particular Sorig bcud len products.
The Sorig products
In 2010 (and still at the time of the publication of this paper in 2013), four
categories of Sorig products were manufactured: (1) supplements (nine products including tonics and spices), (2) health drinks (14 types of herbal teas),
(3) incense (two types of incense), and (4) skin & hair care (20 types,
including creams, oils, lotions, balms, talcum powder, medicinal baths, shampoo and an aroma therapy diffuser).62 A variety of tonics are manufactured
and sold in the first Sorig product series called supplements. They offer examples of contemporary interpretations of medical concepts of bcud len, which
will be discussed below. Several of these supplements use the term bcud len,
either in their product names or product description in the accompanying
leaflets.
To avoid confusion with the terminology used for these products, we need
to differentiate between the terms medicine (sman), tonic (stobs sman, lit.
Kloos 2010, pp. 171, 287.
See http://www.men-tsee-khang.org/hprd/product.htm (last date of access: 6.4.2013).

61
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207

strength medicine), vitamin (stobs sman, bcud sman, zungs, stobs skyed, also
sman mar and bcud rdzas, lit. nourishing substance), aphrodisiac (ro rtsa
sman), and essence extraction (bcud len). Although some of the Sorig herbal
tonics are called stob sman, for example, stobs skyes sman ja (lit. medicinal tea
to increase strength),63 none of these products are considered a sman or medicine as such. Sman are strictly defined as products that have been manufactured at the Men-Tsee-Khang pharmacy. Dr Dawa Ridak explained the
difference: When you are sick, then you take medicine (sman). The herbal
products are supplements for the prevention of illness.64 The pharmacy, however, produces certain aphrodisiacs (ro rtsa sman), which are also called tonics,
but as I was told by Dr Tenzin Taye, they are considered sman because they
also treat other diseases, such as low kidney function or sexual disorders, and
are only prescribed after consultation with a Tibetan doctor.65 Thus, even
though Tibetan doctors call some of their supplements sman, they have a clear
idea that these are not medicines, but supplements. Likewise, there is a distinction between bcud len and ro tsa. Dr Pema Dorje clarified the difference:
While bcud len can be ro tsa, ro tsa cannot replace bcud len.66 In other words,
while essence extractions might increase sexual vigour, they are not mere
aphrodisiacs.
How do Tibetan physicians differentiate between a vitamin and a bcud
len? The English term vitamin is often used to explain in English what bcud
len means. My question what is bcud len? was several times responded to in
English with bcud len is like a vitamin. Contemporary Men-Tsee-Khang
doctors conceive of a vitamin as a substance that vitalises. The term apparently
comes closest to their medical perceptions of a bcud len supplement when
explaining this to Westerners. However, when asking further, they distinguish
between age target groups; while bcud len are particularly aimed at the age
group above 50 or 60, tonics and vitamins can be taken by all age groups.
Treating essence with essence
How do Men-Tsee-Khang doctors explain the effects of contemporary bcud
len products in terms of the medical physiology described in their main text,
the Gyushi?
63
Sold under the label Tonic Tea, this tea is one of the 14 Sorig tea products made from 11
herbs that are said to prolong the life-span, increase bodily strength, enhance the complexion,
and control premature wrinkles and grey hair (Ridak 2009, p. 30).
64
Personal communication, New York, 11.6.2010.
65
Personal communication, Dharamsala, 24.9.2009.
66
Personal communication, Dharamsala, 24.8.2009.

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During a discussion on bcud len in preparation for the 2009 IASTAM conference in Bhutan, where this paper was first presented, Dr Pema Dorje said,
Because the lus zungs bdun are in themselves essences extractions, they are
strengthened through bcud len, which are also essence extractions.67 This
comment illustrates the parallels between ideas of vitality-enhancing bcud len
substances and the distillation process of food essences in Tibetan physiology.
Digestion and distillation have long been linked in Asian medical systems as a
way of reaching perfection68 and also play out in religious practices. Garrett
remarks that the understanding of human by-products as purified distillations of religious practice or moral perfection is also supported by South Asian
and Tibetan presentations of how food creates the body.69 A brief description
of the classical Tibetan medical version of the digestive distillation process will
help us to understand Dr Pema Dorjes statement.
The Tibetan lus zungs bdun (lit. seven body maintainers)also translated
as bodily constituents, bodily energies, or body supportersare equivalent to the seven dhtus in yurveda. The Gyushi describes the physiology of
the digestive process of the lus zungs bdun as a continuous process of refining
essences from the five elements (space, water, fire, earth and wind) and the
six tastes (sweet, sour, salty, bitter, hot and astringent), ingested in the form
of food.70
According to the Gyushi, the digestive process takes six days and is as follows: the essence of food is refined through six stages from the organic food
sap, or chyle, into blood, flesh, fat, bone and bone marrow, finally becoming
the regenerative fluids (semen or blood; khu ba). Desi Sangye Gyatso in his
seventeenth-century commentary to the Gyushi, the Blue Beryl, points out that
it is characteristic of this process that the essence of one stage is transformed
entirely into the constituent of the next stage, expelling all impurities (snyigs)
that are created during this distilling process in the form of excretions, such as
faeces, urine, nails, hair etc., and transforming the essence of each of the lus
zungs into the next stage.71 The final product of this refining process is a
supreme vital essence (Tib. mdangs or mdangs mchog; Skt. ojas). The quality of
mdangs mchog shows in the persons radiance and lustre; it is vulnerable to
emotional stress and can be lost through anxiety. Consequently, mdangs mchog
has to be understood not as an organ-related idea but as an expression of
healthy lus zungs.
Personal communication, Dharamsala, 24.8.2009.
Alter 1999.
69
Garrett 2010, p. 323.
70
Gonpo 1982, pp. 259; Men-Tsee-Khang 2008, pp. 6879.
71
Sangye Gyatso 1982, p. 120.
67
68

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209

I think that Garretts observations on the parallel transformation processes


taking place with human substances in sman sgrub practices as well as in digestive physiology are also applicable to transformative ideas underlying bcud len
products. She suggests that we could see in Accomplishing Medicine two
parallel transformative processes: the ritual transformation of human by-
products (or whatever substances are consumed under their name) into nectar
in the course of a tantric sdhana, on the one hand, and the physiological
transformation of foods, such as nectar preparations, into the perfected essence
of the body, the reproductive substance, in the course of digestion, on the
other.72 Similarly, while making and consecrating a bcud len product a certain
transformation of bcud into an essence takes place. Distilling this bcud further
through ingesting it transforms and affects the zungs and the final essence,
mdangs mchog. Therefore, treating the essence with an essence involves corresponding transformative processes that collectively promote vitality.
The close proximity of semen (khu ba) and its essence, mdangs mchog, in
this chain of distilled essences also alludes to the closely-linked concepts of
sexual power and radiant vitality, which is also evident from the visualised
sexual union practices. These form an essential part of the consecration of bcud
len, where divine semen becomes an important substance of vitality that is
visualised as a blessing flowing into the elixirs that are being consecrated and
enhanced with power and vitality. Despite these connections between meditative sexual union practices and actual vital essences, sexual abstinence (chags
spang) is considered essential during bcud len practices, a point made both in
the Gyushi73 and by lamas guiding bcud len retreats. Lama Yeshe, for example,
warns that experiencing strong sexual pleasure during this retreat is extremely
dangerous; instead the revitalised strength from the aphrodisiac component
of the bcud len pill should be completely directed to gain penetrative concentration in meditation.74
Since Tibetan doctors have the understanding that food can be transformed
into essences, and that the entire digestive process is in itself an extraction of
essences, it comes as no surprise that they would make use of an external
essence to treat the bodily essences and strengthen them with the objective to
enhance vitality and long life. They consider mdangs mchog as the base on
which to promote longevity.75 If the lus zungs are well supported with a good
diet, mdangs mchog will reap the greatest benefit of the transformation and
create the radiant vitality of a person. As the last essence created in the
Garrett 2010, p. 324.
Gonpo 1982, p. 81.
74
Yeshe 2010.
75
Personal communication, Dr Pema Dorje, Dharamsala, 24.8.2009.
72
73

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B. Gerke / Asian Medicine 7 (2012) 196224

istillation process, mdangs mchog is on the top of the internal food chain, so
d
to speak. This process is also linked to the basic principles of Tibetan medical
physiology, the three nyes parlung, mkhris pa and bad kanwhich build the
body-mind complex within the five element cosmology.76 The three nyes pa
influence a persons vitality because the balance of rlung, mkhris pa and bad
kan support the seven lus zungs and in effect promote mdangs mchog.77
How is this essence-distilling process articulated in the context of the Sorig
products? What kind of language is used to demonstrate this process in English to a largely Western or modern Indian-educated clientele?
Taking the essence as a supplement
In the following, I briefly introduce four of the 46 Sorig products that present
themselves as rejuvenating tonics, bcud len, or aphrodisiacs in one form or
another. Three contain the word bcud in their names, two are called bdud rtsi;78
both bcud and bdud rtsi are also translated as elixir in the English brochure.79
None of these are bcud len products for fasting meditation retreats; they are
nourishing supplements to improve health and vitality.
Health Tonic
This tonic was first made in 1996 under the name of gso rig stobs sman.80 The
literal translation of the name of the current product is invigorating medicine, ocean of assembled essences (stobs sman bcud dus rgya mtsho). The English brochure presents this product as a boosting tonic that strengthens
the immune system, promotes as sense of well-being, restores energy, clears
the senses, helps in dealing with stress, and thus supports a long and healthy
life. The effect of the tonic is explained in terms of maintaining the kidney
heat, which in Tibetan physiology is always linked to sexual stamina (symbolised by the kissing couple on the package; see fig.1). A loss of kidney heat

76
For those unfamiliar with three nyes pa: rlung is governed by the wind element and responsible for all movements in the body; mkhris pa has the nature of fire and rules metabolic processes; and bad kan is governed by water and earth and binds substances in the body together.
There is plenty of secondary literature around explaining these nyes pa in great detail.
77
Personal communication, Dr Pema Dorje, Dharamsala, 24.8.2009.
78
One of these nectar products, which is not introduced here, is called wisdom nectar (blo
phel bdud rtsi). It is given to strengthen memory in children (Ridak 2009, p. 14).
79
Ridak 2009, pp. 12, 15.
80
Personal communication, Dr Dawa Ridak, New York, 11.6.2010.

B. Gerke / Asian Medicine 7 (2012) 196224

Fig. 1

211

212

B. Gerke / Asian Medicine 7 (2012) 196224

can lead to a loss of vitality.81 The Tibetan version is shorter and mentions the
strengthening of the bodily elements, the increase of mdangs, the improvement of kidney heat, and the clearing of the senses. According to Dr Pema
Dorje, this type of bcud len is like a ro tsa sman,82 i.e. an aphrodisiac. However, the label sman here does not automatically make the product a medicine, as explained earlier.
As for the design of the product packaging, Dr Dawa Ridak was inspired by
images from the seventeenth-century medical thankas. He said that some
Tibetans took issue with the image of the kissing couple on the package, but
he felt it was appropriate since it was taken from the thankas commissioned by
Desi Sangye Gyatso himself and thus was part of Tibetan medical tradition.83
Elixir of Rejuvenation
This product is said to be particularly beneficial for the elderly. It is called
Elixir of Rejuvenation (rgas pa gso ba bcud len chen mo; lit. the great essence
extraction for the aged; see fig. 2). The English brochure explains the reasons
for ageing according to the Gyushi, and presents this product as a chulen, or
energy booster, which slows down the collective signs of ageing. It also
stresses its qualities as an aphrodisiac. Instructions include taking the pulverised herbs from the first day of the waxing moon and exercising until sweating.84
Dr Tenzin Taye describes it as giving energy to elderly patients. However, it
is warming, so not good for liver problems and in cases of fever.85
This is the only Sorig product that gives specific meditation instructions on
a separate leaflet, describing a longevity practice involving visualisations that
facilitate the extraction of bcud from surrounding elements as well as the recitation of the Amityus (Buddha of Long Life) mantra. These instructions are
meant for those patients who wish to consecrate the supplement they are taking. This is not unusual, since even Men-Tsee-Khang precious pill prescriptions contain instructions on how to consecrate them with the Medicine
Buddha mantra before taking them. What is unusual is the shift away from
this practice being conducted by the physician/pharmacist86 to the practice
being made available to the patient or anybody buying this bcud len product
via the internet. This consecration practice is also more complex than the
Ridak 2009, p. 11.
Personal communication, Dharamsala, 24.8.2009.
83
Personal communication, New York, 11.6.2010.
84
Ridak 2009, p. 12.
85
Personal communication, Dharamsala, 24.9.2009.
86
The Gyushi describes two such consecration practices, which are also depicted on two of the
medical thankas (Parfionovitch, Dorje and Meyer (eds) 1992, pp. 11922, 2758).
81
82

B. Gerke / Asian Medicine 7 (2012) 196224

Fig. 2

213

214

B. Gerke / Asian Medicine 7 (2012) 196224

popular Medicine Buddha mantra instructions that are distributed along with
precious pills. I asked Dr Dawa Ridak how and why this leaflet was created.
He explained:
I requested Khen Rinpoche Lobsang Tenzin in Sarnath to compile this short
practice for patients. Yuthok Yontan Gonpo himself spoke about it, but the problem is that many cannot practise at length. We made it short and accessible for
everyone to do this. Actually, it is important to have the initiation and transmission from an experienced and good lama, but for this short practice, you do not
necessarily need this. If you have faith, you will receive some blessings. Also it
depends on your motivation. Actually, it was compiled to help those who believe
in Buddhist ideas, but there are also suggestions that those who follow other
religious traditions can do this. If you are a Christian, you can visualise your
Christian deity.87

Energize the Body


This Chongchen Chulen (gcong chen88 bcud len; lit: chronic wasting elixir;
see fig.3) is presented as body energizer said to provide vital nourishment to
the body. It is also called a chulen, or energy booster, aimed at patients with
chronic illnesses, respiratory problems and lack of appetite. It rebuilds the
bodys natural strength and immune system and strengthens the activities of
the sexual organs, but is not called an aphrodisiac as such.89 Dr Pema Dorje
gives this tonic to tuberculosis patients.
Boost the Life-span
This product was first made in 2004.90 It is called Tsephel Dhutse (tshe
phel bdud rtsi, lit. life-span increasing nectar). The English brochure labels
it elixir of life, and describes it as a potent elixir that helps to rebuild and
strengthen a weak body, bones and the immune system. It contains herbs and
minerals. Instructions include the Amityus mantra, which should be recited
while taking the elixir and which should evoke a strong sense of prolonged
life.91 The image on the package shows a mother giving musk water to her
child (see fig.4).92
Personal communication, New York, 11.6.2010.
Gcong chen refers to a long-lasting chronic illness, such as tuberculosis.
89
Ridak 2009, p. 13.
90
Dr Dawa Ridak, personal communication, New York, 11.6.2010.
91
Ridak 2009, p. 15.
92
The image was modified from thanka 45, figure 48, in Parfionovitch, Dorje and Meyer
(eds) 1992, p. 262.
87
88

B. Gerke / Asian Medicine 7 (2012) 196224

Fig. 3

215

216

B. Gerke / Asian Medicine 7 (2012) 196224

Fig. 4

B. Gerke / Asian Medicine 7 (2012) 196224

217

The rhetoric of the product descriptions


In the following, I analyse the language that is used in the English and Tibetan
brochures to explain and promote these tonics. Terms such as immune system appear frequently in the English version. Classical Tibetan medicine has
no concept of an immune system as such, but the Sorig brochures paraphrase
Tibetan ideas of vitality and bcud len in Western terms that are commonly
associated with anti-ageing, sexual vigour, well-being and tonics. Dr Dawa
Ridak said, When the body is strong, life will be long. That is how we understand the immune system. In the Tibetan version, the benefit of the products
is expressed in terms of developing radiance and strength of the body (lus
khams kyi mdangs stobs rgyas pa)93 or increasing the strength of zungs (zungs
stobs skyed).94 Dr Lobsang Choejong explained that here zungs refers to the lus
zungs bdun in general, but particularly to the second of the seven lus zungs, the
vitalised blood (zungs khrag). Blood is considered the most important of the
lus zungs and can be strengthened with bcud.
To compare the Tibetan and English product descriptions of Tsephel
Dhutse is illuminating.95 In the Tibetan brochure, this product is clearly
advertised for children, to increase the strength of their zungs and prolong
their lives (byis pai zungs stobs skye la tshe ring du phel); its benefit is to conquer all diseases and evil spirits (nad gdon rnams joms pai dge phan yod).96
Both statements are missing in the English version, which is neither addressing a particular age group, nor diseases, nor evil spirits, but instead emphasises
the balancing of body energies and the mind-body health-promoting aspects
of this potent elixir, including strengthening the immune system. The
instructions for the accompanying spiritual practice are more detailed in the
Tibetan brochure and refer to Tibetan Buddhist practices of reciting mantras
for a certain amount of time. In this case, to prolong the life of the child, the
Amityus mantra should be recited in the morning after washing, on an empty
stomach, as many times as possible. For children above one year, one sachet is
given every three days and for highly emaciated children one sachet with milk
every day. The English version is brief, just mentioning the mantra and the
instruction to recite it as many times as possible while drinking the herbal
mixture. This brief comparison shows that the English brochurewhile
exactly the same in lay-out and designis not a translation of the Tibetan
Ridak 2009, p. 11.
Ridak 2009, p. 15.
95
Ibid.
96
The Gyushi describes childrens diseases frequently being caused by evil spirits (gdon; Jger
1999).
93
94

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B. Gerke / Asian Medicine 7 (2012) 196224

version but a text on its own, specifically catering to a foreign and/or modern
Indian clientele, as much as the Tibetan version is making use of popular
Tibetan cultural practices, catering to Tibetan-speaking clients. Moreover,
only the Tibetan version uses the term disease (nad),97 the English versions
of both the glossy brochure and the leaflet for distributers emphasise the supplement nature of the products. Terms, such as medicine and disease, that
could be legally problematic when selling the products as food supplements in
the West, are avoided.
Manufacturing and consecrating bcud len tonics
Sorig bcud len and tonic preparations claim to have been formulated according to Tibetan Medical Texts.98 Dr Dawa Ridak explains that the bcud len
products are all based on recipes mentioned in the Oral Instruction Treatise,
which, with 92 chapters, is the largest of the four treatises of the Gyushi. The
Elixir of Rejuvenation is based on a recipe from the geriatric chapter (rgas pa
gso ba; chapter 90); the Health Tonic is from the chapter on virility (ro tsa ba
byar ba; chapter 91); the Chongchen Chulen recipe is based on the chapter
on great consumption disease (gcong chen zad byed bcos pa; chapter 11), and
the Tsephel Dhutse recipe on one of the chapters of childrens diseases (byin
nad; chapters 713).99 These recipes have been modified by Dr Dawa Ridak
according to what is available and practical in todays manufacturing process.
For various reasons, these details are not mentioned in the brochure, nor are
the complete lists of ingredients given on the packages. These recipe sources
give insight into the broader application of bcud len supplements beyond geriatrics. The recipes to increase bcud are not limited to the aged but appear also
in the context of nourishing children, rebuilding strength after chronic illness
and increasing sexual drive. They are meant to nourish and support convalescence after a prolonged illness, strengthen the lus zungs, as well as improve
sexual vigour and vitality through increasing the digestive and kidney heat.
The compounding methods of these products also vary. In the geriatric
chapter of the Gyushi, we find that soaking, boiling, straining and mixing in
more ingredients in the process of extracting an essence are key features of
making bcud len; albeit these are not the only methods used in bcud len recipes.100 Not everything that is being extracted becomes a bcud len and not every
Ridak 2009, pp. 13, 15.
Ibid.
99
Personal communication, New York, 11.6.2010.
100
Gerke, forthcoming.
97
98

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bcud len is being extracted. The pharmacist Dr Ngawang Soepa explained it


this way: An extraction of Agar 35 is not a bcud len. Not everything cooked
and extracted becomes bcud len. On the other hand, cong zhi (calcite) as such
is not a bcud len, but through the process of extraction it gains in bcud and
becomes a bcud len.101 Dr Tenzin Taye explained that there are also powerful
ingredients that contain high levels of bcud that would be destroyed through
cooking and extraction processes. In those cases, these ingredients are just
cleaned, ground and added to the bcud len mixture without much processing.102
Thus, extracting the essence does not always involve complex manufacturing
procedures of extraction.
Now follows the description of a contemporary method to make bcud len
supplements used at the Herbal Product Research Department in Dharamsala. When I asked Dr Lobsang Choejor how their bcud len is prepared he
explained the method as follows:
We first weigh all ingredients and grind them into a fine powder, excluding those
which should not be ground, such as honey, molasses and brag zhun (shilajit or
bitumen), which are dissolved into a liquid solution. The powder is then mixed
with the solution into a dough (pag). Some ingredients are boiled, others are just
ground. The base of the granules is rice dough (bras rtsam). With the help of a net
we make the granules. Through the net we can keep their sizes small. Then we dry
the granules for three to four days, either outside when the weather is good or
inside the drying room when its rainy or foggy. Then the granules are sent for
quality control to the Men-Tsee-Khang laboratory. Only when we get the confirmation from the laboratory that they are completely dry and the quality has been
approved, will we pack them well and store them in large containers. Once we
receive a larger order, lets say for 500 packets, well pack the granules into the
little paper sachets, with the help of a machine. Thirty sachets fit into one package. Then we dispatch them for sale.

What kind of medical ideas inform these manufacturing processes?


Dr Lobsang Choejor linked bcud len to the term nus pa, which means
power or potency and is widely used in Tibetan pharmacology. Along with
strength (stobs) and quality (yon tan), nus pa is one of the three main parameters of Tibetan pharmacology, explained in chapter 20 of the Explanatory
Tantra (bshad rgyud).103 Apart from the eight traditional nus pa (heavy, oily,
cool, blunt, light, rough, hot and sharp), according to which medicinal ingredients are classified in terms of potency, nus pa also indicates simply the power
a substance has. Dr Lobsang Choejor explained this as follows:
Personal communication, Dharamsala, 6.8.2009.
Personal communication, Dharamsala, 24.9.2009.
103
Men-Tsee-Khang 2008, pp. 199224.
101
102

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B. Gerke / Asian Medicine 7 (2012) 196224

Bcud len means that some of the ingredients that are inside the preparation have
the power of bcud len. Because they have bcud, they have nus pa. So there is power
and energy. If I give this bcud len to a weak person after a chronic illness,
his energy will be restored. The body itself will take out the bcud from the
preparation.

Dr Choejors comments show that medical ideas of bcud len do not necessarily
refer to pharmaceutical methods of essence extraction. The essence bcud can
also be extracted inside the body from the products that contain substances
that are high in bcud. The point I want to make here is that in explaining the
workings of bcud len, doctors might situate the act of extracting the essence
into the body itself, relying on the digestive distillation process to extract the
bcud from the product ingredients and create good lus zungs.
Finally, I want to comment on the consecration of contemporary bcud len
products. In a bcud len recipe, as in other sman sgrub and bdud rtsi preparations, blessed substances are transmitted through a kind of ongoing fermenting substance (phab rta rgyun ldan), sometimes called mother pill, which is
added to future bcud len, medicines or longevity pills. The phab rta, literally
translating as yeast, is a portion from a previous batch of pills, which is added
to future batches of pills, similar to the continuation of a bread-starter made
from sourdough. The phab rta guarantees a continuity of sacredness in pills
across many generations of lamas.104 Sometimes, high lamas give their personal phab rta to the pharmacist who makes their bcud len pills. The MenTsee-Khang pharmacy and the Herbal Product Research Department do not
use phab rta. However, they do guarantee their continuity of blessings through
adding sacred substances from the Dalai Lamas temple in the form of mantra
pills (ma ni ril bu)105 and Dharma nectar medicine (bdud rtsi chos sman).106
In addition, they conduct their own sman sgrub consecration ritual every two
to three years at the Men-Tsee-Khang. Dr Dawa Ridak said that after they
completed the first bcud len products in 2004, he organised a seven-day sman
sgrub ritual at the Men-Tsee-Khang with monks from the Dalai Lamas
Namgyal Monastery conducting the ritual. The ritual text used was from
the Yuthok Nyingthik Cycle.107 All of these consecrated substances are added
to each fresh batch of Sorig products and Men-Tsee-Khang-made medicines,
following a similar concept of continuity as in the usage of phab rta.
See Samuel and Cantwell, forthcoming, for phab rta in longevity pills.
These pills are consecrated with the mantra of Avalokitevara, om mani padme hung.
106
There exists a large variety of such Dharma pills, prepared by Buddhist lamas from relics
and various mineral, plant and other substances, which are consecrated in rituals and shared with
disciples to confer blessings and wisdom and protect from diseases and malevolent spirits.
107
See Garrett 2009a.
104
105

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221

They accumulate blessings and nus pa, thus interlinking essence-extractions,


nectars and accomplishing medicines.
Concluding remarks
This paper introduced ideas of bcud len in contemporary Tibetan supplements
that are sold as tonics, essence extractions and elixirs. I did not analyse the
actual ingredients of bcud len supplements,108 but tried to understand how
contemporary Tibetan medical practitioners in India view and utilise ideas
surrounding bcud len in the development and promotion of new Men-TseeKhang supplements. I argued that not all bcud len are essence extractions and
that what constitutes an essence receives various interpretations by contemporary Tibetan doctors. Medical ideas of ways in which essences can be
extracted include a range of methods which can be pharmacological, meditative or physiological in nature. All of them, however, are aimed at extracting
bcud from material or spiritual substances for the revitalisation and strengthening of the body.
The range of interpretation of bcud in the various Sorig products introduced
in this paper, as well as the differences in compounding methods, show that
there is no single definition of a bcud len in Tibetan medicine. Contemporary
medical practitioners have skilfully made use of the polysemous nature of bcud
len to create new, popular, income-generating products and promote them in
ways palatable to their Tibetan, Indian, and foreign customers.
The commercial viability of Sorig products cannot be overlooked. It is
reflected in the Men-Tsee-Khang sales figures and in the ways in which the
products are promoted online and in the English brochure and leaflet. Despite
certain legal restrictions, the production of Sorig tonics are a successful incomegeneration project for the Men-Tsee-Khang. It is the tonic and elixir aspect of
bcud len practices that sells, not the purification and fasting aspect. While the
Gyushi explains that rejuvenating bcud len can only have effect when the body
is cleansed,109 such purification drugs (enemas, purgatives) are not produced
at the Men-Tsee-Khang or sold as part of the supplements.110 Manufacturing
simple tonics that can be taken as supplements open global market opportunities, avoiding legal restrictions attached to the sale of medicines. While some
doctors prescribe Sorig products to their patients, others dismiss them as commercial bcud len. Thus, there are a variety of views in the Tibetan medical
For bcud len ingredients mentioned in the Gyushi, see Gerke, forthcoming.
Emmerick 1990.
110
Dr Ngawang Soepa, personal communication, Dharamsala, 6.8.2009.
108
109

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B. Gerke / Asian Medicine 7 (2012) 196224

establishment concerning concepts of bcud len and not all agree with the concept of bcud len as portrayed by Sorig products.
Despite commercial dimensions and global regulations, consecration
remains an essential ingredient of the products. The fact that sman sgrub rituals are performed regularly at the Men-Tsee-Khang to consecrate the bcud len
tonics (and other medicines) reaffirms Garretts earlier statement that although
the bcud len and sman sgrub traditions do have distinct bodies of literature, the
practices are closely intertwined and share many techniques and theories.111
The blessed substances from the Dalai Lamas temple make the products also
attractive for Tibetans who live far away from Dharamsala but want to remain
linked to the blessings of the Dalai Lama. The self-consecration of supplements is also made more accessible to clients through printed leaflets about
meditative consecration practices that can be practised without empowerments and teach patients how to extract essences and bless the substances they
take through visualisation and across religious beliefs. In sum, Tibetan notions
of elixirs, nectars, tonics and essences, which are concerned with vitality
and rejuvenation, are both employed and adapted for contemporary use in the
production and promotion of Sorig supplements.
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