First came Ayurveda, then Traditional Chinese Medicine. Now, Tibetan medicine—a diagnostic and philosophical system dating back thousands of years—is gaining increased acceptance in the West.

Tibetan medicine has commonalities with other traditional medical systems. Dating to the seventh century, the Tibetan government hosted medical conferences with doctors from Greece, Persia, India and China. By the 11th century, Tibetan practitioners had begun to codify their unique synthesis of physical and psychological medicine and Buddhist spiritual practice.

The result is a subtle and complex system that views human health in relation to the processes of the natural world. But some practitioners say that as Tibetan medicine gains popularity, this subtlety may be lost, turning this traditional system into just another commodity in a culture hungry for alternative cures.

Eliot Tokar, a New York City-based practitioner who has studied extensively in Tibet and is also trained in Chinese and Japanese traditional medicine, is concerned that the same big-business model that has entered the dietary supplements industry in recent years will also be applied to Tibetan medicine, with disastrous results.

"Before, the people involved in such products were small-scale manufacturers going into business for the right reasons," Tokar says. "Now, increasingly, traditional medicine is thought of as just another medical product. Companies are applying the pharmaceutical model or the allopathic medical model. The motivation for this has little to do with health or with promoting traditional medicine, but in creating a new saleable product for the supplements or nutraceutical industry."

Because of its subtleties, Tibetan medicine can't be reduced to a bottle of pills and remain Tibetan medicine. At the heart of the system is the idea of the Five Elements: Earth, Water, Fire, Wind and Space. These elements combine in varying degrees to create this world. In the human realm, the functions of the body are thought to be governed by the Three Humors, translated into English as Wind, Bile and Phlegm—each humor governing not only physiological processes, but psychological ones as well.

For example, Wind governs circulation, not only of the blood, but of food through the digestive system and electrical impulses through the nervous system. In terms of the mind, Wind is expressed as materialism or attachment. Bile controls metabolism and liver function, but an imbalance of Bile can be expressed as anger or hatred. Phlegm is thought to provide the body's lubrication, and also to govern memory and will; it is linked on the mental level to ignorance.

Pills or tinctures—often the first type of treatment in the West, even among those who embrace alternative medicine—is not the approach that Tibetan practitioners use to begin treatment, according to Tokar. "Tibetan medicine is increasingly defined as simply the pills used," Tokar says. "But in Tibet, herbal treatment is the third level; first comes behavior modification, then working with the diet, then herbs, then various physical therapies such as massage, acupuncture and hydrotherapy." The result is a holistic treatment system that relates illness to the patient's behaviors and to the natural world.

However, working directly with a Tibetan physician is not an option for many consumers, given the few trained professionals currently working in the United States. Ideally, the physician creates an herbal medicine specifically for a particular patient's symptoms; however, according to Subhuti Dharmananda, Ph.D., the director of the Institute for Traditional Medicine in Portland, Ore., there is a history of standardized formulas in Tibet, largely because the vast distances between settlements made it impossible to blend herbs on site. Traditionally, doctors working outside the capital of Lhasa used a collection of several dozen principal formulas, each containing from eight to 25 individual herbs.

One such formulation available in the West is Padma Basic, an herbal blend manufactured by Padma Health Products Inc. of Switzerland and distributed in the United States by EcoNugenics of Santa Rosa, Calif.

Isaac Eliaz, M.D., president of EcoNugenics, says his company began distributing the product because he was impressed both by the manufacturing quality controls and by the wide-ranging third-party research supporting Padma Basic. "Spiritually, I've been a Tibetan Buddhist for many years, so [Tibetan medicine] is a tradition I have the utmost respect for," Eliaz says.

Eliaz believes the product represents the best of both worlds—ancient and modern, East and West. "I love Padma Basic because it is a traditional Tibetan formula modified to fit the Western world, [and] with all this research," he says. "I'm impressed by how it integrates ancient wisdom with modern manufacturing methods."

Padma Basic is a cooling formula, designed especially to aid circulation and help reduce inflammation. Eliaz says there are more than 20 peer-reviewed studies of the product showing positive effects on conditions ranging from arthritis to coronary artery disease, from multiple sclerosis to diabetes. "The product shows a strong immunomodulatory effect," Eliaz says, and shows promise in treating chronic hepatitis B.

Retailers wanting to help customers explore the promise of Tibetan medicine will need to do more than simply steer them toward a ready-made formulation. While that formulation may be effective, such an approach misses the complex interaction between individuals and the environment at the heart of Tibetan medical philosophy.

The complexity of this system may seem daunting, but in that complexity, Tokar sees an opportunity for natural products retailers. "For 30 years, there has been a grass-roots movement to bring back ideas about natural medicine and natural health care. This was a real alternative instead of just a product name," Tokar says. In the past, he says, natural products retailers were the businesses best-positioned to help people educate themselves about alternative approaches to healing. "It was very common for people to have to read things, talk to friends and make real inquiries."

Why dive into such a complex system? What can Tibetan medicine offer that other approaches can't? According to Tokar, Tibetan medicine isn't just a system for getting well, but also a system for living well. "In Tibetan medicine," he says, "it's thought that the main cause of illness is ignorance—not knowing and not wanting to know. As a result, the three poisons of mind arise: materialism, aggression and ignorance. And what are the cures for those conditions? Mindfulness and ethical conduct cure materialism, compassion cures aggression, and wisdom cures ignorance. Tibetan medicine is not just a clinical system of formulas and strategies to treat Western illnesses."

If retailers are willing to explore Tibetan medicine in depth, rather than simply stocking shelves with Tibetan products, they may find that they can better help customers make basic, far-reaching changes in diet, outlook and overall health.

Mitchell Clute is a poet, musician and freelance writer based in Louisville, Colo.

Natural Foods Merchandiser volume XXII/number 10/p. 72, 74