This paper mainly deals with the following three points, namely, (1) Origination and development of ancient Tibetan medical and medicine theories; (2) Achievements in medical care, academic inheritance and modernization of traditional Tibetan medical and medicine theories after the peaceful liberation of Tibet; (3) The main working approaches for the development of traditional Tibetan medical and medicine theories in the new era.

I. Origination and Development of Ancient Tibetan Medical and Medicine Theories

It is believed by some people that early medical theory in Qinghai-Tibet Plateau had been transmitted and disseminated in Mar scripts of Shang Shung kingdom period before Tibetan scripts system was created. If this point of view is true, then the traditional Tibetan medical and medicine theories have at least a history of over 3800 years. The 7t' century saw the great leap forward of the traditional Tibetan medical and medicine theories when Tibetan scripts, used till today, were created and developed.

As one of the four major traditional medical theories in the world, the traditional Tibetan medical and medicine theories, by broadly assimilating the essence from those of China's hinterlands and the neighboring countries during several thousands years, and by constantly consolidating and improving its own, have become a medical system with its own features and a complete set of theories and clinic techniques. Throughout the history, the traditional Tibetan medical and medicine theories consecutively absorbed the contents of medical theories of ancient India, China's hinterland, and Arab, etc. The other way around, it had also made contributions to the developments of medical theories of China's hinterland, south Asian countries, Russia and Mongolia, etc.

II. Achievements in Medical Care, Academic Inheritance and Modernization of Traditional Tibetan Medical and Medicine Theories after the Peaceful Liberation of Tibet

Before the peaceful liberation, Tibet had long been a society languishing under a system of feudal serfdom, with extremely backward social and economic situation and slow development in all aspects. There were only a few medical, education and production organizations of traditional Tibetan medicine, which were extremely short of financial input. They could only provide medical services to high-level officials; living Buddha in monasteries and upper-class nobles, so grass-root farmers and herdsmen could seldom enjoyed the benefits of the culture of the traditional Tibetan medicine.

After the peaceful liberation, especially since the reform and opening up, medical care in Tibet has witnessed substantial changes and development. Besides those like me who personally experienced this special period of historical development, no one can imagine how great progress and achievements Tibet has made in various aspects after shifting from a system of feudal serfdom to the socialist system.

1. Development of Tibetan Medical and Health Care Undertakings from a Traditional One to A Modern One

Development level of public medical institutions and health care service is a standard directly reflecting social progress level. In 1959, former Medical Institute and Lhasa Institute of Tibetan medicine and Astrology were merged to become Lhasa Traditional Tibetan Medicine Hospital, with its affiliated prefecture- and county-level medical institutions established at the same time. Experts from the two medical institutes and renowned folk specialists in medicine and astrology were invited to work in the departments and to help carry out medical care, education and scientific research in traditional Tibetan medicine and astronomical astrology, thus creating a new pattern of development for prefecture- and county-level medical and public health services.

The decade-long Cultural Revolution not only slowed down development of medical culture around the country but also seriously devastated and impacted the development of traditional Tibetan medical and medicine theories. In 1979, traditional Tibetan medicine ushered in an era of unprecedented development. In 1980, Lhasa Traditional Tibetan Medicine Hospital was renamed Traditional Tibetan Medicine Hospital of Tibet Autonomous Region (TAR), and the scale of affiliated out-patient departments, in-patient departments, pharmaceutical factories of Tibetan medicine, research institutes and prefecture- and county-level medical institutions, manning quotas, production, infrastructures etc., was further expanded. Presently, there are over 500 medical personnel in hospital departments in TAR, all departments and offices are well fitted with modern medical apparatuses and equipments, over 300 beds are available in in-patient departments, inpatient amount reaches over 3500 person-times, and annual clinic attendance of out-patient department reaches over 160,000 person-times. In addition, in 6 prefectures in the whole region, Tibetan medicine hospital has been set up in 10 counties, and Tibetan medicine department has been set up in 64 counties. So far there is one provincial-level Tibetan medicine hospital, 6 prefecture-level Tibetan medicine hospitals, and 10 county-level Tibetan medicine hospitals. In addition, special international funds are available for development of education, scientific research and pharmaceutical production etc. in traditional Tibetan medicine. With regard to development of Tibetan medical institutions, so far, there are over 600 beds in the whole region, annual clinic attendance reaches over 600,000 person-times, and there are over 1,850 medical and pubic health professionals and over rural 600 doctors in the traditional Tibetan medicine with license from the state, thus enabling the traditional Tibetan medicine to better accomplish its mission of "healing the wounded and rescuing the dying, providing medial and healthcare services, and benefiting all people".

2. Transmission of Traditional Tibetan Medical and Medicine Education from the Traditional Way of "Master to Apprentice" to That of Modern College Education

In old Tibet, in order to popularize medical and public health services in Tibetan regions, the Medical Institute and Lhasa Institute of Tibetan Medicine and Astrology, Lhasa Institute of Tibetan Medicine and Astrology (which is the first one with both medical treatment and education in Tibet) were established. However, there were only around 70 students at that time. After the peaceful liberation, the Central Committee of the CPC and the Chinese government attached much importance to medial and educational development in Tibet. To promote overall administration and development, in 1959, the former Medical Institute and Lhasa Institute of Tibetan Medicine and Astrology were merged to Lhasa Traditional Tibetan Medicine Hospital, and a number of renowned senior physicians in Tibetan medicine were employed to work in the hospital. Nearly 100 physicians in traditional Tibetan medicine were cultivated in 1963 and 1970 respectively based on Lhasa Traditional Tibetan Medicine Hospital so as to gradually expand the medical and public health service team of traditional Tibetan medicine. The two batches of learners had not been granted with formal diploma, but they played important roles in inheriting the traditions and breaking the new grounds for future development of Tibetan medical and medicine theories. As of today, most of them are still the backbone force in medical and educational institutions of traditional Tibetan medicine throughout Tibet. In 1974, Lhasa Health Care School provided Tibetan medicine courses and had cultivated over 140 Tibetan medicine physicians with secondary vocational school education diploma by 1981, thus degree education of Tibetan medicine in real sense was available ever since.

Since the 1980s, under great attention and support of the Central Committee of the CPC and the Chinese governments at all levels, education of traditional Tibetan medical and medicine theories has witnessed rapid development. In 1983, Traditional Tibetan Medicine School of TAR was established to cultivate special Traditional Tibetan medicine professionals; in 1985, Tibet University was established based on the former Tibet Normal University. The Traditional Tibetan Medicine Department was set up in the university, thus the first batch of undergraduate students of Tibetan medicine was cultivated. This marked the start of modern college education in traditional Tibetan medical and medicine theories. Traditional Tibetan Medical College of Tibet University was established and inaugurated on September 3, 1989 upon approval by the TAR government. Traditional Tibetan Medical College not only marked that education of traditional Tibetan medical and medicine theories was listed as part of national higher education, but also became the first ethnic medical college education institution that was set up interpedently upon approval of the central government.

Over the past decade, as the Central Committee of the CPC and the Chinese governments attached greater importance and support to development of Tibetan culture, traditional Tibetan medicine, with a long history of several thousand years, witnessed unprecedented development in the aspects such as education, scientific research, medical services and industrial development. In June 1998, Tibetan Medicine Hospital of TAR formally applied to the state government for establishing a master's degree program for traditional Tibetan medicine major, and formally enrolled the first batch of master's degree candidates in 1999 upon approval via national educational testing, thus the hospital became the first unit of master's degree program of traditional Tibetan medicine and cultivated the first batch of post graduates of traditional Tibetan medicine in the world's medical history. In 2004, Tibetan Traditional Medical College and Beijing University of Traditional Chinese Medicine joint started to enroll the first batch of Ph. D. candidates for traditional Tibetan medicine major. In addition, in recent years, with a view of the development of traditional Tibetan medicine, multiple scientific research institutes and Chinese traditional medicine colleges have cultivated a number of high-level professionals for traditional Tibetan medicine research. This marks the historical change of high-level traditional Tibetan medicine professionals from inheritance type to research type and gradual shift of traditional Tibetan medicine to modern development on the premise of fully inheriting traditions.

3. Well Development of Study in Traditional Tibetan Medical and Medicine Theories with Modern Scientific Research Methods

Before the peaceful liberation of Tibet, although the existing traditional Tibetan medicine institutions carried out basic research on the theory, clinics and pharmacy of traditional Tibetan medicine, no research institutions and personnel were specially devoted to traditional Tibetan medical and medicine theories.

After the peaceful liberation, the Central Committee of the CPC and the Chinese government attached much importance to scientific research and development of traditional Tibetan medicine. In the early 1970s, the Tibetan Medicine Institute of Lhasa Tibetan Medicine Hospital was established, and renowned experts were appointed as full-time researchers to carry out systematic research on traditional Tibetan medicine and astronomical astrology. After years of development, the institute was upgraded in 2006 into the Traditional Tibetan Medicine Academy of TAR. In addition, according to the actual situation in teaching, medical care and production of traditional Tibetan medicine, Tibetan Traditional Medical College has successively established its affiliated S&T institute and research offices for traditional Tibetan medicine in prefectures such as, Ngari, Shigatse, Lhoka, Nagqu and Qamdo. As of 2006, there are two provincial-level research institutions, 5 prefecture-level research offices and over 100 full-time research professionals for traditional Tibetan medicine.

Making scientific achievements is the goal of scientific research, and also the significance of implementing scientific research programs. After years of efforts, Tibet has made fruitful achievements in traditional Tibetan medical, medicine and astrology. With regard to study of ancient books and documents, over 100 ancient books and documents on traditional Tibetan medical and medicine theories have been rescued, collated and published by establishing the relevant programs upon approval by the State Administration of Traditional Chinese Medicine and Pharmacy, providing ample reference data for professionals in medical care, teaching and scientific research of traditional Tibetan medicine. In academic research, several dozens of medical research works such as China Medicine Encyclopedia: Tibetan Medicine etc. have been newly complied and published, and a number of modern scientific research achievements such as Standards of Tibetan Medicine Promulgated by the Ministry of Public Health, Material Medicine of China. Tibetan Medicine etc. have been studied and published by means of modern pharmaceutical chemistry etc. In addition, the teaching materials such as Teaching Outline of National Undergraduate Courses of Traditional Tibetan Medicine, Planned Teaching Materials for Undergraduate Education of Traditional Tibetan Medicine in the 21" Century etc. have been published. In medical research, in recent years, the relevant research institutions actively applied to the departments such as Tibet S&T Bureau, the State Administration of Traditional Chinese Medicine and Pharmacy, National Natural Science Foundation of China etc. for establishment of scientific research programs, with 10 million yuan granted. Many of these state- and provincial-level scientific research programs won provincial-level, ministerial-level, state-level and international awards. It is worth mentioning that, to better inherit and preserve traditional culture and cultural relics of traditional Tibetan medicine and to understand and develop its cultural background and historical connotative meaning, Tibetan Traditional Medical College started in 2003 to prepare for construction of "Tibetan Medicine and Astronomical Astrology Museum", searched for and collected cultural relics of traditional Tibetan medicine and astronomical astrology, and participated in formation of the relevant regulations on preservation of the relevant cultural relics. Presently, this task is proceeding smoothly.

4. Development of Production of Traditional Tibetan Medicine from Traditional Ways to Modern Ways

In old Tibet, due to out-of-date pharmaceutical equipments, incomplete organization structure and lack of special personnel, medicines were mainly produced manually in small workshops, so only a small varieties of traditional Tibetan medicines were available and the output was limited. In such case, these medicines could only meet the demand of high officials and nobles and the broad masses of farmers and herdsmen had no access to traditional Tibetan medicines even though they were affordable, not to speak of applying medicines according to their ill conditions.

After the peaceful liberation of Tibet, pharmaceutical factories and preparation labs of traditional Tibetan medicine of different sizes have been established in Tibetan Medicine Hospital of TAR and all prefecture- and county-level Tibetan medicine hospitals for production and research of various finished traditional Tibetan medicines for clinic uses, thereby ensuring to meet the demand of all farmers and herdsmen in the whole region. As of 2006, there are over 20 medium- and large-scale pharmaceutical enterprises of traditional Tibetan medicine and 18 enterprises that have passed the national GMP certification in the whole region, and over 360 varieties of traditional Tibetan medicines have been produced by various pharmaceutical factories, with an annul output of 2,786 tons, production capital of RMB 451.3314 million and annual income of RMB628 million. 14 of these varieties were listed in National Protected Traditional Chinese Medicinal Products, 24 medicinal materials in national major medicine varieties, 218 medicines and 141 medicinal materials in Chinese Pharmacopoeia. In addition, the "Ganlu" trademark of Pharmaceutical Factory of Tibetan Medicine of TAR and "Cheezheng" trademark of Cheezheng Tibetan Medicine Group were awarded the title of China Famous Trademark. In general, thanks to vigorous support by state policies, all-round development has been achieved in preparation, production and research of traditional Tibetan medicines, and presently, production and sale of traditional Tibetan medicines has been listed in special backbone industries in TAR.

Moreover, the state government has strengthened policy support and fund input in research of traditional Tibetan medicine development strategies, preservation of genuine medicinal materials and endangered medicinal materials, protection of plateau environment and improvement of drug administration system etc., effectively ensuring sound and orderly development of traditional Tibetan medicine in such aspects as medical care, education, scientific research and production.

III. Several Points to Be Addressed for Future Development of Traditional Tibetan Medical and Medicine Theories

As a humanistic medical science and a "green science", traditional Tibetan medical and medicine theories meet the demand for new medical concepts in the new era. Although traditional Tibet medical and medicine system is one of the four major traditional medical and medicine systems in the world, its complete medical theory and systematic clinic therapies are yet to be studied with modern science and technologies. Under the premise of affirming achievements, we should find out the existing problems and timely address them in future development.

1. Further Establishing and Improvement the Grass-root Medical and Production Organizations of Traditional Tibetan Medicines

The government should increase the annual expenditure planned for various farming and gazing areas and strengthen construction and manning of grass-root medial organizations of traditional Tibetan medicine to meet the basic demand of the working people.

2. Urgent Need for Study, Inheritance and Exploration of Experience from Senior and Famous Physicians of Traditional Tibetan Medicine

While further strengthen modern educational reform, we should, based on the actual situation of the traditional Tibetan medical and medicine theories, formulate some preferential policies on selecting and allocating students to learn from the experience from senior and famous physicians of traditional Tibetan medicine so as to better solve and accomplish the in-depth inheritance problem of traditional Tibetan medicine. This is a critical problem to be addressed urgently in current teaching of traditional Tibetan medicine.

3. Carrying out Effective Preservation for Famous Sites and Cultural Relics of Traditional Tibetan Medical and Medicine

For famous historical sites of traditional Tibetan medicine, one effective way for preservation of Tibetan historical cultures is to determine preservation class and implement preservation measures. In addition, to better preserve and utilize the unique copies of ancient books and documents on traditional Tibetan medicine kept in Potala Palace, the Archive of TAR and Norbu Lingka etc., it is recommended to collate and publish these ancient books and documents so as to effectively prevent their disappearance and provide precious research data for traditional Tibetan medicine scholars.

4. Further Strengthening The Construction of Traditional Tibetan Medicine Education and Teaching Bases, Especially for Higher Educational Institutions.

Tibet is the cradle of traditional Tibetan medicine, so it is extremely necessary to construct in Tibet a well-equipped modern higher educational institution of traditional Tibetan medicine so as to increase input to provide systematic undergraduate, master's and doctor's degree education in traditional Tibetan medicine and pharmacy, and thus to achieve the development objective of constructing modern higher educational institutions of traditional Tibetan medicine.

5. Strengthening Modern Scientific Researches on and Finding a New Way for Traditional Tibetan Medical and Medicine Theories

Based on further consolidating and improving the functions of existing institutions for teaching, medical care and medicines, modern scientific research on traditional Tibetan medical and medicine theories should be strengthened by use of advanced modern scientific research methods and achievements. This task can be carried out from the following three aspects: (1) applying to establish technology R&D programs on basic topics of traditional Tibetan medicine so as to meet its long-term development requirements; (2) carrying out modern systematic research on principles, methods, pharmacology and treating efficacy of traditional Tibetan medicine and developing new varieties with new dosage forms and high efficacy for some common difficult and complicated diseases such as diabetes, tumor and Aids etc.; (3) further strengthening specific research on ancient books and documents on traditional Tibetan medicine and traditional medical mode so as to completely depict traditional medical concepts with modern sciences and then expand and enlarge the fields and roles of traditional medicines in medical and public health services in the world.

6. Strengthening Preservation of Genuine Medicinal Materials and Endangered Medicinal Materials and Establishing and Implementing A Collection and Preservation System for Traditional Tibetan Medical Materials.

With a vast territory, Tibet abounds in precious natural Tibetan medical materials with high purity due to its unique plateau geographical and climate environments. However, in recent years, acute growth of demand for Tibetan medical materials due to worldwide expansion of services and industrial development of traditional Tibetan medicine and extreme fragility of plateau environment have led to shortage of multiple genuine Tibetan medical materials and disappearance of some varieties. Realizing the severity of this problem, the relevant government departments have initiated some programs for resource preservation, medical material planting etc. However, due to poor implementation of the concerning tasks such as management, scientific research, fund allocation etc., the general work result is not satisfactory, and serious unplanned cutting can still be found in many local areas. Therefore it is imperative for the relevant departments to establish an effective system for scientific collection and preservation of Tibetan medical materials, especially genuine and endangered Tibetan medical materials, and strengthen input in manpower and material resources and scientific research to ensure its implementation.

Wangdui, Professor of Tibetan Medical College of Tibet Autonomous Region

Oct. 11, 2006