I. The Essential Nature of China's Tibetan Medicine

1. Academic Value

1.1. Tibetan Medicine as an Important Research Field in Tibetan Studies

It is generally considered that Tibetan study is a comprehensive discipline, including social science and natural science. Tibetan medicine, dominantly characterized with natural science, is an important research field in Tibetan studies, and it is highly held as one of Five Great Branches of Knowledge (Craft, Medicine, Sanskrit Grammar, Logic, and Buddhist Philosophy) in Tibetan ancient books and records.

1.2. Tibetan Medicine as an Important Branch of Traditional Medicine

In the sense of medical science, Tibetan medicine can be described in two ways. Firstly, as an important branch of the traditional medicine with an integrated system, Tibetan medicine ranks with traditional Chinese medicine, Indian medicine and Arabian medicine, all of which are called the world's four great medical systems. Secondly, Tibetan medicine is a branch of Chinese ethnic medicine. There are 55 ethnic minorities in China and they have their individual medical practices which are wholly taken as the national medicine. Ethnic medicine and traditional Chinese medicine jointly make up China's national traditional medicine, and Tibetan medicine is universally accepted as the representative of ethnic medicine.

1.3. Tibetan Medicine as a Comprehensive Discipline in Development

Systematically both in theory and practices, Tibetan medicine are rich in nature, with its clinical practices dealing with internal medicine, surgery, gynaecology, paediatrics and health care. Particularly, Tibetan medicine is well-known for the study of embryology and diagnosis by the patient's urine. Modern medicine is well developed today, and at the same time Tibetan medicine manifests its important theoretical and practical values. The study of Tibetan medicine is not purely in medical field; it covers both social science and natural science; the former deals with the history of Tibetan medicine and its representative experts, its relation with folk custom, religion and painting; the latter deals with biology, chemistry, physics, pharmacology, pathology, anatomy, paying more attention to the study of Tibetan herbal medicine and clinical treatment.

2. Industrial Value

With the rapid development in the past few decades, Tibetan herbal medicine has become an independent industry, which I have subdivided into three industries the first industry refers to the collection of Tibetan herbal materials, the raising of medicinal animals, and artificial growing of medicinal plants; the second industry refers to the production of medicine and nutriments by using Tibetan herbal materials; the third industry refers to medical treatment, research, education, commerce and tourism that are related to Tibetan medicine. Of the three industries mentioned above, Tibetan medical treatment and the processing of Tibetan herbal materials are most brisk with the other two in the course of rapid development.

3. Cultural Value

Tibetan medicine is not only a branch of science and an industry, but also a unique ethnic culture with the systematic knowledge of it as the core, including basic theories such as Theory of Three Reasons, Theory of Five Origins, and a comprehensive clinical system which, in particular, has gained rich clinical experience in local common diseases and frequently occurring diseases. The main classical books about Tibetan medicine are The Four Medical Tantras (Rgyud bzhi), Medical Investigation of the Lumar King (Sman dpyal zla bavirgyalpo) and so on. Tibetans have formed their conceptions of diseases, society, nature and life from the systematic knowledge of Tibetan medicine which is closely connected with religion, philosophy, astrology, phenology and folk customs. We may conclude that the culture of Tibetan medicine is the subsistence culture of Tibetans and part of the core of traditional Tibetan culture.

II. Development of Tibetan Medicine in China

History has witnessed Tibetan medicine's development, maturity, flourish, and decline. In recent years, Tibetan medicine has been developing better than ever with the central government's energetic support.

1. Legal Status of Tibetan Medicine

The Constitution of the People's Republic of China clearly stipulates that modern medicine and traditional medicine should be equally developed, which fundamentally confirms the legal status of Tibetan medicine as traditional medicine in China.

Chinese government has also promulgated a number of laws and regulations for the management of traditional medicine. Regulations for Traditional Chinese Medicine of the People’s Republic of China stipulate in the supplementary articles that the management of ethnic medicine should follow the regulations. Relevant legal explanations indicate that ethnic medicine has its own independent status, is entitled to the equal policy for traditional Chinese medicine, and at the same time enjoys the preferential policy from the government. There are specific requirements for the protection of Tibetan medicine clearly stated in the documents of trade regulations such as The Regulations for Protection of Traditional Chinese Medicine and The Chinese Pharmacopoeia.

In the past 20 years The Tibet Autonomous Region and the Tibetan autonomous areas in Qinghai, Gansu, Sichuan and Yunnan provinces have issued more than ten local regulations documents in which the development of Tibetan medicine is clearly stipulated.

2. Development of Tibetan Medicine

2.1. Scientific Research and Education of Tibetan Medicine

There are two groups of institutions of research and education of Tibetan medicine the specialized institutions of Tibetan medicine and the relevant institutions.

China Tibetology Research Center, the most authoritative research organ in China, owns an institute of Tibetan medicine; The School of Life Sciences of The University of Ethnic Minorities offers a speciality in Tibetan medicine; The Tibet Autonomous Region boasts The Academy of Tibetan Medicine, Tibetan Medical College, and The Secondary Specialized School of Tibetan Medicine. A training system for professionals of both basic and high levels of Tibetan medicine has been set up. Graduates were granted Master Degree of Tibetan Medicine for the first time in 2002, and admission for Ph. D candidates in the field of Tibetan medicine began in 2004. More and more foreign academic organizations are interested in the study of Tibetan medicine.

At present the study of Tibetan medicine focuses on three fields historical documents, clinical treatment, and pharmacy. In recent years, many translations of classical books of Tibetan medicine have been published; an extensive survey of Tibetan herbal resources in the Qinghai-Tibet Plateau has been made; full-length reference books such as Chinese Tibetan Materia Medica and Chinese Tibetan Medicine have been published. We have done a lot of research on Tibetan herbs and pharmacology with achievements in analysis and refinement of effective elements of Tibetan herbs. A great number of state and provincial programs for Tibetan medicine have been accomplished; academic exchanges are in full activity.

2.2. The Clinical Treatment of Tibetan Medicine

The Chinese government's support for Tibetan medicine began with the establishment of clinical organs. Nowadays, there are 17 independent medical organs in Tibet Autonomous Region, whose 70 counties have set up departments of Tibetan medicine. There are 1850 medical personnel employed by the government and 660 self-employed medical practitioners, with annual clinical treatment of 600,000 patients in the whole region. Hospitals of Tibetan medicine have also been set up in Tibetans-inhabited areas in Qinghai, Gansu, Sichuan and Yunnan provinces. In the mean time, more than 10 -inland cities have established clinical organs of Tibetan medicine, with annual clinical treatment of about 1,000,000 patients. Built in 1992, Beijing Hospital of Tibetan Medicine is the largest and the most influential of those inland clinical organs, and as an important window of Tibetan medicine in the capital of China and a great bridge between Tibetan medicine and international medicine, it has become an influential ethnic medical organ of the country. With Tibetan medicine serving as the main, Beijing Hospital of Tibetan Medicine boasts two combinations the combination of ethnic medicine, traditional Chinese medicine and western medicine; the combination of medical treatment and scientific research.

2.3. Industry of Tibetan Medicines

The encouraging situation of market economy and the favourable policy for developing the western part of China have supplied the industrialization of Tibetan medicines with good opportunities. By the end of 2003, there are 35 companies of Tibetan medicines in all parts of the country (23 of them are in Tibet), of which 40 percent have been reconstructed through GMP and two are listed companies. At the same time, there are 18 companies of traditional Chinese medicine producing Tibetan medicines in the country. By the end of 2003, statistics showed that the annual output value of Tibetan medicines amounted to 1,000,000,000 yuan, which is over 30 times more than that of 1996.

These medicines are used not only in Tibetans-inhabited areas, but also in more than 600 hospitals of other places in the country. Some of rare patent Tibetan medicines are sold in the sale net of 30 provinces of the country, even far away in Southeast Asia, South and North Americas. The industry of Tibetan medicines has achieved an average increase by 129% annually since 2000, and it is one of the six mainstay industries in Tibet.

2.3. Management of Tibetan Medicine

In China, the State Administration of Traditional Chinese Medicine is in charge of the management of national traditional medicine and medical treatment, and it has the special department of ethnic medicine managing and coordinating macroscopic development and routine work of ethnic medicine including Tibetan medicine. The departments concerned are set up in State Ethnic Affairs Commission, State Food and Drug Administration, and Ministry of Education respectively dealing with the establishment of organizations, the management of drugs and the training of professionals in the field of Tibetan medicine. The Tibet Autonomous Region has the special administration dealing with Tibetan medicine work within the whole region. As far as the academic societies are concerned, Chinese Ethnic Medicine Society is the highest among the ethnic medicine societies and it has a panel of experts in Tibetan medicine. Tibet and some other provinces have set up their own academic societies of Tibetan medicine.

III. Development Trend of Tibetan Medicine in China

1. Modernization of Tibetan Medicine Study

Essentially, the modernization of Tibetan medicine study is based on the participation in major modern medical research and the introduction of modern medical science and technology, and it also needs cooperation with other fields and disciplines.

1.1. Research Goals Participation in Major Modern Medical Research

Tibetan medicine has done extensive researches in dealing with cardiovascular diseases, cerebral diseases, digestive system diseases, diabetes and cancer. Some of the researches have shown that Tibetan medicine has its advantages in curing many difficult and complicated diseases with which modem medicine can do nothing. Meanwhile, Tibetan medicine has recently made efforts to try curing nervous system diseased and AIDS. When SARS was spreading in 2003, Tibetan medicine developed many effective preventive drugs. The involvement in solving the major medical problems has demonstrated Tibetan medicine's value, and it is also a right way in the modernization drive of Tibetan medicine.

1.2. Research Scope Multi-Discipline Cooperation

The two important tasks of Tibetan medicine in the modernization drive are inheritance and creation.

Inheritance means to explore historical medical documents, to learn from the Tibetan medicine experts who have made thorough study of medical classics, to carry on the rare legacy of Tibetan medicine of ages, and to conduct the study of the modernization of Tibetan medicine on the basis of the legacy.

Creation research covers many areas including research in curing modem frequently-occurring diseases; research in classic prescriptions of Tibetan medicine and effects of Tibetan patent medicines; research in new technology of producing Tibetan medicines; research in clinical treatments of Tibetan medicine; research in the combination of Tibetan medicine and modern medicine. Therefore, clinical branch sciences of Tibetan medicine are carrying out more extensive cooperation with biochemistry, genetics, microbiology and bioengineering, and an increasing number of sciences are involved in cooperation.

1.3. Research Team Broad Cooperation Among Professionals of Different Levels

In its modernization drive, Tibetan medicine research attracts professionals of different levels and fields. They can be divided into five groups 1) Tibetan medicine professionals who have been trained in the traditional way or master-to-apprentice way; 2) Tibetan medicine professionals who have received education from modern schools; 3) traditional Chinese medicine professionals who are doing inter-discipline researches; 4) researchers who are working on modern medicine or other modern sciences; 5) researchers of social sciences. The modernization of Tibetan medicine depends on the cooperation of the five groups.

2. Main Trend of Medical Treatment of Tibetan Medicine

2.1. Medical Organizations' Entry into the State Health and Care System

Most hospitals of Tibetan medicine in Tibetans-inhabited areas are designated by local governments as medical insurance organizations, whose clinical patients often outnumber those of other hospitals of the same level in the same place. 20 of Tibetan patent medicines have been included into the State Medical Insurance Drugs List, with more patent medicines to be added. Beijing Hospital of Tibetan Medicine became a designated medical insurance hospital in 2003, which indicates that Tibetan medicine has converged into the mainstream of the state health and care.

2.2. Standardization of Medical Management

Traditional clinical treatment of Tibetan medicine works by experience and flexibly treats the individual case according to its symptoms, but this kind of treatment is often vague, leaving not only room for flexible diagnosis, but also room for improvement. Entering the mainstream of the state health and care, Tibetan medicine is faced with two important tasks of making itself vigorous while adapting itself to the requirements of modern medical management.

In 1978, The Standards For Tibetan Medicine In Five Provinces made by the authorities of five Tibetans-inhabited provinces, came into effect and started the standardization of Tibetan medicine. It is the first document of local standards for ethnic medicine in China. In 1995, The Drugs Standards of Ministry of Public Health of the People's Republic of China – Tibetan Medicine, which are the state standards for ethnic medicine, came into effect. These standards define the collection and pharmacy of Tibetan medicine. In terms of medical services, Tibetan medicine hospitals of different levels have been built in accordance with the state standards of management; Tibet Public Health Bureau has drawn up documents of regulations and rules such as Standards of Management of Tibetan Medicine Hospitals of Different Levels and 271betan Medicine Nursing Rules of Operation. All these effective measures have greatly promoted the standardization of Tibetan medicine hospitals.

2.3. Extension of Medical Services

Historically, Tibetan medicine has been characterized with varieties of services including treatment, prevention, and health keeping, and so on. With the idea of returning to nature prevailing in modem cities, people begin to reconsider and explore the value of Tibetan medicine. In general, the services of Tibetan medicine are extending from treating individual cases to offering multi-services which are the following 2.3.1. Increasing Medical Treatment of Diseases the services of Tibetan medicine are now extending from treating traditional diseases to all kinds of modern difficult and complicated diseases.

2.3.2. Creating New Ways of Treatment

Tibetan medicine is characterized with its diagnosis by feeling the pulse and analyzing the urine, its treatment by dipping, acupuncturing and cupping; these traditional methods are combining with modern medical science and technology for improvement and creation.

2.3.3. Providing Medical Services for Sub-healthy People

Services for sub-health people deal with fatigue syndrome, obesity, insomnia, depression and cosmetization. Such services result in the development of health keeping and dipping of Tibetan medicine.

2.3.4. Spreading Knowledge about Health

Ideas of health keeping of Tibetan medicine embody essential Eastern concepts of health keeping. Spreading ideas and practices of health keeping of Tibetan medicine will help to prevent biological and psychological diseases of modern society. The multiform education of health is among new services of Tibetan medicine.

3. Varieties of Tibetan Medicine Industry

China's reform and rapid development of market economy open up bright prospects for the industrialization of Tibetan medicine; the development of western part of the county provides opportunities, capital and professionals. As a result, the rapid development of industrialization not only motivates the development of Tibetan medicine, but also becomes an important increasing point of economy in Tibetans-inhabited areas and even in the western provinces of the country.

Tibetan medicine industry has the following features

3.1. Industry of Tibetan Medicine as The Mainstay Industry in Tibetans-inhabited Areas.

The industry of Tibetan medicine is one of six mainstay industries in Tibet, and it is also a characteristic industry in Qinghai, Sichuan, Yunnan and Gansu provinces. For instance, in Tibet there are 23 factories of Tibetan medicine with annual output value of over 300,000,000 yuan. As long as we work scientifically and keep making new products to dominate the market, the industry of Tibetan medicine will become a major one in the western part of the country.

3.2. Industry of Tibetan Medicine as An Impetus

It is most likely that the industry of Tibetan medicine will become the leading industry in Tibetans-inhabited areas with regard to its speed and scale of development. Its effects on other industries are as follows 1) the needs for raw materials stimulate the growth of the first industry including the collection of Tibetan herbal materials, the raising of medicinal animals, and the artificial growing of medicinal plants; 2) the needs for creation stimulate the development of the third industry including research and education and so on.

3.3. Bright Prospects for Industrialization of Tibetan Medicine

The Qinghai-Tibet Plateau is one of world's regions where living things are most varied and a great number of unique animals, plants and microorganisms exists; it is regarded as a huge and valuable reservoir of genes. People have collected 2172 kinds of plant medicinal materials, 214 kinds of animal medicinal materials and more than 50 kinds of mineral medicinal materials. According to the statistics, plants used for Tibetan medicine nearly make up ten percent of total Chinese plants. Out of the ten percent more than half grow in Tibet and 86 special plateau kinds of Tibetan medicine are produced. The exceptional natural resources make it possible to develop the industrialization of Tibetan medicine.

Moreover, about ten thousand prescriptions have been recorded in historical documents of Tibetan medicine, but now we have only 41 Tibetan medicinal materials and 203 Tibetan patent medicines listed in standards issued by Ministry of Public Health, 306 Tibetan patent medicines listed in the state standards, 14 Tibetan patent medicines listed in the state pharmacopoeia, and 12 Tibetan patent medicines listed in the state protected traditional Chinese patent medicines. Obviously, the industrialization of Tibetan medicine is potential with great prospects.

3.4. Maintenance of Sustainable Development in Harmony with Ecological Environment

As Tibetan patent medicines are mainly produced from plants and animals which exist mostly in the cold plateau with delicate ecology, we must try our best to protect the environment, make rational use of the natural resources, and take strict precautions against blind and destructive exploitation. On the other hand, we should guarantee the quality and reputation of the products.

A man walks with one foot up and the other down to the ground; only with his two feet alternatively up and, down can he advance. It is the same with the alternative rising of eastern medicine and western medicine. We believe that with modern medicine returning to an organic conception of the human body, eastern medicine including Tibetan medicine will fully demonstrate the advantages accumulated in thousands of years within a systematic medical pattern and that eastern medicine and western medicine will complement each other to benefit human health.

Huang Fukai, President of Tibetan Hospital in Peking

Oct. 11, 2006