The Role of Elemental Calculation ('byung rtsi) in Tibetan Medicine

This post is the first of two posts. As I was writing the original post from which the following two posts derive, I realized that you, the readers, would be better served by two separate posts. 

Often referred to by the misnomer "Tibetan Astrology", "Prognostic" Calculation (rtsi) pervades every aspect of Tibetan social and religious culture. Calculation is used for rendering yearly calendars, matchmaking, for funerary arrangements, determination of what sort of rituals one should use on a yearly basis for removing obstacles and so on.


Calculation is generally divided into two categories: "dkar rtsi", deriving from the Kalacakra Tantra and its commentary, the Vimalaprabha; and "nag rtsi", "black" calculation, also known as "'byung rtsi", which is traditionally held to derive from China, but contains what appear to be many Tibetan innovations. There are other systems of rtsi besides these two, such as the system of martial calculation called dbyang 'char, which derives from a non-Buddhist tantra, the Yuddhajayārnava Tantrarāja Svarodayanāma first translated into Tibetan in the 13th century by Lowo Lotsawa, Sherab Rinchen, but they exceed the range of these posts.

The magnum opus of calculation is undoubtedly Desid Sangye Gyatso's Bai dur ya dkar po. The Lhasa block prints, made available in book form in 1972, consists of two volumes amounting to 350 folios, primarily written in dense 7 and 9-syllable verses. Beykar, as it is known amongst Tibetans, is an encyclopedia of information related to the science of calculation, covering diverse topics from the origins of the Kalacakra tantra and the location of Shambhala to a detailed exposition of various types of bhumipatis, sa bdags or landlords. 

Other important authors concerning the broad range of calculation topics are Tagtsang Lotsawa, Kongtrul, Mipham, Lochen Dharmashri, just to name a few of the most well-known Tibetan polymaths who devoted themselves to aspects of the subject.

The presence of elemental calculation in the sequel or uttaratantra of the four tantras has long been a source of controversy among Tibetans, causing authors such as Zurkar Lodo Gyalpo and Thukwan to cast doubt on the Indian origins of the Four Tantras as a whole. Irrespective of the ultimate origins of elemental calculation, (also a controversial topic about which there are numerous Tibetan opinions) it plays a key role in the diagnosis of illness within the rGyud bZhi tradition, respectively, in the pulse and urine diagnosis chapters.

In Tibetan Medicine, there is slippage around the use of the term "khams": used both for the Chinese system of five "elements" and the Indian Buddhist term dhātu which can lead to confusion. In Buddhist texts there is the notion of the catvāri mahābhūtāni ('byung ba chen po bzhi), the four primary elements i.e. earth, water, fire and air. To this a further scheme is added, the pañcadhātu (khams lnga) earth, water, fire, air and space. Finally, we have the scheme of the saḍadhātu (khams drug) with the addition of consciousness. 

Calculation and Diagnosis:

In the pulse chapter, we find that the sites of the pulse of the functional organs, such as the liver, heart, lungs, kidneys and spleen are governed respectively by the wood, fire, metal, water and earth elements familiar to us from Chinese traditional medicine, and depend upon it. As such, this grouping of five elements, or phases (Ch. wu hsing) as the historian of Chinese Medicine, Paul Unschuld (Medicine In China: A History of Ideas; Berkeley, 1985), terms them, have ancient roots in Chinese culture dating from well before the beginning of the common era.

The five elements are used in pulse diagnosis primarily to differentiate the dominant organ in a given season. For example, for the first 72 days of spring, it is held that the liver pulse will be the most active, and that the healthy pulse in general will be thin and tight. 

Another use of the five elements is the calculation of the mother/son enemy/friend cycle which is used in the so called "seven amazing pulses". These seven pulses are a type of prognostication which is performed on a healthy person, used to discover the health of a distant person, where a traveller related to a person is on their journey, and so on. Needless to say, these amazing pulses are the domain only of the most skilled physicians. 

The second main place where the system of elemental calculation appears is in the urine chapter. In this chapter, the principle element of elemental calculation used is that of the cosmic tortoise [srid pa'i rus sbal] used as a basis for the divination of spirit attacks. 

The tortoise is divided into nine sections. The head of the tortoise faces to the south, the tail to the north. The column to the right (the west) represents the location of gods, humans, and spirits from top to bottom (south to north), the column on the left (the east) represents the location of the cemetery, house and fields. The central column represents one's parents and grandparents, oneself, and one's children and grandchildren. 

Using this schematic, one divides the porcelain bowl into nine sections accordingly. Then one observes various omens from the urine such as sudden color change in a given region, no change, the formation of shapes in the film of the urine, and so on, to divine what type of provocation the patient, his family or his property might be suffering from. 

One thing of interest is that there is no mention of the seven amazing pulses in the rgyud chung bdud rtsi snying po (found in cha lag bco brgyad), undoubtedly the source the uttaratantra and the upadesha tantra of the four tantras. Spirit divination with urine is present in this text. However, a similar type of prognostication with pulse, as well as spirit divination with urine can be found in the earlier sman dpyad zla ba'i rgyal po.

Calculation, Illness and Ritual:

A further role that elemental calculation plays in Tibetan medicine is the direct diagnosis of illness. Desid states in the introduction to the section on diagnostics through calculation:

The straight tree of calculation for understanding the production of

the four hundred and four diseases formed from the five elements (bhūta),

in the illusory bodies of migrating beings, the nature of the five elements,

through power of the elemental spirits (bhūtas) and past conditions will be explained.

This type of calculation is a very serious business. To begin with, Desid advises the calculator to avoid alcohol and immoderate conduct. In the virtuous hour of the early morning (meaning around 7:00 am), in an unpolluted place, with a clean (lit. white) floor, on a comfortable seat, with a compassionate mind, take refuge. Also one must resolve to speak very truthfully about the years, months, days, hours, the trigrams, magic squares, planets, stars, bhūmipatis and local spirits (gzhi bdag). Otherwise, he says that one's mind will be "robbed" by the god that governs the hour, and one's prognostication will go awry. Therefore one must perform the calculations in a completely undistracted manner. 

However, it should be pointed out that all of the remedies provided in this chapter are ritual remedies, rituals to supplement the actual medical remedies which one can find in the four tantras. Thus, the primary focus of elemental calculation here is on the usage of gto rites and others kinds of rituals to eliminate illnesses, prolong longevity and so on. 


Apart from of which pulse corresponds with which season,  and the corresponding elemental attribution to the internal organs, we can see from the above that the principle role of calculation in Tibetan Medicine is the diagnosis of the so called kun btags gdon i.e. imputed, invisible, formless spirits, which play in integral roles in the causation of disease.