Essentials of Complementary and Alternative Medicine (June 1999)

N
AVAJO
 M
EDICINE
 T
RAINING
Among the Navajo, medicine training is extremely long, requiring the exact memorization of complex chants, sand paintings, and rituals. Some begin learning in their 
teens, others not until their 50s, generally learning from a relative, clan member, or friend. Medicine man Denet Tsosi recounted that it took six years to learn one of 
the chants from his brother (
32
). In the 1970s, the National Institutes of Mental Health began funding a program in Rough Rock, Arizona, to train Navajo medicine men 
to teach apprentices (
11
, 
118
). The program began with 6 medicine men training 12 students. The average age of the students was 50, and the average age of the 
faculty was 85. Students also learned complementary interventions from Western psychiatrists. The program indicates a growing recognition by psychiatrists that 
culture and cultural expectations can affect treatment outcome.
Payment for Services
The exorbitant fees charged by Western medical practitioners are, from the Native American point of view, a sign of contemptible professional ethics. Because healing 
is a gift from the Great Spirit, it is beyond price and should never be equated with a specified bundle of “frog skins.” Although many healers accept monetary or 
material offerings, most do not charge a set fee. Illness is a time for generosity by a caring community. One should not take advantage of someone when he or she is 
down.
Frequently, the only required gift is a pouch of tobacco. In some traditions, acceptance of the tobacco offering seals a contract between patient and healer. Giving 
tobacco is a way of saying, “I respect your ways, and I offer prayers of smoke to the Great Spirit.” In Cherokee tradition, payment for services is called  ugista'ti, 
probably derived from the verb tsi'giû, meaning “I take” or “I eat.” On a practical level, gifts may help the healer to eat. This is not payment in the common sense of the 
word, but rather a necessity for “the removal and banishment of the disease spirit” (
119
). The offering ensures success of treatment because healing spirits appreciate 
generosity. Value is placed on the source of healing, not primarily on the healer. Hundreds of years ago, the gift was commonly a deer skin or pair of moccasins. 
Today, cloth, groceries, money, and/or other personal expressions of respect and gratitude are offered.
To consider a healing, the Comanche medicine woman Sanapia (
51
) required a ritual offering of dark green cloth, a 5/8-ounce bag of Bull Durham tobacco, and four 
corn shuck “cigarettes papers.” The patient would roll a cigarette, take four puffs, and offer the cigarette to Sanapia. Her acceptance of the cigarette was a contract 
between them, signifying her willingness to help. As a final payment at the conclusion of her services, Sanapia would accept whatever was offered. In 1972, her 
average payment was about $30, groceries, and enough cloth to make several dresses. She treated an average of 20–30 patients per year.
Flexible, sliding scale fees or barter may, nevertheless, place a demand on the resources of an impoverished patient. The patient is responsible for providing food 
and sometimes accommodations for the medicine person, his or her helpers, and others, including community members, who assist in healing ceremonies that may 
last several days. The patient, if he or she is educated in traditional protocol, will probably also wish to make a “sacrifice” of money or material goods to demonstrate 
sincerity and respect towards the healing powers. I have personally met a man who gave away his printing press—his only source of income—to a medicine man in 
gratitude for curing him of psychotic behavior caused by substance abuse. On the other hand, I have seen this same medicine man gratefully accept a pouch of 
tobacco and a twenty-dollar bill from a poor Indian patient who genuinely gave all he had. The medicine person, in turn, gives freely to those in need. He eschews 
greed and acquisitiveness.
PROSPECTS FOR THE FUTURE
Native American healing has made a comeback. More and more Native youth are learning to appreciate their tradition and to realize its strengths. Americans and 
Europeans are also demonstrating an extraordinary interest. This is a mixed blessing, because many non-Natives pursue a romanticized form of “Indian healing” as a 
way of rebelling against the dominant society's values and without learning the wisdom of their own ethnicity. The misrepresentation of Indian teachings by the New 
Age Movement and the stereotyping of Indian behavior present a threat to Indian identity.
8
The passing of the Indian Religious Freedom Act in 1978 was a significant step in restoring the right of Native Americans to practice their spiritual and healing 
traditions. Although this law does not yet have sufficient “teeth,” it is a step in the right direction. Much more needs to be done to restore sovereignty, to return illegally 
appropriated lands, and to preserve the biodiversity necessary for a sustainable and evolving Native herbal tradition. Without their original land base—the source and 
training ground of Native American healing—this most ancient form of holistic medicine can only be a fragment of what it was.
1
 To preserve brevity, in this essay I will reference Native nations by labels commonly used in EuroAmerican literature. However, the reader should be aware that these labels are generally not the 
way that Native people refer to themselves. For instance, the “Iroquois,” a French adaptation of an Algonquin term meaning enemy, call themselves Haudenosaunee, the People of the Long House. I 
hope that proper terms for Native nations will gradually be adopted in world literature.
2
 Other commonly used terms include American Indian and First Nations. Although indigenous Americans usually refer to themselves as “Indians,” there is no universally acceptable designation in the 
literature.
3
 Transpersonal imagery is defined as “imagery that is not confined to a single person's bodymind. It serves as a mode of communication from one person to another, through an unknown, invisible 
pathway” (
120
).
4
 Native American moderate and circumspect use of wild tobacco (primarily  Nicotiana Rustica) as a ceremonial aid and healing agent is sharply contrasted with the EuroAmerican custom of 
recreational smoking of cultivated varieties of the same genus (primarily  Nicotiana Tabacum). Several methods of ceremonial tobacco use have a wide distribution among Native nations, including 
burning tobacco in an open fire, smoking tobacco in a sacred pipe (Lakota:  cannunpa), blowing tobacco smoke over a patient, using tobacco as an offering of gratitude to a healer or healing powers, 
or praying while holding tobacco in the hand. Tobacco smoke carries thoughts and prayers to the Great Spirit and when ingested induces a psychological state of heightened awareness, alertness, and 
intuition. The mind-altering effects can be partially explained by the structural similarity of nicotine to acetylcholine and nicotine's ability to bond to cholinergic receptor sites. Nicotine also triggers the 
release of norepinephrine, epinephrine, serotonin, dopamine, and other compounds. The pharmacology, traditional use, and lore of tobacco are explored in Wilbert (
121
).
5
 The author is an initiate and practitioner of this tradition.
6
 A result of the olfactory-limbic connection. Altered awareness may be explained, in part, by sensory stimulation on many levels: olfactory from smudging; auditory from drumming and singing; visual 
from masks, candlelight, and sacred objects; and kinesthetic from healing dances.
7
 The author was principal apprentice to Cherokee medicine man Keetoowah from 1976 until his death in 1987.
8
 The locus of control over how Native American tradition is expressed should be in the hands of Native people. The National Museum of the American Indian is helping to correct some of these 
problems by presenting the public with a more authentic view of Native tradition, as understood by Native Americans themselves. It is hoped that this trend will continue and that various national and 
multinational organizations, such as the United States Office of Alternative Medicine and the World Health Organization, will include indigenous healers and scholars in health care planning and 
delivery. The World Health Organization and the Global Initiative for Traditional Systems (GIFTS) of Health have, so far, focused only on traditional health systems in developing countries (
122
). 
Although universal and affordable health care is certainly an admirable and necessary goal, it seems to me that no country can “afford” to ignore the accumulated wisdom of indigenous science.
 
C
HAPTER
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J Altern Complement Med 1996;2(3).

CHAPTER 14. T
IBETAN
 M
EDICINE
Essentials of Complementary and Alternative Medicine
CHAPTER 14. T
IBETAN
 M
EDICINE
Vladimir Badmaev
Background
 
Definition and Description
 
History
Tibetan Traditions and Lineages
Principal Concepts
 
The Human as a Psychic Phenomenon
 
Maintaining Health and Disease Prevention: General Rules
 
Maintaining Health and Disease Prevention: Nutrition and its Adjustment to the Seasons of the Year
 
Mental and Emotional Digestion
 
Mind and Memory
Practitioner–Patient Interaction
 
Diagnosis of Health, The Transition to Disease, and Disease
Therapy
 
Physician as Healer
 
The State of Disease
 
Food As Medicine
 
Botanic Treatment
 
Tibetan Massage
 
Subtle Body and Energy Channels in Therapeutic Intervention
Use of Tibetan Medical Practice in the Contemporary Health Care System
 
Major Indications/Preventive Value
The Future
Dedications
Acknowledgments
Chapter References
BACKGROUND
Definition and Description
Tibetan medicine is rooted in several ancient traditions. Its first written document is approximately 1,300 years old (
1
, 
2
). The consensus among Tibetologists is that 
this medical system developed under the influence of Buddhist philosophy and Ayurvedic medicine, which were brought to Tibet from India (
3
, 
4
and 
5
). Tibetan 
medicine was also molded by Western (
6
) (i.e., Greek) and Chinese influences (
5
). According to some accounts, Tibetan medicine originated in the pre-Buddhist 
religion Bon (also known as Bonpo), a unique tradition of Tibetan origin (
7
, 
8
). Tibetan medicine is also practiced in Mongolia (
5
, 
9
), the Buryat Republic of Russia, St. 
Petersburg (
5
, 
10
, 
11
, 
12
 and 
13
), Northern India (
3
, 
4
, 
7
, 
8
), various European countries (
10
, 
14
), and the United States (
15
, 
16
 and 
17
).