Stomach bothering you? It could be exposure to internal cold winds, or perhaps you're not wearing the right clothes.

Pain in the bones and joints? Maybe you need to put your back in balance by showing more compassion toward the aged.

Not exactly the kinds of diagnoses you get from your HMO. But they might be what you would hear from a Tibetan physician.

This weekend in Washington, more than 1,200 Western medical professionals will get an intensive look at Tibet's long history of Buddhism-based medical practice. The First International Congress on Tibetan Medicine is designed to see what the two systems might offer each other.

It's not for new-agers. One seminar title is: "A Tibetan plant preparation as potent inhibitor of cell killing induced by synergism among oxidants, membrane perforators and proteinases: modulation of inflammatory and infectious responses." Seminars dealing with death and dying will be presented, as well as exploration of mental-health issues.

The congress will be opened by the Dalai Lama and will conclude with a ceremony around a sand mandala dedicated to the Medicine Buddha. After its ritual destruction the mandala, a symbolic circular design created by monks during the weekend, will be dumped into the Potomac River as an offering of healing power to the waters.

An exhibit of 17 paintings describing aspects of the Tibetan medical system is on exhibit at the Arthur M. Sackler Gallery until Jan. 3, when it will move to other museums around the country. The show, and an accompanying book, are called "The Buddha's Art of Healing: Tibetan Paintings Rediscovered."

The elaborate fabric paintings, or "thangkas," illustrate a 17th-century medical text called "The Blue Beryl." They were originally kept in a monastery in Buryatia, a republic in the Siberian region of the former Soviet Union.

The Tibetan system developed over 2,000 years and was formalized after the development of the Tibetan alphabet in the 7th century. Due to Tibet's location on the Silk Road, the trade route from the Mediterranean to China, healing practices from many cultures were incorporated into the Buddhist belief that the practice of the religion is itself a healing art, aimed at relieving the suffering of all beings.

In this system, good health is maintained by a balance among three interrelated systems of the body, called humors. Bad-kan (pronounced baygan), the water element, is responsible for mechanical function and structure of the body. Mkhris-pa (pronounced treeba), associated with fire, is responsible for producing the body's heat and enabling digestion. Rlung (pronounced loong) is connected with mobility and is tied to the element wind.

These humors, mixed in varying quantities, reside in different places in the body, and good health comes from their being in balance within the individual and with the world around them. Disease arises when they are unbalanced, often because one element, having dominated its own region, then spills into other regions.

Traditional Tibetan diagnosis proceeds from palpation, the detailed sensing of the pulse; uroscopy, inspection of the patient's urine; and interrogation, discussion and interpretation of the patient's lifestyle and behavior.

Interrogation may involve the patient's diet, sleeping habits, dreams and many behavior aspects, including frequency of sexual intercourse. Tibetan physicians believe that the amount of sex a patient has should vary with the season -- during the cold winter months it is unlimited, but sex more than once a fortnight in the summer may drain vital energies. Dream imagery may even help a physician predict the coming of death.

Pulse-taking is an involved and delicate process, which takes the Tibetan doctor more than a year to learn. With both hands, the physician feels the throbbings in the radial artery of the patient's two wrists. Pressing delicately for as long as a half-hour in some ++ cases, the practitioner can detect problems in the six "hollow organs" (stomach, small and large intestines, gall bladder, urinary bladder and reproductive organs) and the five "full organs" (heart, lungs, liver, kidneys and spleen).

Pulses can be characterized as hot, cold, weak, strong, floating, fluttering, sunken, loose, trembling, thrilling, thin, rough, short, or missing -- to name just a few. Pulse reading is thought to have been introduced from China, where it is also commonly practiced today.

Urine analysis is now used less frequently, largely because the best time to collect urine for examination is immediately after the patient wakes up, and the physician should examine it while it is still warm.

The technique involves whipping the urine in a bowl with two sticks and then inspecting it for color, odor and froth. The procedure is repeated after it has cooled.

Tibetan instructional materials describe more than 150 different manifestations of urine and the maladies they correspond to. This aspect of diagnosis may have been influenced by techniques that originated in Greece.

Treatment may include advice on diet or behavior, medicines or external therapies. In the Tibetan pharmacopoeia, many foods are regarded as having curative properties, but the general advice would be familiar to any Westerner: Eat moderately of a balanced diet, indulging in no food to excess.

To maintain or restore optimal health, personal conduct should be moral and compassionate toward others. Tibetan medicine also evaluates occasional bodily conduct, such as waste evacuation, burping and flatulence, which are not to be suppressed. The foods eaten and the clothing worn should be in harmony with the rhythm of the seasons.

Medicines, derived from a variety of plants, minerals and animal products, gain or lose effectiveness according to when they are taken during the day. For some conditions, it may even be important to alternate a bite of food and a dose of medicine. Tibetan medical students learn to identify hundreds of different plants.

Some treatments are "soothing," to induce the imbalanced humor gently back to its proper state. Others are "evacuating," to flush the imbalance from the body.

Therapies include massage, vacuum treatment with hot cups, acupuncture, the application of oils, cleansing therapies, enemas, aromatherapy and minor surgery. Major surgery is rare, usually practiced only when the body has already been invaded, say by an arrowhead or bullet.

More information about this weekend's conference can be found at www.tibetmedicine.org or by calling 800-805-3976.

Pub Date: 11/06/98