Textual Lives and Living Skills: Doctors and Their Texts in the Practice of Tibetan Medicine

Practitioners and scholars of Traditional Tibetan Medicine generally recognize the centrality of the texts known as the Four Tantras (Tib. དཔལ་ལྡན་རྒྱུད་བཞི, dpal ldan rgyud bzhi), but the relationship between the study of texts, on the one hand, and everyday clinical practice and embodied skill, on the other, is not clear. This dissertation, based on sixteen months of multi-sited fieldwork at four sites of medical practice in Qinghai Province, China, explores this relationship and the everyday use of texts in and out of clinical practice. It addresses three questions about the Tantras:

• 1. As Texts: What do the Four Tantras say about their own history and structure both explicitly and implicitly through their poetics? What are their institutional histories and presents including their relationships with other texts? What hermeneutics do contemporary doctors use to read the Tantras?

• 2. As Practice: How do the teachings of the Tantras relate to practical knowledge, or become embodied knowledge, in practices like pulse examination, and what reflexive role the Tantras play once competency in such practical actions is achieved? What non-pedagogical role do the Tantras play in clinical practice and interaction? Is this ‘legible’ to an informed observer?

and

• 3. Is Tibetan medicine, truly a ‘holistic’ medicine, in what way, and what does ‘holism’ mean?

Drawing on anthropological theories of textuality, semiotics, apprenticeship, and embodied skill, using methodology from linguistic anthropology, philology, ethnopoetics, and microethnography, I look beyond the denotational meaning of the texts to analyze both their poetic structure and their relationships with other texts. I examine the ways that textual claims of holism find their way into clinical practice. I look at the relationship between texts and tactility, showing that even in these most embodied of skills that seem immune to shared attention and discursive intersubjectivity texts still have their place. I show that textual practice is a specific type of embodied skill and offer an alternative view of the relationship between this skill and other embodied skills to more common views. This study has implications for the multimodal and intertextual study of medical systems and practices beyond idealized claims.