Paper short abstract:

This paper explores the treatment of smyo nad - "madness" - in the Tibetan Amdo region of the People's Republic of China, where traditional relationships between medicine and religion are being challenged by societal changes and state regulations.

Paper long abstract:

The relationship between medicine and religion has often been emphasised in the Tibetan tradition, with the predominant Tibetan medical text, the Four Tantras, said to be authored by the Medicine Buddha, and with many medical practitioners traditionally also religious specialists. This relationship is illustrated particularly well by explanations of smyo nad - "madness". Described in the medical texts, and often attributed to spirit-causation, conditions related to smyo nad are more usually treated by Tibetan Buddhist Tantric or monastic practitioners than by medical specialists. Indeed, the majority of Tibetan doctors I interviewed in the Tibetan Amdo region of the People's Republic of China (PRC) in 2018, argued that religious practitioners should be consulted for the treatment of these conditions, with Tibetan medicine (and biomedicine) often seen to be of limited or no use for such cases. In the contemporary sphere within the PRC, where much Tibetan medicine has been institutionalised and many people living in growing cities no longer have easy access to religious practitioners, how are these conditions managed and treated? With a minority of contemporary medical practitioners also being religious specialists, and religious activity banned in state medical institutions, some practitioners skilled in both medicine and Buddhism conduct appropriate rituals for patients elsewhere, and religious specialists continue to be in demand for the treatment of conditions such as smyo nad. This paper explores patients' and practitioners' perspectives on this topic.