Tawni Tidwell
University of Vienna, Department of South Asian, Tibetan and Buddhist Studies, Numata Visiting Professor
I am a biocultural anthropologist and Tibetan medical doctor ("menpa"). My research facilitates bridges across the Euroamerican scientific tradition and the Tibetan medical tradition along with their attendant epistemologies, ontologies, and pedagogical methods such as textual engagement, oral transmission, embodiment, pharmacological synergies, and diagnostic/treatment paradigms. Clinically, I see a broad spectrum of patients, including metabolic disorders, autoimmune conditions, cancer, neural disorders, neuromuscular conditions, fluid metabolism and edemas, women’s health, and mental health. In my transdisciplinary work, I have contributed to understandings of gut metabolism disorders, dré-né, tren, mazhuwa, cancer, pain, women’s health, neural disorders, psychiatric illness, and Tibetan medical pharmacology with a particular focus on the Tibetan medicinal compound tsotel. My current work also tracks Tibetan medical practice in eastern Tibet and Europe as Tibetan medicine becomes increasingly globalized by pharmaceutical industries.
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Articles & Chapters by Tawni Tidwell
Objective: To describe the impact of complex Tibetan herbal formula regimens on symptom duration among ambulatory patients with native SARS-CoV-2 infection.
Methods: This multi-center, cohort study assessed deidentified data from patients with laboratory-confirmed SARS-CoV-2 infection. The study assessed cases from March 12, 2020 to May 5, 2021 for which vaccinations were not available, and thus reflect native infections.
Intervention: Diagnoses were made via telemedicine by a traditional Tibetan medical physician, and herbal formulas were prescribed based on specific symptom presentation of COVID-19 using the personalized medicine approach integral to traditional Tibetan medicine.
Results: Of 145 patient cases assessed for eligibility, 86 (59.3%) met inclusion criteria, and 67 (46.2%) had documented symptom resolution. Resolution of symptoms occurred within a median [interquartile range (IQR)] of 11.7 (10.1-13.5) days. The most common symptoms reported were cough and fever. Time to recovery did not significantly differ based on symptom presentation at baseline, except for a couple symptom groupings such as headache and joint pain where recovery time was shorter when those symptoms were present.
Conclusions and relevance: Ambulatory patients diagnosed with SARS-CoV-2 infection receiving Tibetan herbal formulas had recovery from symptoms at a median of 11.7 days, fewer than other published reports in patients following standard of care. The Tibetan approach of targeting treatment based on symptom groups, especially those within classical Tibetan medical nosology, appears to result in quick symptom resolution.
Aim of the study: We introduce the existing databases and informatics systems that have developed over the last ten years in the Sowa Rigpa field. As such, we present Tibetan medical informatics as an emergent field, detail its most applicable areas for research, and propose an analytical structure for it to inform wider pharmacological, clinical, textual and cultural research analyses in Sowa Rigpa.
Materials and methods: Assessing the available bioinformatics systems, and drawing from Tibetan medicine's basic theory and traditionally applied empirical research methods, this study analyzes Tibetan medical informatics as a data integration approach drawing from: (1) Tibetan medical clinical practice, (2) Tibetan materia medica and pharmacological knowledge, (3) Tibetan medical literature, and (4) applied information and management sciences. This study assesses the existing databases, developments and methodologies of Tibetan medical informatics, and presents the first quantitative analyses from these data sources regarding Tibetan medical works, disease categories, prescription data and pharmacological characterizations. This study also introduces the role of graphic data visualization in assisting hypothesis development and data analysis for Tibetan medical informatics.
Results: The authors introduce the available data respositories for Tibetan medical informatics, and demonstrate five applications of data analysis and visualization techniques: (1) a historiographic depiction of major Tibetan medical schools, figures and works that contributed to the development of Tibetan medicine and its pharmacology; (2) an enumeration of the specific diseases in the Tibetan medical canon as well as the etiological and classification hierarchies; (3) a quantification of the materia medica and compounded formulas in the most frequently used pharmacological texts; (4) a pharmacokinetics and pharmacological modeling of medicine compounding principles; and (5) an analysis of how several recent clinical case studies drew from Tibetan medical informatics and its other data sources.
Conclusions: This study demonstrates the analytical structure and research application areas central to a developing Tibetan medical informatics. It shows how newly developed databases and structures of informatization allow research in Sowa Rigpa to bridge pharmacological, clinical and data science research; clinical practice; education structures and cultural dimensions. The study shows that Tibetan medical informatics is poised to support efforts in traditional knowledge preservation, education development and access and greater rigor in research and clinical practice. The study also suggests that this new field facilitates tools for demonstrating Tibetan medicine’s capacity for pharmacological insight, whole systems treatment and illness prevention, and comprehensive patient care.
Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations.
The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.
Objective: To describe the impact of complex Tibetan herbal formula regimens on symptom duration among ambulatory patients with native SARS-CoV-2 infection.
Methods: This multi-center, cohort study assessed deidentified data from patients with laboratory-confirmed SARS-CoV-2 infection. The study assessed cases from March 12, 2020 to May 5, 2021 for which vaccinations were not available, and thus reflect native infections.
Intervention: Diagnoses were made via telemedicine by a traditional Tibetan medical physician, and herbal formulas were prescribed based on specific symptom presentation of COVID-19 using the personalized medicine approach integral to traditional Tibetan medicine.
Results: Of 145 patient cases assessed for eligibility, 86 (59.3%) met inclusion criteria, and 67 (46.2%) had documented symptom resolution. Resolution of symptoms occurred within a median [interquartile range (IQR)] of 11.7 (10.1-13.5) days. The most common symptoms reported were cough and fever. Time to recovery did not significantly differ based on symptom presentation at baseline, except for a couple symptom groupings such as headache and joint pain where recovery time was shorter when those symptoms were present.
Conclusions and relevance: Ambulatory patients diagnosed with SARS-CoV-2 infection receiving Tibetan herbal formulas had recovery from symptoms at a median of 11.7 days, fewer than other published reports in patients following standard of care. The Tibetan approach of targeting treatment based on symptom groups, especially those within classical Tibetan medical nosology, appears to result in quick symptom resolution.
Aim of the study: We introduce the existing databases and informatics systems that have developed over the last ten years in the Sowa Rigpa field. As such, we present Tibetan medical informatics as an emergent field, detail its most applicable areas for research, and propose an analytical structure for it to inform wider pharmacological, clinical, textual and cultural research analyses in Sowa Rigpa.
Materials and methods: Assessing the available bioinformatics systems, and drawing from Tibetan medicine's basic theory and traditionally applied empirical research methods, this study analyzes Tibetan medical informatics as a data integration approach drawing from: (1) Tibetan medical clinical practice, (2) Tibetan materia medica and pharmacological knowledge, (3) Tibetan medical literature, and (4) applied information and management sciences. This study assesses the existing databases, developments and methodologies of Tibetan medical informatics, and presents the first quantitative analyses from these data sources regarding Tibetan medical works, disease categories, prescription data and pharmacological characterizations. This study also introduces the role of graphic data visualization in assisting hypothesis development and data analysis for Tibetan medical informatics.
Results: The authors introduce the available data respositories for Tibetan medical informatics, and demonstrate five applications of data analysis and visualization techniques: (1) a historiographic depiction of major Tibetan medical schools, figures and works that contributed to the development of Tibetan medicine and its pharmacology; (2) an enumeration of the specific diseases in the Tibetan medical canon as well as the etiological and classification hierarchies; (3) a quantification of the materia medica and compounded formulas in the most frequently used pharmacological texts; (4) a pharmacokinetics and pharmacological modeling of medicine compounding principles; and (5) an analysis of how several recent clinical case studies drew from Tibetan medical informatics and its other data sources.
Conclusions: This study demonstrates the analytical structure and research application areas central to a developing Tibetan medical informatics. It shows how newly developed databases and structures of informatization allow research in Sowa Rigpa to bridge pharmacological, clinical and data science research; clinical practice; education structures and cultural dimensions. The study shows that Tibetan medical informatics is poised to support efforts in traditional knowledge preservation, education development and access and greater rigor in research and clinical practice. The study also suggests that this new field facilitates tools for demonstrating Tibetan medicine’s capacity for pharmacological insight, whole systems treatment and illness prevention, and comprehensive patient care.
Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations.
The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.
The initial set from the Eighty Tibetan Medical Thangkas was produced during the reign of the Fifth Dalai Lama (1617-1682) when his regent Desi Sangye Gyatso (Sde srid sangs rgyas rgya mtsho) summoned famous medical scholars and painters from all over Tibet to paint a complete series of medical scrolls, drawing from the initial instructional diagrams made by Lhunding Dudtsi Gyurme, a renowned physician of the Jang School. After combining contributions and perspectives from all schools of Tibetan medicine, the series was sketched and drafted by Lhodrak Norbu Gyamtso and tinted by Lhépa Gényen. The initial part of the series was completed in 1688, comprising a total of 60 thangkas. Later, it was supplemented to a total of 79 thangkas integrating content of urinalysis and moxibustion points as described in the Medical Arts of the Lunar King (Sman dpyad zla ba'i rgyal po), as well as fresh materia medica specimens collected from various regions across the Tibetan Plateau. Recently, the eightieth and final thangka was added to depict famous Tibetan medical doctors throughout history, thus becoming the Eighty Tibetan Medical Thangka series.
In contemporary times, the Eighty Tibetan Medical Thangka series is still valued and used in Tibetan medical education throughout Tibetan medical colleges and universities inside and outside Tibet. Tibetan medicine professors continue to value the series' necessary use for teaching and for student learning of Tibetan medical theory and practice. Based on the old renderings of the Tibetan medical thangkas, more research related to how the illustrated content details key aspects of Tibetan medical theory and practice, as well as education pedagogy and related history should be conducted.
Comparison and the “comparative disciplines”, of course, never allow for straightforward, monolithic projects, and cannot be methodologically innocent in their goal to “make equal”, comparare, different things. Comparison is never safe from applying a measure that is disadvantageous to some participants, flattening incommensurable differences, or oversimplifying complex networks of ideas and influences. These and other pitfalls led Gayatri Chakravorty Spivak, in her 2003 Death of a Discipline, to speak of a demise of comparativism as an approach to the human world which divides it into neatly catalogued cultures, generally in translation, within a globalised whole. Instead, she proposed that the field be reshaped into one in which peripheries, local languages, and hybridisation between cultures assume the foreground.
This criticism is not to be ignored, and these pitfalls must be a major concern for a project such as ours. Comparative Guts, with its focus on “image” and “body”, attempted to address some of these issues in various ways: by questioning definitions of knowledge and who should be its repositories; disrupting the very concept of “image” as stably given and immediately and objectively evident to (primarily visual) perception; undermining the slicing of cultures into discrete regions and eras; and questioning the mapping of the animal body into recognisable, universal “parts”.