Abstract
I discuss the long-standing practice of ingredient substitution in traditional Tibetan medicine as an adaptive resource management strategy that has enabled resilience in the larger socio-ecological world of medicinal resources, cultural knowledge, and ecological stewardship. Given that there are increasing pressures on and threats to the natural resources utilized in Tibetan (and other) traditional medicines, this flexible strategy should be supported and further accommodated in the growing industry of medicine production. Current industrialized pharmaceutical standardization suffers from a rigidity that partially threatens a sustainable resource management strategy. The theoretical orientation I utilize draws from Resilience Theory literature and discusses adaptive cycles, panarchy, and rigidity traps in the sphere of traditional Tibetan medical knowledge, medicine production, and resource management.
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Notes
Padma, Inc. in Switzerland (a leading producer of Tibetan medicines in Europe) source most of their ingredients from outside China and about 50% from within Europe (Herbert Schwabl email communication May 4, 2020). However, Switzerland may be the exception to such low usage of PRC-sourced materials. Stephan Kloos confirmed (email May 4, 2020) that a large majority of materials used in the traditional medical system of Mongolia are imported from China. Clearly more data are needed to arrive at a definitive assessment of what and where the strain on resources is.
Salick and colleagues have done similar research in other alpine environments as part of the GLORIA (Global Observation Research Initiative in Alpine Environments) Program.
While the CITES list was originally compiled by IUCN, there are some slight discrepancies between the IUCN Red List and the CITES list.
In this study, the researchers utilized herbarium specimens collected in the region as early as 1872 to demonstrate a marked decrease in size of the plant. They hypothesize that this is due to harvesters favoring larger-sized plants.
During my research in the summer 2015 in Shangrila, Yunnan Province, I met a medicinals trader selling saffron. The Hui Muslim man was from Lanzhou but had set up an import business in Lhasa and was in Yunnan working business deals to sell the goods he trades at the Prefectural Tibetan Medicine Hospital. The saffron (Crocus sativus) he was selling was imported from Iran, he claimed. A local doctor explained that saffron originally from Kashmir (now also grown in Iran) was much better quality (and hence preferred) than that grown domestically. While I was not able to confirm the identity of the domestically grown saffron, I suspect it might in fact be safflower, Carthamus tinctorius. Saffron (Crocus sativus) imported from Iran appears to be less expensive (on the global market, at least) than that grown in Kashmir, at least in late 2014 and 2015 (as reported in Business Standard of India, Nov 27, 2014).
Martin Saxer (2013: 105–106) reported that in 2009 only about 10% of the research efforts at the Mentsikhang were devoted to cultivation research.
The discussion of correlation between scientific (mainly Linnaean) classification and “non-scientific” classification is a broad topic of interest in ethnobiology (Berlin 1992; Ellen and Reason 1979) that I discuss more fully in other publications (Glover 2005, 2018). Simply put, at certain levels of a taxonomy there are some strong correspondences (although never 100% equivalence) between the Linnaean system and non-Linnaean systems, while at other levels there are vast divergences.
Aumeeruddy-Thomas and Lama (2008: 173–75) report that in Dolpo, Nepal, doctors of Tibetan medicine were somewhat reluctant to talk with conservationists about their knowledge of substitutions. The reasons for this are unclear, but it may be the result of a combination of disagreement among the medical practitioners themselves of how to approach substitutions, a discomfort with sharing this type of knowledge with outsider, non-medical specialists, and concern with how medical practice may or may not line up with conservationist priorities. It is also noteworthy that the authors note how at national-level workshops, practitioners generated “a list of substitutes that were acknowledged to be effective for use by the authoritative Chagpori Institute of Darjeeling” (p. 174), attesting to the power of the authoritative voice throughout the larger Tibetan cultural world.
Here I purposely use Tibetan names for ingredients since the polysemy of these terms in part reflects the flexibility of the system.
In Chinese medicine (to the best of my knowledge), deer musk has also traditionally been used as a medicine, and substitutions are also used, but plants are not generally seen as possible substitutes for animals.
One thing that must be kept in mind is that this may all constitute what Scheffer et al. (2012) identify as “local resilience.” In the case of local resilience, grand catastrophes can still occur.
It is also true that in China the existence of regulations does not necessarily mean they are always strictly followed, nor that the logic of regulations is necessarily flawless (Saxer 2013).
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Acknowledgements
I would like to thank Dr. Ma Liming of the Diqing Prefectural Hospital of Tibetan Medicine in Shangrila/Rgyalthang, China for helping me understand Tibetan medicine production, and Stevan Harrell, Jack Hayes, and two anonymous reviewers for suggestions to the manuscript.
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Glover, D.M. Traditional Medicines in a Global Economy: Resource Sustainability and Resilience in the Traditional Tibetan Medical Practice of Ingredient Substitution. Hum Ecol 49, 33–42 (2021). https://doi.org/10.1007/s10745-020-00198-6
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DOI: https://doi.org/10.1007/s10745-020-00198-6