Tara Rokpa's links with TTM


Basics: the Fourfold Tantra


Traditional hanging scroll painting of Yuthog Yonten Gonpo (1112-1203), main proponent of the Fourfold Tantra

The importance of this text
Origins of the text
The form it takes
Commentaries and other texts
Translation of the Fourfold Tantra



The Fourfold Tantra sits at the very heart of Tibetan Medicine. Its advent, in the 8th century, and its widespread use in an expanded form from the 12th century onwards, were two of the most significant steps in the history of TTM.

Its importance lies in the lucid brilliance with which it draws into a meaningful whole major elements of Indian, Chinese, and Tibetan medicine - as well as some from Mongolia and Persia.


Without the breadth of vision of this text's main proponent, Yuthog Yonten Gonpo, Tibetan medicine would have simply been an interesting but rather heterogeneous gathering of major portions of the healing arts in Asia. As it is, all these various elements appear within one coherent theory, which owes much to the Buddhist understand of the relation between mind and matter, mind and body.

Yuthog himself is surrounded by legend and was doubtless an extraordinary figure, who visited India many times and whose clear and penetrating mind was able to possess and present an overview of all the various components present in the medical sciences of Tibet and India of his time. His work is not merely the fruit of a exceptionally clear mind but also that of a wide-ranging medical experience and considerable travel. By his time, TTM had four centuries of practical application, from which a wealth of pragmatic observations had emerged.

an illuminated page from the Fourfold Tantra

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There has been and remains heated debate among Tibetans about this key text. Some see it as a work given in India by the Buddha, translated into Tibetan in the 8th century by Vairocana, hidden shortly afterwards under the instructions of Padmasambhava (who considered it too precocious for its times), unearthed by Drapa Ngonshe in the 11th century and elaborated into its full form in the 12th century by the Second Yuthog. Others see it more as simply the genius of the Second Yuthog.

About its origins, Professor Meyer says, in "Oriental Medicine":

  The origin and history of the Four Tantras remain obscure and were the subjects of heated dispute among Tibetan scholars. Some accepted it for what it claims to be: the authentic teachings of the Buddha 'Master of Remedies' (Bhaisajyaguru), translated from Sanskrit, whereas others saw it as a treatise of dubious authorship. Some even went as far as to deny a Sanskrit original and believe it to be the work of a Tibetan author - one or the other Yuthog - observing quite correctly that it contains notions foreign to India, notably those which appear to be Chinese. However, the opinion that the Four Tantras were the authentic word of the Buddha prevailed under the political authority of the Fifth Dalai Lama and his regent Sangye Gyamtso, who firmly upheld this view. They believed the Four Tantras were first taught in India by the historical Buddha when he first manifested as the 'Master of Remedies'. Later, in the eighth century, Vairocana is said to have translated and offered the text to his master Padmasambhava, who then concealed it in the monastery of Samye. In the second half of the eleventh century it was supposedly rediscovered by Drapa Ngonshe (1012-90) and the following century it ended up in the hands of Yuthog the Younger, who completed the Treatise by adapting it to the local conditions of Tibet. This would explain how it came to contain non-Indian elements.

This is a reasonable exoteric explanation. The view of one of (if not the) greatest contemporary TTM physician, Professor Khenpo Troru Tsenam, resolves such controversy by pointing out the way the Buddha is envisaged in Northern Buddhism, i.e. not just as an historical Indian figure but also as a constant inspirational presence (sambhogakaya) to this world during the five millennia following his enlightenment and, more generally, as the guiding presence of the absolute, anywhere and in anyone. If this 'pure mind' had appeared to Yuthog and guided his brilliant work of the Four Tantras, then the text becomes at one and the same time the authentic teaching of the Buddha and a contemporary edition. This does not preclude the possibility of it being also a revision and update of an ancient text - authentically from the Buddha - made suitable to its times by the Buddha's own, later, influence on Yuthog.

Whatever the origins of the Fourfold Treatise, it is certainly the text of TTM and a brilliant one at that. So much of TTM literature is composed of commentaries to the Fourfold Treatise and, like many great works, it always seems to stand above and beyond its commentaries in a pristine and commanding position. Its fame spread throughout Asia, as far as the Russian court where, in 1860, the Czar ordered its translation.

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The Fourfold Tantra takes the allegorical form of a dialogue between two celestial sages in the paradise of Tanaduk, a heavenly land filled with medicinal rocks, plants, trees and shrubs. Tanaduk is a metaphor for wisdom, indicating that a truly enlightened mind is always in a medical paradise, for it knows how to put to maximum use almost any substance, be it animal, vegetable or mineral, in the environment in which it finds itself. Sage 'Born of the Mind" asks key medical questions to Sage "Wisdom of the Sciences", who expounds the various chapters of each of the sections of this work as his answers.

   The Root Tantra consists of 6 brief chapters which are a synopsis of all the various elements of TTM in their logical relation to one another. It is the prelude to what follows.
   The Explanatory Tantra consists of 31 chapters which develop the theoretical bases of TTM, from its conception of the human body - its genesis, structure, physiology and pathology - through to diagnosis, treatment and medical ethics.
   The Instruction Tantra is by far the largest. It consists of 92 chapters which are clinically-oriented, describing physiopathology, types, symptoms, diagnosis and treatments for each disorder.
   The Final Tantra consists of 27 chapters focuses particularly on practical aspects of diagnosis and therapy.

The content of these chapters is presented in a condensed verse form (mainly four lines of nine feet) which is quite hermetic. It would be impossible to simply read it and gain understanding. To penetrate its meaning requires the use both of written commentaries and - most importantly - the personal introduction to the traditional meaning by someone who possesses the lineage of transmission. The versified form aids memorisation and most TTM physicians will have learnt the Fourfold Tantra by heart.

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Many commentaries have been written to the Fourfold Tantra. As mentioned above, they are almost indispensable for its understanding. Yet one must be cautious in their use, as the original text stands head and shoulders above all the commentaries and each commentary can only go as far as the wisdom and experience of its author allows. In our research work at Tara, we have followed the advice of Prof Khenpo Troru Tsenam and consulted various major commentaries as the subject matter of each chapter is considered. This has proved very useful.

One commentary has received a lot of attention in English-language publications and translations in recent years. It is the Blue Beryl Treatise of Desi Sanjay, the regent of the 5th Dalai Lama. Its author was a brilliant scholar and it seems he used a team of researchers with a view to making the definitive commentary to the Fourfold Tantra. Although there is no doubting the light that his commentary often brings to the original work, one must always bear in mind the fact that he was not a practising physician. Sometimes we found - working under Professor Troru Tsenam's guidance - that other commentaries gave more satisfying explanations of specific points. There are two famous medical traditions in Tibet - Byang and Zur - each of which has its own commentaries, such as the "Instructions of the Ancient Masters" (mes.po zhal.lung) of Zurkarpa (zur.mkhar.pa), originator of the Zur school.

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