Study On Basic Theory And Normal Urine Index Of Tibetan Medical

Objective: Tibetan Medicine urinalysis is an important observational diagnosticmethod in the Tibetan medical system. Developed over the course of one thousandyears, it has become a sophisticated diagnostic method with a rich history of practiceand unique system of medical diagnosis; has played a major role in the enrichment ofthe medical system, in addition to being world renown throughout its long history.Given the increasingly popular trend of the development of traditional medicalsystems, there exist unprecedented opportunities to conduct research on Tibetanmedicine; especially, as regards the depths of Tibetan medical urinalysis, and how theurine reflects various bodily injuries; how it pervades our liquid excretory systemsuch that it reveals various types of colors, steam, odor, bubbles, froth,“geya”,transition periods, manners of transition as well as post-transition reactions can revealthe three humors:(Wylie transliteration) rlung, mkhris pa, and bad kan, and the “sevenwondrous pulses”, which are interdependent and complimentary. The insufficiencyand/or excess, and turbulence of these reveal a patient’s symptoms. Because thethree humors can be further simplified into hot or cold, urinalysis is ultimatelyemployed as a comprehensive, dynamic, sensory, intuitive, simple, and safe diagnosticmethod to determine a patient’s hot or cold disorder, and if done skillfully, much more.Presently, modern research on Tibetan urinalysis is wanting—especially in terms ofobjective, randomized and controlled studies. Many scholars take Tibetan medicaltheory to be a set of old practices, unfounded in a systematic and scientific set oftheories. As such, more should be done in order to pursue good quality andstandardized research on Tibetan medicine that all-the-while adheres to traditionalTibetan medical theory. Thus, this effort should undoubtedly include full use ofmodern technology as a means to increase urinary diagnostic indicators, and researchefforts should be focused on the examination of functional disorders, diagnosis andtreatment in order to improve the standard level of care and research, effectivelydeveloping Tibetan medicine, as a whole.Method: This study was carried out by means of textual and experimental research.Tibetan medicine’s urinalysis was categorized and analyzed by way of “”,the “” and other seminal works of urinalysis. Its historical andtheoretical origins, academic characteristics, and clinical applications were alsoresearched. Regarding the experimental aspect of the study, urine samples from bothsick and healthy individuals were collected and analyzed through a photoelectriccolorimeter. Moreover, these same samples also underwent a traditional Tibetanmedical urinalysis, thus comparing the so-called traditional “subjective” methods, tomodern, objective laboratory analyses.Results:①Literature: Tibetan urinalysis is at least1300years old and is considered tobe part of the Three Eras16Diagnostic Systems of urinalysis. This theoretical system described urine as being concentrated to the four natural colors of blue; yellow; whiteand red, and the four composite colors of black, purple, green and brown, eachbearing its own significance and reflecting reflecting rlung, mkhris pa, bad kan, thethree humors; symptoms indicating their insufficiency and/or excess and turbulence;the identification of “geya”, as indicated by its color, shape, location, and principaldisorders arising in the vital and vessel organs. The Four Medical Classics containsthe following number of instances concerning topics dealing with urinalysis:“urinecolor”:144;“steam”:26;“urine odor”:27;“formation of bubbles”:23;“foam”:10;“transition time of urine”:10;“transition mode of urine”:10;“characterizations afterthe urine changing”:35;“clarity or turbidity of urine”:17;“closing urine leakage”:24;“hot or cold urine”:19; in sum, a total of350instances—outlining186kinds ofdiseases, the basis from which such pathological deviation is measured against the“normal” or healthy body—are discussed on the topic of urinalysis. According toTibetan medical theory, normal urine is characterized as having a medium amountof steam, a clear, yellowish color, uniform bubble size, with timely rupture, thecharacteristic foul smell of urine, once cooled, begins to deteriorate, tastes slightlysalty and sour, evenly distributed geya, a surface tension as thin as the wings of a bee,is heavy to the touch, and does not produce any hissing, pounding or grumbling noiseswhen being evacuated from the body.②Experimental results of chromatographicanalysis: normal human urine Gardner Color, is on average5.35, with a standarddeviation of0.47; and female’s are average of5.3201, with a standard deviation0.98335. The men in this experiment were on average5.3003, with a standarddeviation of0.84187; the first morning urine was on average5.4431, with a standarddeviation of0.96012; and the second morning urine was on average5.1753, with astandard deviation0.83199. Microscopic observation: the colour of normal Geyamostly is brown, has morphological differences.Conclusion:①Urinalysis has a long history: systematically documented in the eighthcentury work The Moon King’s Clinical Treatise, the former is recognized as theearliest extant ancient manuscript belonging to the collection of Tibetan medicineclassics. In this text, a theoretical model using two different traditional models inorder to explain rlung, mkhris pa, and bad kan is put forth. At it’s core, the authoremploys ancient Indian medical concepts and traditional Chinese yinyang’s theory of5elements. Nevertheless, the two aforementioned systems do not have completesystems of urinalysis of their own, therefore, we can confidently say that Tibetanmedicine’s urinalysis took root in ancient Indian medicine theory and was latercomplemented with Chinese medicine, to yield, what is today, a unique combinationof medical theories, representing the highest level of urine diagnostic techniques.②The theoretical system is complete: from the doctor, the patient, to the ideal basis ofcomparison, Tibetan medical urinalysis has sound bases for diagnosis. The normalurine traits—which are, that a patient’s urine have a medium amount of steam, a clear,yellowish color, uniform bubble size, with timely rupture, a characteristic foul smellof urine, once cooled, begins to deteriorate, tastes slightly salty and sour, has evenly distributed “geya,” a surface tension as thin as the wings of a bee, is heavy to thetouch, and does not produce any hissing, pounding or grumbling noises when beingevacuated from the body—are compared with those of one being diagnosed. Alsotaken into account are a patient’s gender and age, in addition to other details. Thispoint indicates that Tibetans were fully aware of geographic, seasonal, physical, age,gender, and other factors on the impact of urinary clinic.③A rich clinical practice:according to The Moon King’s Clinical Treatise:“All living things exists by way ofthe five elements and so the five senses should, thus, be used to diagnose them”.This states that the use of the sense organs: sight, hearing, smell, taste, and touch, isthe basis for diagnosis, and so, as regards urine, the color, sound, smell, taste, andtouch likewise represent a comprehensive diagnostic approach. Specifically,urinalysis deals with the three phases of urine: when it’s hot; warm; and cool, and thecolor, steam, foam, transition time, mode of transition, residue, foam, odor, sound (thesound when you pour the urine), touch (applied to the skin after feeling) and sixteenother diagnostic criterion which are observed during these various phases.④Reliablediagnostic indicator: According to Tibetan medical theory, rlung, mkhris pa and badkan can be found in predominance in different parts of the body, yet each pervades theentire system. It is due to this that every disease can be apprehended by way ofurinalysis, as it can be considered to be the most fundamental diagnostic method indistinguishing hot and cold disorders. All criterion in the diagnosis of disease by wayof urinalysis can be ranked according to the following, in descending order ofimportance: urine color, urine after changes in phase, odor, steam, geya, foam, surfacetension, time and manner of transformation. Although the Four Medical Classicsparticularly underline the importance of geya, the results have shown urine color to bealso very important, as it has many dynamic and revealing features.⑤Colorimetricdetermination or urine to determine a “normal” color yielded4.88-5.82. This is areliable figure with which to compare the experimental values. In the resultsobtained, there were obvious differences between men and women. This confirmsthe gender discrepancy already present in the traditional theory of Tibetan medicalurinalysis. The first morning urine and a secondary morning urine also had significantnumeric discrepancies. This further confirms traditional Tibetan urinalysis theory’sinsistence on obtaining the first morning’s urine.⑥Microscopic observation: geya isthe general term for the visible components of urine. Three aspects of geya, namely,color shape and position, are examined. Typically, due to the physician’s limitation,only color and shape are taken into consideration. In accordance with Tibetanmedical theory, geya can be found in even physiologically normal urine, formed bymostly brown-colored elements originating from the blood and bile. Differences in theshape, size and quality of the geya solid sediments found in the urine can elucidate thebasis of an imbalance, whether rlung, mkhris pa or bad kan. As such, urinalysisplays an important role in Tibetan medical diagnosis.