A Comprehensive Analysis On Tibetan Medical Enema Therapies And Clinical Case Study Results

Background.The present research concerns the context for investigating enemas therapy practices in Tibetan medicine.Enemas are one of the five dynamic cleansing therapy classes in Tibetan medical practice.The Four Treatises classic(dpal ldan rgyud bzhi)of Tibetan medicine details two types: mild and strong enemas,jamtsi('jam rtsi)and niruha(ni ru ha).However,in the Tibetan medical commentaries and recapitulations,theory and experiential expositions,past Tibetan medical scholars have delineated many types.Despite their foundational importance and commentarial elaboration,in China's National Scholarship Database,there are only seven short articles related to enemas.Recently,in the journal and edited volume publications Snowland Medicine and Astrology(Gangs lcongs sman rtsis),Tibetan Medical Education and Research(Bod sman slob gso dang zhib 'jug),Tibetan Medical Published Works Compendium(Bod lugs gso rig gi dpyad rtsom phyogs bsdus),China's Tibetan Medicine(Krung go bod kyi gso rig),not a single article related to enemas has been published.For example,in China's Tibetan Medicine,from the first issue of the 2007 volume to the second issue of the 2017 volume,586 articles have been published,yet not a single article on enemas.Furthermore,from 1999 to 2009,masters degree graduates of Tibet University of Tibetan Medicine have produced 124 masters theses and 8 doctoral dissertations,yet not one project on enemas.Even prior to these years,not a single masters or doctoral student has conducted research on mild or strong enemas.This study seeks to address the lacuna in enema therapies research.Context in other medical systems.Beyond enema treatments in Tibetan medicine,though such practices exist in other medical systems such as traditional Chinese medicine,the implementation in clinical practice is still developing.Enema practices in contemporary integrated Chinese and Western medicine are demonstrating clear results.In China's National Scholarship Database,research on enemas using integrated Chinese-Western medical approaches number more than 5,816 published articles.From these published works,research on enema treatments for pediatric dysentery,hepatitis B,and diabetes,as well as both acute and chronic illnesses,conditions difficult to treat by other methods and so forth are demonstrating impressive results.Therefore,the research on enema therapies preceding that in Tibetan medicine is extensive.Methodology.Firstly,this study has methodologically begun with an extensive literature review:(1)the extant literature related to medical use of enema in the Kangyur and Tangyur(collected works of Buddha's Words and treatises),medicalclassics,as well as related commentaries have been analyzed;(2)the published works on enema treatments of contemporary Tibetan medical physicians,professors,and scholars,identifying innovative intellectual contributions;and(3)the modern scientific literature related to Tibetan medical enema therapies,assessing new analytical contributions;and(4)summarizing the analytical results.Secondly,this study conducted full clinical case reviews as follows:(1)collected clinical cases implementing enema therapies from the Liver-Gallbladder,Gynecology,and External Illness departments of Qinghai Provincial Tibetan Medical Hospital,as well as related district and regional branch clinics;(2)from these clinical case reviews,this study thoroughly assessed 70 patient cases from Qinghai Provincial Tibetan Medical Hospital and 40 patient cases from North Qinghai Lake District Tibetan Medical Hospital;(3)from these detailed patient case assessments,this study classified and analyzed the specific treatment methods and achieved results for each of the reviewed cases;and,finally,(4)this study summarized the results.Thirdly,this study conducted a series of semi-structured and structured interviews,which were then(1)coded by question type and response;and(2)statistically analyzed and summarized.Results.First,this study provides the first body of research on Tibetan medical enema therapy practices.Second,this is the first actual analysis of enema therapies in Tibetan medicine that integrates both the theoretical foundations as well as the contemporary implementations.This study claims that enemas are not just a mere treatment for one illness condition;but posits that enema practices be developed for each given illness.Based on analyzing the benefits in doing so,this study offers a new paradigm and clinical practice approach.Conclusion.This study has achieved the following:(1)establishing a complete theoretical structure for the compounded formulas(sbyor ba),added ingredients(kha tshar),medicinal substrates(sman rta),and treatment approaches for jamtsi,niruha,and rengbu enema practices of the five dynamic cleansing therapy classes;(2)uncovering the deterioration of clinical practices related to enema practice theory;(3)recognizing the significant benefits of implementing enema therapies in clinical practice;(4)demonstrating that compounded formulas and additive ingredients for enemas beyond those found in the Four Treatises are being used and providing benefit to patients in clinical practice;and(5)clearly recognizing that enema practices are critical as both general foundation and health-promoting,life-extending practices in Tibetan medicine.