Tom Dummer, the author of Tibetan Medicine and Other Holistic Health-Care Systems, is perhaps better known for being the Inaugural Principal of the European School of Osteopathy (1974) and one of his other works the Textbook of Osteopathy. Dummer's extensive background in herbalism, naturopathy, osteopathy and later Tibetan Buddhism gave rise to the writing  of this book, as an introduction to Tibetan medicine framed for the western mind.

Tibetan Medicine is ancient with written records going back to at least 400AD. Throughout the centuries it has been transmitted in unbroken lineages by masters of the art. With the 1959 ejection from Tibet knowledge of this rich cultural heritage has become more widely available.  

The book is broken into two parts. Part 1 introduces the reader to a brief history of Tibetan Medicine as well as relevant associated Buddhist concepts. Part I relates Tibetan Medicine to holistic therapies in the west, particularly osteopathy.

Although a knowledge of Buddhism is not required to read this text, it would probably be of benefit as in reading the book I found some areas a bit dense due to his lack of familiarity with some of the concepts discussed. Dummer does however strive to explain and reference these topics and rarely is something mentioned without being explained to some degree.

Energy Medicine

According to Dummer, the vitalist concept of life force in Tibetan Medicine, called rLung or Wind, is the total potential energy of the mind and body, and formed by the 5 energies (elements) of air, fire, water, earth and space. This dynamic force is comparable to prana or chi in other traditional medicines, and travels throughout the body in a network of channels called nadi. In a healthy person the continuous circulation of this rLung (Wind) maintains homeostasis and health. When this flow is disrupted imbalances occur giving rise to ill health. Although the anatomy of these energic channels is described, it is clear that there is ambiguity in relation to some of the terms. For example, as Dummer points out, the word nadi can mean energy channel, vein, artery, tendon and muscle, which perhaps unsurprisingly gives rise to confusion and difficulty with western understanding.

Of course there is considered to be no credible western scientific evidence to support a belief in vitalism, which is perhaps why contemporary osteopathy has largely abandoned this metaphysical position in favour of increasingly precise physical and psycho-emotional causes of musculoskeletal distress. But in reading this book I get the sense that Dummer lived in an integrated world with depth and colour that went beyond reductive views and scientism, and I feel he was far richer for it.

Philosophy of Health

Where as osteopaths appear to sometimes struggles to define health and its origins - "health is a living principle in the body, and it cannot be defined" Becker (2001, p97), Tibetan Medicine characterises it as the balance of three principles of function or humours. Dummer explores in reasonable introductory depth the holistic basis of Tibetan Medicine. The role energies, the humours, diet, excretion, attitude and behavior play in health and ill-health are discussed. 

Diagnostic approaches used to determine causation for each specific patient are discussed and include examination of the tongue and urine (largely foreign to western trained medics), and palpation which is used in the form of 'taking the pulses'. Dummer concisely introduces treatment approaches over 20 or so pages that left me wanting to learn more about the application of this ancient art and more detail on some of the practical advice offered.

Dummer's sense of humor is evident in the text with lines such as the following,  written in the context of the raw food diets ill suitability to many people "These remarks do not apply to raw-food fanatics, who in their extremism are not likely to take a 'middle-way' attitude, regardless of the flatus and intestinal discomfort that they may well suffer along with those in their close proximity".

Relationship with other holistic therapies

The second half of the book is dedicated to exploring the relationship between Tibetan Medicine and other holistic therapies, particularly herbalism and osteopathy. Dummer's extensive background in both these therapies puts him in good stead to have this discussion.

Dummer considers osteopathy the "perfect complement to tibetan medicine". It is clear he viewed osteopathy as a system of medicine in its own right and not a medical auxiliary. He offers little insight into his reasoning for this view beyond the ability of osteopaths to independently diagnose. Perhaps this is something he explores more in his other book the Textbook of Osteopathy. 

Although this text is now over 20 years old, Dummer's chapter on osteopathy is as relevant today as it ever was, illustrating the depth of knowledge 45 years of practice imparts. Osteopathic principles and models are explored comparatively with Tibetan medicine. Dummer viewed osteopathy up to that point in four broad evolutionary stages:

1872 - 1920 Developmental stage

1920 - 1960 Structural Mechanical stage

1960 - 1975 Cranial/functional phase

1975+ The middle-way - equal emphasis to dynamic functional-structural aspects

It is interesting to note he felt the cranial/functional phase peaked in 1975 and that since then an integrative path has formed.

The last section of the book investigates mind-body approaches in both Tibetan Medicine and osteopathy, as well as self-help methods for achieving personal balance, taking into account biopsychosocial considerations. This highlights the inherently holistic philosophy governing both Tibetan Medicine and osteopathy.

Tom Dummer had remarkable depth of vision in developing what must have been a difficult book to write in reconciling seemingly disparate topics into a common vernacular. I cannot help but wonder what he would make of the current 'state of the nation' of the osteopathic profession. A recommended read for anyone interested in the alternative medicine, the history of medicine and osteopathy's role relative to other holistic therapies.

Thanks for Caren Hallahan for lending me her copy of this book.

References

 
Becker, R. (2001). Life in Motion: The Osteopathic Vision of Rollin E. Becker,  Stillness Press, Oregon.

Fuller, R. (1989). Alternative Medicine and American Religious Life. Oxford University Press, USA