The Three Mental Poisons causing Disease
According to Tibetan medicine, humans are born with imperfections of the mind that cause it to fall in love with an illusion of what life should be like which (through ignorance) leads to sadness and suffering.
Ignorance is 'the root cause of all disease'
All disorders in Tibetan medicine are considered to have their roots in an imbalance of the three humors of Wind, Bile, and Phlegm which are influenced by our emotions, the three metal poisons, and the five elements. In Tibetan medicine the mind is considered core to health and disease and it views all disease as starting from ignorance that gives rise to the three mental poisons of attachment, hatred, and delusion which form the basis of all disorders. According to Tibetan medicine, humans are born with imperfections of the mind that cause it to fall in love with an illusion of what life should be like which (through ignorance) leads to sadness and suffering.
What are the three mental poisons?
Attachment is the mental poison that forms first, followed by anger and then delusion. Desire and attachment are viewed as principle causes of both happiness and sadness. Attachment gives temporary pleasure and happiness which leads to more desire and eventually to the emotions of anger, jealousy and dissatisfaction which affect the wind humor residing in the upper part of the body, heart, lungs, and colon. Hatred is the next mental poison to form manifesting from emotions and states of mind such as ambition, power, jealousy, fear, attachment, and pride. Hatred causes heat in the body and disturbs the bile humor which resides in the middle part of the body, liver, and gallbladder. Delusion forms last stemming from anger which prevents a person from thinking clearly causing them to become close-minded and unable to see the situation from the other perspective. Close-mindedness is considered to cause doubt, fear, ignorance, delusion, lack of awareness, selfishness, and negativity and affects the head imbalancing the phlegm humor which resides in the upper part of the body.
Like Ayurvedic medicine (see my blog 'Could Ayurveda be the Missing Link?') and Chinese Medicine (see my blog 'If Chinese Mecicine isn't looking for the cause, why does it have answers Western medicine will never find?'), Tibetan medicine also acknowledges the Five Elements of Space, Air, Fire, Water and Earth and and how imbalances between them can cause disease. Chinese Five Element Theory refers to them slightly differently as Water, Fire, Earth, Metal and Water but the concept is the same, imbalances in one or more elements disturb the body and cause disease.
What are the three humors?
According to Tibetan medicine, the three humors of Wind, Bile, and Phlegm govern all biological, psychological, psycho-pathological and emotional functions of the mind and body with the quality and quantity of humors in an individual being determined by the parents constitution, and the individual’s diet and lifestyle in the current life.
Wind is connected with the central nervous system, Bile with the endocrine system, and Phlegm with the immune system via the lymphatic system. When imbalanced, the humors, also known as ‘threefold faults’ due to their ability to cause disease, cause abnormal functioning of the seven bodily constituents (tissues of the body) and the three eliminatory channels (urination, defecation, perspiration) resulting in physical and mental illness. The 3 eliminatory channels of urination, defecation, and perspiration together with the Seven Bodily Constituents make up the ten objects where the humors function in the body.
The start of disease
Tibetan medicine considers ignorance the distant cause of disease manifesting as one or more of the three mental poisons, and aggravation of the three humors as the immediate cause of disease affecting the Seven Bodily Constituents and three eliminatory channels thus disturbing health. Wind is one of the main causes of all disease disturbed by too much mental activity, emotions, insufficient food and sleep, overuse of stimulants and fast food, and stress. Bile is disturbed by emotions of hatred, conflict, anger towards others, remaining in hot and damp places, excessive alcohol consumption, and too much sun. Phlegm is disturbed by large meals, excessive sleeping, living in damp and cold places, and staying in an unhappy or difficult situation. Eating foods that are not aligned with the seasons and/or tastes that are not conducive to an individual’s constitution or the season also imbalances the humors.
How disease progresses
Tibetan medicine has four stages of disease that describe the deterioration of health as the humors become disturbed by poor diet, lifestyle, seasonal changes and evil spirit. The four stages are accumulation, aggravation, spreading and localisation. In the early stages of accumulation symptoms are not clearly manifesting, during the aggravation and spreading stages there are usually clinical signs and symptoms, and in the final stage of localisation symptoms are clearly apparent in both humor and location.
The strength of disease depends on the individual life force, time of day, season, weather, diet and lifestyle of the individual. Diseases are classified into hot and cold diseases with extreme hot and cold conditions amongst the nine fatal conditions in Tibetan medicine. Cold diseases relate to Wind and Phlegm which are cool in nature, and hot diseases related to Blood and Bile which are hot in nature. Tibetan medicine recognises 404 diseases in total sub-divided into four groups of 101 diseases including diseases specific to the humors, specific areas of the body, and diseases relating to fevers.
Disease diagnosis
Diagnosis of diseases in Tibetan medicine is by visual observation, touch, and interrogation means. Visual diagnosis includes examining the complexion, nails, faeces, tongue, and urine which is a large part of Tibetan medicine. Touch encompasses pulse diagnosis, and interrogation describes detailed case taking. Tibetan medicine recommends treatment begins whilst a humor is still located in its natural location before it’s had a chance to spread to other locations and during the season it accumulates rather than when it arises, for example, Wind conditions typically arise in July and August but shouldn’t be treated until May and June, Bile conditions arise in September and October but shouldn’t be treated until July and August, and Phlegm conditions arises in march and April but aren’t to be treated until January and February.
The six seasons of the Tibetan year
Maintaining balance of the three humors Wind, Bile and Phlegm underpins optimal health according to Tibetan medical philosophy. The 3 humors naturally increase, manifest and pacify throughout the six seasons of the year and relate to one or more of the five elements of Space, Air, Fire, Water, and Earth. Staying healthy through diet and eating seasonally according to Tibetan medicine requires dietary and lifestyle modifications that respect the ebb and flow of the humors and elements as we move through the seasons. The Tibetan year comprises six seasons with each season lasting 2 months with the Tibetan year beginning in February which is the first month of the early spring season.
1. Early Spring (February - March)
Early Spring covers February and March and is considered a conflict season with an astringent quality characterised by the Earth and Air elements. The arrival of warmer Spring temperatures begins to melt the manifesting Phlegm with the heat attacking the cold causing humidity to manifest in the body depending on individual humor imbalance. At this time of the year foods need to be light, dry, and rough to balance the heavy qualities of the manifesting Phlegm.
2. Late Spring (April - May)
Late Spring covers April and May is considered a hot and dry season where Wind begins to accumulate. It has a bitter quality from the Water and Air elements and the heat from the warmer temperatures keeps the wind humor under control. Late Spring is a transition season from cooler temperatures to warmer, so at this time of the year we want to be eating the balancing sweet taste of Earth and Water in the form of protein, vegetables and fruit (not cake and chocolate) to calm increasing Wind and moisten increasing dryness from the cold.
3. Summer (June - July)
June and July fall under the Summer season and are characterised by Fire and Earth with a sour quality that increases the bile humur causing Bile to increase at the same time that Wind is manifesting causing evaporation and humidity in the body. At this time of year we want to be eating a balance of warm and cool foods to balance internal and external heat.
4. Autumn (August - September)
The Autumn seasons covers August and September and is characterised by the Fire and Water elements that bring a salty quality to the season. Autumn is when Bile is manifesting due to the hot, sharp, sun energy but it is also when the cooler temperatures begin to arrive which attack the heat and decrease humidity, therefore at this time of year we want to be eating sweet foods to help control manifesting Bile and bitter and astringent foods help to balance the sweet taste and balance accumulating Bile.
5. Early Winter (October - November)
Early Winter is the second conflict season with opposing forces of heat and cold. Bile is pacifying and Phlegm is increasing meaning Earth and Water are rising giving the season a sweet quality causing Phlegm to increase. Internally the body is hot but externally it is cold. November is when things begin to stabilise and feel calmer. Early Winter is a time of transition from warm to colder temperature so food should be cooked well and be mildly warming and include salty, sour and sweet tastes to calm Bile and control increasing Phlegm.
6. Late Winter (December - January)
Late Winter comprises the Fire and Air elements giving the season a pungent quality. The Fire and Air elements increase in the body to maintain metabolism during this cold humid season. In late winter, Bile is pacifying whilst Phlegm is increasing. Late Winter is a cold and damp season when Phlegm is accumulating so the diet should continue to comprise mild warming, well-cooked foods with Phlegm balancing spices to warm the metabolism.
Tibetan Therapies to rebalance the humors
Strategies used to correct disease in Tibetan medicine include dietary therapeutics that include eating in accordance to the seasons and the six tastes such as eating raw and bitter foods in summer for their cooling and moistening effects and cooked and pungent foods in winter for their warming and drying effects. Tibetan medicine also advocates living a lifestyle according to the seasons such as undertaking more physical exercise in the early spring and more calming exercises in the autumn with the conflict seasons of early spring and early winter requiring specific transitional awareness and treatment. Education regarding the importance of not supressing the body’s natural urges to sneeze, vomit, defecate, urinate, eat, or drink and the use of medicines including oral emetics and purgatives, herbs, ointments and medicinal baths are also used and would be taken at the specific times of the day when the humors are peaking; morning for Phlegm, midday for Bile, and evening for Wind. Tibetan medicine also recommends avoidance of faulty food combinations (same concept but slightly different foods from Ayurvedic faulty food combinations) such as chicken with yoghurt, eggs with fish, fish with milk, peanuts with honey, honey and melted butter in equal weights, milk with walnuts, and peaches with any other fruit to reduce the risk of imbalancing the humors.
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