Tibetan medicine plurality

Tibetan medicine historically has had multiple medical lineages, despite ancient, shared literary medical canons. However, since the second half of the 20th century in Tibet, increasing state control and commoditization has lead to centralization and standardization of Tibetan medicine. Here we investigate how much variation in the use of medicinal plants remains in contemporary Tibetan medicine. Medicinal plants used and/or sold by fifteen Tibetan medical institutions, markets, and doctors, as well as two additional non-Tibetan markets, are inventoried and vouchered (where allowed). The data are ordered by Non-metric Multidimensional Scaling. Four distinct groups are defined: (1) government recognized Tibetan medical institutions and their disciples both in Lhasa and elsewhere, (2) local herbal doctors near Mt. Khawa Karpo, eastern Himalayas, (3) Tibetan medicinal markets in Lhasa and near Mt. Khawa Karpo, and (4) non-Tibetan medicinal markets near Dali and Kunming, Yunnan. This clearly documents the plurality of Tibetan medical traditions—official, local, and market—while differentiating these from non-Tibetan markets.