Sowa-Rigpa explained: Himalayan medicine and its history

This review explains what Sowa-Rigpa is, where it comes from and where it is practised in India. It draws on pages from the Ministry of Ayush and on a general World Health Organization (WHO) explanation of traditional medicine. It is information only. It makes no claim that any therapy works for any disease, and it is not a substitute for advice from your own doctor.

1. Introduction

India's Ministry of Ayush was created as a full ministry on 9 November 2014. Its work covers Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy, which together are called the Ayush systems ^[1]. Sowa-Rigpa is the Himalayan member of that group. It is also called Amchi medicine ^{[1, 2]}. The Ministry's 2024 report says the system is rooted in Buddhist philosophy, which stresses interdependence, karma, love and compassion ^[1].

The Ministry describes Sowa Rigpa as one of the oldest traditional medical systems in the world, with roots going back thousands of years ^[1].

2. What the name means

The name comes from the Bhoti or Tibetan language. "Sowa" means healing and "Rigpa" means knowledge or science, so together the name means the knowledge of healing ^{[1, 2]}. Practitioners are called Amchi or Menpa ^[1]. The Ministry's introduction page calls the system the Amchi system and explains that it was reinforced in the Trans-Himalayan region ^[2].

3. History as the Ministry describes it

Official pages give the following account of its origins.

• The fundamental textbook is the Four Tantras. In Tibetan it is written rGyud-bZhi (also Gyud-Zi), and in Sanskrit it is Chatush Tantra ^{[1, 2]}.
• According to the system's own tradition, as quoted by the Ministry, these teachings were first given by Bhagwan Buddha near Bodh Gaya, and were later passed on by his disciples ^[1]. Ayush Next, the Ministry's career portal, likewise says the system is believed to have started in India with Bhagwan Buddha ^[3].
• India was a centre of Buddhist art and culture and attracted Tibetan students, and Indian scholars were invited to Tibet. Indian literature was translated into Tibetan, later enriched in Tibet and kept in Tibetan literature. The Four Tantras was translated from India and then expanded in Tibet ^[2].

These are traditional accounts. They describe how the system understands its own history and are not the result of a modern scientific test.

4. Where it is practised

The Ministry says Sowa Rigpa has flourished across the Himalayan belt, including Ladakh, Sikkim, Arunachal Pradesh and Himachal Pradesh, and parts of Nepal, Bhutan and Tibet ^[1]. Another Ministry page lists the Indian Himalayan regions as Ladakh, Spiti and Lahaul in Himachal Pradesh, Jammu and Kashmir, Darjeeling in West Bengal, Arunachal Pradesh and Sikkim. It adds that the system is also found in parts of China, Mongolia, Nepal, Russia and Bhutan ^[2].

Ayush Next says demand for trained professionals exists in the Himalayan region and elsewhere in India, and also in Nepal, Bhutan, Mongolia and Russia ^[3].

The Ministry's 2024 report gives a sense of the size of the system in India. As on 1 April 2024 it counts 5 Sowa Rigpa hospitals with 22 beds and 62 dispensaries. It says the dispensaries are in Arunachal Pradesh, Himachal Pradesh, Jammu and Kashmir, Sikkim and Ladakh, and that Ladakh has the largest share ^[1]. It counts 84 registered practitioners as on 1 January 2024 ^[1]. These are small numbers, which fits a system that is mainly regional.

5. How it fits with the other Ayush systems

The Ministry's introduction page says Sowa-Rigpa is perceived to be similar to Ayurvedic philosophy. It also says that features such as its principles, do's and don'ts, pulse examination and dietary guidelines show its closeness to India ^[2]. The page notes that several medicines of Indian origin, such as Ashwagandha, Guggulu, Triphala, Ashok and Haridra, are used in the system ^[2]. Pulse examination is listed among its features ^[2]. The page does not describe treatment methods, so this review does not describe any.

The Ministry's report also describes a National Institute of Sowa Rigpa in Leh, established in 2020 as an autonomous institute under the Ministry of Ayush ^[1]. Ayush Next, the Ministry's career portal, says the institute was established in 2020 to preserve and promote the system ^[3].

6. What WHO says about traditional medicine in general

WHO explains that traditional medicine covers health-care systems from different historical and cultural settings. They are distinct from and pre-date modern biomedicine. WHO says they have an experience-based origin and emphasise nature-based remedies and holistic, personalised approaches that aim to restore balance of mind, body and environment ^[4]. WHO also reports that 170 of its 194 Member States have reported on the use of herbal medicines, acupuncture, yoga and other traditional systems ^[4]. WHO says safety depends on practitioner competence, product quality, good communication and strong regulation, and that adverse events and quality problems can happen in any area of health care ^[4]. It also says that efficacy and safety should be established through rigorous scientific validation, even for remedies used for a long time ^[4].

7. Practical points for readers

• Treat Sowa-Rigpa as a traditional system, described officially as such. Its claims should not be taken as proof that a particular remedy works for a particular illness.
• Medicines and practices vary, so ask what a product contains and who made it.
• Do not use any traditional remedy to delay seeing a doctor for a new or worsening problem.
• Tell your doctor about every treatment you use. The doctor decides your medical treatment.

8. When to see a doctor

See a doctor, in person, for any new, severe, persistent or worrying symptom, and before you stop or change a medicine your doctor has prescribed. Do not wait for a traditional treatment to work first. In an emergency, call your local emergency number (112 in India, 911 in the United States).

9. Conclusion

The Ministry of Ayush describes Sowa-Rigpa as an ancient healing system of the Himalayan belt, named for the knowledge of healing and based on the Four Tantras. It is practised by Amchi or Menpa healers in Ladakh, Sikkim, Arunachal Pradesh, Himachal Pradesh and neighbouring countries. WHO reminds readers that safety rests on skilled practitioners, quality products and open communication. Choose a registered practitioner and keep your doctor informed.