Chzhud-shi Treatise (Essays on Tibetan Medicine)

Chapter 26 of the treatise Jude Shea describes the practical foundations of a physician's healing tactics.

These, while of historical interest, have not lost their significance in modern times.

Four points are discussed:

1. When to heal is easy;
2. when to heal is difficult;
3. When to heal is to heal only slightly, and
4. when to leave it untreated.

"...The patient is easy to treat if the doctor knows all the constituent parts (sections) of medical science at the proper level and is distinguished by moral purity, if the medicines are prepared according to all the rules and have all the therapeutic virtues;

— If the patient himself is sensible, has perfect reason, fulfills all the doctor's instructions, and is able to understand the cause and circumstances that have caused the disease;

— when the disease is cured in its initial period and proceeds without complications.

"It is difficult to heal" patients in circumstances contrary to those mentioned above, as well as those who are hostile to doctors, those who are frivolous, perverted by a bad life, who have lost all faith in a cure, etc.

"A "light cure" is necessary when the patient has benefited from a therapeutic regimen and "still has time left in his life, allotted to him by fate.

"To leave a patient untreated" is when the treatment will not produce positive results, when there are clear signs of death, when the patient is afflicted with the "nine terminal, terminating afflictions."

The "nine terminal afflictions" in Tibetan medicine refer to:

1. "the expiry of the period of life predetermined by fate (the occurrence of natural death);
2. violation of all internal connections of the body's material elements;
3. complete absence of therapeutic effect (imminent death by any treatment);
4. damage of vital organs;
5. cessation of the activity of the rLung that supports life (due to the neglect of the disease);
6. transition of fever, fever of its highest limits;
7. transition of the body's cold to its lowest limits;
8. complete exhaustion of the basic forces of the body;
9. excessive exhaustion (agonal state)"...