Medicine and Memory in Tibet: Amchi Physicians in an Age of Reform by Theresia Hofer (review)

The recent emergence of Asian "traditional" medicines as increasingly popular medical, economic, and cultural resources in national and international health care policies has coincided with a renewed academic—especially medical anthropological—interest in the wider topic. The realization that medical traditions like Chinese medicine, Ayurveda, or Sowa Rigpa have—or are currently being—transformed into modern, innovative, and lucrative industries has opened up space for exciting new perspectives and research on medical history, global health, reformulation regimes, or pharmaceutical assemblages (e.g., Lei 2014; Pordié and Gaudillière 2014a, 2014b; Kloos 2017a). To some extent, such perspectives entail a shift of focus from remote villages and rural healers to urban laboratories, corporate offices, and state policies, constituting an important step from earlier approaches that studied Asian medicines mostly through the lens of "traditional culture." Yet the industrialization and mainstreaming of Asian medicines remain partial and historically and structurally predicated on unofficial, noncapitalist, marginal actors and practices, whose agency, experiences, and narratives are easily overlooked in modern Asia, if not actively silenced. Indeed, despite a good corpus of work on "traditional medicine" in rural Asia, there are very few book-length ethnographies focusing on Asian medicine's modern development outside the centers (e.g., Craig 2012; Pordié and Kloos, forthcoming). As far as Tibetan medicine is concerned, Theresia Hofer's outstanding book Medicine and Memory in Tibet not only identifies this gap, but also fills it with a perfectly balanced combination of rich ethnography, subaltern history, and anthropological analysis.

Based on "officially unofficial" (22) fieldwork in an economically marginal part of the Tibetan Autonomous Region—rural Tsang, particularly Ngamring County—in 2003 (six weeks) and 2006–07 (three months, while based in Lhasa for one year), Medicine and Memory in Tibet offers an excellent historical-ethnographic account of Tibetan medicine's development in Tibet from the 1940s to the present decade. What sets the book apart from the existing literature is its decentered and gender-sensitive perspective: instead of the well-documented medical institutions in Lhasa or all-male monastic institutions, the main protagonists here are both male and female lay amchi (practitioners), their lineages, and medical houses on the fringes of the state. Tracing their life stories by analyzing their memories and narratives in the context of state power—from the old Ganden Phodrang government to communist "reforms," enforced collectivization and decollectivization, and most recently liberal market reforms—Hofer convincingly illustrates the important role played by lay rural amchi in Tibetan medicine's survival and transformation through that time period. "The revitalization of Tibetan medicine," it thus emerges, "is far more than a top-down, state-led process pertaining to mainly government institutions; rather it is characterized by multiple agendas and actors with diverse projects" (20). The explicit and overarching aim of this book, then, is to challenge the hegemony of (exclusively male) Tibetan medical historiographies produced by—or based on research at—the central institutions of Tibetan medicine since the 1950s, most importantly the Lhasa (and later also the Dharamsala) Men-Tsee-Khang (11).

Medicine and Memory in Tibet is organized in a chronological fashion, but besides covering consecutive decades (chapters 1 and 2 [1940s and 1950s], chapters 3 and 4 [1960s and 1970s], chapter 5 [1980s and 1990s], and chapter 6 [2000s to the present]), each individual chapter also makes an original contribution to the study of Tibetan medicine by focusing on a distinct topic. Thus, chapter 1 ("The Tibetan Medical House") argues that the transmission of Tibetan medical knowledge in rural Tibet may be better traced through "medical houses" rather than lineage. Indeed, Hofer's data reveals that the classical lineage ideology, in which knowledge is passed from father to son (or uncle to nephew) is not reflected in practice, where the house—which can be male or female—appears as the more stable form of transmitting medical knowledge. While such medical houses dominated the...