*What follows is a reshare of a post from Ben Joffe of Sky Press’s personal blog A Perfumed Skull. A small portion of this essay was also translated and included as an appendix in The Tibetan Book of Health published by Sky Press.
“The following essay, published in a 1999 edited collection of some of Dr Nida’s articles on Tibetan medicine, describes Dr Nida’s efforts to resuscitate and promote a traditional Tibetan healing practice known as Yookchö/Yukcho(e) (dbyug bcos), or ‘Stick Therapy’. Stick Therapy, also sometimes called ‘vajra-stick/rod’ (rdo rje dbyug) practice, involves tapping repeatedly and in a steady rhythm on particular treatment points on a patient’s or one’s own body with a specially prepared pliable stick with a bundle or knob on one end in order to treat specific ailments. Stick Therapy is one of several traditional Tibetan healing practices which were originally (or simultaneously) developed by tantric Buddhist yogi/nis for use on their own bodies for the purposes of self-healing in the context of meditation retreat, which were then apparently taken up and developed as more exoteric medical therapies for use on the bodies of uninitiated patients.
This trajectory should not surprise us. Indian and Tibetan tantric yogic texts regularly describe the more immediate, medical benefits of various esoteric contemplative disciplines involving elite, initiatic procedures like deity yoga or manipulations of the subtle winds, channels, chakras, and drops of the subtle body, alongside explanations of these practices’ more ultimate soteriological or ‘religious’ purposes. More than just a tantric meditative practice exploited for its subsidiary or incidental therapeutic benefits, however, percussive Stick Therapy was expressly developed as a sort of yogic ‘first aid’, as a therapeutic intervention which Tibetan meditators could use to resolve ‘bodily obstacles’ (lus bgegs) – hindrances which manifest in retreat in the form of physical and mental pain and illness and which are traditionally understood to be a result of demonic interference.
As part of his efforts to revive the once standard model of ‘yogi-doctor’ (sngags sman) practice – that is, integrated esoteric tantric ritual and exoteric medical treatment – Dr Nida has spent a great deal of time and energy reviving and promoting external Tibetan therapies around the world. Therapies like massage, Stick Therapy, cupping and so on are relatively cheap, safe, and simple to apply, and yield great benefits. While the central ‘textbooks’ of exoteric Tibetan healing, the Gyushi or ‘Four (Medical) Tantra’ (rgyud bzhi) outline a number of highly effective, traditional external therapies, many forms of massage and other external therapies have also been preserved in more esoteric, tantric contexts as modes of self-healing or enhancement. The types of massage and external manipulations mentioned in revealed treasure or terma (gter ma) texts and other Tibetan tantric Buddhist sources assume by definition that practitioners will apply such healing methods to their own bodies. Given this, broadly speaking, when one sees an advert for any sort of allegedly ‘tantric’ massage meant to be applied to others’ bodies one can be fairly certain that in the majority of cases these are more recently invented New Age or neo-tantric practices without a traditional pedigree or link to classical Shaiva/Shakta or Buddhist lineage-based tantric practices.
Even so, this rule of thumb is complicated a little by the example of Yookchö and other yogic practices which have been reapplied as bodily techniques that the expert tantric yogi/ni applies to the bodies of patients. As such, the indigenous practice of Yookchö offers a fascinating example of the extent to which medical and tantric yogic expertise have overlapped in Tibetan contexts, and the degree to which Tibetan healing practices criss-cross between domains of knowledge and blur the lines between these.
Anyway, here’s the translation of Dr Nida’s essay. I hope you will find it interesting!
Miscellaneous Observations on some of My Research done to Revive Yookchö Stick Therapy
I prostrate, make offerings, and go for Refuge to the King of Medicine Yuthok!
Yookchö (‘stick therapy’) is a therapy that is not taught in the Gyüshi or Four Medical Tantras of Sowa Rigpa or Tibetan medicine. Of the four well-known categories of medical treatment found in Tibetan traditional medicine – diet, lifestyle, pharmaceuticals, and (external) treatments – it belongs to the last of these. In terms of the origin of the practice, it’s clear that there are two directions from which it was disseminated: through being spread and developed by practitioners who practiced Dharma and medicine inseparably, in a thoroughly integrated way, and through being proliferated through the practices and [clinical] research of [those who were] solely [involved] with medicine.
Regarding the first direction, in the terma of [the fifteenth century] treasure revealer Ratna Lingpa’s ‘The Wish-Fulfilling Jewel of Stick Therapy’ the symbolic dimensions, inner meanings and practical applications of Stick Therapy [are described; brda don ‘phrin las gsum] and mustard seeds [empowered] through visualization/recitation of the yidam or tantric meditational deity’s form and mantra must be fastened to the stick. Yookchö was taught/revealed as a form of medical treatment through which yogis could resolve physical/bodily obstacles. It would seem that, after initially using phurba daggers, ritual rods or wands (sba mkhar), thigh-bone trumpets, dorjes and similar methods for ritually blessing [patients], tantric yogis then gradually innovated the use of the Yookchö stick. Alternatively, it is also possible that it was a [medical practice] that was later integrated with Dharma.
Regarding the second [direction]: the contents of the text ‘Pith Instructions on the Vajra-Stick’ written by the great physician Gyaltsen Palzang deal with medical practice, at the same time it teaches various cycles of visualization [to be used as part of Stick Therapy]. These are only taught in medical texts, however, and aren’t [methods] that are explained in Dharma texts. Extremely ancient Tibetan peoples initially relied on a rough or gross [healing] science as part of which they struck afflicted parts of the torso with their fists or pressed into them with their elbows. Later, during the Stone Age, people realized that they could use sticks and stones for this purpose, and from that point on the foundation was laid for using these tools to strike painful or diseased points on the body. Through doing concrete research into [the effects] of these practices on sicknesses, these procedures were elevated and made into a complete medical science.
There is no specific historical background information for Yookchö practices, and it is not really possible to point to anything like a foundational [Indian] scripture or basic text of Yookchö which offers both a broad and deep treatment of core principles. As such, Yookchö is a special, distinctively Tibetan therapy, one which did not spread or develop outside of the Tibetan context. Looking at the sources, it is clear that the main subjects taught in both the forms of Yookchö that spread in tandem with Dharma and those which have the power of mantras attached and which have special features like self-generating as the deity and so on, are equivalent. In both types of texts, the procedures for treating illnesses – the way of constructing the Yookchö stick, of applying the therapy, the specific points for tapping, the types of illness the therapy is and isn’t appropriate for, averting and suppressing [side-effects arising from treatment] and so on – are taught in careful and extensive detail from an equivalent perspective.
Be that as it may, the lineage for such practices has been broken for a long time. The reason for this seems to be that the use of stick therapy is not efficacious in only a few days for most diseases. Moxibustion and hot cupping procedures are slightly simpler and more convenient [to perform] than Yookchö and give more immediate results as well, and thus some doctors have replaced Yookchö [with these other methods]. Modes of transport in Tibetan society are not that convenient and Tibetans live in scattered, remote regions and overworked, busy doctors and patients alike face obstacles in [making use of] medical treatments for several days consecutively. Moreover, more recently, ordinary doctors do not really take an interest in external treatments and only use chemical medicines. These days in Tibetan areas there very few practitioners of things like mig thur surgical procedures [i.e. the use of hollow ‘needles’/scraping instruments for treating cataracts and other eye disorders] or of strong and gentle medicated enema treatments [that use catheters], i.e. ni ru ha and ‘jam rtsi, and it is easy to understand why. As a result of these factors, I think that catheter/hollow needle [i.e. thur ma] and stick therapy treatments were set on a path of progressive decline.
Furthermore, the oral instructions for these practices were transmitted via secret or ‘single master-to-single-disciple’ lineages, so it could be that this is another reason why their transmission and continued use has been broken or interrupted. For example, although the pith, oral instructions of the Vajra-Stick had been maintained continually and uninterruptedly [for generations] up until the time of physician Gyaltsen Palzang, they were only actually written down in his lifetime [i.e. during the seventeenth century]. In the conclusion to his text, he made it clear that he had put these instructions into writing “at the urging of his dedicated students” and “in order to benefit others”. Retaining the aural-lineage in mind, aiding its memorization in this way, is a means of [ensuring that] the practical, oral instructions associated with one-to-one or oath-bound lineage practices continue and proliferate.
The initial focus of my research on this [topic] was on the lineage of source-texts [for Yookchö], the two main texts being Ratna Lingpa’s revealed terma text called “The Wish-Fulfilling Jewel of Stick Therapy from the Guhyasamaja” which is included in the Rinchen Terdzö and ‘The Pith Instructions on the Vajra-Stick’ which was composed by the physician Gyaltsen Palzang and which came out of the Potala Palace library. I began doing this research in Italy at the Shangshung Tibetan medicine school from August 4, 1998 and have continued to do research on [Yookchö’s effects] on sicknesses until the present. When it comes to the construction of the Yookchö stick and its special features, the essential shape of the stick needed to implement the practice, it is made in this way. There is one kind of stick, which as is stated in Ratna Lingpa’s “Wish-Fulfilling Jewel of Stick Therapy’ is “of sba or smyag shad wood, about a finger’s thickness and a cubit’s length, with the end slightly carved into. Attach a bundle of mustard seeds into which you have recited the seven syllables of OM MA NI PAD ME HUNG HRI seven hundred thousand times and have recited/visualized the yidam’s mantra seven hundred thousand times.”
The teaching on using sba and smyag shad wood** is given here due to the need for flexibility. Using a stick with flexibility for striking afflicted points is very important. The springiness of the stick is fitting since it does not damage the skin, it returns the flow of blood and rlung [vital ‘wind’ energy] to their natural state and expels residual, congested, sick [energy]. The length having to be one cubit or one cubit and four fingers long is because of the appropriateness of this length for the way in which and force with which one [has to] strike [the patient with the stick]. If the stick is any shorter than this it will lose its pliability, if it is too long there is the problem of it not landing on the afflicted points [correctly or with precision], so the length of the stick is definitely something that requires attention. Reciting the seven golden syllables and repeating seven hundred thousand visualizations/mantra recitations of the yidam fastens the force or power of these mantras to the stick and is major requirement for treating demon-caused or psychological sickness. There is a difference between sticks which have mantric power and those which don’t. The instruction to bore into the end of the stick and to place mantric syllables and [consecrated] mustard seeds into it and then bind it refers to the wrapped piece of bone [at the end of the stick] in which the mustard seeds are bundled which comes down on the [specific therapeutic] points. This does not wound the skin or hurt the bones and has the additional benefit of adding very little to patients’ pain.
In sum, every line taught in scripture has a reason and rich inner significance behind it and as such, I have done each thing in accordance with these textual instructions. On August 4, 1998 with the German woodworker Andrea I constructed two types of Yookchö stick making reasonable estimates from the principles taught in the ‘Wish-Fulfilling Jewel of Stick Therapy’ scripture, one with a bent and one with a straight end, as shown in the illustrations below:
In other traditions, the materials and proportions and so on of the stick are generally as described before but the shape or appearance is a little different. Here, it is taught that the stick has a single round wooden ball or knob attached to it shaped like a bird’s egg, as shown below:
This kind of stick is a little less appropriate for use on points on the head and points on the front and back of the body where there are bones but I have noted that it is more useful for points where there is muscle and in cases where the sickness is ‘heavy’. The reason for this is that this kind of stick/knob is able to come down on the patient’s points more heavily and forcefully.
A collection of Yookchö sticks (photo courtesy of Karen Stone of Arura Healing Center, Melbourne, Australia)
The specific treatment points for Yookchö are divided into two categories: afflicted or ‘sickness’ points (nad gsang) and naturally-existing/anatomical points (rang bzhin gyi gsang). The former are points which have pressure or pain and which feel better when they are pressed or struck. Points [like these] where a trace remains when they are pressed, where there is deep soreness when pressed into with the thumb, where the skin has a greyish appearance or is slightly warm, and where there is no inflammation of the muscles, veins, bones and so on, will all benefit from the application of Yookchö. The latter [‘natural’] type of point includes points on the head: the crown point, the four inner and four outer depressions on the nape of the neck, the point between the eyebrows and the two points two fingers’ widths to the left and right of this, the two points to the side of the artery in the temples, the point one fingers’ width behind the earlobes, the points around the larynx/windpipe, the front point of the hairline, points on the ear, points about a tshon’s length [from thumb joint to the top of the finger nail] around the nape points etc.; points on the back of the body: from the first cervical vertebra measured four fingers width up, the second, third, and fourth vertebrae, the sixth and seventh and ninth, the twelfth, thirteenth, and fourteenth, and the eighteenth and nineteenth vertebrae. Points on the front of the body: point in the middle of the breast midway between the nipples, the two points in the depressions right below the sternum, the fire-equalizing point three tshon below the sternum, points of the upper and lower intestines, and so on. Points on the limbs: points where the arms meet the shoulders, around the hip socket, and so on.
In addition, it is clear that benefits come when one taps on certain moxibustion points as well, so seeing that there are many more points than just those that are taught in these two source texts confirming other points through [individual] investigation will prove to be of great value and merit.
There are appropriate and inappropriate conditions for tapping or striking. Of these, appropriate place to hit are the specific points described above; appropriate sicknesses to apply tapping to are disorders involving rlung in the head, headaches and head pain, deafness, a numb/paralyzed or twisted neck, discomfort of the tongue, lameness and numbness/paralysis of the hands and feet or extremities, an unhappy heart, for upper body pain, stod ‘tshang conditions where rlung becomes congested in the upper body, madness caused by problems with the srog rlung, grang sbos liver conditions where the liver is cold and bloated, diseases of the diaphragm, swelling of the liver, chronic stomach disease (pho gcong), deterioration of digestive fire/heat, lhen diseases connected with the bad kan humour, lcags dreg pho glang digestive conditions, cold rlung disorders of the intestines, rlung disorders of the kidneys, gynecological disorders involving swellings of the blood, a twisted throat, muteness, and other such diseases explained in the authoritative texts. The therapy also has clear value for several other diseases not written about here.
Regarding inappropriate applications, there are inappropriate treatment points and inappropriate conditions for treatment.
The ‘Pith Instructions of the Vajra-Stick’ states that “the areas to not hit are those points which should be avoided because of illness. You should avoid striking all of these: firstly, the aperture of Brahman, the sensory organs, over the heart or on the breasts, over the dimples of the cheeks and the ‘black’ temporal artery, directly over the liver, spleen, or kidneys, on the navel or the male or female genitals, on the shoulder blades, on inflammation of the knees or the kneecaps, on goiters, the ankles, or anywhere where there is fluid retention or inflammation. Secondly, avoid practicing on all hot feverish infections connected with mkhris pa, sicknesses from poison, hot-condition swellings, jaundice, cases where the skin is very hot and there are pustules, wounds, and tumours of any kind”. This is very easy to understand.
The main essential point of these contraindications is to prevent afflicted areas from being harmed, broken or damaged, to prevent sickness from spreading, and so on. Otherwise, it is not appropriate to apply Yookchö in cases of broken bones, wounds from weapons, old wounds, fever, unripened fever/hot conditions, fever from [systemic] disturbances/ imbalanced hot conditions (‘khrugs tshad), conditions caused by excessive heat (rgyas tshad), chu ser sicknesses, or on small children/infants, and one should also avoid striking the stations of the bla [the vital energy which moves through different areas of the body in tandem with the lunar cycle]. If one hits the bla points there’s the danger that the bla could leave/be displaced.
As for the teachings on how to tap or hit [with the stick], the ‘Wish-Fulfilling Jewel of the Stick Therapy of Guhyasamaja’ explains that “when you strike first do it just with the stick’s own weight. Strike defective points without causing swelling and increase the force on the skin. Make each strike smaller in turn and land each blow continuously.” As stated, at first bring down the stick solely by its own force. If you use too great a force the fine capillaries in the skin will get damaged. It is also important that the patient gets used to the tapping gradually. One has to increase the force of the blows on the skin without causing any problems or damage. Even if patients’ undamaged skin, muscles and so on are in pain, if they slowly get used to the tapping and you apply it with a continuous, uninterrupted force and rhythm then it will be okay. As far as the length of time one has to tap, this primarily requires investigation into the illness being treated. If imprints from striking become hard, the illness is intensifying and this requires that one tap for a long[er] time. With some rlung conditions like rlung-related pain and so on, striking is permissible solely because it is capable of opening up the tiny pores/body hairs – the explanation given for this is that it is in order to expel the rlung which has gotten caught up in eddies (rlung ‘khyims pa).
Generally, experience shows that it is suitable to apply stick therapy twice a day, for fifteen to thirty minutes each time. Regarding the suppression of side-effects: doing so is a very beneficial part of this therapy so one really ought to pay particular attention to this. As is taught extensively in the ‘Pith Instructions of the Vajra-Stick’, “if the stick is used incorrectly and rlung is generated, if there are no marks from the tapping then one should apply massage. If heat/fever emerges then one should wash stick-imprints with urine, with camphor and other cooling medicines”. Otherwise, in “The Wish-Fulfilling Jewel of Stick Therapy” it is also taught that: “If after two days, pain or heat increases or a bright mist of light appears discontinue treatment. Anoint the point/s with urine, deer musk, and ‘wild substances’ [ointments made of ‘wild’ tantric materia like aconite, predatory animal fur etc.]. If blood swells up and causes pain/pressure, pierce the point with a needle and drain the blood. Or else apply a yak’s horn. If that doesn’t help insert the horn and do it yourself. If boils or pustules arise after treatment with the stick again pierce these with a needle or suck the fluid out with one’s mouth. In general, avoid piercing with a needle any point where there is a throbbing pulse.” And further, “It is okay to pierce swellings with a red colour which are distended with either dark red blood or [clear/yellowish] chu ser [serous fluid]. Avoid piercing with a needle those points from which swelling does not develop. If swellings are black in colour and there is black chu ser these must be sucked out. If the point hardens, the sickness is intensifying so tap for longer. Light blue-grayish swelling and yellowish, dull spots are mkhris pa [‘bile’], grayish dull spots are rlung [‘wind’ humour], for which the pores/small hairs are left to open. If after applying the stick pain in the trunk is prolonged/extended, recite a long HAAAAA syllable and shake the body. If there is pain in the lower parts of the body, walk around in an appropriate fashion, dance, and strike the ankles and heels continuously [with the stick]. If rlung rises up then massage only on the belly, around the first cervical vertebra, on the imprints left by the stick, and on the yar sgo [rlung points on the top of the skull]. In cases of heart-rlung, psychosis, crestfallenness/depression [i.e. rigs pa ‘phyo ba, a ‘dejected mind/reason’], fainting, intense interior coldness in intestines, and bloating, apply heat, light, and oil firmly to the areas around these afflictions on specific points where there are no marks from the stick. Thus, will you will you resolve the obstructions and demonic provocations of the above-mentioned sicknesses, and every meditation-defect.”
After having constructed the sticks and having informed myself about which illnesses and afflicted points were to be treated and avoided and so on, I applied Yookchö therapy to several dozen patients and through this saw great benefits. I observed in particular that the therapy was extremely useful for things like blood and rlung disorders, stod ‘tshangs or rlung congestion in the upper body, upper body pain and so on. In light of these findings I came to have deep confidence and belief in this therapy. I present a few simple patient case-studies below:
PATIENT CASE-STUDY I:
Italian, worked as a labourer/craftsman. Found it difficult to bend his body, more specifically had a lot of pain around the left side of his seventeenth vertebra. His heart was unwell and from time to time he would say crazy or erratic things. His mind [shes pa, i.e. conscious awareness, cognition] was unclear/foggy and dejected. He had great pressure and pain in the center of his chest between his nipples and all the way from the first cervical vertebra up until the twenty first [L2]. His general pulse was ‘hollow’ and ‘floating’ and his male pulse was clearly weak and sluggish. His urine was white coloured and had many bubbles/a lot of foam which dissolved slowly. I identified srog rlung disorder and rlung-related pain. I applied stick therapy to points afflicted with pressure and pain and to several rlung points uninterruptedly on a daily basis from seven to eight in the evening. The patient improved visibly and the pain around his seventeenth vertebra disappeared completely and he was able to bend his body normally. His heart became well and although roughly six months have now passed, the patient states that he has not become unwell again.
PATIENT CASE-STUDY II:
Italian, profession labourer. For three months, the treatment point of the left hip-joint had been in pain and legs were dragging and it was difficult to walk. Specifically, patient was unable to sit cross-legged and when they did sit they had difficulty standing back up. At times they had sharp, vivid pain in the knee-pit and a lot of pressure and pain, and they thought this felt better after hitting. The general pulse was floating, urine was a grayish colour with a lot of foam with average dissipation. I diagnosed a rlung disorder with dragging leg/limp. I applied stick therapy for a week on the hip-joint point after which the patient showed clear improvement. When patient sat there was only a little pain. Walking returned to normal.
PATIENT CASE-STUDY III:
Italian, profession secretary. Headaches for many years, with more specific symptoms such as dizziness and nausea before her period, loss of appetite and psychological discomfort. There was pain and pressure in certain mkhris pa and rlung points and when pressed patient felt that this helped. Applied stick therapy for this for three days, after which there was improvement. Most symptoms disappeared and patient felt well.
PATIENT CASE-STUDY IV:
American, worked as graphic designer. He had slept in an inappropriate position and at that time due to something like a sudden stroke of rlung or rlung affliction, for about two days his neck had been stiff/paralyzed and in great pain. It was difficult for him to move his head and eating, drinking, and working had become inconvenient. I diagnosed a frozen neck and applied stick therapy two times to points on his neck after which he improved.
So it was that I initially conducted research into reviving Yookchö stick therapy, using simple procedures for simple conditions. From the various stages of my investigations I have directly established that Yookchö procedures are of minimal difficulty, have very easy requirements in terms of tools, produce few side-effects for patients, and most especially, are extremely beneficial. I have accordingly come to realize that Stick Therapy has many extraordinary features and I have great hope that it will be the subject of deeper research [in the future]. Since the practical research [I have conducted so far] is by itself hardly likely to prove sufficient, I am continuing to investigate the medical effects of the therapy on a variety of different diseases. I thus encourage other Tibetan doctors to do research into the therapeutic applications of Yookchö for a host of different diseases and conditions as well, and [offer] this brief discussion here so as to facilitate this in some small way. I close here then in expressing the hope that Tibetan hospitals will construct Yookchö treatment rooms on the side where doctors will be able to practice stick therapy on patients and their problems.
** Sba shing is typically said in dictionaries to refer to ‘rattan cane’, and it is used to translate the Sanskrit vetra. It can potentially refer to other species in different contexts, however, and Dan Martin has suggested that in some sources it may even refer to willow. Alessandro Boesi and Francesca Cardi identify smyag shad as a kind of high-altitude meadowsweet Spiraea arcuata.
** Since the publication of this early essay, Dr Nida has also published a small collection of Stick Therapy source materials as an appendix in his 2015 book on tantric healing practices, “The Interdependent Science of Mantra Healing’ (rten ‘brel sngags bcos rig pa), several chapters of which I have already translated and shared on this blog. These include texts from Zurkharwa Nyamnyi Dorje (1439 – 1475), Terton Ratna Lingpa, Kawa Shakya Wangchuk Kunga Gyaltsen, Jadrelwa Legpa Palzang. Legpa Palzang was a student of Urgyenpa Rinchen Pal, a monk and master Stick Therapist from the thirteenth century.
– from Nyi zla lce nag tshang. “Dbyug bcos la skyar gso’i zhib ‘jug byas pa’i snyan zhu thor bu”. In Nyi zla’i gso rig ched rtsom gces btus. Lanzhou: Kan su’i mi rigs dpe skrun khang, 1999, 214 – 226.