# In the Forbidden Land/Chapter XLVIII

    Illnesses and remedies—Curious theories about fever—Evil spirits—Blacksmith and dentist—Exorcisms—Surgical operations—Massage and cupping—Incurable illnesses—Deformities—Deafness—Fits and insanity—Melancholia—Suicides.
THE Lamas became quite communicative, enabling me, partly with the little Hindustani that I knew and partly with the Tibetan I had picked up, to enter into a conversation about illnesses and their remedies, certain as I was that they must have strange notions on the subject. I was not disappointed in this surmise, and from that conversation and my own observation on previous and subsequent occasions, I am able to give a few details of the methods of the Lamas in curing the more frequent ailments found in the country.
The Lamas explained to me that all diseases arose from fever, instead of fever being an accompaniment of most illnesses, and furthermore, that fever itself was but an evil spirit, which assumed different forms when it entered the body, and caused all sorts of complaints. The fever demon, they asserted, was a spirit, but there were yet other demons who were so good as to bring us riches and happiness. For instance, when a man after a dangerous illness visited a a cave, waterfall or river-gorge which these demons were supposed to haunt, he might have a relapse and die, or he might be instantly cured and live happy ever afterwards. In the latter case, as would naturally be expected, the recipient of such inestimable privileges generally returned to pay a second visit to the kindly spirits who made his life worth living, "but," said the Lamas quite seriously, "when he goes a second time he will get blind or paralytic, as a punishment for his greediness."
"The evil spirits," continued a fat old Lama with crooked fingers, which he clenched and shook as he spoke, "are in the shape of human beings or like goats, dogs, sheep or ponies, and sometimes they assume the semblance of wild animals, such as bears and snow leopards."
I told the Lamas that I had remarked many cases of goître and also other abnormalities, such as hare-lip and webbed fingers and toes, as well as the very frequent occurrence of supernumerary fingers or toes. I asked them the reason for such cases, and they attributed them, with the exception of webbed fingers, to the mischievous work of demons before the child's birth; they could not, however, suggest a remedy for goître.
Inguinal and umbilical hernia are quite common, as I have on several occasions observed, and coarse belts are made according to the taste and ingenuity of the sufferer, but are of hardly any efficacy in preventing the increase of the swellings.
A common complaint, especially among the older women, was rheumatism, from which they seemed to suffer considerably. It affected their fingers and toes, and particularly the wrists and ankles, the joints swelling so as to render them quite stiff, the tendons contracting, swelling, and becoming prominent and hard in the palms of the hands.
Both before and after my conversation with the Lamas I had opportunities of ascertaining that the stomachs of the Tibetans are seldom in good working order. But how could they be when you consider the gallons of filthy tea which they drink daily, and the liquor to which they are so partial? This poisonous concoction is enough to destroy the gastric juices of an ostrich! The tongue, as I have mentioned already, is invariably thickly furred with a whitish coating, and Tibetans have often complained to me of tumours as well as of painful burnings in the stomach, the latter undoubtedly caused by ulcerations. It is to be regretted that, even in the high land of Tibet, the worst of all sexual diseases (called by the Tibetans Boru) has made vast numbers of victims, palpable traces of it showing themselves in eruptions, particularly on the forehead and on the ears, round the mouth and under the nostrils, on the arms and legs. In cases of very long standing, a peculiar whitish discoloration of the skin and gums was to be noticed, with abnormal contraction of the pupils. That such a disease is well rooted in the country we have proof enough in the foul teeth which the majority of Tibetans possess. In nearly all cases that I examined, the teeth were, even in young men, so loose, decayed and broken as to make me feel quite sorry for their owners, and during the whole time I was in Tibet—and I came in contact with several thousand people—I believe that I could almost count on my fingers the sets of teeth that appeared quite regular, healthy and strong. As a rule, too, the women had better teeth than the men. No doubt the admixture of bad blood in the Tibetan race contributes a great deal to the unevenness and malformation of their teeth, and if we add to this the fact that the corruption of the blood, even apart from disease, is very great owing to their peculiar laws of marriage, it is not surprising that the services of dentists are everywhere required. The teeth of Tibetans are generally of such a brittle nature that the dentist of Tibet—usually a Lama and a blacksmith as well—has devised an ingenious way of protecting them from further destruction by means of a silver cap encasing the broken tooth. I once saw a man with all his front teeth covered in this fashion, and as the dentist who had attended to him had constructed the small cases apparently with no regard to shape or comfort, but had made most of them end in a point for mastication's sake, the poor man had a ghastly appearance every time that he opened his mouth. The Tibetans are not very sensitive to physical pain, as I have had reason to judge on several occasions, when I have seen teeth extracted in the most primitive fashion, without a sound being emitted from the sufferer.
In South-Western Tibet the Hunyas (Tibetans) have the same strange notions on transmigration of evil spirits that are common to the Shokas. For instance, if a man falls ill, they maintain that the only remedy is to drive away the evil spirit which has entered his body. Now, according to Tibetan and Shoka ideas, evil spirits always enter a living body to satisfy their craving for blood: therefore, to please the spirit and decoy him away, if the illness be slight, a small animal such as a dog or a bird is brought and placed close by the patient; if the illness be grave, a sheep is produced and exorcisms are made in the following fashion. A bowl of water is whirled three or four times over the sick man's head, and then again over the animal selected, upon whose head it is poured. These circles, described with certain mystic words, have the power of drawing the spirit out of its first quarters and causing it to enter the brain of the second victim, upon whose skull the water is poured to prevent its returning back.
"Of course," said my informer with an air of great gravity, "if you can give the evil spirit a present in the shape of a living being that will satisfy him, he will depart quite happy." If the illness is slight, it means that the spirit is not much out of temper, and a small present is enough to satisfy him, but if the disease is serious, nothing less than a sheep or even a yak will be sufficient. As soon as the spirit has changed his temporary abode the animal is quickly dragged away to a crossing of four roads, and if there are no roads a cross is previously drawn on the ground, where a grave for the animal is dug, into which it is mercilessly thrown and buried alive. The spirit, unable to make a rapid escape, remains to suck the blood of his last victim, and in the meantime the sick man, deprived of the company of his ethereal and unwelcome guest, has time to make a speedy recovery. When a smaller animal is used, such as a dog or a bird, and when the patient complains of more than one ailment, the poor beast, having been conveyed to the crossing of four roads, is suddenly seized and brutally torn into four parts, which are flung in four different directions, the idea being that, wherever there may be spirits waiting for blood, they will get their share and depart happy. After their craving is satisfied, the evil spirits are not very particular whether the blood is human or not. In Shoka land especially, branches with thorns and small flying prayers are placed on each road to prevent their immediate return. These are said to be insuperable barriers to the evil spirits.
When a patient completely recovers, the Lamas naturally obtain money for the exorcisms which have expelled the illness, and they never fail to impress upon the people the extraordinary powers they possess over the much-dreaded demons.
The Tibetans are unsuccessful in surgery, first of all because they do not possess sufficient knowledge of human anatomy; secondly, because their fingers are wanting in suppleness and sensitiveness of touch; and lastly, because they are not able to manufacture instruments of sufficient sharpness to perform surgical operations with speed and cleanliness. In Tibet everybody is a surgeon, thus woe to the unfortunate who needs one. It is true that amputation is seldom performed; but if it should become necessary, and the operation is at all difficult, the patient generally succumbs. The Tibetan surgeon does not know how to saw bones, and so merely severs the limb at the place where the fracture has occurred. The operation is performed with any knife or dagger that happens to be at hand, and is, therefore, attended with much pain, and frequently has disastrous results. The precaution is taken to tie up the broken limb above the fracture, but it is done in such a clumsy way that very often, owing to the bad quality of Tibetan blood, mortification sets in, and, as the Tibetans are at a loss what to do on such occasions, another victim goes to join the majority.
Considering the nomadic habits of the Tibetans and the rough life they lead, they are comparatively immune from very bad accidents. Occasionally there is a broken arm or leg which they manage to set roughly, if the fracture is not a compound one, by putting the bones back in their right position, and by tightly bandaging the limbs with rags, pieces of cloth and rope. Splinters are used when wood is obtainable. A powder made from a fungus growing on oak-trees in the Himahlyas is imported and used by the Tibetans near the frontier. A thick layer of it, when wet, is rubbed and left upon the broken limb, over which the bandaging is afterwards done. In a healthy person, a simple fracture of the leg, which by chance has been properly set, takes from twenty to thirty days to heal, after which the patient can begin moving about; and a broken arm does not require to be kept in a sling more than fifteen or twenty days. If these cures are somewhat more rapid than with our more civilised methods of bone-setting, it is merely due to the wholesome climate and the fact that the natives spend most of their days out in the open air and in the sun, undoubtedly the best cure for any complaint of that kind; but, of course, it is but seldom that the bones are joined properly, and they generally remain a deformity. More satisfactory results are obtained with cases of dislocations by pulling the bones into their right position.
In case of wounds the bleeding is arrested by the application of a wet rag tightly bound over the wound. In most cases of unbandaged wounds that came under my notice the process of healing was a very slow one, the great changes in the temperature between night and day often causing them to open of themselves. They made good headway towards recovery in the beginning, but the skin was very slow in joining and re-forming.
Burns are treated by smearing butter over them; and a poultice of rhubarb is used to send down swellings of contusions as well as for the purpose of bringing boils, from which the Tibetans suffer much, to a speedy maturation.
Aconite is given for fever and rheumatism, and a rough kind of massage is used to allay pain in the muscles of limbs. It is generally done by the women, who, as far as I could judge, practised it with no real knowledge but merely contented themselves with violent rubbing and pinching and thumping until signs of relief appeared on the sufferer's face. Whether, however, these manifestations were due to actual soothing of pain, or to the prospect of the masseuse bringing her treatment to an end, I could never properly ascertain. Tibetan fingers are not well adapted for such work, being clumsy and, compared with those of other Asiatic races, quite stiff and hard.
Cupping is adopted with success. Three or four small incisions are made close to one another and a conical cupping-horn about seven inches long, having a tiny hole at its point, is applied over them. The operator then sucks through this small aperture until the horn is full of blood, when it is removed and the operation begun again. With poisoned wounds the sucking is done by applying the lips to the wound itself.
Bleeding is used as a remedy for bruises and swellings, and for internal pain, also for acute attacks of rheumatism and articular pains. If it is not sufficient, the branding cure is resorted to, and if this should also fail, then the tinder cones, to be described later on, come into play and, the seat of the pain being encircled with them, they are set alight. When even this remedy proves inefficacious, and the patient survives it, the illness is pronounced incurable!
Natural abnormalities and deformities are frequent enough in Tibet, and some came under my notice in nearly every camp I entered. Deformities of the spine were common, such as displacement of the shoulder-blades; and I saw during my stay in Tibet many cases of actually humpbacked people. There were frequent cases, too, of crookedness of the legs, and clubfoot was not rare, while one constantly met with webbed fingers and supernumerary fingers and toes, as well as the absence of one or more of them. Malformations of the skull, such as the two sides being of marked unequal shape or an abnormal distance between the eye sockets, were the two most common deformities that came under my notice.
The ears of men of the better classes were much elongated artificially by the constant wearing of heavy earrings, which sometimes even tore the lobe of the ear.
The most frequent and curious of all was the extreme swelling of children's stomachs, caused by the umbilical cord not being properly tied at birth. The operation was generally performed by the mother and father of the newly-born or by some friend at hand. The infants had such enormous paunches that in some cases they were hardly able to stand; but, as they grew older, the swelling seemed to gradually abate and the body assumed its normal shape.
Deafness was common, but I never came across any dumb people, though I now and then encountered cases of painful stammering and other defects of articulation arising from malformation of the palate and tongue.
Occasionally, however, the difficulty of speech was caused by dementia, which seemed very common in Tibet, especially among the young men. Whether it was caused by cardiac affection subsequent to organic vices, as I suspected, or by other trouble, I could not say for certain, but presently I based my suspicions on certain facts which I happened to notice, besides the presence of symptoms indicating great nervous depression and strain, extreme weakness of the spine and oscillations of the hands when spread horizontally with the fingers and thumbs wide apart. This may in one way be accounted for by the difficulty that men have in obtaining wives, owing to the scarcity of women. Apoplectic and epileptic fits and convulsions were not of very frequent occurrence, but they seemed severe when they did occur. The fire cure was usually applied in order to drive away the spirits that were supposed to have entered the body, but, all the same, these fits at times resulted in temporary or occasionally permanent paralysis, and much derangement and disfiguration of the facial expression, particularly about the eyes and mouth. I had occasion to study three very good specimens of this kind at Tucker, at Tarbar, north of the Brahmaputra River, and at Tokchim.
Much to my regret I never came across any violent cases of insanity during my stay in the country, though many times I observed strange peculiarities among the men, and signs of mania, more particularly religious.
In women I several times noticed symptoms of melancholia, caused no doubt by abuse of sexual intercourse, owing to their strange laws of polyandry. I was told that occasionally it led to suicide by drowning or strangulation. However, I was never able to keep any of the suspicious cases under close observation for any length of time, and, as our arrival into Tibetan camps generally created some amount of fear and sensation, and we usually left before they could be quite at home with us, I never had a chance of studying the subject more closely.