In his discourse, HH the 14th Dalai Lama at Jevetsal, Ladakh on 3rd July, 2013, which was well documented by S.T.Phuntsog in his paper says: ' The philosophy of Tibetan medicine is Buddhist in nature and the different aspects of Dharma constantly re-emerge. Over two and a half millennia ago, the Buddha emerged as a human scientist and an omniscient physiologist. He explained that all animate and inanimate  phenomena are the manifestation of the five cosmic physicals energies, i.e. solid, liquid, heat, gas and space which embrace all the process of creation and evolution of the universe and the laws of biology. All living matter is in a state of constant activity and change and never in a state of equilibrium, i.e. becoming, degenerating and dying- the law of impermanence. The internal milieu of the body, tissue and fluids are always in a state of thermodynamic activity, producing the required energy. No single element or unit functions independently, but all act interdependently and intra-dependently. This is the Buddha's doctrine of non-substantiality that was fully adopted by the major philosophers of the Theravada and Mahayana schools.

The basic theory of Amchi is explained under the principles of five elements and three humours within a complete and logical framework. Disorder results when the ratio of these elements becomes imbalanced in our body. It is believed that all breathing creatures on the earth are sick until we give up the root cause, which is ignorance. Tibetan medicine talks about  presence of 84,000 different types of afflictive emotions in the mind means that the number of disorders also goes up to same number.

 

The chief method of diagnosis is the taking of the pulses, a highly skilled technique that requires  years of practice. Many Easterners and Westerners were surprised with the such technique that it interest many of them leading to the popularity of Tibetan medicine. A close Amchi explained that there are twelve pulses together, six on each side. The pulse reading was not just to feel the physical movement of the artery, but also the energy flows corresponding with the functioning of different organs. They also diagnose a patient from the color and texture of different parts of the tongue and eyes. Facial expression, tone of voice, as well as quickness to anger and other modes of behaviour are also taken into account. 

In my short conversation with Dr. Tsetan, a physician to HH the Dalai Lama, told me that Amchi system is a Tibetan medicine system. However, due to some political reason and pressures, if the system is to introduce internationally , it will not be patented as 'Tibetan medicine' but as 'Sowa-Rigpa' or 'the science of healing', so that it could become a full fledged medical association with recognition from national government and international organization. Thus, Sowa-Rigpa has gained considerable respect in the West and of course in India. The consulting patients are not only Tibetan and Ladakhi, but many Indian and Westerners. 

The Amchi system is still much practice in Ladakh. With an administrative office or clinic at Leh known as Men-tse-Khang , it has its official branch at Choglamsar. Besides there are many private amchi, both Ladakhi and Tibetan, who people still approach for treatment. Arthritis, Bile and gastric patient mostly consult Amchi as they believed them to be more efficient than Allopathic medicines. Muxabation therapy is mostly used in Ladakhi Amchi tradition to cure the sickeness. 

The majority of the theories, principles and practice of Amchi medicine are similar to Indian Ayurveda, combined with a few Chinese principles and Tibetan folklore. The first Ayurvedic influence came to Tibet during the 3rd century AD, but it became popular only after  the 7th century with the arrival of Buddhism in Tibet. Thereafter, the trend of exporting Indian medical literature, along with Buddhism and other Indian art and sciences, continued until the early 19th century. Since India was the birthplace of Buddha and Buddhism, it has always been a favourite place for Tibetan students to learn Buddhist art and culture, and many Indian scholars were invited to Tibet to propagate Buddhism and other Indian art and sciences. Medicine used to one of the students' favourite subjects because of its high social and religious status.

 

The service of Amchis have always been significant for the people of Ladakh for public health and social activities, wrote Padma Gurmet, and further explains that before 1960s, Sowa-Rigpa used to be the only health care facility for the ordinary people in most parts of Ladakh and the other Trans-Himalayan regions of India. Allopathic medicines was introduced only after 1947 when Ladakh became part of India. It was then introduced as the only officially recognized health care system, but has not replaced the Amchi system in many parts of Ladakh until date.

 

Amchis have a high social and spiritual status as there representative of the Medicine Buddha and their services for ailing beings are priceless. Besides treating the patients as the doctor of the village, Amchis are the most learned and resourceful person of the village. Being an Amchi has been a matter of great prestige in Ladakhi society.

How a person becomes an Amchi in Ladakh is explained briefly in Padma Gurmet's research. He wrote: it takes several years to become a skilled Amchi, and this requires hard theoretical and practical trainings. In Ladakh Amchis are generally trained through the lineage system, learning from members of their own families. After finishing their trainings, the  new Amchi has to give an exam in front of the entire community, and in the presence of some of some expert Amchis, in a ceremony of rtsa mkrid. 

Earlier, according to Ladakhi tradition, Amchis never asked for fees for their medicine and services: the patients offer whatever they wish or can afford, and much of a time the Amchi's services are given without payment. In return for their services, the villagers used to offer the Amchi's family crops during harvest-time as well as free labour. Nowadays, with the change in society and traditions, there is a minimal consultant charge, but nothing in comparison to the fees charged by Allopathic doctors.

Most of the ancient Amchi families have already lost their family traditions and are only left with their family names, Padma Gurmet surmised in his studies. He cites, however, Amchi leaders have made some efforts, and few Amchi leaders have been given government support. Unfortunately, this will not be enough to ensure the survival of this tradition unless it gets proper recognition and support from national government and international organization.