Review of Mixing Medicines: Ecologies of Care in Buddhist Siberia by Tatiana Chudakova. New York: Fordham University Press, 2021, 344 pp.

Reviewed Book

Mixing Medicines: Ecologies of Care in Buddhist Siberia by Tatiana Chudakova. New York: Fordham University Press, 2021, 344 pp.

Mixing Medicines: Ecologies of Care in Buddhist Siberia. Tatiana Chudakova, New York: Fordham University Press, 2021, 344 pp.

Cover of Mixing Medicines (2021)

Barbara Gerke

University of Vienna

Mixing Medicines is a critical and welcomed contribution to the ethnography of technologies and knowledge production in the field of Asian medicine, specifically on Tibetan medicine (Sowa Rigpa). The monograph’s focus on the most northern peripheries of the vast central and south Asian terrain where Sowa Rigpa is practiced extends our understanding of this medical tradition in a radically different political and social context: Buddhist Siberia. Here, Tibetan medicine had a strong pre-Soviet institutional presence in Buryat monasteries and underwent Stalinist prosecution. In this well-written and in-depth ethnographic account, anthropologist Tatiana Chudakova highlights how Soviet policies have influenced the ways in which Sowa Rigpa is practiced, promoted, and researched in Buryatia. Notably, practitioners there rely on the same fundamental Tibetan textbooks—although in their Russian translations—that were compiled in the Tibetan language largely between the thirteenth to seventeenth centuries, and are also key to Sowa Rigpa practice in India, Bhutan, Nepal, Mongolia, and ethnic Tibetan regions of the PRC. Since there are more Russian translations of Tibetan medical texts than in any other language, and they have remained largely unstudied outside Russia, it would have been helpful to list at least key translations in a separate bibliography. The Russian Sowa Rigpa texts make for their own politics of translation, which Chudakova explores through the history of the Badmaev family, famous for bringing Tibetan medicine from Buryatia via St. Petersburg to the West. Already in the nineteenth century, these translations steered debates about the “scientification” versus “backwardness” of Tibetan medicine and its value (chapter 1). Medical anthropologists in the field are aware of this debate through Martin Saxer’s (2005) documentary film, Journeys with Tibetan Medicine. Chudakova not only fills a long research gap since Saxer’s work, but also adds fresh perspectives to the extensive anthropological research on Sowa Rigpa, which has concentrated on ethnic Tibetan regions in the PRC, Mongolia, and the Himalayas.

The second chapter analyses the development of the pulsometer, a technical device that simulates the key diagnostic method of pulse reading. In no other geographic region of Sowa Rigpa practice have practitioners (emchi) or researchers of Tibetan medicine attempted to invent a technological gadget to standardize such a highly valued sensory and subjective skill that requires years of training. Based on interviews with emchi and scientists involved in this long-term project (it began in 1983), Chudakova skillfully weaves the Russia-specific historical context of the pulsometer into her analysis, which involved Putin’s “Health Priority Project” and groups of young athletes. Her conclusions on “how such devices are themselves enhanced and extended through the actors and practices for which they are supposed to substitute” (105) leads her to further question how the failure of standardization actually “buttress[es] the legitimacy of Tibetan medicine as a lived practice in Buryatia” (105). This chapter provides the context for her subsequent discussions on practices of integration, while the Conclusion updates the reader on the post-2017 privatization and commercialization of Tibetan medicine, as well as emchi survival strategies through the recent economic decline.

The book’s middle chapters unpack multiple issues of “integrative medicine.” Chapter 4 explores the activities at the East-West Medical Centre in Ulan-Ude, where Tibetan medicine is practiced, but classified as “phytotherapy” since it is not fully recognized. The question of what integrative Tibetan medicine in Buryatia means for the different stakeholders (scientists, medical professionals, religious figures, and patients) is rather complex. Chudakova does well in deciphering the multiple layers and perspectives with nuance and care. Thus, the reader is not left with a single answer to these complex questions: How is Tibetan medicine in Buryatia distinctively Buryat? Can it be part of the national integrative health care or does it remain localized at the periphery? What is counted as “traditional” care, and what are the legalities of whom such traditions belong? In fact, the book title Mixing Medicines emerges as a clever metaphor for the practices of turning Tibetan medicines into an integrative medical practice by “mixing” methods, approaches, and epistemologies of different medical traditions across space and time. 

Substances enter the scene in Chapter 6, through ethnographies of a plant collection trip, and excursions through “raw materials” and their processing, as well as patient narratives revealing intricate interactions with formulas and the bodies they heal. Working with post-soviet and acclaimed “pure” Buryat ecologies these emchi live and work far north of the Himalayas that generally provide most of the materia medica found in Tibetan formulas. Often, Buryat emchi mix local and “reverse substitutes” (imported substances not available in Siberia) into their medicines, experiment with different processing techniques described in classical texts, and in the process create “opaque” pharmaceuticals that are difficult to trace and follow complex logics. The author approaches the intricate artisanship of medicine making as a form of “unpredictability,” a nice way to contrast complex efficacies of Tibetan multicompounds with the more “predictable” single ingredient model.

The book also covers several conferences the author attended in Buryatia between 2006 and 2017 from which she teases out important debates and questions on people’s minds when naming or thinking about the future of Tibetan medicine. We hear the voices from monastics, emchi (often trained in biomedicine), scientists, health care developers, and administrators. This is juxtaposed with visits to posh Tibetan medical clinics in Moscow and encounters with emchi who treat patients in their living rooms. In total, the reading experience is rewarding, extensive, and filled with accomplished analyses of what all is considered “Tibetan Medicine” in integrative ways in Buryatia and Russia. The book could have benefited from more analysis of gender and the author’s own positionality, for example during the conferences, which she uses extensively as an effective ethnographic stage, but without contextualizing this form of event ethnography as a specific method, and her role in it. In Mixing Medicines one meets many people’s voices and Chudakova’s clear observational skills and astute analysis, but ethnographic self-reflexivity in the field remains a bit opaque.

That said, Chudakova’s analysis is excellent, and the book is a must read for any Sowa Rigpa researcher. It raises questions on whether in Russia we should talk about Tibetan medicine in terms of reform and integration, or rather in terms of revival. Thinking through these known debates in new contexts helps to deconstruct “center-periphery” imaginaries and are great to think and teach with. By unpacking “multiple logics of caring and knowing,” the book succeeds in revealing the “uneasy encounter between Tibetan medicine and other therapeutic, ecological, and epistemological rationales and commitments” (22). The six chapters hold well together. Since chapters are extensive and the prose has well-crafted but long sentences, the book would suit teaching advanced classes in medical anthropology. By the end of the book “Tibetan medicine” is deeper understood as a living practice of astounding malleability in the ways it has moved between and among Central and South Asian societies and their histories. The reader is left with a sense of blurred “authenticity” in terms of what “real” Tibetan medicine is—a dynamic that is also good to think and teach with.