Development of quality control parameters for two Bhutanese medicinal plants (Aster flaccidus Bunge and Aster diplostephioides (DC.) Benth. ex C.B.Clarke) using traditional and modern pharmacognostical platforms.

Bhutan's scholarly traditional medical system is called Bhutanese Sowa Rigpa medicine (BSM). It was integrated with the modern healthcare system in 1967. Over 200 medicinal plants are used to produce more than 100 poly-ingredient medicinal formulations. Although BSM is supported by well-documented principles, pharmacopoeias, diagnostic procedures, treatment regimens, and traditional quality assurance systems, modern quality control parameters have become essential to distinguish closely related species and prevent contamination from exogenous impurities. This study aims to establish reliable analytical methods and quality control parameters for Aster flaccidus Bunge and Aster diplostephioides (DC.) Benth. ex C.B. Clarke used as ingredients in the BMS poly-ingredient medicinal formulations. Furthermore, their reported phytochemicals and biological activities are also discussed in this study. Standard pharmacognostic techniques, including macroscopical and microscopical examinations of crude drugs, were employed to establish the quality control parameters for two Aster species. The physicochemical limits were determined as per the World Health Organization (WHO)-recommended guidelines and methods described in the Thai herbal pharmacopoeia. A high-performance thin-layer liquid chromatography (HPTLC) was used to develop a comparative chromatogram/phytochemical fingerprint for the crude extracts obtained from two Aster species. A literature review was conducted to record their isolated phytochemicals and biological activities. Two Aster species possess macro- and microscopic features such as colour, appearance, and shape. Physicochemical analysis of crude drugs from two Aster species including HPTLC fingerprinting of their methanol crude extracts also yielded adequate data to differentiate and confirm two Aster species before adding them to the BSM poly-ingredient medicinal formulations. From the literature review, only A. flaccidus was found to be studied for its phytochemical constituents, whereby 11 pure compounds were isolated from aerial parts and roots. The current study revealed distinct species-specific distinguishing features, including ecological adaptation, micromorphology, anatomy, physicochemical values, HPTLC chromatograms. These parameters can be used to authenticate the species identity and prevent adulterations, thereby improving the quality and safety of BSM formulations.

Dataset of materia medica in Sowa Rigpa: Tibetan medicine botanicals and Gawé Dorjé's classification system.

This article provides the most updated dataset of Latin botanical identifications for the materia medica in Tibetan medicine, known as Bö Luk Sowa Rigpa (Tib. Bod lugs gso ba rig pa), or the "Tibetan knowledge field of healing," often denoted in English simply as Sowa Rigpa. As one of the major scholarly Asian traditional medical systems, Sowa Rigpa is the principal health resource for populations across Tibetan regions of China, Mongolia, Bhutan, Nepal, India, and culturally-related areas of Russia. The geography represented by this medicinal plant dataset extends across the entire Tibetan plateau, its adjacent ranges, the wider transregional Himalayas, central Asia and much of the Indian subcontinent. Data collection drew from textual analysis of the seminal works of the Tibetan medical canon, including the Four Medical Treatises, Crystal Orb and Rosary among others; as well as the contemporary definitive work Stainless Crystal Mirror of Materia Medica by Gawé Dorjé. Study authors applied the same classification system as Gawé Dorjé, yet reanalyzed specimens according to a database cataloging research on regional herbarium botanical specimens, geographic distributions and regional plant chemistry studies, and confirming proper identification with the most current modern botanical taxonomies. Subsequently, almost 700 of the most commonly used materia medica were selected for compilation. Thus, this dataset represents updated botanical identifications and confirmations from both early and contemporary sources. Botanical specimen names were entered into spreadsheet format with Gawé Dorjé's categories listed alongside Deumar Tendzin Püntsok's early standard. Enclosed raw data are written in Unicode Tibetan font to retain fidelity to entries in the classical texts, with parallel columns in standard Wylie Tibetan transliteration and phonetic transcription. Latin botanical names are updated for each materia medica specimen using Kew's Medicinal Plant Names Services (Kew-MPNS) with missing entries supplied by World Flora Online (WFO) and Flora of China (FoC). This dataset is the first publicly available comprehensive ethnobotanical identification of Sowa Rigpa materia medica with Latin binomial nomenclature. This dataset was developed to inform botanical and pharmacological analysis of the Tibetan medical materia medica repertoire as well as make comparative analyses of related materia medica in other Asian medical systems.

Dataset of illness classifications in Sowa Rigpa: Compilations from the Oral Instructions Treatise of the Tibetan medical classic (Rgyud bzhi).

This article shares the comprehensive dataset and five visualized examples of disease categories in Tibetan medicine, or Sowa Rigpa (Tib. Gso ba rig pa), translated as the "knowledge field of healing." Sowa Rigpa is a scholarly Asian traditional medical system rigorously transmitted through canonical texts and oral teachings originating in Tibet with an extensive pharmacopeia, comprehensive treatment repertoire, and nuanced etiological explications of its nosology of diseases. This medical tradition is practiced across a broad region of Asia, particularly in Tibetan regions of China, Himalayan regions of India (Ladakh, Sikkim, Himachal Pradesh), Nepal, Bhutan, Mongolia, Russia, and recently in Europe and North America. The data herein depicts disease classifications listed in the encyclopedic compendium "Oral Instructions Treatise" (Man ngag rgyud) of the Tibetan medical classic, the Four Medical Treatises (Rgyud bzhi), compiled in written form during the twelfth century CE. Visualized examples depict etiological relations among diseases in five of the fifteen major categories of disease: rLung Illnesses, Béken Illneses, Pediatric Conditions, Eye Conditions and Tropical Infectious Diseases. Disease names were entered into spreadsheet format and categorized by etiological hierarchical structure. Data are written in Unicode Tibetan font to retain fidelity to entries in the classical text, with parallel columns in standard Wylie transliteration. Subsets of the data are visually depicted through a graphic platform called Interactive Tree of Life to demonstrate etiological associations. This dataset is the first publicly available enumeration of the specific diseases, classifications and etiological relationships from the Tibetan medical classic. The data are linked to the article entitled "Tibetan Medical Informatics: An Emerging Field in Sowa Rigpa Pharmacological & Clinical Research" (Dhondrup et al., 2020).

Humanitarianism from Below: Sowa Rigpa, the Traditional Pharmaceutical Industry, and Global Health.

In this article I explore, for the first time, the relationship between Sowa Rigpa (Tibetan medicine) and global health, tracing "the global" in ethical discourses and pharmaceutical innovation practices of Tibetan medical practitioners. I argue that Sowa Rigpa's engagement with the world and its global health activities outside China can be understood as a form of "humanitarianism from below," while its industrialization in China aligns with global health in different ways. In providing new insights into recent developments of Sowa Rigpa, I aim to decenter the notion of humanitarianism and contribute to a broader understanding of global health.

Sowa Rigpa Humanitarianism: Local Logics of Care within a Global Politics of Compassion.

This article examines the circulation of humanitarian ideas, materials, and actions in a non-biomedical and non-Judeo-Christian context: Sowa Rigpa or Tibetan medical camps in India and Nepal. Through these camps, practitioners and patients alike often overtly articulate Sowa Rigpa medicine as part of a broader humanitarian "good" motivated by a Buddhist-inflected ethics of compassion and a moral economy of care, diverging from mainstream public health and conventional humanitarian projects. Three ethnographic case studies demonstrate how micro-political interactions at camps engage with ethical and religious imaginaries. We show how the ordinary ethics of Sowa Rigpa humanitarianism gain distinct political meaning in contrast to non-Tibetan forms of aid, reconfiguring the relationship between Buddhism, essential medicines, moral economies, and politics. While Sowa Rigpa as a medical system operates transnationally, these camps are organized around local logics of emergent care, employing narratives of "charity" and Buddhist compassion when addressing health needs.

The transnational Sowa Rigpa industry in Asia: New perspectives on an emerging economy.

This article advances the hypothesis that "traditional" Asian pharmaceutical industries are rapidly growing in size and prominence in contemporary Asia, and identifies a lack of empirical data on the phenomenon. Addressing this gap, the article provides a quantitative outline and analysis of the Sowa Rigpa (Tibetan, Mongolian and Himalayan medicine) pharmaceutical industry in China, India, Mongolia and Bhutan. Using original data gathered through multi-sited ethnographic and textual research between 2014 and 2019, involving 232 industry representatives, policy makers, researchers, pharmacists and physicians, it assembles a bigger picture on this industry's structure, size and dynamics. Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations. The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.

rLung, Mind, and Mental Health: The Notion of "Wind" in Tibetan Conceptions of Mind and Mental Illness.

This article presents an analysis of the way in which rlung ("wind, breath") functions as a mode of explanation for what Western medicine regards as "psychiatric" illness, based on field research on the topic of mental health, illness, and healing conducted within a Tibetan population in Darjeeling, northeast India. The article explores this notion of rlung and its relationship to body and mind, in order to examine its role in the causation and treatment of various forms of "mental illness", before analysing some similarities and differences between rlung-related categories and biomedical classifications of mental illness.

Geopharmaceuticals of Himalayan Sowa Rigpa medicine: Ethnopharmacological uses, mineral diversity, chemical identification and current utilization in Bhutan.

ETHNOPHARMACOLOGICAL RELEVANCE: Geological materials, such as minerals, have a long history of usage as ingredients in multicompound formulations of Himalayan Sowa Rigpa medicine - as well as in its localized form of Bhutanese traditional medicine (BTM) - for treating various disorders for over thousand years. Yet, hardly any scientific research has been done on their ethnopharmacological efficacy and chemistry. AIM OF THE STUDY: This study documents and correlates the rarely explored ethnopharmacological and chemical identification of various minerals and their ethnomedicinal uses in BTM formulations for the first time. MATERIAL AND METHODS: A five stage cross-disciplinary process was conducted as follows: (1) a review of classical literature of Sowa Rigpa texts (Tibetan medical texts, pharmacopoeias and formularies) that are still in use today; (2) listing of mineral ingredients according to Sowa Rigpa names, followed by identification with common English and chemical names, as well as re-translating their ethnomedical uses; (3) cross-checking the chemical names and chemical composition of identified Sowa Rigpa minerals with various geological mineral databases and mineral handbooks; (4) authentication and standardization of Sowa Rigpa names through open forum discussion with diverse BTM practitioners; (5) further confirmation of the chemical names of identified minerals by consulting different experts and pharmacognosists. RESULTS: Our current study lists 120 minerals as described in Sowa Rigpa medical textbooks most of which we were able to chemically identify, and of which 28 are currently used in BTM herbo-mineral formulations. Out of these 28 mineral ingredients, 5 originate from precious metal and stone, 10 stem from earth, mud and rocks, 8 are salts, and 5 concern 'essences' and exudates. CONCLUSIONS: Our study identified 120 mineral ingredients described in Sowa Rigpa medical textbooks, out of which 28 are currently used. They are crucial in formulating 108 multicompound prescription medicines in BTM presently in use for treating more than 135 biomedically defined ailments.

Animal-derived natural products of Sowa Rigpa medicine: Their pharmacopoeial description, current utilization and zoological identification.

ETHNOPHARMACOLOGICAL RELEVANCE: The Bhutanese Sowa Rigpa medicine (BSM) uses animal parts in the preparation of numerous polyingredient traditional remedies. Our study reports the taxonomical identification of medicinal animals and the description of traditional uses in English medical terminologies. AIM OF THE STUDY: To taxonomically identify the medicinal animals and their derived natural products used as a zootherapeutic agents in BSM. MATERIALS AND METHODS: First, the traditional textbooks were reviewed to generate a list of animal products described as ingredients. Second, animal parts that are currently used in Bhutan were identified. Third, the ethnopharmacological uses of each animal ingredients were translated into English medical terminologies by consulting Traditional Physicians, clinical assistants, pharmacognosists, and pharmacists in Bhutan. Fourth, the animal parts were taxonomically identified and their Latin names were confirmed by crosschecking them with online animal databases and relevant scientific literature. RESULTS: The study found 73 natural products belonging to 29 categories derived from 45 medicinal animals (36 vertebrates and 9 invertebrates), comprising of 9 taxonomic categories and 30 zoological families. Out of 116 formulations currently produced, 87 of them contain one or more extracts and products obtained from 13 medicinal animals to treat more than 124 traditionally classified illnesses. Only five animal ingredients were found available in Bhutan and rest of the animal parts are being imported from India. CONCLUSIONS: Out of 73 natural products described in the traditional textbooks, only 13 of them (some omitted and few substituted by plants) are currently included in 87 formulations of BSM.

Pharmacological, ethnopharmacological, and botanical evaluation of subtropical medicinal plants of Lower Kheng region in Bhutan.

BACKGROUND: The Bhutanese Sowa Rigpa medicine (BSM) uses medicinal plants as the bulk ingredients. Our study was to botanically identify subtropical medicinal plants from the Lower Kheng region in Bhutan, transcribe ethnopharmacological uses, and highlight reported pharmacological activities of each plant. METHODS: We freely listed the medicinal plants used in the BSM literature, current formulations, and the medicinal plants inventory documents. This was followed by a survey and the identification of medicinal plants in the Lower Kheng region. The botanical identification of each medicinal plant was confirmed using The Plant List, eFloras, and TROPICOS. Data mining for reported pharmacological activities was performed using Google Scholar, Scopus, PubMed, and SciFinder Scholar. RESULTS: We identified 61 subtropical plants as the medicinal plants used in BSM. Of these, 17 plants were cultivated as edible plant species, 30 species grow abundantly, 24 species grow in moderate numbers, and only seven species were scarce to find. All these species grow within the altitude range of 100-1800 m above sea level. A total of 19 species were trees, and 13 of them were shrubs. Seeds ranked first in the parts usage category. Goshing Gewog (Block) hosted maximum number of medicinal plants. About 52 species have been pharmacologically studied and only nine species remain unstudied. CONCLUSION: Lower Kheng region is rich in subtropical medicinal plants and 30 species present immediate economic potential that could benefit BSM, Lower Kheng communities and other Sowa Rigpa practicing organizations.