In her much-anticipated second book, Janet Gyatso confronts a fundamental imbalance arising from the past century of Tibetan studies and Buddhist studies scholarship, which has overwhelmingly characterized Tibetan intellectual and cultural history as “religious” in nature. To address this imbalance, Being Human in a Buddhist World presents a richly textured study of the relationship between medicine and Buddhism in Tibet, particularly during a critical period between the fourteenth and seventeenth centuries where Gyatso finds certain parallels with scientific developments in early modern Europe.

Marshalling a wealth of research, Being Human in a Buddhist World examines scholarly debates following the twelfth-century systematization of Tibetan medicine within the classic Four Treatises (Rgyud bzhi), rendering this sometimes arcane body of literature accessible for a wider audience. Gyatso traces a series of “double movements” between scientific and religious approaches to knowledge formation in these debates, arguing that Tibetan physicians’ concern with everyday matters of life and death gave rise to a “medical mentality” or a critical stance toward an ideal system and authoritative tradition, while remaining deeply informed by Buddhist concepts and practices (pp. 1, 13). Her work convincingly demonstrates that the significance of these debates reached far beyond the medical, as scholars invoked “the evidence of the empirical” in ways that challenged the Buddhist authority at the heart of Tibetan politics (p. 7).

This intricately argued book progresses in three sections, with seven chapters arranged topically and in reverse chronological order. Part one examines a period when the relationship between medicine, Buddhism, and politics reached an apex within the seventeenth-century state-building project of the “Great Fifth” Dalai Lama and his political successor, Desi Sanggyé Gyatso. The Desi (regent), in particular, linked his political legitimacy to medical activities, including founding a centralized medical institution in Lhasa, writing an influential medical history and major commentaries on the Four Treatises, and commissioning a unique set of seventy-nine medical paintings. According to Gyatso, the Desi's medical scholarship exhibited an “especially critical mentality,” not only through its unprecedented scope, systematic detail, and reference to direct observation, but also through self-conscious reflection on the meaning of mistakes and innovation within a literary context that held the words of Buddhist texts and teachers sacred (p. 83). Ultimately, Gyatso argues, the Desi's solution to these problems contained a number of contradictions, as his activities “pushed medicine toward autonomy” as a domain of learning and practice, while attempting to preserve the status of medicine as part of a wider Buddhist epistemology (p. 137).

Part two closely examines the earlier permutations of two major medical controversies in which the Desi intervened, which can be broadly grouped as historical and anatomical. The historical controversy developed between scholars who credited the Four Treatises as the authoritative Word of the Buddha, and a “critical wing” who used historicist arguments—or “empirical grounds”—to challenge the Four Treatises’ authorship while still preserving the text's connection to Buddhist authority (p. 189). The anatomical controversy, meanwhile, concerned attempts to reconcile the observable, material features of the “medical body” (such as arteries and veins) with invisible features of the “tantric body” (such as the subtle channels and idealized gender differences), the latter linked to Buddhist regimes of personal cultivation (p. 208). In both these debates, Gyatso emphasizes the role of rhetoric in mediating between textual and empirical authority, allowing Tibetan scholars to be “riding two horses at once” by appealing to different ways of knowing in often inconsistent and contradictory fashion (p. 388).

Part three continues to follow these double-movements within two discourses from the Four Treatises with special implications for social life: gender and women's illnesses, and the ethics of being a physician. For Gyatso, the Tibetan medical discourse of gender is especially demonstrative of a “commitment to getting things right” as well as its limits in light of cultural constructions and social realities (p. 283). The Four Treatises’ ethical framework for physicians, meanwhile—with its distinction between “the way of humans” and the “True Way”—is shown to hold the potential to relativize Buddhist ideals in favor of values concerned more with the unpredictable and uncontrollable social realities impacting a physician's practice (p. 345).

Bridging studies of religion, science, and medicine, Being Human in a Buddhist World will be a valuable resource for scholars interested in thinking through these topics comparatively within and beyond Asian studies. The book will be valued by specialists and in graduate courses for its contributions to Buddhist studies and Tibetan studies, including an overview of the complex Tibetan system of tantric anatomy. At the same time, this intellectual history draws attention to the dearth of social histories of Tibet, and in particular Tibetan medical culture, which might shed further light on the rhetorical contradictions Gyatso identifies among Tibetan medical scholars. Questions remain about the impact of bitter sectarian controversies on knowledge debates, as well as the role of connections with India, China, Mongolia, and traveling Europeans in processes of Tibetan innovation. Such lines of inquiry will be greatly indebted to the historical and methodological considerations broached in this book, which will continue to inform scholarship concerning Tibet and Tibetan Buddhism for a long time to come.