This edited volume is based on papers presented at two conference panels during the Fourteenth Seminar of the International Association for Tibetan Studies covering historical and anthropological research on Sowa Rigpa (Tibetan medicine). In his brief yet thoughtful introduction to Knowledge and Context in Tibetan Medicine, editor William A. McGrath identifies the general theme as “the transformation of medical concepts across traditions” (p. xi). He sets out four overarching aims for the volume: (1) answering the call for detailed analytical studies that “reveal the composite, variegated and dynamic nature of Tibetan medical traditions”;Footnote ¹ (2) expanding the scope beyond the canonical Four Tantras (Rgyud bzhi) “root text” and its commentaries while recognizing the complex tensions between centralization/orthodoxy and subaltern diversity; (3) challenging the disciplinary divide between philology and ethnography; and (4) exploring the relationships and “vicissitudes of semantics” (p. x) that cut across the medicine/religion dichotomy. Methodologically, these admirable aims are approached throughout the book by foregrounding the particular spatiotemporal and sociohistorical contexts in which shifts in meanings of key concepts take place.

The five essays that make up part one trace the definitions of specific (clusters of) concepts relating to Tibetan medicine: “brown phlegm” (Tib. bad kan smug po) and its likely derivation from the Greco-Arab “black bile” in early Tibetan sources (Henk Blezer); the controversy surrounding Yutok the Elder as an (a)historical founding figure (Yang Ga); the identification and multifaceted deployment of secret ingredient names (Tib. gsang sman) in regent Sangyé Gyatso's (1653–1705) authoritative works (Tony Chui); the development of anatomical illustrations and nomenclature of the internal organs since the seventeenth century (Katharina Sabernig); and the mapping of potential correlates of biomedical cancer and Tibetan medical conditions (Tawni Tidwell). Yang Ga's critical appraisal of Elder Yutok's biography in light of more reliable traditional historical works, Chui's decryption of secret medicines through the lenses of Tantric hermeneutical debates and Gelukpa hegemonic state politics, and Sabernig's evaluation of empiricism versus aesthetics and metaphor in the transition from classical medical paintings to modern anatomical atlases are all significant, nuanced, and clear analyses.

Yet the first and fifth chapters (by Blezer and Tidwell, respectively, both over fifty pages long) stand out because of their exceptionally careful contextualization and engagement with wide-ranging source materials. This is a delight for the scholar, but the level of detail—including extensive footnotes—can be daunting for nonspecialists. Sabernig (trained as a biomedical doctor and medical anthropologist) and Tidwell (a Sowa Rigpa physician-scholar and biocultural anthropologist) provide tantalizing comparisons with modern categories (concerning visceral anatomy and cancer) that go decisively beyond simplistic one-to-one correspondences, which is highly relevant for contemporary practice.

In part two, five more chapters tackle the interface between medical and religious healing in premodern texts (Tsering Samdrup, Carmen Simioli, and McGrath), in the current therapeutically pluralistic landscape of mental illness (Tib. sems nad) in Darjeeling (Susannah Deane), and in relation to the commodification and visual representations of “precious pills” (Tib. rin chen ril bu) in Tibetan areas within China versus the Indian diaspora (Barbara Gerke). The last two essays are the only ones based on ethnographic fieldwork, whereas only Gerke effectively integrates fieldwork with textual analysis, historical framing, and a theoretical anthropological argument (on pharmaceuticalization and “Tibetanness”). Deane reports that most lay Tibetans did not seek out Sowa Rigpa practitioners for suspected spirit-caused illnesses, adding that the relevant sections of the Four Tantras “appear somewhat irrelevant in terms of both diagnosis and treatment” in the narratives she collected (p. 333). These observations illustrate how difficult it remains to fulfill the third overall aim of this volume.

The three remaining philological contributions are exemplary achievements of goals 1, 2, and 4. Their rich exploration of the Tibetan medico-ritual nexus is certainly one of the major strengths of the book. Samdrup's refreshingly concise chapter on the pre-twelfth-century Nine-Fold Magical Cord Cycle (’Phrul gyi the gu brgu skor), for instance, reveals the early differentiation and social relations between ritualist physicians (Tib. sman bon) and wound healers (Tib. rma mkhan) in times of war. Simioli, on the other hand, extensively frames the thirteenth-century (?) Great Vase of the Amṛta of Immortality (’Chi med bdud rtsi bum chen) on infectious diseases within the complementary—and at times contrasting and competing—bodies of praxis of alchemy and rejuvenation (Tib. bcud len), mercurial iatrochemistry, “accomplishing medicine” (Tib. sman sgrub), ritual magic (Tib. las la sbyor ba), Indian Tantric Buddhist demonology, Chinese sphygmology, and the Nyingma revealed treasure (Tib. gter ma) and seminal essence (Tib. snying thig) literatures. Even though her preliminary study could only highlight these connections with pertinent examples, this impressive list evokes a startling complexity, setting the agenda for future research.

Finally, McGrath's illuminating genealogical approach to the consecutive redactions and transmissions of channel divination rituals (Tib. rtsa'i pra sgrub) and channel examination techniques (Tib. rtsa la brtag pa) in the Four Tantras, Yutok and Drangti lineages, sets a new standard, elevated further by summarizing flowcharts. Tracing oracular divination rituals known as prasenā (Tib. pra se na) through cosmopolitan and derived vernacular instructions, he notes the early “imbrication of prasenā divination with healing rituals” (p. 274) from the eighth to the tenth century. Prasenā then gradually became associated with channel examination, being adapted for more specific use in medical contexts from the eleventh or twelfth century onward. This, in turn, led to ongoing dialogue and professional struggles between Tantric diviners and more empirically minded physicians, which convincingly shows how “unresolved conflicts are embedded within the accretive repertoires of medical traditions” while “each performance of learned instructions is a momentary resolution of such conflicts” (p. 302).

Knowledge and Context in Tibetan Medicine will not win a prize for the originality or explicitness of its title, but it surely sets an ambitious course for “navigating the ocean of Tibetan medical literature” (McGrath, p. vii). In this respect, it contains essential readings not just for Sowa Rigpa scholars, but also for historians of Asian medicine, religion, and science. The volume must also be commended for its balanced authorship in terms of gender and inclusion of early-career researchers. A full-fledged integration of philological and anthropological sensitivities has not quite materialized. This rare combination of expertise seems especially hard to obtain nowadays, with decreasing funds for long-term fieldwork, advanced language training, and multiyear projects and positions. Nevertheless, this collection of papers definitely expands the scope and depth of academic Tibetan medical research to previously unstudied sources and interconnections.