In Tibetan the three humors (or Doshas) are called Nod-jed Nye-pa (གནོད་བྱེད་ཉེས་པ་, “that what inflicts harm”). These humors are Wind, Tripa (bile) and Beken (phlegm). The reason why they are called “that what inflicts harm” can be understood through description of causes of diseases. 


Distant primary cause: Marig-pa (མ་རིག་པ)

།དང་པོ་ནད་འཁྲུགས་སྣ་ཚོགས་ཚུལ་ཅན་གྱིས། །གྲངས་མེད་གྱུར་པས་ལུས་ཉིད་གཟིར་གྱུར་པ། །དེ་རྒྱུ་རེ་རེར་བསྟན་པར་མི་ནུས་པས། །དེ་བས་ནད་ཀུན་སྤྱི་རྒྱུ་བརྗོད་པ་ནི། །ནད་རྣམས་ཀུན་གྱི་རྒྱུ་ནི་གཅིག་པུ་སྟེ། །བདག་མེད་དོན་མ་རྟོགས་པས་མ་རིག་ཅེས། །དཔེར་ན་བྱ་ནི་མཁའ་ལ་ལྡིང་གྱུར་ཀྱང༌། །རང་གི་གྲིབ་མ་དེ་དང་མི་འབྲལ་ཞིང༌། །འགྲོ་ཀུན་བདེ་བར་གནས་ཤིང་སྤྱོད་ན་ཡང༌། །མ་རིག་ལྡན་པས་ནད་དང་འབྲལ་མི་སྲིད།

The innumerable causes and conditions that disturb the balanced state of health give rise to the innumerable forms and natures of disorders, which affect the body as a whole. It is impossible to reveal each and every cause for each and every disorder, however it can be said that the general cause of all disorders is the one and only Marig-pa (ignorance), which does not understand the intrinsic reality of the lack of self. For instance, no matter how high the bird may soar in the sky, it is never separated from its shadow. Similarly, even though all sentient being live in health and harmony, as they are associated with Marig-pa it is impossible for them to be separated from disease.

Specific causes: mental poisons (འདོད་ཆགས་ཞེ་སྡང་གཏི་མུག་)

།ཁྱད་པར་རྒྱུ་ནི་མ་རིག་ལས་བྱུང་བའི། །འདོད་ཆགས་ཞེ་སྡང་གཏི་མུག་དུག་གསུམ་ལས། །འབྲས་བུ་རླུང་མཁྲིས་བད་ཀན་ཉེས་པ་སྐྱེད།

Ignorance or Marig-pa produces the 3 underlying specific causes of diseases - mental poisons. They are desire-attachment, hatred and delusion/ close-mindedness, that lead to imbalances in Wind, Tripa, and Beken respectively.

These mental poisons produce countless emotions, both positive and negative and are the cause of karma, reincarnation, health and sickness, joy and sorrow, happiness and suffering, birth and death. 


Desire-Attachment (འདོད་ཆགས་) 

The first of the three poisons, desire-attachment, can also be understood as craving, lust, desire, or greed. We constantly want to hold onto what we have and are always seeking more. However, every good thing we possess will eventually change. Moreover, if our happiness depends on always obtaining something else, true contentment will remain out of reach. This is the possessive mindset that arises from desire, leading to wind energy and Wind disorders. The Wind channel, located at the center of the body, connects the reproductive organs to the brain via the spinal cord.


Hatred (ཞེ་སྡང་)

Hatred is destructive mind and an aggressive energy. It generates rage and hostile emotions, acting like a fire that burns both body and mind, leading to loss of judgement and awareness. The Tripa channel, linked to the blood circulation system, is rooted on the right side of the body and flows through the liver and gallbladder to the brain and other body parts.


Close-mindedness (གཏི་མུག་) 

Defined as the inability to see things as they really are. This includes mental dullness, doubt, and stupidity. It generates heavy elements like water and earth and results in Beken humor. The Beken channel, related to the lymphatic and endocrine systems, is rooted on the left side of the body, passing through the spleen, kidneys, brain, and other body parts.


Proximate causes: three Nye-pas 

།ཉེ་རྒྱུ་རླུང་དང་མཁྲིས་པ་བད་ཀན་གསུམ། །རྣམ་པར་མ་གྱུར་ནད་ཀྱི་རྒྱུར་འགྱུར་ལ། །རྣམ་འགྱུར་མ་སྙོམས་ནད་ཀྱི་ངོ་བོ་ཡིན། །ལུས་དང་སྲོག་ལ་གནོད་ཅིང་གདུང་བས་སོ།

The 3 proximate causes are Wind, Tripa and Beken. In their balanced states they are the potential causes of all disorders, whereas when imbalanced they manifest as the nature of disorders and cause harm and suffering to the body and to life.

The normal state of Tripa, if disturbed, burns the bodily constituents. Like the nature of the Fire element with which it is associated, Tripa is hot and flares upwards, though it is located in the middle part of the body. There is no hot disorder which does not develop from Tripa.

The normal state of Beken, if disturbed, diminishes bodily heat. Since it is heavy and cool, like the nature of Earth and Water elements with which it is associated, it tends to fall downward, though it is located in the upper part of the body. There is no cold disorder which does not develop from Beken.

Wind associate with both hot and cold disorders. When associated with hot disorders it assists in burning, and when associated with cold disorders it facilitates cooling. It moves throughout the upper, lower, inner and outer parts of the body. It disturbs and helps in manifestation of both hot and cold disorders. Therefore, Wind is the sole cause of all disorders.

In conclusion, in Tibetan medicine, the Doshas or humors are called Nod-jed Nye-pa (གནོད་བྱེད་ཉེས་པ་, "that which inflicts harm") because they highlight the idea that all suffering starts with Ignorance (Marig-pa). This Ignorance leads to Desire-attachment, Hatred, and Close-mindedness, which then cause the imbalances known as Wind, Tripa, and Beken. By understanding this chain of causes, Tibetan medicine shows us that to truly heal and find balance, we need to address our deeper ignorance and the emotional turmoil it creates. This holistic approach not only aims to treat physical ailments but also to promote overall well-being by fostering both mental and spiritual health.

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