2D computer-based cephalometric prediction in Dolphin Imaging software offers a good orientation to professionals during the surgical procedure of bimaxillary surgeries since its use is considered clinically relevant in daily practice.

Tibetan precious pills are frequently attributed with a variety of efficacies, from “magical” powers, prevention of poisoning and infectious diseases, protection from harmful spirits and exposure to diseases while travelling, to rejuvenating and prolonging life through clearing the senses and promoting strength and vigor. They are prescribed as strong medicines for severe diseases, but are also advertised as rejuvenating tonics for the healthy. This paper explores the rejuvenating qualities attributed to precious pills in terms of how they are currently advertised, how rejuvenation is and has been explained in Tibetan works on precious pills, and how Tibetan physicians understand these attributes. How do these domains interact and refer to each other? I compare aspects of rejuvenation in precious pill formulas with contemporary presentations of precious pills online and on published leaflets given out to patients in India and elsewhere. In Tibetan medical texts certain precious pills that contain the complex and processed mercury-sulfide ash called tsotel in addition to a large variety of other medicinal substances are presented as “precious pills” or rinchen rilbu, and only some of those are said to have rejuvenating effects on the body; most are primarily prescribed for specific diseases. The practice of giving precious pills to the healthy emerges more prominently in eighteenth to nineteenth century manuals on administering precious pills (Czaja 2015), which parallels the establishment of influential medical and monastic networks that promoted the making of tsotel and precious pills. I argue that precious pills have more recently widened their specific therapeutic target beyond that of medicine into becoming popular pills for rejuvenation, even if they do not contain tsotel, as part of pharmaceutical commodification. I also show how presentations of precious pills as “rejuvenating” are deeply linked to their availability.

No other compound in Tibetan medical pharmacology seems to be as fascinating, con troversial, and enigmatic as tsotel (btso that, lit. 'cooked ash'), the processed mercury sulphide ash that provides the base material of many of the popular Tibetan 'precious pills' (rin chen ril bu). The compound contains-apart from numerous herbs and other ingredients-eight metals and eight rock components. Tsotel practices, which can be traced back to the thirteenth century in Tibet, are considered the pinnacle of Tibetan pharmacology. The commercial value of tsotel gives it a strong economic and social life of its own. This paper analyses the social life of tsotel from an anthropological perspec tive and sketches key aspects of tsotefs biography, which in one way or the other are linked to medical, political, and religious perceptions of mercury: tsotel events with their political and institutional agendas; the value of tsotel as a medical, religious, and politi cal commodity; safety and toxicity debates; and tsoteCs religious and political efficacy. I argue that the social life of tsotel is increasingly linked to perceptions of toxicity and safety because of its chief ingredient, mercury, being contested in a globalised arena of tightened international regulations as well as the recent attention given to heavy metal toxicity issues in Asian medicines. Also, several fundamental misconceptions of the substance of mercury itself, its processed form of mercury sulphide, and of the con tamination of herbal ingredients with heavy metals will be highlighted. Examples are based on ethnographic fieldwork with Tibetan medical practitioners and pharmacolo gists in India and Nepal.

Sowa Rigpa is generally translated as ‘the science of healing’ and often used synonymously for ‘Tibetan medicine’. Historically, Sowa Rigpa can be considered a borrowed term from Sanskrit, accompanied by an adopted sense of ‘science’, which initially signified all forms of medicine known to the Tibetan world, regardless of their place of origin. Over the centuries, Sowa Rigpa became linked to local, indigenous, and ‘enskilled’ practices; later, to nationalist political sensibilities; and of late to cultural belonging. The term evokes territoriality, claims to ownership of knowledge, concerns over sustaining national identities, and considerations about how place-based healing practices and material resources relate to the globalizing ideas about traditional Asian medicines. Textual and ethnographic analyses and interviews with practitioners from China, India, and Nepal show how Sowa Rigpa exists at once as a marker of shared intellectual and cultural histories and forms of medical practice and as a label for a globally circulating medical system with distinct interpretations. Looking at Sowa Rigpa as operating in de- and reterritorialized global spaces makes visible how, why, and to what end modernity forgets (Connerton 2009), thereby allowing for broader conclusions applicable to other medical contexts.

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