Contested Issues of Efficacy and Safety between Transnational Formulation Regimes of Tibetan Medicines in China and Europe

Abstract

Tibetan medicines are key material objects for medical treatment and have become part of a global trend of 'pharmaceuticalisation', playing increasingly important political and socio-economic roles in an 'alternative modernity'. As I argue in this paper, they also have become key 'sites of contestation' between different epistemic values and styles of practice related to efficacy and safety that are reproduced in and through specific formulation regimes. Based on my multisited ethnography of production, prescription, and use practices of Tibetan medicines in China and Europe, this paper conceptualises three distinct formulation regimes, offering a heuristic model for transnational comparison-a classical, an industrialised or reformulated, and a polyherbal regime. The first two are the major orientations while the polyherbal is a conjoint hybrid with either the classical or the industrialised formulation regime. Globalised national drug safety regulations legalise and confer legitimacy to industrialised Tibetan formulas that follow biomedically defined efficacy, safety, and disease categories, while classical formulas produced by private physicians or small-scale cottage pharmacies are increasingly marginalised as producing 'unsafe' and at times illegal medicines, and need to find new ways for adapting and circulating their formulas.

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“…As mentioned, my essay is a programmatic one, and I hope that this will be seen as an opportunity rather than a shortcoming. Yet it is worth mentioning that, since the time of its writing, rich empirical work that substantiates the notion has been published by both the RATIMED team (Blaikie 2016; Harilal, forthcoming; Kloos 2015Kloos , 2016bKloos , 2017 and others (Craig and Gerke 2016;Gerke, forthcoming;Pordié 2016;Pordié and Gaudillière 2014b;Schrempf 2015). Much of this work may not refer to the term itself or even focus directly on any bigger picture (yet), but it is noticeably driven by an awareness of a larger whole and by a collaborative desire to map its as-yet-unknown contours.…”

“…Craig 2011;Saxer 2013); on issues of safety, efficacy, and reformulation in medicine production (cf. Blaikie 2015;Gerke 2015;Pordie and Gaudilliere 2014a;Schrempf 2015); on interactions with biomedicine, science, and public health (cf. Adams 2002aAdams , 2002bAdams , 2007Adams and Li 2008;Janes 1995Janes , 2001; and on dynamics of nationalism, intellectual property, and moral economies in relation to traditional medical knowledge (cf.…”

Tibetan Precious Pills as Therapeutics and Rejuvenating Longevity Tonics

“…22 Craig 2012: 6, original emphasis. 23 For example, Craig 2010and Schrempf 2015: 288. 24 See Witt (2009 for a differentiation between efficacy and effectiveness.…”