Sensation and perception of pain according to the theory of constitution in Tibetan Medicine

Abstract

Based on a holistic humoral medical theory and practice, Tibetan Medicine, Sowa Rigpa, opens access to a deep understanding of specific concepts of chronic diseases. The threefold humoral theory of the interaction of wind (rLung), bile (tripa) and phlegm (bedken) can only be revealed by the core of Tibetan Medicine, its body mind concept. Constitutional weakness as well as the patient's diet and behavior play a central role in medical theory, diagnosis and therapy. The theory of constitution is an important diagnostic method to differentiate between constitutional disorders and humoral diseases. The three main constitutions in Tibetan Medicine are differentiated as follows: wind constitution, bile constitution and phlegm constitution, followed by four mixed constitutions. Constitution implies a variation of general and specific weaknesses in psychological and physical aspects. Therefore constitution also varies in the sensation and perception of pain. In Tibetan Medicine pain in general is considered as a symptom of infection or inflammation, which has heated the ‘nerves’ and blocked the local wind. That penetrates or burns the body's tissues in general and specific locations. The body consciousness perceives the pain through wind and the nervous system. The transmission of the sensation of pain is depending on the stimulation ability of the system. Wind constitutions tend to experience a strong sensation of pain, a low tolerance and hypersensitivity. Their sensation of pain underlies often changes in perception and is strongly dependent on the general current emotional and mental state of the patient. But also a pathologic sense of touch and neurological disturbances and disorders are among the tendencies of a wind constitution. The disease pattern ‘Wind in the Heart’ (Nying-rLung) exemplifies the connection between mind, wind and pain. Bile constitution has a semi-strong sensation of pain. Due to the tendency to inflammatory disorders it tends to lead to sharp pains. Migraine is a typical pain caused by bile. Phlegm constitution has a low sensation of pain and a great tolerance. Phlegm causes non-inflammatory disorders. Fibromyalgia is an example for pain resulting from a phlegm disorder. The theory of constitution is a useful tool in the patient's process of understanding and accepting his/her own disease and helpful in preventive medicine.