“Medicine beyond borders”: Tibetan moxibustion manuscripts from Dunhuang and medical exchange on the Silk Roads

This paper explores the nature and characteristics of the Tibetan medical tradition within the context of the Silk Roads as a multicultural and multilingual network, focusing on the tenth-century Tibetan moxibustion manuscript Pelliot tibétain 1058 (PT 1058), discovered in Mogao Cave 17 at Dunhuang. The Silk Roads served as a significant venue for the exchange and synthesis of diverse tangible and intangible materials from East and West, including trade goods, religions, art, and even human genes. It was also an important site in the history of medicine, where different medical traditions interacted and evolved. Dunhuang, in particular, was a crucial point on the Silk Roads that functioned as a multicultural hub in which various ethnic groups, languages, and knowledge systems coexisted. The medical manuscripts discovered there provide valuable textual evidence for understanding the formative stage of the Tibetan medical tradition. The main body of this paper is divided into three parts. First, to explore Tibetan medical tradition, its origin and its nature, it examines a well-known narrative about the King Songtsen Gampo (r. ca. 617–650) and the nine foreign physicians, including Indian, Chinese, and Greek. This narrative can be understood as a symbolic or “historicized” story, emphasizing Tibetan medicine not as a single tradition, but a synthesis that integrates diverse foreign elements from its early stages. Second, it investiagtes three Tibetan moxibustion manuscripts from Dunhuang, Pelliot tibétain 127, 1044, and 1058, considering their general structure and content. Particular attention is given to PT 1058, the earliest surviving example of Tibetan medical diagrams. The paper provides an English translation of the Tibetan moxibustion points and offers detailed interpretations, linking them to specific acupunture points in Korean and East Asian traditional medicine. Many of the moxibustion points in PT 1058 correspond with acupuncture points, such as Huantiao (GB30), Fengshi (GB31), Chengjin (BL56), Chengshan (BL57), and Taichong (LR3). It is also notable that PT 1058 includes the same method to locate Fengshi (GB31): “when the body is upright and the arms are naturally extended, the point where the middle finger touches the thigh.” This suggests the connection between the Dunhuang manuscript and East Asian medical traditions. It then compares PT 1058 with Chinese and Uighur moxibustion manuscripts, identifying similarities that show how medical knowledge was transmitted and systematized through visualized representations of the body combined with practical therapeutic knowledge along the Silk Roads. Finally, the paper critically examines contemporary efforts by India and China to institutionalize traditional Tibetan medicine, Sowa Rigpa, within their respective national cultural heritage agendas. Such state-driven cultural politics, I argue, risk neglecting or overshadowing the hybrid origins and multicultural dimensions of Tibetan medical tradition that is deeply rooted in the transcultural exchanges of the Silk Roads. In conclusion, this study highlights Tibetan medical tradition not merely as a conventional medical system, but as a dynamic and living knowledge system that emerged from a pluralistic environment of intercultural transmission. Today, it stands as a symbolic heritage embodying Tibetan historical memory and cultural agency.