%0 Generic
%A Besch, Nils Florian
%D 2006
%F heidok:7893
%K tibetische Medizin , Medizinethnologie , amchi , ProfessionalisierungTibetan medicine , medical anthropology , modernization , alternative modernities
%R 10.11588/heidok.00007893
%T Tibetan Medicine Off the Roads : Modernizing the Work of the Amchi in Spiti
%U https://archiv.ub.uni-heidelberg.de/volltextserver/7893/
%X The central theme of this dissertation is an anthropological analysis of modernization processes of Tibetan medicine in the remote Spiti valley in the north-western Indian Himalayas. The investigation of the politico-economical and socio-cultural change of the daily practices of the physicians of Tibetan medicine (called amchi) refers to Max Weber’s notion of rationalization. The activities of the amchi in modernizing their conditions of work, are therefore especially examined in view of a rational "Zweckorientierung" as well as an increasing bureaucratization (organizational structures, accountancy, control, efficiency). This is framed into a detailed ethnography of the main aspects of amchi medicine – diagnosis, medicine production and administering, and religious practices –, as well as the social and economic aspects of their work. This amchi practice currently observed in Spiti is further confronted with extracts from the Rgyud bzhi, the most important classical text of Tibetan medicine, representations of Tibetan medicine in English literature and interviews with Spiti amchi.  The thesis discusses the development of Tibetan medicine in context of the conditions of Spiti valley, that must be understood in medical and political terms, historically as well as contemporarily, as a marginal frontier area. The rapid changes of the social and politico-economic environment, especially the introduction of the capitalist market economy with cash crop-production, wage-labor and commoditization, have led to a depersonalization and individualization of the local society. The social "disembedding" (Giddens) is especially visible in the breakdown of mutual reciprocity (gift exchange) between villagers and amchi, that was earlier the socio-economic basis of the medical work. This has led in combination with further factors, as there are state supported biomedicine, school and college education and the merging of time and space (through road connections to the Indian plains), to a rapid decline of the medical tradition of Spiti valley within the last two decades. To oppose this development the amchi started a process of professionalization (set up of an association and a local clinic) in the late 1990s. Despite the continuing exclusion from public health care, the Indian state supported this process financially and forced a bureaucratization within the association and the clinic, as well as a monetarization of Tibetan medicine. Weber has argued that modernization entails a loss of values, norms and religious practices – a process that has been observed in the rationalization and secularization of Tibetan medicine in its centers in Lhasa and Dharamshala (Adams, Cantwell, Janes, Samuel). In contrast to that, emphasize the Spiti amchi today the local transmission of medical and religious practices in their amchi lineages and substantiate thereby their specific tradition – to be differentiated from other, institutionalized educations – and therefore an explicit, local identity.