This essay examines historical and contemporary connections between Buddhist and medical traditions through a study of the Accomplishing Medicine (sman sgrub) practice and the Yuthok Heart Essence (G.yu thog snying thig) anthology. Accomplishing Medicine is an esoteric Buddhist yogic and contemplative exercise focused on several levels of ''alchemical'' transformation. The article will trace the acquisition of this practice from India by Tibetan medical figures and its assimilation into medical practice. It will propose that this alchemical practice forms the central nexus of connection between Tibetan medicine and the Buddhist Nyingma tradition, and that this little-studied link is not a marginal feature of Tibetan medicine but rather one that has had a significant shaping factor on each tradition throughout history.

This paper addresses the development of scholastic medical traditions in Tibet through an examination of lists of physicians. I consider the debates that such lists and their accompanying narratives engender for Tibetan historians and reflect on the contributions they make to the identity of the medical tradition. By examining the structure and content of classificatory methods in medical histories, I argue that temporally organized lists document the place of medicine across time, geographically organized lists document the reach of medical knowledge across space, and thematically organized lists document the intertwining of medical knowledge and skill with other aspects of intellectual and civil life. In making these lists, medical historians paint a portrait of the Tibetan medical tradition that evokes connections to Buddhism and the strength and cosmopolitanism of the imperial period. Medical histories thus emphasize a picture of Tibet in the broader context of Asia—a Tibet whose empire lives on culturally or intellectually, if not militarily.

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This article considers a Tibetan anthology, the Eighteen Additional Practices (Cha lag bco brgyad ), that includes some of the earliest indigenous Tibetan medical works still extant, and examines more closely its first text, a history of the Four Tantras. Several of these works display an explicit concern to show medicine to be part of Buddhist history. Other texts in the collection exhibit the heavy influence of what we might call religious practice on the work of medical healing. The anthology's first text articulates an explicit connection between Tibetan medical literature and Indian Buddhism. This article compares this work's structure and content to other Tibetan medical histories and addresses its role in early medical history.

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