Tibetan External Therapies

Sorig Khang International offers comprehensive practical training in Tibetan medicine’s rich variety of external therapies. This includes Ku Nye massage, moxibustion, cupping, blood letting, Yukcho, acupuncture and many more, as well as the manufacture and usage of specialized implements and instruments.

As one of Asia’s three great healing systems, TTM approaches chronic diseases with a holistic viewpoint, whilst remaining compatible with any practice of traditional and modern medicine.

Treatment in TTM

The treatment of individuals for preventive, curative or alleviating aims is one of the fundamental principals in any medical tradition. In Sowa Rigpa therapies of any kind are therefore categorized in the third division, the Root of Treatment Methods; the other being the Root of Health and Disease, and the Root of Diagnosis - both forming the basis for the following root.

The Root of Treatment Methods nourishes four trunks:

  1. Diet: According to Tibetan Medicine, individuals should be aware of their typology, in order to partake of a diet which helps to maintain balance. Diet can be adjusted for different types of imbalances according to whether the affliction is hot or cold in nature, or pathology according to the three nye pa (energy principle in TTM).
  2. Lifestyle: Tibetan Medicine considers a healthy lifestyle to consist of an awareness of every moment and all circumstances of our lives - waking, sleeping, eating, working, exercising, socializing. Attention is paid even to situations such as sneezing or crying.
  3. Medicine: In the Tibetan pharmacopea, natural herbs, plants and wild flowers are employed for their therapuetic effect. A variety of mineral substances, and a small number of animal-derived substances are also used. Many of these substances can be found all over the world, however some specific and particularly powerful herbs and minerals are found only on the Tibetan high plateau. Due to the pristine nature of this environment, the ingredients of the Tibetan Materia Medica is particularly pure.
  4. External Therapies: TTM describes physical health as a balance between the three nye pa. Specific external therapies can be used to restore balance in each of these energies. This therapeutic wealth is used individually or as supportive means in combination with other types of treatment.

Trunk of External Therapies

The Four Tantras, the primary reference work of Sowa Rigpa dubbed ‘Bible of Tibetan Medicine’, by Yuthok in the 13th century, mentions Ku Nye, moxibustion, compress therapy, blood letting, medicinal bath and acupuncture (as part of surgical therapy) in the section about external therapies within the fourth tantra.

They can be complemented by additional therapies, some of them mentioned in the other tantras, some added in the historical development of Tibetan medicine through cultural influences, termas (spiritual discovery) or individual experience.

In the Second Tantra we can find a special group of external therapies that originated in the Buddhist influences on Tibetan medicine: mantras. They are spiritual kinds of healing and include methods concerning diet, lifestyle, medicine, as well as external therapies. They can also be used independently. In this context mantra healing is often considered the ‘fifth trunk’ of the treatment method.

External therapies can be divided into physical and energetic treatment.

Physical Therapies
  • Mild Therapies
    • Compress
      • Hot
      • Cold
    • Bath therapy
      • Hydrotherapy
      • Steam therapy
    • Massage
    • Hor Me
    • Cupping
      • Cupping therapy
      • Horn therapy
    • Smoke therapy
    • Stick therapy
  • Invasive Therapies
    • Blood letting
    • Moxibustion
    • Surgical therapy
      • Acupuncture
      • Operation
Energetic Therapies
  • La massage
  • Chakra massage

Though all kinds of therapies might affect the nyes pa, energetic external therapies particularly aim at treating energetic imbalances, whereas physical therapies try to affect body and mind positively through the nye pa. There are no contraindications for these kinds of treatment, however, the effect depends highly on the therapist’s or practitioner’s qualification.

Ku Nye Massage

This most famous external therapy is the traditional Tibetan Ku Nye (bsku mnye) massage. It is especially useful in prevention and treating lung (wind energy) disorders and can be used for almost every patient. There are different types of ku nye for various patients and disorders. The three steps of ku nye are:

  1. ‘Ku’, preliminary treatment such as oil application, joint movement, warming up etc.
  2. ‘Nye’, the actual massage including different methods, instruments, treatment of specific locations etc.
  3. ‘Chi’, after-treatment such as removing the oil with powder, bath or shower.

Relative contraindications of Ku Nye are cancer or tumors.

Me Tsa (Moxibustion)

Moxibustion or short ‘moxa’ can be applied to various cold diseases. The heat of certain substances is especially effective against disorders or blockages of bad kan. Traditionally moxa was regarded as invasive therapy due to its cauterizing effect. Matching to Western medical standards only mild and non-invasive types are used.

In fact traditionally there are four levels of moxa:

  1. Warming up: gradual application of heat
  2. Heating up: moxa application of seven times on one point
  3. Burning: moxa application of 14 times on one point
  4. Cooking: moxa application of 21 times/completely burning a moxa cone on one point (traditionally scars are expected)

Another grading possibility is the ‘test moxa’, the mildest moxibustion type. This is for example used in unclear indications and with warm materials such as stones, wood etc. in order to see a patient’s reaction to the test treatment.

Other materials used with moxibustion are for example certain herbs, plant parts, animal products (such as horn), metals etc. While applying moxa it is essential to avoid sensitive body parts such as sense organs.

Relative to absolute contraindications for moxa are hot natured diseases.

Hor Me (Mongolian Moxibustion)

Another excellent external treatment of rlung is the modified form of moxibustion called Hor Me, ‘Mongolian moxa’. It works through application of heat through certain substances and oils.

There are various methods on how to apply hor me. Usually little bags filled with herbs and soaked in warm oil can be placed on certain body parts. Traditionally felt cloth and river stones were also used.

Compress Therapy

The treatment with compresses belongs to the group of Lum or bath therapy. The hot compress with salt, stones or herbs is especially suitable for treating bad kan disorders. There are various kinds of compresses used for more indications such as cold compress for hot natured diseases.

A relative to absolute contraindication for the compress therapy are e.g. intoxications, infectious diseases, anemia, etc.

Sweating Therapy

Sweating therapy, also called ‘steam therapy’ belongs to the group of bath therapy. It is has been used since long time in many cultures with different kinds of application. It is based on releasing heat and toxins through sweating of the body or certain body parts.

In Tibetan medicine this external therapy should only be used as treatment of superficial mkhris pa.

Contraindications for steam therapy are deep mkhris pa disorders, infectious inflammatory diseases, as well as general weakness, loss of appetite, etc.

Water Wheel Therapy

A good way of treating local mkhris pa is the ‘Water Wheel’. Cold water is used to spray on affected locations. Sensitive places (organs, joints) should be avoided. The medicinal bath is the supergroup of hydrotherapies, including water tapping, a variation of the Water Wheel.

Smoke Therapy

This therapy consists of smelling the aroma of medicinal substances, which are burning on embers. By allowing the smoke to reach the patient’s body or by letting the patient inhale the smoke of different mixtures of plants and minerals this therapy my prevent disorders or rebalance imbalances of the nye pa.


The effect of cupping therapy removes excess of the nye pa accumulated in the body. A little piece of cotton is lit up and place into a cup, traditionally made of copper. By attaching the cup on the affected body part the partial vacuum will suck out waste wind, bile, or phlegm.

Yukchö Stick Therapy

Yukchö Stick Therapy is one of the treatment methods discovered through the combined medicine and spiritual practice as a terma - a spiritual treasure or knowledge revelation - and added to the external therapies of TTM. Different ways of tapping or massaging would traditionally help the spiritual practitioner during their retreat. Originally secret the benefits of this method are now available to the medical practitioner as self or as patient treatment.


Blood letting is an invasive therapy as well as a purgative treatment for blood disorders. It is used for treatment of deep mkhris pa.

One may think that blood letting is about purging a lot of blood, however it mostly requires just a few drops for a good blood letting session. There are specific standard points used depending on different localizations of the disorder or disease.

Contraindications of blood letting are general weakness and rlung disorders. Blood letting should not be used for children or seniors.


The ‘most effective therapy of all’ in the external treatment is the surgical therapy. Its division of acupuncture uses an own system of points and locations on the body to eliminate even chronic disorders of inner organs, bodily constituents or the energies. Sophisticated materials, tools and techniques support the effect of Tibetan acupuncture.

La Massage

La massage is a psycho-physical treatment which involves visualizing various forms and colors, and chanting the correct sound according to different points on the Path of La. This technique is used to replenish lost La energy, a supreme energy present both in Traditional Tibetan Medicine and the ancient lore of Tibetan Astrology. Considered to be one of the subtlest and finest frequencies along the spectrum of lunar energy, La pervades the human body, stirring it to give us strength, stability and clarity of mind. Its vital energy is considered to be an essence of our consciousness.

Chakra Massage

This gentle treatment with soft or without physical contact is based on the spiritual system of the Vajra body with its subtle channels. In order to untie the knots of energy stagnation in the main energy centers, chakras, this treatment has been developed by spiritual masters and transmitted in an unbroken lineage. The method includes visualization of forms, colors, or mantras.