Photo above: Ngawang Thayi, 39, a Buddhist monk who is a doctor specialising in Tibetan and Western medicine, answers patients' questions in the clinic of Drepung Monastery, in Lhasa, the Tibet autonomous region.
The fragrance of Tibetan incense lingers in the clinic where monk Ngagwang Thayi donned rubber gloves, a mask and a white coat on top of his saffron robes.
He checked the head of a patient before performing a minor operation to drain blood from the hypertensive patient's head.
Just one minute earlier, Ngagwang Thayi had tightened a bandage on the patient's forehead by twisting a chopstick. He then jabbed and forced a "7"-shaped knife between the man's eyebrows to let out a stream of dark blood.
"Blood lipids can cause headaches, dizziness, red eyes and a green face; therefore, the excessive accumulation of blood lipids should be let out," he said.
"Yet we can't do it carelessly. We have to pick an auspicious day, and the patients have to drink herbal drugs and chant sutras, and are forbidden from doing a series of things before the operation," such as not drinking cold water.
The method, which has been practiced for more than 1,900 years since the rise of the Bon religion, can also cure a wide range of conditions such as varicose veins and liver and stomach diseases, he said.
Ngagwang Thayi, 39, is a monk from and working for the Drepung Monastery. He is also a well-educated doctor who has mastered the Tibetan, Han and Western medical sciences.
As early as the eighth century and well before Yuthok Yonten Gonpo founded the Tibetan traditional medical science, monk-doctors have prevailed in Tibet.
According to local researchers, the current number of monk-practitioners has dropped along with the development of modern medical science, both in the East and West, and thanks to the Tibet autonomous region government's efforts to provide professional and inexpensive medical services and insurances to locals.
In Lhasa, the region's capital, there are 60 to 70 monk-doctors, according to a local official's estimate. In comparison, all practitioners were religious figures when the predecessor of the Hospital of Tibetan Medical Sciences was established in 1916.
Yet many Buddhists and followers visit from neighbouring Gansu and Qinghai provinces to find a cure in such clinics of religious background for assurance and comfort.
'Comforting and patient'
Hanging on the walls of the clinic, which is at the foot of Drepung Monastery in the west suburb of Lhasa, are not only banners of thanks, but also a thangka, a delicate and pious Buddhism painting or embroidery on a piece of fine cloth that depicts Buddha.
The thangka described a mandala, displaying the model of the cosmic and people's inner world, with the Medicine Buddha residing in the centre.
Right under the Medicine Buddha's sight, the monk-doctors received hundreds of patients per day.
Monk-doctors were called Lhaman, or divine and revered doctor, in the Tibetan language, by the 38th Tubo emperor, Trisong Detsen.
According to doctors at the clinic, every one of them had to spend more than 10 years learning and reciting Gyushi, or the Four Medical Tantras, as well as passing the State's examination for a practitioners' license.
Moreover, Gyushi demanded doctors have a kind heart and refrain from drinking, sleeping too much and gorging.
They also have to pray during drug making. In Drepung Monastery, about 20 high monks will gather to chant sutras, such as the sutra of the Medicine Buddha, for three days, as part of a ritual to pray for holy effectiveness of drugs that the monastery makes traditionally.
Due to the doctors' special status, people from all walks of life, especially those from pasturing and farming areas, visit them frequently.
Bang Tsering, 43, a Lhasa driver said, "It's more effective to get treated by a monk-doctor. I can describe my illness clearly to them."
Businessman Dekyi Droma, 35, from Qinghai province, who suffers lung disease, said, "I feel comfortable here because the doctors are more patient.
"It is cheaper too. They don't charge diagnosis fees."
Monk-doctor Ngawang Lhundrup, 62, who has practiced for 39 years, said, "It does not matter if most of the patients can cover the bill or not."
He said the clinic spends about 50,000 yuan (S$10,000) a year providing free treatment to disadvantaged groups.
"We received Tibetans from the Amdo and Kham areas, Hans, Mongolians and even foreign tourists. We receive and charge them equally and prescribe Western or Eastern drugs according to their preference."
While practicing traditional bloodletting, the 60-square-meter clinic has also opened rooms for modern type-B ultrasonic scans and for injections and dripping.
The famous Drepung clinic received its operating license in 1996 to help people outside the monastery. Its revenues are transferred to the monastery to ease the government's and Buddhists' burden of supporting the monastery.
Eight medical staff members, including six monks and two nurses, work there.
They earn 1,600 yuan a month - nothing more than others, such as a cook, in the monastery.
Tseten Jigme, director of the Tibetan medical science and medicine literature research centre under the Hospital of Tibetan Medical Science, said monk-doctors are good for society.
"On the one hand, monks can keep their personal religious practice undisturbed through curing people, which is accumulating good karma in Buddhism teaching. And on the other hand, they can benefit people."
Past and present
Tseten Jigme said monasteries, both big and small, have spent money to train their in-house monk-doctors since ancient times.
The rise of monk-doctors began in the late eighth century, when Yuthok Yonten Gonpo founded the Tibetan medical science.
Since 1696, Desi Sangye Gyatso, regent of Tibet in the 17th century after the passing of the fifth Dalai Lama, established a medical college on the Chakpori Hill, and later another one beside the Potala Palace and a third one in Doilungdeqen county.
The colleges only admitted monks then.
In 1916, the predecessor of the Hospital of Tibetan Medical Science was established, with a tradition of selecting most students and practitioners from monasteries unchanged.
From 1916 to 1959, the colleges and hospitals trained more than 1,000 monk-doctors but only one female doctor, according to Tseten Jigme.
Then in 1959, the Chakpori Hill Medical College merged with another college to form today's Hospital of Tibetan Medical Science and began accepting students from society.
"Nowadays, we have few monk-doctors because there are professional hospitals and clinics everywhere in every county and village," said Tseten Jigme.
In 2011, the autonomous region's government began allowing monks and nuns to join the social medical insurance system on a voluntary basis. In 2012, hospitals began providing free body examinations to them.
"So, the need for monk-doctors has decreased substantially along with the development of the modern health system," Tseten Jigme said.
He added that the monk-doctors now can be found in the Sera, Drepung, Ganden, Tashilhunpo and Samding monasteries. Yet only the ones in Drepung and Tashilhunpo are open to the public.
Norbu, head of the medical administrative office of Lhasa city's health department, said authorities do not have an exact number of the group.
But almost every monastery has a big or small team of doctors. Sixty to 70 monk-doctors work in Lhasa, Norbu said.
Though the number is dwindling, Tseten Jigme added it would be wrong to believe that monk-doctors are better than ordinary ones.
He gave an example that many toiled a long way to see a doctor - a descendant of Yuthok Yonten Gonpo - in Doilungdeqen "not because the doctor has unparalleled skills, but for their imagination and expectations".
He added the economic situations in different monasteries differ, so that some can sponsor students to develop into qualified doctors, and some cannot. But many monk-doctors began practicing even before they finish their studies because of personal reasons or economic difficulties.
"This is irresponsible to society, a sin, and running against the teaching of Tibetan medical science," he said.
"The good news is that the government has favourable policies to support prospective students' learning and our hospitals are providing more training opportunities to them."
Local health departments also have conducted regular checks in the clinics as the monks provide services to a sprawling group.
Norbu said his office examines monk-doctors' behaviour, prescriptions, drug qualities, licenses and health conditions and service standards routinely.
He added that health departments have carried out a plan to train more Tibetan doctors, including Tibetan monk-doctors.
"Monk-doctors will never go away despite development in science. But we need time to gradually help them recover their glory."
Dorje Chodrak, an intern in the clinic, said Tibetan medical science is well known to the world and he hopes he can inherit it to serve the public.
"I don't have big dreams. All I want is to use what I learned to help others," he said.