The article presents one Tibetan doctor's perceptions of practicing Tibetan medicine in various different national contexts. In each context we find a localized form of Tibetan medicine that in various ways is subject to the transformative forces of modernity and scientization. His story catalogues the historical changes that have occurred in Tibetan medicine in last forty years from the perspective of a medical practitioner who has experienced them directly. These changes have presented strong challenges to its theoretical and practical basis and to the social organization of the tradition. The article assesses the extent to which Tibetan medicine can still be said to be a unified field of knowledge and practice.

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