Arguing over the Buddhist Pedigree of Tibetan Medicine: A Case Study of Empirical Observation and Traditional Learning in 16th- and 17th-Century Tibet

This article examines the relationship between the practice and theory of medicine and Buddhism in premodern Tibet. It considers a polemical text composed by the 16th–17th-century Tibetan physician and tantric Buddhist expert Sokdokpa Lodrö Gyeltsen, intending to prove the Buddhist canonical status of the Four Medical Tantras, the foundational text of the Tibetan medical tradition. While presenting and analyzing Sokdokpa’s polemical writing in the context of the broader debate over the Buddhist pedigree of the Four Tantras that took place during his time, this discussion situates Sokdokpa’s reflections on the topic in terms of his broader career as both a practicing physician and a tantric Buddhist ritual and contemplative specialist. It suggests that by virtue of Sokdokpa’s tightly interwoven activities in the spheres of medicine and Buddhism, his contribution to this debate gives voice to a sensibility in which empiricist, historicist, and Buddhist ritual and contemplative inflections intermingle in ways that resist easy disentanglement and classification. In this it argues that Sokdokpa’s reflections form an important counterpoint to the perspectives considered thus far in the scholarly study of this debate. It also questions if Sokdokpa’s style of argumentation might call for a recalibration of how scholars currently construe the roles of tantric Buddhist practice in the appeal by premodern Tibetan physicians to critical and probative criteria.


Introduction
An important goal recently formulated in the study of Buddhism and medicine is to chart the initial stirrings of a critical epistemic distance between the pragmatic mechanisms of healing and traditional Buddhist learning (Gyatso 2015). With this goal has come the imperative to trace the shifting perspectives such a distance might afford Buddhist physicians concerning traditional modes of religious authority. A key implication of this line of inquiry is therefore to analyze how the case of Buddhism and medicine might compare with the presumed cleavage between traditional authority and empirical inquiry in late premodern Europe that is often associated with the birth of modernity. 1 In this article, I attempt to contribute to this research agenda by considering how the 16th-17thcentury doctor, tantric Buddhist ritual expert, and doctrinal scholar Sokdokpa Lodrö Gyeltsen (Sog bzlog pa Blo gros rgyal mtshan, 1552-1624), critically interrogated the textual sources of the Tibetan medical tradition. I ask how Sokdokpa's literary effort to negotiate a rapprochement between traditional Buddhist learning and the practice of medicine in Tibet compares to other attempts to do so 1 For a general survey of Buddhist discourses about and engagements with healing and medicine, see Demiéville ([1937Demiéville ([ ] 1985, and more recently, Salguero (2015). among practicing Tibetan physicians and Buddhist exegetes of his period. In this, I seek to add an important voice to those considered in Janet Gyatso's landmark study of the Tibetan debate over the Buddhist canonical status of the Four Medical Tantras. The Four Medical Tantras serves as the seminal literary source of the Tibetan medical tradition. 2 The relevance of Sokdokpa's contribution to this debate is both historical and intellectual in scope. It is evident from Sokdokpa's writings that he was a high-profile physician during his early adult life. 3 However, in his later years, Sokdokpa would sideline the practice of medicine in favor of a career as a Buddhist doctrinal scholar, tantric ritual expert, and contemplative practitioner. His renown as a doctor therefore never reached the level of other luminaries of Tibetan medicine, such as Zurkharwa Lodrö Gyelpo (Zur mkhar ba Blo gros rgyal po, 1507-1579) and the Desi Sangyé Gyatso (sDe srid Sangs rgyas rgya mtsho, 1653-1705), whose lives and medical careers Janet Gyatso so deftly traces in her magisterial recent work. Indeed, Sokdokpa composed no works directly about the Four Medical Tantras save the one short treatise intending to prove its Buddhist canonical status that will be presented here. 4 He is better known in the annals of Tibetan history for his multi-decade project to use tantric rituals to avert Mongol military incursions into Tibet; for his voluminous apologetic writings, in which he defends his Old School tradition against polemical attacks; and for his immersion in and propagation of the Old School's Great Perfection traditions (Gentry 2017).
However, despite Sokdokpa's relative obscurity in the scholarly field of medicine in Tibet, his short treatise on the Buddhist pedigree of the Four Medical Tantras was not produced in isolation. The writing clearly reflects knowledge of not only Zurkharwa's similarly themed writings from the previous decades but also the longer history of this debate to which Zurkharwa likewise responded. Sokdokpa's work also figures in the Desi's reflections on the topic in the decades following Sokdokpa's passing. In his treatise, Sokdokpa confronted the very same problems with which these more illustrious figures wrestled. He also marshalled some of the very same resources in his argumentation. However, the results Sokdokpa reached are strikingly different.
In this paper, I explore how these different results might relate to the overlapping commitments of Sokdokpa's diverse socio-religious involvements. I present and analyze Sokdokpa's treatise on the Buddhist pedigree and canonical status of the Four Medical Tantras, comparing his arguments on a selection of key points with those of Zurkharwa and others. In so doing, I seek to build on my recent study of Sokdokpa (Gentry 2017) to show how this figure's unique career path from physician to Buddhist religious specialist provides an important counterpoint to the voices thus far considered by Gyatso in her study of this debate. I argue that accounting for Sokdokpa's perspective in this argument calls for a treatment of his medical practice as tightly interwoven with his role as a tantric ritual master and contemplative practitioner. I also address the larger question concerning what Sokdokpa's entry into the debate might imply about the intersection of medicine and Buddhism in premodern Tibet.

Word of the Buddha or Tibetan Composition? The Tibetan Debate over the Provenance and Buddhist Pedigree of the Four Medical Tantras
Scholars have noticed in writings composed by Tibetan doctors from at least the 14th century on a mounting tendency to call critical attention to discrepancies between the Four Medical Tantras' literary descriptions of material exigencies and the direct observations and common knowledge of Tibetans 2 Gyatso (2004Gyatso ( , 2015, pp. 143-91. For a partial translation of the Four Medical Tantras, see Clark (1995). Gyatso (2015, p. 436n64) prefers to translate the term rgyud, typically a Tibetan rendering of the Sanskrit term tantra, as "treatise". Because this translation choice would, by my estimation, decide in advance the flow of arguments in the debate, which often centered precisely on how this fourfold medical text relates to more standard Buddhist tantras, I have chosen to stay closer to the source terminology and render it back into the Sanskrit term tantra.
themselves. 5 This tension has expressed itself foremost as a debate that raged for centuries between, on the one hand, those who claimed that the Four Medical Tantras originated in India as the Word of the Buddha (Tib. sangs rgyas kyi bka', Skt. buddhavacana) and was subsequently translated into the Tibetan language, and, on the other hand, those who claimed that it was instead composed originally in Tibetan as a treatise orśāstra. 6 Janet Gyatso has described in rich detail the origins, historical development, and shifting claims of this debate. 7 In this article, I will only paraphrase the main points before moving on to consider Sokdoka's specific contributions, which Gyatso chose to leave out of her discussion. 8 Critics of the Buddha Word position have pointed to numerous details found in the Four Tantras itself-its language, ritual elements, botany, diet, climactic details, astrology, material culture, geography, and more-which, according to their empirical observations and knowledge of Sanskrit literary conventions and local and foreign customs, could have only originated in Tibetan or even Chinese cultural milieus. They have often credited Yutok Yönten Gönpo (g.Yu thog Yon tan mgon po, 1126-1202) with the authorship of the Four Tantras and not BuddhaŚākyamuni. In this, they were squarely attacking the literal interpretation of the opening narrative frame of the basic text of the Four Tantras itself (rtsa rgyud). The narrative opening of the basic Tantra draws from canonical Buddhist literature to present the teacher, audience, teaching, time, and place of the teaching-known traditionally as the "five excellences"-in a way that is common to the narrative openings of most Buddhist sūtras and tantras.
The basic Tantra's narrative frame of the "five excellences" so persuasively mimicked the literary conventions of Indian Buddhist scriptures that it provided a charter in Tibet for the assumption that the Four Tantras is a sermon spoken directly by the Buddha and translated into Tibetan from a Sanskrit source text during the heyday of the Tibetan imperial period in the 8th and early 9th centuries. Proponents of the Word of the Buddha position have typically identified the figure of Yutok Yönten Gönpo not as the author of the Four Tantras but as a skilled physician and Buddhist master instrumental in the transmission of the Four Tantras. They have often accounted for the absence of the Four Tantras in Tibet until the 12th century by claiming that shortly after it was translated into Tibetan, it was hidden, only to be rediscovered as a treasure text (gter ma) and transmitted to Yutok in the 12th century. 9 These conflicting views about the Buddhist canonical status of the Four Tantras-whether it is a sermon delivered by the Buddha or a later Tibetan composition-created an intellectual divide within the Tibetan medical community. The debate eventually gave rise to a subgenre of apologetic literature called "proving the Four Tantras to be the Word of the Buddha" (rgyud bzhi bka' sgrub), the composition of which became practically pro forma throughout the history of Tibetan medicine for Tibetan doctors who maintained the Buddhist canonical status of the Four Tantras. 10 Importantly, 5 When exactly such writings started to surface is, nonetheless, a matter of debate. Karmay (1998, pp. 228-29) and Ehrhard (2007, p. 151) claim that it started in the 14th century. However, Czaja (2005/6) and Gyatso (2015, p. 151) suggest that such writings appeared close to the initial appearance of the Four Tantras in Tibet in the 12th century and were part of the medical discourse in Tibet throughout its long history. 6 For recent scholarly discussions of the sources of the Four Medical Tantras, see Emmerick (1977), Fenner (1996, and Yang Ga (2010). 7 Gyatso (2015), pp. 143-91. For an inclusive survey of the various positions taken in this debate from the 14th century to the present period, see Yang Ga (2010), pp. 7-21. 8 Gyatso (2015), p. 455n57. 9 In the 17th century, there appeared a hagiographical tradition of two different figures connected with the Tibetan medical tradition bearing this same name-the 12th century Yutok Yönten Gönpo, who then became Yutok "the younger", and Yutok "the elder", who is said to have flourished during the 8th and 9th centuries. For more on this development and its persistence to the present period, see (Gyatso 2015), pp. 119-20, and 428n203, which cites Yang Ga (2010Ga ( , 2014 and lists a number of pre-17th-century Tibetan medical writings that reveal no knowledge of two Yutok Yönten Gönpos. Gyatso mentions that Sokdokpa too shows no awareness of Yutok "the elder" and begins his narration of Yutok Yönten Gönpo's life with an uncomplicated dating of him as a contemporary of the 12th-13th-century Sakya master Jetsün Drakpa Gyeltsen (rJe btsun Grags pa rgyal mtshan, 1147-1216), a prestigious physician in his own right (Nges don snying po, p. 231.5-231.6). See also Gyatso (2015, p. 107) for details about this Sakya figure's role as a physician. 10 Gyatso (2015); Czaja (2005/6), p. 132;and Karmay (1998), pp. 228-29. unlike similar Tibetan accusations of the non-Indian pedigree of Buddhist scriptural works, the claim that the Four Medical Tantras was composed in Tibet by a Tibetan was not necessarily intended to cast doubt on the value and efficacy of this foundational medical work. Rather, this position represented a major strain of thought among practicing Tibetan doctors themselves about the origins of their own tradition. In this respect, as Gyatso carefully points out, the debate over the Buddhist pedigree of the Four Tantras was quite unlike similar debates over the canonical status of Buddhist scriptures that had also been playing out in Tibet for centuries, often leveled against the authenticity of the Old School's tantras and its system of ongoing revelations or treasures. 11 Nonetheless, as Gyatso also highlights, defenders of the Buddha Word position clearly drew key arguments from these and other related Buddhist doctrinal debates-often times, as mentioned above, ascribing to the Four Tantras the status of a treasure text-even as their interlocutors were not questioning the general value and authority of the Four Medical Tantras in their critical treatment of this work's putative Indian Buddhist provenance. 12 Karmay (1998), in his pioneering introduction of this topic to the scholarly world, draws from the 15th-century figure Tashi Pelzang's (Bkra shis dpal bzang) defense against these criticisms to summarize the opposing camp's problems with the Buddha Word position. These criticisms cover observations of textual infelicities and general inconsistencies with respect to known Tibetan translations of canonical Indian Buddhist source texts, such as the first line of the basic Tantra reading, "Thus have I said", instead of the expected opening formula, "Thus have I heard"; 13 the inclusion of non-Buddhists among the original audience; the natural Tibetan literary style of the text, atypical of works translated from Sanskrit; its inconsistency with respect to known Indian medical works in terms of structure, language, and content; its exclusion from the Tibetan canonical collections of translated works, the Kangyur (Bka' 'gyur) and Tengyur (Bstan 'gyur); and internal discrepancies between the basic Tantra and the explanatory Tantra. 14 More compelling, perhaps, are criticisms of the text's inclusion of elements of clear Tibetan and perhaps Chinese provenance, such as astrological terms and measurements; dietary prescriptions (i.e., mention of the Tibetan staple of roasted barley flour, or tsampa); climactic conditions; terms and ritual elements common to the Tibetan Bön tradition; and the mention of tea, porcelain, and other items that Indians presumably did not have access to in the past. 15 Gyatso points out another important target of critique not mentioned by Karmay: the fabulous details of the basic Tantra's narrative setting, specifically, the presumed teacher, audience, time, teaching, and, most importantly, place-the city of Sudarśana, along with the description of its surrounding mountains and the medicinal herbs said to be growing on them. 16 Critics of the Buddha Word position particularly homed in on the incommensurability between the Four Tantras' elaborate description of Sudarśana and what was generally known in Tibet about the actual geographical, botanical, and climactic conditions of the Indian subcontinent. Ongoing arguments about the purported location, or non-location, as the case may be, of the city of Sudarśana detailed in the basic Tantra's narrative opening constitutes an important thread in this argument. 17 Sokdokpa's contribution to this issue, in particular, provides a fresh perspective on the debate that has hitherto escaped notice.
Although Sokdokpa's defense of the Buddha Word position touches upon all of these criticisms, he focuses the bulk of his energy on the issue of the "five excellences"-the teacher, audience, teaching, time, and place of the teaching. Sokdokpa, however, inverts this order slightly, treating "place" as the crucial hinge in his overall argument, and only secondarily considering the identities of teacher, audience, teaching, and time. In this paper, I follow suit to consider, in turn, Sokdokpa's reflections on place, teacher, audience, teaching, and time. I then touch on the related issues of canonicity, revelation, and transmission, before venturing some final observations. However, to better understand Sokdokpa's thoughts on these topics, a general introduction to the text and its context of production, along with a brief foray into the wider significance of the "five excellences", are first in order.

Critique and Reconciliation: Sokdokpa's Reflections on the Matter
Sokdokpa formally entered the debate with his composition of a short text entitled Essence of the Definitive Meaning: Proving the Four Tantras to be the Word of the Buddha. 18 It is not clear from the colophon of this work when exactly he wrote it. However, Sokdokpa's reference to himself there as "the indolent one" (snyoms las can), a self-deprecating nickname he appears to have adopted around 1605, suggests that it was composed sometime in the first decade of the 17th century. 19 Sokdokpa also mentions in the colophon that he composed it at the behest of "the great doctor of Latö, Pöntsang Sönam Namgyel" but offers no additional details about the context of its production. Unfortunately, little to nothing is known about the great doctor of Latö.
We do know from Sokdokpa's autobiography, however, that by 1605, he had already made the transition from his career as a physician, which had occupied his early adulthood. By the first decade of the 17th century, he was well on his way to becoming a tantric Buddhist ritual specialist of considerable renown. 20 Sokdokpa's smooth transition was only made possible through the foundational training he received as a physician. Although the details of Sokdokpa's training as a physician are sparse, the erudition of his writings, which he began composing while still a practicing doctor, indicates that his expertise extended well beyond the diagnosis and treatment of physical illness to encompass materia medica, astrology, geomancy, poetics, the plastic arts, and, most importantly, the entire range of Buddhist theory and practice. 21 Thus, when he was no longer healing the physical bodies of individuals, Sokdokpa was often called upon to use his unique set of skills to restore social and environmental order by protecting against collective calamities, such as epidemics, natural disasters, civil wars, and especially foreign military invasions-at the hands of Mongol armies foremost-through ritual ministrations and associated sacred architecture and public works projects. 22 The efficacy of such collectively oriented ritual projects was premised on a confluence of theories common, in large part, to both Tibetan medicine and tantric Buddhism. 23 Although medicine had been demarcated as a 18 Sog bzlog pa Blo gros rgyal mtshan (1975c). Rgyud bzhi'i bka' bsgrub nges don snying po. In the catalogue of Sokdokpa's collected works, penned by Sokdokpa himself, he calls this work Sman dpyad rgyud bzhi'i bka' sgrub nges don snying po and classifies it under "turning back objections" (rtsod bzlog), or "apologia". In another version of this text, an unpublished manuscript housed at Namchi Monastery, in Sikkim, India (Sog bzlog pa Blo gros rgyal mtshan n.d.), the title page alternatively reads Rgyud bzhi bka' sgrub nges don snying po. In both editions, a partial title appears in the text's body as Sman dpyad rgyud bzhi bkar sgrub pa, whose grammar calls for a different parsing, "proving the Four Medical Tantras as Buddha Word," instead of the published version's, "proving the Buddha Word [status] of the Four Medical Tantras". 19 Nges don snying po, p. 241.1. The nickname "the indolent one" (snyoms las pa) also appears in the concluding colophon of Thunder of Definitive Meaning (Nges don 'brug sgra, p. 601), completed in 1605. In neither colophon does Sokdokpa refer to himself directly by name. However, his inclusion of the Essence of the Definitive Meaning in his "catalogue" and his reference in the text to his teacher Shikpo Lingpa, in addition to stylistic consistencies with his other writings and the Desi Sangyé Gyatso's later reference to it (see discussion below), provide ample evidence for this attribution. 20 Sog bzlog pa Blo gros rgyal mtshan (1975d). Sog bzlog lo rgyus, pp. 246.4-253.3; cf. Gentry (2017), pp. 122-28. 21 This wide range of training and expertise was also the case for the famous 16th-century physician Zurkharwa Lodrö Gyelpo.
See Gerke and Bolsokhoeva (1999). 22 Sokdokpa's interconnected involvements compare closely with those of the famous 13th-century physician and thaumaturge Lharjé Gewabum (Lha rje dge ba 'bum), who perhaps served as the paradigmatic figure of this type in Tibet and of whom Sokdokpa was recognized as the reincarnation. For details about this figure's life and career, see Sørensen (2007), pp. 480-83. For more on the matrix of associations invoked in recognizing Sokdokpa's identity with this figure, see Gentry (2017), pp. 106-9. 23 See Van Vleet (2016, p. 267) for a fine summary, with reference to Gyatso (2004), Garrett (2009), andCraig (2011), of the observations made in classical and contemporary scholarship concerning the relationship between medicine and tantric Buddhism, "in terms of epistemological practices generating divergent modes of sensory vs. subtle experience; in terms of discrete field of study in Tibet centuries before Sokdokpa's time, medical traditions in Tibet have generally tended to overlap considerably with Buddhist theory and practice. 24 This confluence of medicine and Buddhism was not unique to Tibet. It was also a pronounced feature of late Indian Buddhist tantric literature, such as the Kālacakratantra and its associated corpus, whose theories, modes of treatment, and materia medica, among other aspects, were often common to earlier Indian medical traditions, such asĀyurveda. As these later Indian tantric traditions spread and became popular in Tibet from the 11th century on, they exerted a tremendous influence on the development of Tibetan medicine, and Buddhism. 25 For Sokdokpa and other erudite Buddhist physicians like him, this confluence between medicine and Buddhist tantra not only enabled easy transition between the roles of doctor and ritual specialist. It also facilitated expertise in one domain to be easily applied to the other. For example, Sokdokpa is quite clear in a short writing that details the ingredients and procedures for the concoction and ritual treatment of tantric sacrament, otherwise known as "accomplished medicine" (sman sgrub), that it ought to incorporate many of the same substances and follow the same manner of preparation that figure in other kinds of medicines geared more specifically toward healing physical illnesses. 26 Moreover, the range of outcomes promised through ingesting this tantric medicine invariably includes the healing of physical diseases and longevity, not just advancement on the spiritual path. Gerke (2019) has also shown that this overlap in material constitution, preparation, and goals runs the opposite directions as well, with explicitly medicinal remedies such as the famous "Cold Compound Black Pill" incorporating many of the same patterns that feature in the production of tantric "accomplished medicine".
Sokdokpa's unique career path and skill set exemplifies well this intersection between medicine and Buddhism in Tibet. I would argue, moreover, that the permeability between these discourses and practices, in and of themselves, as well as in Sokdokpa's personal career as a Buddhist physician and ritual master, afforded him a particularly privileged vantage point from which to contribute to the debate over the Buddhist canonical status of the Four Medical Tantras. Sokdokpa's privileged position, conspicuous throughout his composition, is reflected foremost in how he enlists his combined erudition in medicine and tantric Buddhism to deftly tack between a wide range of disparate points-in turn empirical, historical, philological, contemplative, and ritual in register-to stitch together his argument. To give some taste of Sokdokpa's style of argumentation, the discussion ahead dips into the somewhat dizzying labyrinth of associations and references characteristic of the line of reasoning expressed in Essence of the Definitive Meaning. Witnessing how his argument weaves together so many seemingly different discourses and domains of knowledge and expertise can, I believe, help throw into relief the challenges we face in understanding the entangled relationships between Buddhism and medicine in 16th-and 17th-century Tibet.
To be clear, however, the style of writing and argumentation that Sokdokpa brings to bear in Essence of the Definitive Meaning is by no means limited to this text alone. Throughout many of his writings, specifically in his other apologetic and polemical writings and in his biography of the Indian tantric practices aiming to generate longevity and vitality in addition to the ultimate goal of Buddhist enlightenment; and in terms of ritual practices serving to empower medical practitioners, consecrate medicines, and bring blessings to the wider community." Gerke (2019) adds important details to this picture with her succinct summary. 24 Gyatso (2015), pp. 100-2. 25 Wallace (2001), pp. 49-55. In offering copious examples of such confluence, Wallace (2001, p. 51) observes that "the boundaries between magico-religious and empirico-rational treatments become far less noticeable in Buddhist tantric medicine than in its precedents." Here, Wallace is referring precisely to the late tantric Buddhist traditions that Tibetans inherited from India. 26 Sog bzlog pa Blo gros rgyal mtshan (1975a). Bdud rtsi sgrub pa'i rim pa lag tu blangs pa'i tshul dgongs don rab tu gsal bar byed pa.
For a detailed discussion of this text, see Gentry (2017), pp. 316-32. For discussion and analysis of closely related practices centering on the production of tantric "accomplished medicine", see (Cantwell 2015(Cantwell , 2017Sehnalova 2018Sehnalova , 2019aSehnalova , 2019b. For a detailed discussion of an important Indian Buddhist precedent for the preparation and ritual treatment of tantric medicines and pills, whose ingredients also often figure in broader Indian medical traditions, see Stablein (1976). Stablein (1976, p. 76) refers to the production of "tantric medicine", which the Mahākālatantra explicitly calls "accomplished" or "perfect medicine", as a "combination of what are normally conceived of as faith healing, pharmacology, and psychiatry". tantric master Padmasambhava, Sokdokpa's reasoning shifts easily between orientations which might be described, respectively, as robustly probative or critical in historicist, philological, or empirical terms, on the one hand, and doggedly devotional or traditional in scriptural, doctrinal, or ritual terms, on the other. 27 This peculiar feature of Sokdokpa's style as a thinker and writer might be best characterized as a fresh combination of critical inquiry and devout traditionalism, between and within which distinctions are certainly made but without always necessarily entailing the pronounced tensions we might ordinarily expect from bringing these two orientations together. We can already see this combination of reasoned critique and erudite traditionalism at work in the structure of Sokdokpa's Essence of the Definitive Meaning. Sokdokpa divides his composition into two sections: (1) a presentation of opposing positions and (2) proof that the substance of the Four Tantras is in fact the Word of the Buddha. In the first section, Sokdokpa includes both the positions of the opposing camp of thought, namely, that the Four Tantras are not the Word of the Buddha but a treatise composed in Tibet, and the positions of his own camp that the Four Tantras are in fact the Word of the Buddha but whose various reasons are by Sokdokpa's estimation flawed and therefore cannot sufficiently demonstrate this fact.
In summarizing the positions of the opposing camp, Sokdokpa brings up most of the arguments listed above against the Indian provenance of the Four Medical Tantras, with a special focus on the most damning ones-those that make an appeal to empirical knowledge. 28 Sokdokpa draws particular attention to the observation that the majority of medicinal substances, dietary prescriptions, and other implements and procedures explained therein are only found in Tibet and nowhere else. Remarkably, perhaps, Sokdokpa is in complete agreement with these observations. He even heaps praise on the "many intelligent Tibetan scholars" who noticed these discrepancies and therefore concluded that the work is a Tibetan treatise. 29 This stark admission, turned praise, stands out as a highly unusual opening rhetorical maneuver for a treatise set on proving that the Four Tantras is Buddha Word. Among his predecessors and contemporaries in this debate, Sokdokpa's acceptance and positive appraisal of the opposing camp's sharp criticisms compares in its critical spirit only with the evaluations made by the famed physician and medical scholar Zurkharwa Lodrö Gyelpo in his similarly themed writing composed in 1572. 30 Sokdokpa takes serious issue, instead, with those in his own school of thought-other Buddha Word proponents-none of whom, he decries, can adequately respond to these trenchant critiques. In dismissing these failed attempts to defend the Buddha Word thesis, he briefly summarizes and roundly rejects each in turn. 31 Only when Sokdokpa offers his own proof that the Four Medical Tantras is the Word of the Buddha does his reasoning on the issue become more explicit. Sokdokpa structures his argument here according to three divisions: (1) identifying the city of Sudarśana; (2) explaining the identity of the teacher, audience, and teaching; and (3) when the Four Tantras emerged and, specifically, how it emerged in Tibet. 32 In slightly abridged format, this structure covers the five excellences of place, teacher, audience, teaching, and time.
Sokdokpa is clear throughout this section that he bases much of his appraisal of these issues-the identities of the "five excellences" of the basic Tantra's narrative frame-on the account found in Yutok Yönten Gönpo's "detailed life story" (rnam thar rgyas pa), other related narrative accounts, and, most significantly, his involvement with the practice of the Yutok Seminal Heart (g.Yu thog snying thig) ritual and contemplative cycle, specifically its Guru Sādhana (bla sgrub). 33 Garrett (2009, p. 223 that the Yutok Seminal Heart Guru Sādhana constitutes "a complete contemplative-yogic curriculum for the Tibetan doctor", following, in several respects, the Old School of Tibetan Buddhism, through which the practitioner can ultimately hope to gain awakening in a single lifetime. This cycle contains a range of medicinal practices centering primarily on the ritual concoction or "accomplishment" of "medicine" (sman sgrub) and its use in healing, 34 interwoven with numerous texts that detail the full spectrum of tantric Buddhist practice, organized according to the following threefold structure: (1) "generation stage" yoga, which includes not only deity yoga sādhanas but also a number of magical rituals, common to most tantric cycles, intended largely for pragmatic purposes; (2) "completion stage" yoga, which includes a range of subtle body practices for the manipulation of its subtle energies and fluids, along with associated physical exercises; and (3) Great Perfection instructions of the Old School variety, such as introduction to one's basic awakened awareness and the ensuing practice of "natural liberation" (rang grol).
Despite this cycle's Old School connections, the practice of the Yutok Seminal Heart Guru Sādhana does not seem to have been restricted to a fringe group of Old School yogi-physicians. Tradition has it that this cycle was revealed in a visionary experience by none other than the 12th-century Yutok Yonten Gönpo himself. 35 Moreover, among its subsequent propagators and practitioners are counted some of the most prestigious physicians in Tibetan history, such as Yutok's direct disciple Sumtön Yeshé Zung (Sum ston Ye shes gzungs, b. 12th c), the founder of Zurkharwa Lodrö Gyelpo's Zur tradition of medicine Zurkharwa Nyamnyi Dorjé (Zur mkhar ba Mnyam nyid rdo rje, 1439-1475), the Fifth Dalai Lama Ngawang Lozang Gyatso (Ngag dbang Blo bzang rgya mtsho, 1617-1682), and the Desi Sangyé Gyatso, to name but a few. 36 Sokdokpa's treatise shows that he was also steeped in this tradition, as he draws extensively from it to offer what seems by all accounts a rather unusual defense of the Buddha Word pedigree of the Four Tantras. Indeed, despite the apparent leaps of logic and flirtations with inconsistency on display in his overall argumentation, much of Sokdokpa's line of thinking comes into sharper focus only when considering the implicit ritual and contemplative function the five excellences play in the Yutok Seminal Heart Guru Sādhana, and all tantric cycles for that matter.
The sādhanas, initiation liturgies, and other generation stage contemplative rituals included in this cycle follow the standard tantric practice of taking the opening narrative frame of the five excellences found in the governing tantra from which they derive as a contemplative framework to imaginatively perform whenever practicing the liturgies of the cycle. 37 In the case of the Yutok Seminal Heart Guru Sādhana, the governing narrative framework is that which is found at the opening of the Four Medical Tantras' basic text, but with a telling twist. Contemplative practitioners cum physicians envision during initiation ceremonies their personal guru in the space above them as the Medicine Buddha, Bhais . ajyaguru, indivisible from none other than Yutok Yönten Gönpo, the founder of this tradition. 38 The daily sādhana practice that this initiation authorizes entails that physicians merge with the guru in turn, to, in effect, become Yutok Yönten Gönpo/Bhais . ajyaguru in their personal medical practices. 39 This equation between Bhais . ajyaguru, Yutok Yönten Gönpo, and the practicing physician extends, by the analogical associations made through the rubric of the five excellences, beyond the identity of the teacher. It also impacts the ritual contemplative identities of place, audience, teaching, and time-the other four of the five excellences.
When attempting in the discussion ahead to follow the details of Sokdokpa's argument, whose manifold strands and connections sometimes give it an unwieldy shape and direction, it will be 34 Garrett (2009, p. 223) observes, moreover, that the cycle as a whole is referred to as "Accomplishing Medicine" (sman sgrub). 35 Ehrhard (2007), p. 161. 36 Garrett (2009), pp. 223-24. 37 For a standard example of this dynamic, specifically as it applies to tantric pedagogical settings, see Patrul (1998), pp. 8-10. 38 G.yu thog snying thig bla sgrub kyi dbang chog bde chen klong yangs (1981), p. 49.1. 39 Van Vleet (2016), p. 280. helpful to bear in mind that his considerations of the five excellences are driven by three primary imperatives: (1) the text of the Four Tantras itself, particularly its opening narrative frame, whose coherent exegesis Sokdokpa is compelled to provide by simply taking part in the debate; (2) empirical observations important for the practice of medicine and pharmacology, particularly as these conflict with or corroborate details in the Four Tantras; and (3) the tantric logic of the Yutok Seminal Heart cycle, which, for Sokdokpa, tends to mediate between these two. Let us turn now to Sokdokpa's considerations of place to get a sense of how these imperatives and the associations they conjure impact the direction of his argument.

Place
The place of Sudarśana-the location from the basic Tantra, where the Four Tantras was first revealed-is a key point of contention in the Buddha Word debate. Most of the defenses of the Buddha Word thesis that Sokdokpa disapprovingly cites depend precisely on identifying the setting of the initial teaching of the Four Tantras in India or somewhere else on the subcontinent. One argument refuted by Sokdokpa cites Buddhist vinaya literature to argue that the teacher was in fact Buddhá Sākyamuni, who, while residing in a "place of medicine" for six years, manifested himself as the Medicine Buddha, Bhais . ajyaguru, and emanated the location of the teaching, Sudarśana and its surrounding four mountains, along with the interlocutors. 40 Sokdokpa rejects this claim as "just one's own private talk" on the basis of its obscurity-no one, he counters, has ever heard of such a story. 41 On this point Sokdokpa might have been targeting Zurkharwa, who recounts a similar story in his 1572 treatise. 42 Another argument has it that the teaching took place in the Indian city of Ud . d . iyāna, identifying it as the city of Sudarśana from the Four Tantras. 43 Yet another similar defense locates the original teaching at the Vajrāsana, the cite of BuddhaŚākyamuni's final awakening in Bodhgaya, explaining that this is the city of Sudarśana mentioned in the Four Tantras and identifying its four surrounding mountains-Gandhamādana to the east, Vindhya to the south, Malaya to the west, and Himavat to the north-as the actual location of the medical herbs that would be so instrumental in Tibetan medicinal remedies. 44 Sokdokpa rejects these claims primarily by recounting the details of the physical layout of Sudarśana and its mountainous environment as described in the basic Tantra's opening narrative framework. In so doing, he draws attention to the discrepancies between it and what is known of the actual geological, geographical, botanical, and climactic features in the vicinity of Bodhgaya and Ud . d . iyāna, respectively. 45 Along the way, Sokdokpa displays his considerable erudition in the material medica available to Tibetans of his time. He also takes the occasion to venture hypotheses about the actual mountains referred to by the names Gandhamādana, Vindhya, Malaya, and Himavat: The real Mount Vindhya, he puts forth, is actually in the north, on the border between India and China, and not in the south, as the basic Tantra details; Malaya refers to somewhere sandalwood grows, so it can only be in the south and not in the west; Himavat refers to any mountain where cooling substances grow; and Gandhamādana, based on the medicinal substances described as growing on it in the basic Tantra, cannot exist in the east, as it claims. In this way, we see Sokdokpa roundly reject details in the Four Tantras by appealing to knowledge of the geographical, geological, botanical, and climactic knowledge 40 Nes don snying po, pp. 219.5-219.6. 41 Nes don snying po, p. 220.1. 42 Gyatso (2017) of the region that was then available to him as a practicing physician deeply invested in the pragmatics of medicinal preparation, diagnostics, and treatment.
Further along these lines, Sokdokpa fields the possible retort that, although such things might not be present in those locations during their own time, they could very well have been there in the past, as the whole setting was an emanation of the Buddha. 46 However, Sokdokpa rejects this notion as well, patently refusing to invoke the magical powers of the Buddha to resolve these gaping inconsistencies. 47 Although, he concedes, there are indeed many such stories in the scriptures in which the Buddha transforms even the entire earth through his miraculous power, Sokdokpa decisively observes that nowhere in the scriptures is there mention of him magically manifesting the city of Sudarśana and its surroundings. Thus, in addition to rejecting such accounts in the face of counterfactual empirical evidence, Sokdokpa also appeals to scriptural precedent, or in this case, the lack thereof, to demonstrate their implausibility.
Sokdokpa revisits the topic of Sudarśana's location at greater length when he turns toward his own position on the matter. Sokdokpa's argument here is quite subtle. However, a rough outline of its rationale becomes more visible when recalling Sokdokpa's involvement with the Yutok Seminal Heart Guru Sādhana and the analogical thinking it calls for with respect to the five excellences. He begins, for instance, by boldly asserting that by describing the city of Sudarśana's presence in the Medicine Buddha Bhais . ajyaguru's pure land of Vaid .ū ryanirbhāsā, as the basic Tantra clearly stipulates, what is in fact meant is that Yutok Yönten Gönpo experienced this in a visionary dream. 48 Telling here is that he cites Yutok's life story, drawn from the Yutok Seminal Heart cycle, as textual support for this important detail and punctuates this pithy statement by presenting a challenge to his readership-only those of superior faculties, bates Sokdokpa, will gain understanding through this remark alone. 49 Presumably addressing the dolts among his readership next, Sokdokpa goes on to explain his point in greater detail. He opens the discussion by citing the basic Tantra's elaborate description of Sudarśana, before describing that Yutok Yönten Gönpo in fact emanated the entire city of Sudarśana, precisely as described in the basic Tantra, within the wider setting of Bhais . ajyaguru's pure realm Vaid .ū ryanirbhāsā. Slightly confusing here is that Sokdokpa is insistent that Sudarśana never existed anywhere within our world, or even within the three realms of existence for that matter, even as he follows standard Buddhist scriptural style to in fact locate the pure land "beyond innumerable world systems below here." 50 Further along these lines, rather than confine it entirely to Yutok's private visionary experience, he exaltingly accords Sudarśana some modicum of objective status by describing it as "a place of tathāgatas that arose from virtue formed while Yutok, [now] Bhais . ajyaguru himself, was practicing the conduct of a bodhisattva in the past." 51 It would seem, then, that in equating Yutok with the Medicine Buddha, he intends to identify the city of Sudarśana as both a sublime visionary realm manifested by Yutok well beyond our world and, at the same time, an actual pure land, also manifested by Yutok, in his identity of Bhais . ajyaguru, also beyond our world.
It helps to recall in this connection that Mahāyāna theory typically accords pure lands a kind of emanational status, as they are said to be "purified" through the pure aspirations, vows, and virtues formed and developed while bodhisattvas traverse the bodhisattva path. 52 Once bodhisattvas reach buddhahood, these mental attitudes, now perfectly fortified through eons of focused resolve and concerted vocal and physical effort, culminate in the form of perfected worlds, replete with optimal conditions for other beings born there to reach awakening themselves. Worlds such as ours, on the other hand, form from the ripening of collective karmic predispositions, driven by an uneven mixture 46  of positive and negative mental attitudes, and are therefore not exactly any more or less real than their pure land counterparts but simply less "pure".
Having staked his claim on the issue of Sudarśana-at once Yutok's vision and Bhais . ajyaguru's pure land-Sokdokpa weighs in again on his own camp's arguments about the location of Sudarśana in the world, which he had already dismissed as ineffective, to make a crucial distinction. Here, he singles out as a telling example the tendency among "ordinary teachers of the Four Tantras these days" to wrongly interpret as literal the description of myrobalan fruit found in the basic Tantra, particularly the remark that this fruit possesses all six kinds of flavors when this patently contradicts the obvious empirical fact of the myrobalan fruit's actual flavor palette-five flavors, excluding salty-as described in the explanatory Tantra and confirmed by the Ayurvedic texts of the Carakasam . hitā and the As . t .āṅ gahr . dayasam . hitā. 53 Sokdokpa goes on to criticize that one should "put forth authentic textual traditions as one's witnesses" and thereby be able to understand the difference between the myrobalan taught in the basic Tantra-as growing on Mount Gandhamādana east of the city of Sudarśana-and the myrobalan fruit referred to in the explanatory Tantra, which grows on this planet. 54 Indeed, Sokdokpa gibes, not to do so is unreasonable, as it causes one to prattle on pointlessly in order to make sense of such obvious inconsistencies. He concludes this discussion by revisiting his previous argument about the mountains surrounding Sudarśana to extrapolate the example of myrobalan to "all the statements" in the basic Tantra about what grows on the other three mountains of Vindhya, Malaya, and Himavat, described in the Tantra as south, west, and north of Sudarśana, respectively. Addressing an unnamed opponent here, he states: "All of these things are in the four directions surrounding the emanated city of Sudarśana, within Buddha Bhais . ajyaguru's pure land of Vaid .ū ryanirbhāsā. But they certainly do not exist in the realm of this earth, as you contend." 55 The explanatory Tantra, as Sokdokpa's argument would seem to imply, corresponds to this planet, and should accordingly be followed for all material specifications, whereas the basic Tantra, with its description of Sudarśana and surrounding mountains, has no correlate on earth.
In assigning Sudarśana the status of a visionary experience, or a pure land, outside of the material exigencies of our world, Sokdokpa had clear precedents from which to draw. Zurkharwa Lodrö Gyelpo's previous considerations on the topic seem to have set the standard for Sokdokpa's maneuver by similarly carving out a space for Sudarśana outside the real world. Moreover, Zurkharwa had already done so precisely by noting his observations about how the specifications of the material world simply do not match up with the descriptions of Sudarśana that we find in the basic Tantra.
However, Zurkharwa's position on precisely what, then, the actual Sudarśana maps to shifts throughout his different treatments of the topic. After describing it as a "manifestation" in an early consideration, in his later stand-alone treatise on the topic, he couches it and the rest of his identifications of the five excellences in terms of the rubric of outer, inner, and secret dimensions. 56 He thereby offers a hierarchy of views, positioning the secret level as the final truth and the two others as progressively less true accounts by comparison. According to this typology, the secret and truest identity of Sudarśana is that of Yutok's own home town, which Yutok styled into the fabulous imagery found in the basic Tantra, as patterned after its actual physical features; he did this "to convince those that are hard to satisfy", namely, ordinary Tibetans who would not have confidence in a text unless it were construed as Buddha Word. 57 The Buddha Word thesis, by contrast, is for Zurkharwa only the outer explanation. In reality, or "secretly", Zurkharwa seems to argue that the Four Tantras is a treatise composed by 53 Gyatso (2015), pp. 181-91; Gyatso (2017). 57 Gyatso (2015) Yutok, pure and simple. As Gyatso points out, Zurkharwa's rubric is an inversion of the usual pattern in the threefold outer, inner, and secret typology; it does not subsume the outer account as simply an exoterically valid expression of a higher-order esoteric truth, as it is typically enlisted. Rather, Zurkharwa's positioning of the Buddha Word thesis-the least quotidian of the three accounts-at the outer level suggests, by Gyatso's estimation, that Zurkharwa regarded it as an expedient fiction, required by Tibetans who out of their veneration for the Buddhist tradition could not handle the truth of the matter. 58 Sokdokpa's position on Sudarśana contrasts markedly with Zurkharwa's more hardnosed approach. If Sokdokpa was indeed inspired by Zurkharwa's reflections on the topic, as he seems to have been, he takes this line of reasoning in a very different direction. Instead of offering shifting perspectives on the position in a way that ultimately ends up attributing Sudarśana to a flight of Yutok's fancy recorded for expedient purposes, Sokdokpa champions the exalted nature of Yutok's visionary life. Moreover, unlike Zurkharwa, Sokdokpa refuses to confine the imagery of Sudarśana only to Yutok's private imaginary world. Rather, as we shall see shortly, for Sokdokpa this experience also refers to another time, long before, when Yutok originally taught the Four Tantras in his actual identity of Bhais . ajyaguru, not here on earth but in Bhais . ajyaguru's actual pure land.
The Desi Sangyé Gyatso, writing decades after Sokdokpa in his Mirror of Beryl, also weighed in on the topic of the location of Sudarśana to deliver perhaps the most extensive inventory ever of all the different viewpoints on the matter. 59 Toward the end of this litany he calls out Sokdokpa, ascribing to him the position that the city was both present in Bhais . ajyaguru's pure land and manifested "in this field" by Yutok from the virtues he accrued while practicing bodhisattva conduct in the past. 60 The Desi unceremoniously rejects Sokdokpa's position as utterly untenable according to either scripture or reasoning. However, unless the Desi means by "this field" Bhais . ajyaguru's pure land and not this earth, as it would ordinarily mean, and unless by "manifestation" he means visionary experience, the Desi's characterization of Sokdokpa's position comes across as a strawman argument. Contrary to the Desi's depiction, Sokdokpa is quite insistent that Yutok's "manifestation" of the city does not appear anywhere on earth. Intriguingly, the Desi's mentor and the leader of Tibet, the Fifth Dalai Lama, had banned the circulation of Sokdokpa's literary works a few decades before. 61 We might therefore surmise that the Desi felt emboldened to critically cite a position from the controversial Sokdokpa that no one else could corroborate. Nonetheless, by citing Sokdokpa's position here, even if incorrectly, and recording elsewhere in his presentation that he consulted Sokdokpa's writing on the topic, 62 the Desi ended up enshrining Sokdokpa in the annals of Tibetan medical history.
It is worth noting here that the Fifth Dalai Lama himself may have been far more positively predisposed toward features of Sokdokpa's argument than was his protégé the Desi. Van

Teacher, Audience, Teaching, and Time
This brings us to Sokdokpa's remarks about the identity of the teacher, audience, teaching, and time. Here too, Sokdokpa's argument is better understood in connection to his involvement with the Yutok Seminal Heart Guru Sādhana. Recall that the contemplative rituals included in this cycle entail that physicians merge with their personal guru to become Yutok Yönten Gönpo/Bhais . ajyaguru in their personal practices. 65 We have already seen ripples of this identification in Sokdokpa's somewhat perplexing take on the city of Sudarśana.
Sokdokpa begins his considerations of the teacher by reiterating his assertion that the Buddha Bhais . ajyaguru mentioned in the basic Tantra is none other than the 12th-century Yutok Yönten Gönpo. Sokdokpa goes on to argue that Yutok Yönten Gönpo manifested not only the city of Sudarśana within his own pure land of Vaid .ū ryanirbhāsā, but, in keeping with the other details of the basic Tantra's opening narrative frame, he also manifested the interlocutor sage Mind-Born from his awakened speech so that he could request the teaching, along with the interlocutor Knowledge-Wisdom, who would serve as the Four Tantras' annunciator or surrogate "teacher". 66 Sokdokpa details, moreover, that Yutok, as Bhais . ajyaguru, manifested this scene by sequentially entering four different states of meditative absorption to emanate through the blessings of his equipoise a different manifestation of the figure Knowledge-Wisdom-corresponding to expressions of Bhais . ajyaguru's awakened mind, body, qualities, and activities, respectively-so that he could deliver to Mind-Born each of the Four Tantras, in turn. 67 Sokdokpa's treatment of the audience and the teaching are terse by comparison. Sokdokpa simply follows the text of the basic Tantra on these points, conceding that the audience is the fourfold grouping of Buddhists, gods, sages (Tib. drang srong, Skt. r . s . i), and non-Buddhists and that the teaching is simply the Four Tantras of basic Tantra and the other three. 68 However, in so assiduously following the basic Tantra's narrative scene, he introduces a major fault line into his argument. This issue begins to surface more visibly when he rhetorically addresses a possible point of contention about the audience including non-Buddhists, when Buddhist pure lands are not, in theory, supposed to include them. 69 Sokdokpa quickly brushes this possible criticism aside with the excuse that the teacher included them on that occasion in order to bring greater benefit to beings. Here, it would seem, Sokdokpa is caught midway between the dictates of addressing the description of a fourfold audience in the basic Tantra's opening frame, as would be expected for a commentary, and his broader aim to lift the entire teaching event into Yutok's visionary experience, outside historical time and the vicissitudes of actual audience members, whoever they might be. However, Sokdokpa's identification of Sudarśana as at once an actual pure land and a visionary experience also compromises any unequivocal position in this regard.
With Sokdokpa's discussion of the time of the original teaching, his argument becomes even more fraught with internal tensions. Rather than exclude the time of the teaching from the sequence of ordinary historical time, as we might expect given his argument about the location of Sudarśana as beyond the three realms of existence and the identity of the teacher as Yutok and Bhais . ajyaguru, he instead refers to common notions of temporality in Buddhist scripture to claim that it was originally taught long ago, when a previous buddha Kanakamuni was present in our world and beings had a lifespan of 30,000 years. 70 To be clear, however, Sokdokpa is nonetheless firm that the actual teaching of the Four Tantras still occurred in Bhais . ajyaguru's pure land of Vaid .ū ryanirbhāsā-not on earth. 71 However, he nonetheless follows the Four Tantras' opening narrative frame to describe how each of the four kinds of audiences present for the teaching-gods, sages, non-Buddhists, and Buddhists-heard a teaching that was consistent with its respective tradition: the gods heard the gSo dpyad 'bum, the sages heard the Carakasam . hitā, the non-Buddhists heard a text composed byĪśvara, and Buddhists, such as Somarāja and others, heard texts composed by the protectors of the three families. Meanwhile, only some emanated sages, such as sage Mind-Born, heard the Four Medical Tantras, whose geography, temporal frame, customs, diet, and medicines correspond with those of Tibetans. 72 Sokdokpa's allegiance here to the Four Tantras' depiction of its own mythic origin puts his argument on shaky ground, even as his interpretation of various audience members goes a long way toward explaining why the Four Tantras have Tibet as their primary physical point of reference, when the original teaching was given in another realm altogether. After quoting the basic Tantra itself in support of this general account, he goes on to argue, at some length, with recourse to citations from the basic Tantra and Mahāyāna sūtras, that there is nothing particularly unusual about different audience members receiving different messages based on one and the same statement. 73 However, this seems to miss the point. In allowing for non-emanated audience members, it seems that Sokdokpa would rather adopt a conservative commentarial voice to preserve a literal interpretation of the Four Tantras' narrative frame than sweepingly attribute the entire scene to the vivid details of Yutok's/Bhais . ajyaguru's visionary experience/manifestation, a conclusion to which his earlier considerations of the place and the teacher would seem to naturally lead. 74 Sokdokpa commits to this maneuver even as it might mean admitting actual non-Buddhist audience members, with their own diverse sensibilities, into Yutok's visionary world and, more problematically, Bhais . ajyaguru's pure land. This also requires Sokdokpa to address the historical issue of why, if Bhais . ajyaguru also taught the ancient sources of Indian medicine together with the Four Tantras in the hoary past, these Indian texts and traditions seem to predate the Tibetan Four Tantras by centuries. The Four Tantras could not be the source of the Indian Ayurvedic medical tradition, could it? Sokdokpa tries to gain some ground on the point of the timing of the original teaching by injecting a more quotidian historicism into his account. He contends that Buddha Kanakamuni was in fact the actual teacher on earth of the gSo dpyad 'bum pa, an important Ayurvedic source text, rather than the god Brahmā, as traditionally held in India. To this effect Sokdokpa recounts fragments of a narrative vignette, along with citations from the As . t .āṅ gahr . daya and Candranandana's commentary on this Indian medical work, the Padārthacandrikāprabhāsa, to argue that Brahmā was in the audience of this teaching but not its teacher or composer, who was in fact Kanakamuni. 75 This move enables Sokdokpa to get around the obvious discrepancy of the Four Tantras' ahistorical claim to be the source ofĀyurveda. 76 However, it also clearly sidesteps the more pressing problem raised in his account of audience and time-how, given the putative visionary/manifested nature of the teaching scenario, could it have happened at a discrete time in the past, with an audience of diverse beings who each heard a different teaching? Are we to assume by this that Sokdokpa is not in fact equating Bhais . ajyaguru's pure land with Yutok's visionary experience after all, even as he is insistent on Yutok's actual identity as Bhais .  Meulenbeld (1999Meulenbeld ( -2002 Other arguments addressing this anachronism were manifold among participants in this debate. See Gyatso (2015), pp. 160-61, 166-67.

Historical Persons and Trans-Historical Buddhas
Sokdokpa revisits the issue of the identification between historical Tibetan persons and trans-historical buddhas when providing his account of how the Four Medical Tantras appeared among humans on earth and, specifically, how it appeared in Tibet during this present degenerate age. Here, Sokdokpa doubles back to refine some of his previous arguments and more rigorously articulate his overall reasoning on the topic. Sokdokpa begins this section with his clearest statement in the text on the origin of the Four Tantras among humans: The lord of beings, venerable Yutok, comprehended by means of his super-knowledge of recollecting former lives how he taught his own mantra to the fourfold audience in the city of Sudarśana in Vaid .ū ryanirbhāsā. Then, out of his compassionate consideration for the beings in Tibet to be tamed, he recounted it to himself. Thus, through saying, 'Thus have I said at one time . . . ' and the rest, he wrote down the Tantra in words. 77 In this passage, the time of the original teaching is now resolutely set at a specific occasion in the past, as something Yutok recollected having taught in a former lifetime, even as it becomes present in his recollecting and recounting. More pointedly, with this admission of the 12th-century Yutok Gönpo as the human author of the basic Tantra, coming as it does on the heels of the repeated insistence on the identity of Yutok with Buddha Bhais . ajyaguru, Sokdokpa seems to be edging ever closer to a position in which the Four Medical Tantras could be both the Word of Buddha and a treatise composed in Tibet by a Tibetan.
In identifying the teacher with the teaching's initial recounter, Sokdokpa appears to be drawing from the resources of his Old School tradition, whose famous *Guhyagarbhatantra contains a similar identification in its opening formula to illustrate its origin in the non-dual gnosis of awakening. 78 The 15th-century entry into this debate of Tashi Pelzang-also a Buddha Word advocate, and perhaps the first person to draw explicit attention to the textual variation of "said" in the place of "heard"-enlists a similar argument to try and resolve the apparent discrepancies. 79 Sokdokpa runs with this identification between teacher and recounter, using it as a platform from which to explain away all the inconsistencies between the putative Indian origins of the Four Tantras in Buddha Word and all the many details found in the Four Tantras itself-its astrological terms and calculations, material cultural elements, dietary prescriptions, and the like-which clearly reflect Tibetan cultural and linguistic conventions unknown in India. 80 Indeed, Sokdokpa contends that all these inconsistencies are readily apparent there because "the Tantras has come about from the confluence of the compassion of the buddhas and the aspirations of disciples. So just because it has thus arisen in accordance with Tibet does not prove that it is not the Word of the Buddha." 81 For scriptural support of this notion, Sokdokpa draws a comparison with a statement found in the Indian Vimalaprabhā commentary of the Kālacakratantra, which describes how the initial recounters (Tib. sdud par byed pa po, Skt. saṁgītikāraka) of the Buddha's various teachings are responsible for writing them down in the different languages of their intended audiences. Sokdokpa extracts from this passage, which lists a number of possible scriptural languages, the phrase most relevant to Tibet: "Likewise, the three vehicles are written about in the Tibetan language for the land of Tibet." 82 He goes on to provide an additional scriptural citation to buttress this claim and, in so doing, ends up 77 Nges don snying po, pp. 230.3-230.4. Interestingly, the unpublished Namchi manuscript of the text has here "before himself" (rang gi sngar) instead of the New Delhi version's "his own mantra" (rang gi sngags). This would change the translation from, " . . . how he taught his own mantra to the fourfold audience . . . " to " . . . how he taught the fourfold audience, in front of himself . . . ". 78 Gyatso (2017), p. 437n82. 79 Gyatso (2017) relativizing the proper scriptural language of the Buddha's dispensation in light of his "skillful means" and "blessings", by which one and the same message can communicate multiple teachings to different audiences in deference to their individualized propensities. 83 To be sure, Sokdokpa is on more solid ground here than with his similar discussion of the diverse audiences and understandings of the Four Tantras' initial teaching. However, his strong appeal to skillful means and blessings, in which anything goes, nonetheless introduces the related risk of losing touch with historical specificity.
However, just as Sokdokpa seems on the verge of jettisoning historical veracities in favor of the ever-protean skillful means and universal blessings of the Buddha-a traditional Buddhist exegetical maneuver that could bypass the need for any credible account-he tempers his previous claim significantly to deliver a historicist rendering of how the Four Tantras emerged in Tibet. Here, he draws once again on the biographical tradition of Yutok Yonten Gönpo to give a brief summary of his life. Once again, Sokdokpa's main source here is the History of the Yutok Seminal Heart Guru Sādhana (g.Yu thog bla sgrub kyi lo rgyus), whose authorship is attributed to Yutok's direct disciple Sumtön Yeshé Zung. 84 It is abundantly evident in this section that Sokdokpa does not appeal to this history for a treasure account of the Four Tantras' origins. Quite the contrary. In keeping with the trajectory of his argument, he seizes precisely on a crucial passage in this history that attributes to Yutok the actual composition of the Four Tantras. In this, he roundly rejects that the Four Tantras is a treasure text, making a sharp distinction between the pure visionary experience (dag snang) through which Yutok recollected, recounted, and recorded the Four Tantras and the complex modes of concealment and revelation typical of the treasure tradition in which Sokdokpa was himself steeped. However, with this maneuver, he does not at all reject the status of the Four Tantras as Buddha Word. In fact, it becomes clear throughout the course of Sokdokpa's argument on this point that he intended this precisely to prove the Buddha Word thesis.
Sokdokpa's argument goes as follows: He first draws from Buddhist emanation theory to reiterate Yutok's identification with Buddha Bhais . ajyaguru and to explain how he could nonetheless appear as an ordinary Tibetan: "Although he was Buddha Bhais . ajyaguru in person, he showed himself in the perception of disciples to be a skilled physician and householder." 85 He goes on to further demonstrate this identity by relating Yutok's life story, in abridged format, focusing on his exemplary Buddhist erudition and great spiritual accomplishments, such that, "in the end, he departed for the celestial realms without discarding his body." 86 Sokdokpa then explicitly draws attention to the History's acknowledgement of the compositional nature of the Four Medical Tantras, but at the same time, he is careful to frame it in visionary terms: "When this emanated buddha body had himself written in the form of words the Four Tantras (de lta bu'i sangs rgyas sprul pa'i sku de rgyud bzhi yi ge'i ris su rang nyid kyis bris te yod tsa na), he directly encountered the lords of the three families and others." 87 He goes on to offer a supportive citation from the History of the Yutok Seminal Heart Guru Sādhana, which directly names Yutok as the author of the Four Tantras and, at the same time, situates his act of composition in a visionary framework. In so doing, the History places the Four Tantras on par with the Unexcelled Yoga Tantras, widely considered in Tibet as the Buddha's most exalted dispensation, stating that "in terms of blessings", they are no different. As if anticipating that this equation might be misinterpreted, the passage that Sokdokpa quotes from the History extends beyond this basic assertion about their identical "blessings"; immediately thereafter, it describes a visionary encounter and prophecy that Yutok received just after completing the treatise that is patterned directly after very 83 Nges don snying po, pp. 231.1-231.4. 84 Sum ston Ye shes gzungs (1981). For more on this history, see Gyatso (2015), pp. 154-57, 166, 169, 180, 279-80 andEhrhard (2007). 85 Nges don snying po, p. 231.6. 86 Nges don snying po, pp. 231.6-232.2. 87 Nges don snying po, pp. 232.2-232.3. similar framing episodes found in Buddhist sūtras and tantras. This section of Sokdokpa's citation from the History appears as follows: He acquired in his lifetime the twofold attainment in a single form. Because he was then prophesied by tutelary deities and they conferred on him their permission, he composed this great treatise on medicine (gso dpyad kyi bstan bcos chen po 'di btsams . . . ), whose blessings are absolutely no different from those of the Unexcelled Tantras. After completing his composition, the protectors of the three families and the buddhas throughout the ten directions, accompanied by bodhisattvas, appeared in the sky before him, amidst innumerable gods making offerings to them. They said: 'Son of noble family, ahoy! In the future this great treatise (bstan bcos chen po 'di) will be an unexcelled, unsurpassed, sublime protection for beings. Wherever it is present will have excellent auspiciousness and well-being. Those who take up, carry, recite, master, and teach it in full to others will be the elders among all bodhisattvas. They will attain the state of non-abiding nirvān . a in this very lifetime. At the very least, those who memorize each verse of this text will never again fall [into the lower realms] and will have all their negative deeds and obscurations accrued from time immemorial purified'. 88 The overall effect of this citation, I would argue, is to frame the Four Tantras as Buddha Word, even as it calls the Four Tantras a "treatise" and attributes its authorship to the 12th-century Tibetan Yutok Yönten Gönpo. This is in striking contrast to how Kyempa Tsewang (Skyem pa Tshe dbang, 15th c.), Zurkharwa Lodrö Gyelpo's slightly older contemporary and fellow Zur tradition physician, enlisted the very same citation from the History decades before to argue instead that the Four Tantras is in fact a treatise and not the Word of the Buddha. 89 Sokdokpa, on the other hand, is quite explicit in his framing remarks and subsequent discussion that by supplying us with this citation from the History he intends to lead his readership to the opposite conclusion.

6.Śāstra and/or Buddhavacana?
But what in the above citation constitutes a "treatise", such that it can, at times, be equated with Buddha Word? Unlike other participants in this debate, Sokdokpa remains conspicuously silent on this issue. However, it can perhaps be surmised from these passages that he intends it in the broadest sense possible to mean an inspired composition, one that issues from the agency of an awakened being.
On this note, Sokdokpa's seeming advocacy of the Four Tantras as both Buddha Word andśāstra would seem to directly contradict the opinion of the vast majority of Tibetans, who have definedśāstra precisely as subsequent statements about the Word of the Buddha. We find relevant critical reflections on this topic expressed by the famous Sakya masterŚākya Chokden (Śākya mchog ldan, 1428-1527) several decades before. 90Śā kya Chokden's discussion comes in a letter in which he attempts to defend the Buddhist canonical pedigree of the Old School tantras, even as he points out that many such texts have greater resemblance to Tibetan writings than works translated from Sanskrit. In so doing, he appears to have drawn from earlier Indian Buddhist notions to argue that the functional efficacy of a teaching to lead toward liberation ought to define its authenticity rather than any putative provenance in India or whether it was directly spoken by BuddhaŚākyamuni. 91 Perhaps it should come as no surprise thatŚākya Chokden cites the Four Medical Tantras as the paradigmatic example of such a textual type, stating that although it might not be the actual Word of the Buddha or a treatise written by an Indian master, it can nonetheless function on par with Buddha Word. 92Śā kya Chokden elsewhere 88 Nges don snying po, pp. 232.3-233.2. This citation appears nearly verbatim in Sum ston Ye shes gzungs (1981), pp. 14.1-14.6. 89 Gyatso (2017), p. 166. 90Śā kya mchog ldan (2006). 91 For more on this and other standards of authenticity in Indian Buddhism, see Davidson (1990). 92Śā kya mchog ldan (2006), p. 569. articulated more focused considerations detailing why the Four Tantras should be viewed as a Tibetan treatise-albeit an authentic one-and not Buddha Word. 93 Zurkharwa Lodrö Gyelpo citesŚākya Chokden to this effect in his own treatise on the topic. 94 Sokdokpa too would have certainly been cognizant ofŚākya Chokden's sentiments about the Four Tantras andśāstra more broadly sometime prior to 1605; he cites his argument about the Old School tantras verbatim and provides commentary on it in his famous Thunder of Definitive Meaning composed that year. 95 As we have seen, he also seems to exhibit knowledge of Zurkharwa's treatise on the Buddha Word debate, although nowhere does he refer to it directly. Nonetheless, as we have seen, Sokdokpa took a very different approach to the issue, even as he cites the History of the Yutok Seminal Heart Guru Sādhana for support of his unusual claim.
As alluded to above, another related reason for Sokdokpa to quote this passage from the History seems to have been to cast doubt on the popular narrative recounting the treasure origins of the Four Medical Tantras. The final line of Sokdokpa's quotation from the History states: "Moreover, the student destined to propagate this will be prophesied as the only suitable vessel. Thus, it should not be taught to anyone until such a one has appeared." 96 With this, Sokdokpa segues into a discussion of how Yutok transmitted the Four Tantras to his student Sumtön and to no one else late in Yutok's life, thus explaining why no one else among Yutok's many students knew of the transmission. 97 It was in fact Sumtön, Sokdokpa asserts, who fabricated and circulated the popular story that the Four Tantras had instead been revealed by Drapa Ngönshé (Grwa pa mngon shes, 1012-1090) from a pillar in Samyé monastery. 98 Otherwise, Sokdokpa claims, with recourse to quotations from a text titled Sumtön's Spontaneously Present Five Awakened Bodies, no one would have taken the Four Tantras seriously; no one among Yutok's students was aware of the Four Tantras' unique circumstances of production and transmission or had faith in Yutok beyond his role as a skilled physician. 99 Sokdokpa concludes this discussion with a pithy summary of the point at hand: Generally, the reasons for not being able to fathom that the Four Tantras were spoken by Yutok is because of (1) not regarding Yutok as a buddha, (2) not understanding how to unravel the intent of the basic Tantra, (3) not reading Yutok's Detailed Life Story (rnam thar rgyas pa), the Sealed Songs (mgur bka' rgya ma), and so forth, and (4) not practicing the Guru Sādhana (bla sgrub). Sumtön the Great, Zurkhar Chöjé, Tülku Shikpo Lingpa, and other authoritative persons (Tib. tshad ma'i skyes bu, Skt. pramān . apurus . a) have held that the word of BuddhaŚākyamuni and the speech of Yutok are both the authentic Word of the Buddha (sangs rgyas kyi bka' yang dag pa nyid). 100 When pausing briefly over Sokdokpa's list of reasons here, it becomes clear that he appeals to a combination of evidentiary sources. Some are documentary in nature, such as the narratives of Yutok's life and teachings, and other narratives deemed by Sokdokpa as authoritative. These describe Yutok as on par with an emanation of a buddha and as the author of the Four Tantras. However, another source of Sokdokpa's judgement is his opponents' inability to properly comprehend the gist of the Four Tantras' basic text. Here, it would seem that he is invoking his previous observations, indirectly rooted in empirical understandings, about the discrepancies between the basic Tantra's opening narrative frame and the material exigencies of the known physical world. The implication, it would seem, is that without interpreting this narrative scene of the Four Tantras as a visionary experience that unfolded in Yutok's consciousness-not in this world, even as it recollects an actual pure land-and without thereby sharply distinguishing it from the pragmatic material directives on botany, climate, diet, physiology, and the rest found in the explanatory Tantra, there would be little hope of reconciling these accounts.
Yet another type of evidence enlisted here, lack of experience on behalf of his opponents with the practice of the Yutok Seminal Heart Guru Sādhana, might appear at a glance to simply signal a rhetorical appeal to the authority that experience and realization hold within Buddhist traditions. When read at face value, however, herein lies an important key to understanding Sokdokpa's argument as a whole. Recall that, in keeping with standard tantric Buddhist traditions practiced in Tibet, the practice of the Yutok Seminal Heart calls for the identification between the Four Tantras' original narrative frame's "five excellences" of teacher, audience, teaching, time, and place-the setting of its visionary recollection/revelation for Yutok-and the setting of any initiation and sādhana practices performed by subsequent masters and practitioners of this tradition. For practitioners of such a tradition, forming, stabilizing, and realizing their identification with a buddha by imaginatively construing it do be so in ritual contemplative settings through the medium of the guru and/or founder of the tantric tradition is intrinsic to the project of "taking the fruition as the path", the sine qua non of Vajrayāna practice in Tibet. This dynamic fluidity of identities across historical time and cosmic space enables a handy deferral to a visionary dimension outside quotidian time and space that need not conform to empirical observations and common knowledge of the physical world. But at the same time, this set of identifications also enshrines as its paradigmatic charter an originary moment of revelation and therefore calls for practitioners to account for its subsequent transmission and spread through historical sequential time and quotidian space. Such reasoning, resolutely tantric in orientation, colors Sokdokpa's argument throughout.

Authenticating Visionary Revelations: Authoritative Persons, Canonical Parallels, and Modes of Buddhavacana
Throughout his treatise, Sokdokpa patently refuses to consign the Four Tantras to the status of treasure teachings, even as he argues for its origins in Yutok's visionary experience and, more pointedly, its status as Buddha Word. Sokdokpa is particularly adamant that the Four Tantras were not the treasure revelation of Drapa Ngönshé, despite the widespread circulation of this account during his time. Early in Sokdokpa's treatise, when dispensing with what he judges to be erroneous previous attempts to defend the Buddha Word thesis, he summarily rejects the approach of applying to the Four Tantras the "five excellences" in a way that construes them as treasure revelation. But by thus rejecting this treasure account, which, as Gyatso points out, conveniently sidesteps the thorny problem of the Four Tantras' invisibility in Tibet until the 12th century, 101 Sokdokpa parts ways with a major strain of thinking on this topic among his Buddha Word camp's predecessors and peers.
In the final pages of his treatise, Sokdokpa returns to this issue in greater detail to deliver his final blow to the credibility of the treasure account. After quoting the standard rendition of the narrative, Sokdokpa attacks it on several fronts. The most compelling evidence he marshals is that there is no mention of the Four Tantras and no common language, for that matter, among any of Drapa Ngönshé's known treasure revelations. Furthermore, Sokdokpa continues, the translation into Tibetan of the Four Tantras by Vairocana prior to their concealment in the 9th century-a crucial hinge in the story that had become by Sokdokpa's time standard for most Buddha Word proponents-is nowhere verified in any known translation catalogue from the Tibetan imperial period. 102 As we have seen throughout his discussion, Sokdokpa prefers instead to follow the Yutok Seminal Heart in sharply distinguishing the Four Medical Tantras in Tibet as a product of Yutok's visionary experience. However, Sokdokpa was steeped in Tibet's treasure traditions. He actively practiced and propagated the treasures of Shikpo Lingpa, Pema Lingpa, and others, although he was never active or retroactively identified as a treasure revealer himself. 103 Sokdokpa did have visionary experiences though-many of them, the vivid details of which he narrates often in his writings. 104 However, he refused to designate his visions as treasure revelations, a distinction which for other visionary masters would become blurred as the revelatory status of "pure visions" shifted in and out of focus for later synthesizers of these traditions. 105 Despite Sokdokpa's insistence on this distinction, he nonetheless takes a page from his Old School tradition's general defenses of the authenticity of treasure revelations to deliver his final thoughts on what, then, the actual mode of revelation of the Four Tantras is in light of its status as Buddha Word. The basic underlying premise of Tibet's treasure traditions of ongoing revelation is that any utterance or composition can indeed be the Word of the Buddha if it ultimately derives from the awakened agency of a buddha, even if no buddha is physically present. Tibet's treasure traditions nonetheless often attempted to authenticate their revelations by articulating a complex network of mediations. 106 However, this was by no means uniformly articulated. Moreover, at root the treasure traditions were in fact relying on a much more basic notion of the scriptural authenticity of ongoing revelation, drawn from earlier Indian Buddhist standards that had already shifted the focus away from the historical figure of a buddha and other mediating factors to place the premium of authenticity squarely on the impersonal awakened nature of the source-awakening itself, theoretically accessible to anyone who could realize and embody it. This basic rationale for ongoing revelation periodically enabled revelations to come simply and spontaneously though visionary experiences, otherwise known as "pure visions" (dag snang), relatively unmediated by the usual mechanisms of revelation and authentication that became standard features of treasure traditions in general.
Yutok's visionary experience, by Sokdokpa's account, appears to be mediated primarily by memory, as he recollects his identity as Bhais . ajyaguru in the original teaching scenario. Memory also figures similarly in treasure revelation episodes, as revealers recall their roles as audience members in their treasure revelation's original teaching event during the Tibetan imperial period. For most treasure revelations, memory is additionally accompanied by a number of other mediating factors-non-human beings, undecipherable scripts, dreams, visions, consorts, and more. However, even with these more densely mediated instances, it is often the approval of authoritative masters and their milieu that ensures a treasure revelation's wider acceptance and transmission. 107 It might therefore be the case that with less mediated and deliberate channels of revelation, such as pure visions, the testimony of "authoritative persons" performs an even more important function in demonstrating authenticity. Sokdokpa's final evidentiary source in the citation presented above-the testimony of the three figures of Yutok's student and biographer Sumtön the Great; the redactor of the Four Medical Tantras and founder of the Zur tradition of medicine in Tibet, Zurkharwa Nyamnyi Dorjé; and none other than Sokdokpa's own tantric guru, Tülku Shikpo Lingpa-might be a case in point. Particularly telling here is that Sokdokpa bolsters his appeal to their opinions on the matter by referring to them all as "authoritative persons" (Tib. tshad ma'i skyes bu). This is a well-worn Buddhist trope of authenticity based on the authoritative testimony of realized beings, such as buddhas and advanced bodhisattvas, who can know things through their highly refined sensibilities that remain obscure for all others. 108 Within this framework, Sokdokpa argues that although the Four Tantras is not a treasure revelation, but a visionary revelation, or visionary recollection, this need not disqualify it from being Buddha Word. Indeed, he blithely continues, it is easier to prove the Buddha Word status of the Four Tantras without construing it as treasure.
As a matter of course, Sokdokpa then turns his attention squarely to the Four Tantras' Buddhist pedigree. Here, he offers a spirited explanation of how the practice of medicine is in general authentic Mahāyāna Buddhist practice and how the Four Tantras, in particular, because of their inclusion of the ten principles of tantra, qualify as secret mantra. In the section on Mahāyāna, Sokdokpa draws several citations from the Four Tantras to compare with well-known rubrics of a bodhisattva's training in ethics, contemplation, and philosophical outlook, such as the four immeasurables and the six perfections. 109 He concludes abruptly that "the entire path of the perfections is included therein", allowing that one can reach the state of unexcelled awakening through the Four Medical Tantras as well. 110 Sokdokpa spends considerably more energy demonstrating how the Four Medical Tantras qualifies as Buddhist tantra. Much like his argument with Mahāyāna, here too it depends on comparing known Buddhist tantric concepts and practices with the content of the Four Tantras. After drawing from the Guhyasamājottaratantra to offer a widely accepted general definition of tantra, 111 Sokdokpa maps specific features of the Four Tantras-its injunction to practice cleanliness and proper hygiene, inclusion of view and conduct, integration of generation and completion stage yogas, and instruction of the entire path of ripening and liberation-to each of the four classes of Buddhist tantra-kriyā, caryā, yoga, and unexcelled yoga, in turn. 112 Sokpokpa goes on to give a detailed account of how the Four Tantras actually contains all the ten principles of Buddhist tantra, the inclusion of which, he remarks, proves a tantra to be genuine according to all the different schools of Buddhism in Tibet. Following Pan . chen Vimalamitra's enumeration of the ten principles of tantra, Sokdokpa cites copiously from the Four Medical Tantras and especially from the Yutok Seminal Heart Guru Sādhana to demonstrate that they indeed contain teachings on proper tantric Buddhist view, conduct, man . d . ala, initiation, commitments, accomplishments, activities, mantras, mudrās, and meditative absorption-this, by Sokdokpa's estimation, proves them to be authentic tantra. 113 Sokdokpa then invokes an older and more broadly applicable typology of what constitutes the Word of the Buddha to deliver his final statement on the topic. Here, he draws from a traditional threefold Buddha Word rubric of (1) that which was spoken directly by a buddha, (2) that which was spoken by another but permitted or approved of by a buddha, and (3) that which was spoken by another but inspired by a buddha through the blessing power of his meditative absorption. 114 The enlistment of this threefold schema was a standard maneuver in this debate, as it enabled advocates of the Buddha Word thesis to acknowledge the Four Medical Tantras as Buddha Word while conveniently sidestepping the need for the speaker to have been the flesh and blood BuddhaŚākyamuni himself. 115 More broadly, as mentioned above, admitting of other sources of Buddha Word, beyond a historically present buddha, also functioned as an interpretative mechanism that could conceivably throw open the gates for the acceptance of ongoing scriptural revelation, such as we find in the Tibetan treasure traditions. But unlike other participants in this debate, who tended to follow the Four Tantras' opening 108 Silk (2002). 109 Nges don snying po, pp. 236.5-237.3. For a discussion of how the Desi Sangyé Gyatso later frames the practice of medicine as a bodhisattva practice, see Schaeffer (2003 Davidson (1990), p. 294. 115 Gyatso (2015), p. 152. narrative to argue for the inspired or approved nature of the discourse, 116 Sokdokpa uses this rubric to argue that the Four Tantras squares with all three types: Since it is the speech of the actual Medicine Buddha, it is the Buddha Word of direct speech (zhal nas gsungs pa'i bka'). Since the very same thing was explained to the fourfold audience through the play of the teacher's meditative absorption, in the manner of questions and responses between sage Knowledge-Wisdom and Mind-Born, it is the Buddha Word of approved speech (rjes su gnang ba'i bka'). And since the very same thing, out of consideration for disciplines, emerged spontaneously from the mind of Yutok through the blessings bestowed by the teacher, it is the Buddha Word of blessed speech (byin gyis brlabs kyi bka'). 117 Sokdokpa is quite explicit throughout Essence of the Definitive Meaning that his argument as a whole is based in large part on his familiarity with a particular cross section of the narrative corpus of Yutok's life story, namely, the life stories in which Yutok is depicted as a buddha, and the lineage history of the Yutok Seminal Heart Guru Sādhana. 118 As has been witnessed in the details of how Sokdokpa enlists these sources, they paint a picture of the practice of medicine and Buddhism as deeply intertwined, perhaps inextricably so. But Sokdokpa's work with these narrative literary sources nonetheless enabled him to assume a critical distance with respect to both sides of the debate and thereby bring about a novel rapprochement of the two positions. Indeed, his references to key episodes from these and other narratives seem to have helped him pay careful heed to the epistemic demands of historicity and empiricism expressed in theśāstra position, without either disregarding or diluting the claims of the Buddha Word thesis beyond jettisoning the treasure account.
In so doing, he took several cues from his predecessor in the debate, Zurkharwa, but rather than apply as the framework for his argument the well-worn rubric of outer, inner, and secret-or its novel inversion, as Zurkharwa does-Sokdokpa used citations and lines of reasoning common to Zurkharwa's treatment to collapse the sharp distinction between Buddha Word and treatise, Yutok as author and Bhais . ajyaguru as teacher. Sokdokpa thereby reconciles the two positions in a way that merges medical and Buddhist discourses into a single stream. Zurkharwa, on the one hand, would try subtly to disambiguate these positions, order them hierarchically, and promote thereby a vision of Yutok the Tibetan as the Four Tantras' secret human author, despite his public persona in the eyes of most Tibetans as Bhais . ajyaguru in person. For Zurkharwa, invoking the visionary dimension of Yutok's life was not enough to resolve the gaping inconsistencies. However, for Sokdokpa it provided the necessary leverage to have both a human author and a divine revealer, without either separating them sharply or merging them entirely but, rather, keeping them operative in their own distinct but ever-permeable domains of action.

Concluding Reflections
As Janet Gyatso astutely observes, the debate over the status of the Four Tantras as either the Word of the Buddha Word or a Tibetan treatise "came to entail a reckoning of scriptural authority with empirical evidence." 119 Participants in this debate throughout its history proposed a diverse range of approaches to the issue, often enlisting the same or similar resources, but toward quite different ends. In the 16th and 17th century, this debate came to a head, particularly with the writings of Zurkharwa Lodrö Gyelpo, who produced some of the most strikingly fresh reappraisals of traditional textual authority in light of evidential considerations that the world of premodern Tibet had ever known.
Sokdokpa's entry in this debate, penned only a few short decades after Zurkharwa's, presents a valuable counterpoint to the voices considered thus far. If indeed we can characterize this debate as Gyatso does in terms of the nascent rumblings of a "rift" between the commitments of Buddhism and the pragmatics of science, then Sokdokpa probably occupied the Buddhism side of this divide. 120 Yet, as I have attempted to demonstrate throughout this essay, the particular features of Sokdokpa's considerations in this debate, together with those of his broader career, strongly suggest that for him, medicine and Buddhism were very much intertwined.
To summarize Sokdokpa's argument, his strategy is to tack back and forth between a body of diverse documentary evidence-drawn from both the field of medicine and Buddhism-and a range of empirical evidence-drawn from both his own observations and those of others-to gradually break down any distinction between the Four Medical Tantras and the Word of the Buddha. In so doing, he (1) invokes Buddhist conceptions of the manifold nature of Buddha Word, extending beyond whatever was spoken by a historical buddha; (2) argues that original compositions might therefore also qualify as the Word of the Buddha if they are sufficiently inspired; and (3) draws from the biographical corpus of Yutok Yönten Gönpo and his own practice of the Yutok Seminal Essence to illustrate that that this figure's revelation/composition of the Four Tantras qualifies as an important example of this mechanism at work. While fully accommodating and even robustly arguing for the accuracy of the historicist and empirical critiques against the Indian Buddhist pedigree of the Four Tantras, Sokdokpa nonetheless relies on traditional Buddhist conceptions of scriptural authenticity and ongoing revelation to champion a vision of the Four Tantras as authoritative Buddha Word and as a treatise composed by a 12th-century Tibetan.
Sokdokpa's involvement with the literature and practice traditions of the Yutok Seminal Heart forms a crucial lynchpin in his argument. As he himself puts it, without practicing this ritual and contemplative cycle and participating in the visionary world it unfolds, it would be difficult to draw the identifications between Bhais . ajyaguru and Yutok Yönten Gönpo, and the rest of the five excellences, to properly appreciate how a text can be both a Tibetan composition and Buddha Word-a treatise composed based on a visionary experience in 12th-century Tibet and a teaching spoken by a buddha long before, in a galaxy far away.
However, Sokdokpa's Buddhist commitments did not at all entail that he would shy away from the gaping inconsistencies between the textual tradition of the Four Tantras and his and others' empirical observations and historicist sensibilities. As we have seen, Sokdokpa embraces the hardnosed criticisms of the opposing camp and takes to task those in his own camp whose attempts to defend the Buddha Word thesis do not rigorously enough assimilate those criticisms. However, unlike Zurkharwa, who in the final analysis seems to broker a position in which the Four Tantras is in actual fact a Tibetan treatise only masquerading as Buddha Word to please Tibetans who might otherwise not accept it, Sokdokpa stakes his claim on a more incisive and complete reconciliation of the two positions, until he breaks them down into the singular claim that the Four Tantras is both a Tibetan treatise and Buddha Word.
Often, we can witness in the details of Sokdokpa's argument that these aspects of tradition and critique are not exactly opposed or in tension but buttress one another as he attempts to strike the proper rapprochement. Such complicity raises the question of whether Sokdokpa's tradition may have been just as much a tradition of critique as it was a tradition of faith or, indeed, if these two aspects were strictly separable for him at all. There are further indications elsewhere that traditional authority for Sokdokpa demanded not just his devotional allegiance but also his probative analysis. His complex intermingling of critical inquiry and spiritual commitment extended beyond the issue of the Four Tantras' putative Buddhist pedigree into other aspects of his career. Sokdokpa exhibits a very similar combination of features in his text-critical treatment of the literary sources of the life of the Indian tantric master Padmasambhava. 121 He also displays a strikingly similar sensibility in his voluminous apologetic works. 122 On both accounts Sokdokpa has gone down in the annals of Old School history as the greatest apologists of his oft-critiqued Old School tradition.
It is hoped that by considering Sokdokpa's contribution to this debate, whose diverse commitments to medicine and Buddhism were perhaps more integrated throughout his career than others thus far considered, an important voice might be added to the history of the argument-one that calls greater attention to how Buddhist reasoning and medical reasoning can also sometimes be made to work in tandem. It might well be, as Gyatso argues, that "a rift between science and religion had been clearly suggested" in this debate. 123 However, the case of Sokdokpa suggests that Buddhist traditions in Tibet may have had their own critical resources-interwoven with and not necessarily opposed to the empirical, physical practice of medicine-through which a self-consciously probative ethos could emerge and develop, but along different lines than those intimated in the familiar narrative of the birth of modernity in Europe.
Funding: This research received no external funding.