Nine Contexts for Disease

The nine contexts for disease are the circumstances in which we can find ourselves when disease arises, influenced by the humors. They relate to the three contexts of age, location, and season. These factors offer another level of complexity in gaining a holistic understanding of individual health.




Windy & Cool

rLung is exacerbated in cold and windy environments, especially those that are generally dry.

Hot & Dry

Tripa is exacerbated in hot & dry climates, though hot and damp places can also cause issues.

Cold & Wet

Pekén is exacerbated in cold and wet climates, especially those that experience long winters.


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Old Age

During the later years of our life, starting around 65, our system is naturally predominated by rLung.


During the middle portion of our lives, from around puberty until 65, our system is naturally predominated by Tripa.


During childhood (until around the age of puberty), our system is naturally predominated by Pekén.



Evening & Dawn

rLung arises during the dry early Summer, after accumulating throughout the Spring months.

It also naturally arises during the late afternoon and early pre-dawn hours (around 3am), producing insomnia and restlessness for some.


Midnight & Noon

Tripa arises with the dry heat of early Autumn, after accumulating throughout the summer and being suppressed during the classical monsoon season. 

It also arises at noon and midnight, bringing a burst of energy.


Dusk & Morning

Peken arises during the Spring, following gradual accumulation throughout the Winter months. 

It also naturally arises at dusk and mid-morning, creating drowsiness/sleepiness that can either facilitate sleep or make it difficult to rise.


Time of Day

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© 2020 Shrīmālā Healing Arts. Tibetan Medicine is a millennia-old healing discipline formally acknowledged in Tibet, China, India, Bhutan, and Nepal. However, it is not a licensed medical discipline in the USA, UK, or EU, and therefore is not regulated by the FDA, AMA or any other regulatory body in these countries. Erik is not legally qualified to diagnose any conditions, and no herbal formulas recommended or supplied are intended to prevent, treat, or cure any disease. Therapies or treatments pursued under a Tibetan Medicine Practitioner should not be treated as a replacement for qualified care by a licensed physician.