The Three Excretions

The three "impure" excretions, as opposed to reproductive fluids which are partially connected to "pure" substances, are urine, perspiration, and feces. These substances are naturally produced as byproducts of metabolism and other physiological functions. If they are produced in excess or deficiency, this indicates imbalances in the organism. Therefore, excretions are very helpful signposts of internal health.


Urine is produced as liquid waste from foods and beverages that we eat/drink. It is extracted from the large intestine and transported into the urinary system, having passed through the entire GI tract.

Urinalysis is an ancient form of diagnosis, with many features shared with Traditional Greek Medicine. As a prime indication of humoral metabolic function, the color, smell, viscosity, sedimentation, and bubble formation in urine help to evaluate the inner health of a patient. 

Of the three excretions, urine is the most frequently encountered in Tibetan Medical practice. Patients are always advised to come to their first TTM appointment with their morning urine, which is analyzed along with the pulse, tongue, and discussion of symptoms.


In additional to classical medical diagnosis, urine is traditionally used in a form of divination to determine supernatural or energetic causes of imbalance. This is an ancestral tradition, likely based in indigenous Tibetan practices. 


Feces is produced from the solid portion of food that we eat. After food has passed through the stomach, small intestine, and large intestine, leftover waste that could not be effectively metabolized is released as bowel movements.

The consistency, color, smell, and ease of passing is all taken into account when analyzing health through fecal diagnosis. An excess of bulky feces, constipation, or loose stool can indicate excess Pekén, as the phlegmatic qualities stall digestion and decrease our ability to transform food into bodily constituents. Scant, dry feces (often appearing like deer droppings) can indicate an excess of rLung, since an increase of wind in the lower GI tract can roll feces into dry pellets. Explosive diarrhea can indicate excess Tripa, since the heat of Tripa can cause inflammation in the GI tract and a hot quality to bowel movements.

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Perspiration is another helpful indicator of internal health, usually appearing with physiological overheating ​as well an anxiety. 

The frequency, volume, and smell of perspiration is all taken into consideration when considering the physiological state of a patient. Tripa individuals, and those experiencing a temporary excess of Tripa, will often have pungent sweat, producing an unpleasant body odor. rLung individuals will often sweat due to anxiety, which is a less-pungent kind of perspiration more connected with rLung's function in the skin. Pekén individuals often sweat less, since the moisture in their body is more "frozen," though if they do sweat then it is often less pungent than for those with a Tripa excess.

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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.