Similar to traditional Chinese medicine(TCM),Tibetan medicine emphasizes the concepts of holism,balance,and etiology.With the individual as the nexus of macro-and micro-ecologies,multi-layered systemic etiologies,inform therapeutic pharmacologies for cultivating network effects to induce the healing response.Tibetan medicine approaches health and healing through perspectives that frame the balance achieved in the internal world as inextricably linked to balance in the external world,and vice versa,that includes expressions of mind and consciousness.The external world refers to the broader context of the natural world as comprised of matter and energy expressed through five elemental dynamics(Chi.Tu,Shui,Huo,Feng and Kong;Tib.Sa,Chu,Me,rLung and Kha)describing principles of solidity,cohesion,heat,motility,and interactive space,or earth,water,fire,wind and space,respectively.The internal world refers to the local context of the physical mass and biochemical cascades of energy transfers comprising the human body,its behaviors and functions,including cognitive factors,as also expressed through the five elemental dynamics.The external and internal systems merge as a unified whole,where the five elemental dynamics characterize materio-energetic exchanges between the broader and local ecologies of individual body and natural world,as well as social relations,mental affects,and contextual conditions.The interdependence,opposition,restriction and transformation among three physiological systems known as nyepa(Three Causal Factors)-rLung,Tripa and Beken(pronounced loong,trīpa,baekan,respectively)-are used to discuss the balance of the whole.The causal origins of disease are explained through disturbances to these systems as a combination of afflictive mental factors,physiologic imbalances,and disturbing conditions from the natural world,such as environmental toxins,pathogens,and exposures.Of the three causal origins,afflictive mental factors are particularly emphasized as important etiological conditioning influences.Initiation and progression of disease is divided into four stages:baseline stage,initiating stage,developing stage,and maturing stage.Each stage has an explicit therapeutic paradigm for treatment,recovery,and health maintenance demonstrating the distinct theoretical framework for disease treatment in Tibetan medicine as specific to individual body,particular disease etiology,and constitutionally-directed unique compound metabolism pharmacodynamically.