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TATIANA CHUDAKOVA, 2021, Mixing Medicines: Ecologies of Care in Buddhist Siberia, 

New York: Fordham University Press, 333 pp. ISBN 978-0-8232-9431-2, ISBN 978-0-8232-9430-5,  

ISBN 978-0-8232-9432-9. 

 

KEYWORDS: Medicine, Russia, Buddhism, History of Science, Production of Knowledge 

 

In today’s globalized world, it is common for individual patients and broader communities to seek 

health advice and intervention across multiple medical traditions, often combining biomedical 

approaches with others dubbed “traditional,” “complementary,” or “alternative.” In Tatiana 

Chudakova’s Mixing Medicines: Ecologies of Care in Buddhist Siberia the author deftly 

historicizes and analytically engages a captivating landscape of medical pluralism in Buryatia, one 

of three “ethnically Buddhist” regions in Russia. Central to the volume is a critique of the manner 

in which anthropologists often assumes that patients are driven away from biomedicine either by 

way of the failures of “official” medicine fostering desperation and medical omnivory, or via a 

pursuit of self liberation and economic subjecthood through the embrace of “unofficial” 

alternatives. Chudakova’s analysis suggests that these assumptions of a “centrifugal force” fail on 

two levels – first by assuming a biomedical center, and second because outward spinning 

inherently results in separation. Conversely, Tibetan medicine (Sowa Rigpa) and “modern” 

medicine are deeply intertwined in Siberia, “mixed” and cohabitating, even if they fail to achieve 

state-sponsored integration. And those entrusting Tibetan medical practitioners (emchi) are not just 

moving away from a biomedical center, but moving toward new projects of self-making in the 

post-socialist state.   

 

In six dense chapters, Chudakova demonstrates the complex, politically ensnared, and continually 

evolving place of Tibetan medicine in ideological projects of nation-making, economic 

commercialization, and identity. Centered on encounters with practitioners, patients, and 

administrators at the “East-West Medicine Center” – a state institution that explicitly aims to offer 



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rehabilitative medicine that combines “Eastern” and “Western” healing traditions – the research 

additionally includes observations from professional research conferences, a university research 

laboratory, and adjacent medical and religious spaces.  

 

Chapter One makes clear the always-already hybrid and contested nature of Tibetan medicine in 

Siberia, where Buddhism arrived around the same time as the region’s incorporation into the 

Russian Empire. In subsequent centuries, competing epistemologies of religion and science 

emerged in the translations of central medical texts, and secular national consciousness pushed the 

Buddhist underpinnings of Tibetan medicine underground and aligned its therapeutics with 

biomedicine. The messiness of making and remaking of Tibetan medicine as medicine is 

illustrated in Chapter Two through the case study of the “pulsometer” – a scientifically engineered 

machine meant to mimic and objectivize the use of pulse (or, pulses) for diagnostic purposes 

beyond the cardiovascular system. Rooted in the broader socialist project to discover the 

bioelectric thermal radiation underpinning extrasensory perception, the pulsometer centered on 

reverse engineering emchi perception through mechanization and imaging. But the continued 

reliance on emchi for not only calibration but interpretation of results, in the end, created a 

codependent “prosthetic” relationship. 

 

Chapter Three focuses on the prescribed manner in which peripheral regions like Buryatia are 

conceived in Moscow as the source of extractable natural resources, including the pharmacopeia 

of Tibetan medicine as an export for symptomatic, palliative care. This contradicts the emchi 

approach to treatment as both holistic and responsive to regionally-specific ailments. These 

contrasting approaches are illustrated in Chapter Four, which centers on the East-West Medicine 

Center. Despite “Eastern” practitioners’ mission to address the “real” (root) causes of disease and 

to restore health by correcting subtle and individually experienced dysregulations and 

disadaptations to the environment, patients perceive their stay as a peripheral act of self-care rather 

than a medical necessity and they pick and choose treatments based on previous experiences and 

what they’ve heard from others is efficacious. Ironically, because the doctors at the East-West 

Medicine Center listen to their symptoms with a sympathetic ear, patients value the “personalized” 

care they receive. Meanwhile practitioners see themselves as incapacitated from offering the 

individualized care that is at the center of Tibetan medicine.  



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Chapter Five dives deeper into the failures of integrating “official” and “unofficial” medicine in 

Russia. Legally, “unofficial” medicine is governed by a complex framework of regulations – 

“folk” practices (like homeopathy, medical massage, and reflexology) requiring a permit to 

practice (though no clear system exists for obtaining one), while healing techniques that are seen 

as religious are treated as small business ventures and subject to labor codes. In practice, Tibetan 

medicine can be legally practiced within the confines of biomedicine or as a religious business, 

this choice presenting a moral conundrum for emchi. The “official” medicine route requires 

reporting out in ways that are palatable to biomedicine, dividing singular practices into “Eastern” 

and “Western” components, diagnosing and responding to symptoms rather than getting to root 

causes, prescribing medicines that exacerbate imbalances, and treating each medical intervention 

as an island rather than considering their mutual impact on one another. On top of this, emchi in 

biomedical settings are expected to devote extensive time and emotional and social labor to 

sourcing ingredients and preparing remedies for patients. But, as a business, emchi are debasing 

the medical status of their enterprise.  

 

Chapter Six illustrates the arduous and highly contingent labor of making plants into therapeutic 

objects. The work is not simply extraction from a natural environment, but requires understanding 

of and engagement with relational histories, and monitoring for fluctuations in availability amidst 

constantly shifting human ecologies. This is followed by a conclusion in which the dissolution of 

the East-West Medicine Center (due to financial restructuring and perhaps lack of theoretical 

integration between its two directional currents) has left former practitioners more free to practice 

outside of biomedical structures in the private sector, but also subject to new forms of legal 

scrutiny. Chudakova stretches her theoretical muscle to discuss body politics, ontology, and 

precarity, ultimately arguing that economic and social upheaval are nothing new to the region of 

Buryatia and that it is through continued adaptation that both Tibetan medical practitioners and 

Tibetan medicine has and will continue to become locally rooted.  

 

The depth of Chudakova’s historical contextualization of Russia and Tibetan medicine allows even 

someone unfamiliar with the region to follow the complex terrain covered in Mixing Medicines. 

And yet, the pages devoted to achieving this may have shortchanged the depth of its ethnographic 



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emplacement and authorial reflexivity. Given the sophistication of the analysis and the extension 

of fieldwork over a period lasting more than ten years (2006-2017), it is clear that the author’s 

work was inspired through in-place experiences. But these manifest in the volume primarily 

through self-described ethnographic “events,” “episodes,” and “examples” – a description of the 

landscape when helping to collect plants, a snippet of conversation by office workers where each 

speaker is introduced through their personality quirks, or excerpts from conversational interviews 

with medical practitioners. Aside from a few self-depricating vignettes of interlocutors finding 

comic relief in her research agenda, the reader sees very little of the author in this volume and is 

rarely presented with a throughline connecting specific experiences and the emergence and 

iterative confirmation of ethnographic insight. Those snippets that do appear are instead used with 

some frequency to introduce (and justify?) what some readers may find to be peripheral historical 

minutiae. Still, few will find fault in the volume’s lucid writing, adept organization, breadth of 

secondary source work, and simultaneous insight into macrolevel subjects, like the history of 

science and the production of knowledge, and the microlevel details of accessing and laboring over 

Tibetan medicine in Siberia.  

 

Arianna Huhn is a Professor in the Department of Anthropology at California State University 

San Bernardino and Director of the campus Anthropology Museum. A graduate of the George 

Washington University and Boston University, her training is in museum studies, medical 

anthropology, and African Studies. Fieldwork on food, health, and healing in Mozambique is 

published as Nourishing Life: Foodways and Humanity in an African Town (2020). Her museum 

work has focused on uplifting hidden stories through art and storytelling through exhibitions that 

include In|Dignity, Afróntalo, and INTO LIGHT California.  

 

 

 

© 2025 Arianna Huhn 

 

https://www.berghahnbooks.com/title/huhnnourishing
https://www.csusb.edu/indignity
https://www.csusb.edu/anthropology-museum/exhibitions/previous-exhibitions/afrontalo-2023
https://www.csusb.edu/anthropology-museum/exhibitions/previous-exhibitions/light-2022

