Reporting of Tsakar (neuropathy) as the top-most common condition in Traditional Medicine centres in Bhutan: a review

Abstract

Tsakar has been observed as the most common disease presenting at the Traditional Medicine centres across the country for the past five years. The proportion of patients with Tsakar ranges between 13.00% – 16.20% based on the annual statistics for the years 2019 – 2023. Tsakar in Traditional Medicine is equivalent to neuropathy in allopathic medicine. According to Sowa Rigpa, the main causes of Tsakar include rigorous labour and dysfunction of white channels which cause the imbalance of wind and blood in the body. The symptoms associated with Tsakar are physical deformation of mouths and eyes, loss of speech and consciousness, the body becoming immobile, and involuntarily loss of excretions (faeces and urine). This review is based on interviews with the treating physicians at the National Traditional Medicine Hospital, programme managers, and field experts. Firstly, Bhutan Traditional Medicine Disease Coding system developed for the purpose of statistical classification of Traditional Medicine diseases includes Zadrip under Tsakar category. This has led to the overrepresentation in the compilation of annual statistics. Zadrip is a cerebrovascular disease referred to as stroke in allopathic medicine. Zadrip causes immobility of hemi-section of the body, stiffness of limb, urge for vomiting and swollen lingual veins. Secondly, the use of steam and herbal baths for the treatment of Tsakar is effective in symptom resolution leading to its growing demand. Thirdly, similarities in the symptoms between Zadrip in Traditional Medicine and stroke in allopathic medicine have led to diagnostic challenges requiring meticulous evaluation.