Manufacturing Tibetan Medicine: The Creation of an Industry and the Moral Economy of Tibetanness, by Martin Saxer, emerged from doctoral research on the industrialization of Tibetan Medicine, underpinned by fieldwork in Tibetan regions of the People's Republic of China. Saxer's monograph charts the creation of a pharmaceutical industry in the space of less than a decade on the Tibetan Plateau and the attendant marketing of “Tibetanness” for global consumption. It explores how the increasingly industrialized manufacture of Tibetan medicine impacts it as a traditional knowledge system, in terms of its theory and practice. Two main themes in this study are those of modernization and of cultural preservation, exploring how these apparently contradictory trajectories are negotiated by actors in the field. Common to them both is what Saxer describes as “Tibetanness”: a notion of commoditized ethnicity as a form of moral economy. The book is framed using the concept of assemblage, in which any contemporary phenomenon is comprised of a number of components, some of which may be ancient, their contemporaneity being located in their assembly.

After the first chapter's general introduction and overview, Chapter 2 sets the scene for Saxer's study, contextualizing it with a recent history of Tibetan medicine (Sowa Rigpa) and its industrialization; the transition “from pharmacy to factory”. It introduces a central theme of the monograph in describing how global forms, via the national level, are recontextualized at the local level. Resultant from this, Saxer argues, are conflicting configurations both of “the modern project” and of “visions of Tibetanness”. In Chapters 3 and 4, the main ethnographical sections, Saxer focuses on the manufacture of pharmaceuticals, highlighting interpretations of regulations regarding production and how they express the Chinese party-state's quest for legitimacy and control. In the third chapter Saxer critically examines the implementation of global regulations locally and how these have and are affecting the production of Tibetan medicines. Saxer compares “good manufacturing practices” (GMP) articles with Tibetan texts as back-drop to his ethnography of production. He concludes that the introduction of GMP and associated regulations have given rise to a “legally grey area”, due to the uncertainty of which there is room to manoeuvre. This in turn makes “the loopholes … as important as the rules and regulations themselves”. The sourcing and trade in medicinal plants is the subject of Chapter 4, which describes how Tibetan medicine's relations with nature are reconfigured by border regimes, and an overriding pressure exists on all actors to conform to directives originating from Beijing. This raises issues concerning quality and sustainability. In the final three chapters Saxer looks at industry's role in the (re)manufacture of Tibetan medicine as a system, in terms of its technologies and its theoretical aspects. In Chapter 5 he poses the question as to whom Sowa Rigpa belongs; who is entitled to profit from it. He highlights the fact that this question entails a perspective on Sowa Rigpa wherein it is no longer regarded so much as a system of knowledge as a conglomerate of intellectual property. In the light of “global piracy”, he proposes this be viewed as knowledge becoming a “globally tradable commodity”. The question of how intellectual property regimes could best be adapted to suit the needs of traditional knowledge systems such as Sowa Rigpa thereby becomes superseded by the question of how traditional knowledge systems could best be reshaped in response to the requirements of intellectual property regimes. He concludes that “turning knowledge into a form of property changes the property of that knowledge”. Chapter 6 explores ritual aesthetic and material aspects of the industry, and how aesthetics functions in the “process of becoming” that is this commodification. Saxer focuses on regulations such as the GMP, presenting them as ritual. In terms of product packaging and design, he analyses the use of aesthetics for social and strategic purposes and how the sphere thus created mutually affects the modus operandi of the Tibetan medicine industry. He suggests that the Tibetan medicine industry attempts to adhere to the requirements of a disenchanted scientific modern, whilst simultaneously presenting as embodiment of an enchanted, “magic” Tibet. This recourse to ethnic identity and how the Chinese party-state sanctions and perpetuates an economy of ethnicity in the name of cultural preservation is further expounded in Chapter 7. Here Saxer develops the concept of “Tibetanness” as moral economy, core position of the monograph, on the basis of the aspects of industry discussed in previous chapters, drawing these together in the concluding chapter by returning to the notion of assemblage.

Saxer's monograph is an ingeniously structured and insightful work, which gives significant contribution to the field of inquiry and opens up interesting avenues for further research. As Saxer mentions, his study could benefit from the inclusion of ethnographic data including the voice of officials within the PRC's health bureaucracy responsible for the administration of Tibetan Medicine. However, due to the political climate during the time of his fieldwork, this was not possible. The possibility of conducting interviews with the people necessary to undertake such research was precluded by the Chinese party–state restrictions on contact with foreigners, and the very real political dangers entailed by even passing association with them during times of unrest. Indeed, given that his fieldwork was interrupted by the worst social unrest in Lhasa particularly, and Tibetan regions more generally, since the late '80s, it is an extraordinary achievement that Saxer gleaned as much as he did and was able to produce an ethnographic monograph of such considered depth.

A critique of the study could be to argue it has been rendered almost instantly irrelevant by the fact that its subject is changing so fast it is becoming history whilst being written. As Saxer himself points out, his research does approach a “moving target” in that industrialization is very much in progress and sweeping changes in China's political landscape over recent years mean many of the particulars of the study have already become history. However, that this is the case can also arguably be construed as a strength of the work, in that the importance of the study does not lie so much in the particulars but in the developments they indicate and their implications beyond the immediate situation for Tibetan medical theory and practice in the People's Republic of China. The research has great relevance for approaches to traditional medicines and the interpretations of regulations arising from their industrial production globally. It also lays foundations for a variety of other research explorations in the field. One possible such study, as Saxer himself suggests, would be an examination of how doctors view transformations affected by industrialization and a survey of changes in the consumption patterns of their Tibetan and Chinese patients.

Saxer's monograph makes a valuable contribution to a growing literature concerning modernities and Tibetan medicine, the evolution of traditional knowledge systems and the manufacture of traditional medicines in response to contemporary systems of regulation and production. It explores issues highly relevant to the question of how, or if, traditional systems of medical knowledge can survive and adapt to the industrialization of their medicines, interacting successfully with state regulatory bodies and global markets. It examines what impact global markets have on the knowledge bases of traditional medical systems and the manufacture of their medicines, understood as inextricably linked to the ethnic identities of their practitioners. It is an important resource for medical anthropologists, for those working in the fields of Tibetan and Chinese studies, and indeed to all those at any interdisciplinary intersection involving cultural identities or the commodification of ethnicity.