Between 1916 and 1924, a Tibetan public healthcare programme that focused on childcare and natal astrology comprised a central aspect of the mission of the Lhasa Mentsikhang (Institute of Medicine and Astrology). Assessing previously unused Tibetan language materials-including the Thirteenth Dalai Lama's edict for implementation and an accompanying childcare manual-the programme is contextualized with regard to regional developments in British India and China. Like British 'mothercraft' education programmes of the same period, the Tibetan initiative links the health of the population (from infancy) to the health of the state and its economy. Rather than appealing to the authority of 'scientific' colonial medicine, however, this paper discusses how indigenous medical techniques and theories are put forward as effective means to prove the nascent Central Tibetan state's benevolence, legitimacy and sovereignty via intervention in the domestic sphere. Such attention to medical reform and to the domestic sphere brings light to an underappreciated effort by the Thirteenth Dalai Lama to cultivate a sense of Tibetan subjecthood and to reconfigure the relationship between his government and various segments of society. Significantly, this childcare initiative was entrusted not just to mothers, and the category of class is here more germane than the category of gender central within British programmes. Various social groups within a specifically delineated Tibetan territory are assigned tasks in the programme's implementation, illustrating the desire to incorporate each into a reorganised Tibetan state bound by a newly articulated Buddhist ideal of shared social responsibility.

After the conclusion of the bitterly sectarian Mongol-Tsang war in 1642, the Fifth Dalai Lama Ngawang Lopzang Gyatso (1617–1682) created a state system of medicine in Central Tibet – patronizing medical schools, printing textbooks, and implementing official examinations – as a central project of Buddhist governance. Reasoning that medicine was a type of non-sectarian or impartial knowledge that could "benefit enemies, [and] make enemies into friends," he began to patronize the Sanctuary of Assembled Sages (Drang srong 'dus pa'i gling), a medical school of the Tsarong family lineage, previously associated with the defeated King of Tsang, the Zur medical tradition, and the Kagyü order of Tibetan Buddhism (rivals to the Dalai Lamas' own Gelukpa order). In 1676 the Fifth Dalai Lama wrote a set of regulatory guidelines (bca' yig) for the Tsarong school in order to reconfigure the school's primary ritual practice, the Yutok Heart Essence (G.yu thog snying thig), and institute his own new Medicine Buddha Sūtra liturgy (Sman bla'i mdo chog). Within these Guidelines, the Fifth Dalai Lama distinguished a faulty tantric ritual framework and "wrong views" associated with the Kagyü tradition, which he claimed could be refuted, from the Tsarong school's medical treatment methods, which he argued could still be suitable to practice through a reliance on correct bodhisattva motivation and ethical discipline. In doing so, the Fifth Dalai Lama laid the groundwork for an official Tibetan Buddhist medical orthodoxy, or ritual framework for medical learning and practice, that would bracket differences in "view" between medical lineages and authorize the transmission of medical technologies across Tibetan and foreign contexts.