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The book is an outcome of the research conducted in collaboration with the amchis of Nepal and with support from the Himalayan Amchi Association (HAA), Kathmandu; WWF Nepal; Dartmouth College, USA; and the Central Department of Botany (Tribhuvan University), Nepal. The objective of this collaborative research was to document Tibetan medical knowledge, with a focus on medicinal ingredients prescribed in Sowa Rigpa and the aspects of substitution. The book is divided into three parts and four chapters. The first part describes historical and philosophical aspects of Sowa Rigpa from the perspectives of amchi from Nepal. It also includes the history of knowledge transmission and clinical practices among Nepal’s amchi practitioners. The second part deals with the current practices of Sowa Rigpa in Nepal from socio-cultural and economic perspectives, and includes an account of medicinal ingredients prescribed, including ingredients derived from rare and threatened species. The second part also covers the crucial topic of practices of substitution (Tibetan: tshab) for substances derived from species that have become endangered or are at risk. The third part is comprised of a detailed compendium of medicinal plant species. This book documents 570 medicinal plant taxa (including lichens and fungi), and 54 different types of minerals prescribed in Sowa Rigpa in Nepal. In addition, body parts of 46 animal species prescribed in Sowa Rigpa literature are also documented. We have identified mostly locally available products derived from plants (total 92 taxa), animals (4 domestic species) and minerals (9 types) as substitutes for rare and threatened species (25 plants and 30 wild animals) and for species not available locally (33 plants).