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First Stage - Dissolution of Earth


  • External manifestation of the first stage is when the dissolution of earth shows up as the deterioration of the hard or solid parts of one's body.


  • This includes emaciation, weakness, fatigue and clouded vision. Sleep is one way people begin to make the transition to the other side and the fatigue assists this.


  • The internal manifestation of the first stage is described as mirages of the mind. Dreams can foreshadow and you may begin to see loved ones who have passed on speaking to you.


  • Such mirages will evolve into other inner visions as one passes through the other stages.


Second Stage - Dissolution of Water


  • The external manifestation of the second stage, when the dissolution of water into fire happens, is a decrease in the liquids of the body.


  • When the mouth becomes dry and blackens, there is a marked decrease in other liquids such as urine, blood, sweat, etc.


  • The internal manifestation of the second stage is a vision of smoke.


Third Stage - Dissolution of Fire


  • The external manifestation of the third stage, the dissolution of fire info wind, is coldness in the body, especially around the navel, considered the heat center of the body. The heat pulls inwards as the life wind shortens.


  • This stage is also marked by an inability to digest food and drink, forgetfulness of friends' names, unconcern about the affairs of others, the loss of smell, and short inhalation and long exhalation. The death rattle is accompanied by apnea versions of breathing cessation.


  • The internal manifestation is a vision of sparks within the smoke seen in the second stage.

Fourth Stage - Dissolution of Wind


  • The external manifestation of the fourth stage, the dissolution of wind, is very close to the end and often moves quickly with inability to perform physical actions and unawareness of or unconcern with external worldly activities.


  • The subject neither tastes nor recognizes textures.


  • The internal manifestation is the addition of a sputtering candle flame or lamp to the mirage.


Fifth Through Eighth Stages - The Subtle Stages Dissolving into Space 'Clear Light'


  • The fifth stage as the wind dissolves into space happens rather quickly and is the first subtle stage.


  • External manifestations of the entrance to the subtle stages are a complete cessation of movement, breath, heartbeat and memory.


  • While to a westerner it might seem that death has occurred, the Tibetan tradition is that the subject still retains a consciousness.


  • Internally the subject perceives a white appearance. As the subject advances through the subtle stages, the white appearance first turns red, then black. The appearance of black is considered the stage of near-attainment of enlightenment, which at the end, transforms into the clear light of death.

Dr. Nashalla Gwyn Nyinda, Menpa TMD MA Acu LMT began the study of Tibetan Medicine over twenty years ago and has attended Chagpori Institute Clinic in India, the [Ching hi] Qinghai Tibetan Medical College, Tibet, The Shang Shung Institute of Tibetan Medicine, Naropa University, and The Institute of Taoist Education and Acupuncture. She is now an Adjunct Professor at Naropa University and teaches healing techniques worldwide. Certified as a teacher of the TARA Approach in 2004, she taught this Japanese acupressure system and mentored practitioners, translated it into Tibetan, and taught this in Asia. Dr. Nyinda also teaches Buddhism at the Rocky Mountain Thrangu Center, and is the director of the Nyinda Clinic of Tibetan Medicine & Holistic Healing Clinic in Boulder, Colorado.

Prepared for TLC’s website by Don Million, 2022.


The 5 Stages of Dissolution When Dying

Taken from Tibetan Medical Approaches to Care in the Dying Process,

a Talk Given by Dr. Nashalla Gwyn Nyinda for TLC / 9-10-22


Editors note: These five stages are experienced during the end of life and can be observed by those who are in the process of transition, family, friends, caregivers, and medical professionals. This knowledge will increase awareness of how to assist the dying and will inform those who are dying about the general process they will experience during the last weeks or days of life. These states can fluctuate and arise in order or not. Additionally recommended resources from TLC are Chagdud Khadro's video and DVD 'Teachings and Advice for the End of Life' found on our TLC Rental Videos and TLC DVD Archive pages.

To see a full array of slides explaining the stages of dissolution from  Dr. Nyinda's TLC program,  

"Tibetan Medical Approaches to Care in the Dying Process", click HERE .

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