In Thailand’s North, time-honoured Lanna medical wisdom persists
Before Western medicine became the norm at hospitals throughout Thailand, traditional healing systems were widely practised. This was particularly true in the North, where a rich tradition of disease prevention, diagnosis, and treatment—based on Tai and Mon-Khmer practices—dates back thousands of years.
While modern Western medicine typically examines and then treats the perceived symptoms of illness, these Lanna traditions take a more holistic view. Every sphere of human activity becomes an opportunity for enhancing one’s health. Meals, for example, are planned so that they contain a balance of all the basics needed for a healthy body. These include not only such obvious modern-world constituents such as protein, carbohydrates, and vitamins, but also a range of herbs, roots, rhizomes, seeds, and seasonings believed to alleviate everyday aches and pains as well as prevent common ailments.
For example, kra-chai (Chinese key), a root of the ginger family that is a common seasoning in fish dishes, is known to cure a number of gastrointestinal ailments. Likewise, another member of the ginger family, khaa (galangal), reduces gas, while kha-min (tumeric) relieves constipation. Many other common seasonings consumed along with Lanna food contain very effective anti-oxidant properties.
Today, indigenous Lanna natural therapies have enormous utility for treating chronic diseases such as arthritis, chronic fatigue, irritable bowel syndrome, nerve dysfunction, muscle pain, and certain skin conditions.
The most internationally famous type of northern Thai medical therapy is nuat phaen boraan, or “traditional massage”. This extensive and highly refined massage system combines characteristics of massage (stroking and kneading the muscles), chiropractic (manipulating skeletal parts), and acupressure (applying deep, consistent pressure to specific nerves, tendons or ligaments), in order to balance the functions of the four body elements. These four elements are din (earth: the solid parts of the body, including skeleton, muscles, blood vessels, tendons, and ligaments); naam (water: blood and bodily secretions); fai (fire: digestion and metabolism); and lom (air: respiration and circulation).
A multi-pronged approach uses the hands, thumbs, fingers, elbows, forearms, knees, and feet, and is applied to the traditional pressure points along the various sen, or meridians, while also kneading the musculature around these lines. Depending on which muscles and meridians are being treated, the therapists will massage their patients while the latter are lying on their stomach, back, or side, or while they are sitting cross-legged.
Massage has traditionally been considered such a keystone of national health that from the Lanna period until the early 20th century, Thailand’s public health ministry maintained an official massage division. Under the influence of international medicine and modern hospital development, however, responsibility for the national propagation and maintenance of Thai massage was eventually transferred to Wat Pho in Bangkok, where it remains today.
Northern Thais, meanwhile, have retained their own separate tradition of massage therapy, the training for which is today centred at the Traditional Medicine Hospital in Chiang Mai. Lanna massage, although hardly radically different from the Wat Pho approach, features a softer touch and a more continuous movement of the therapist’s hands, fingers, and so on. One interesting variation specific to the Chiang Mai area is the use of a wooden mallet and blunt wooden peg to lightly but firmly tap the musculature above the nerve meridians. In Lanna this practice is called dok sen (hammering the meridians). In another northern Thai technique, yam khaang, the therapists heat the sole of one foot on a thick sheet of hot, oiled iron (taken from a field plough), then apply the warm foot to areas of the patient’s body, such as the lower back, to relieve sore muscles.
Certain aspects of massage therapy also have psycho-spiritual components. The wood used for the dok sen therapy should come from a tamarind tree that has been struck by lightning, as it is believed such a tree has been bestowed with rare energy from celestial realms. Likewise, the iron from a plough is deemed most auspicious for the yam khaang heated-foot massage because the ploughing of fields is believed to remove “bad energy” from the earth.
Lanna massage always starts with the feet, then slowly moves up the legs, then to the torso and arms. The client then turns over for work on the buttocks, back, and shoulders, after which the client sits cross-legged for more back, neck, head, and face massage. At the end the therapist lies back on the mattress with the patient lying on top of them (back to front), while the therapist gently rocks the body into various positions. When the massage is skilled, afterwards the patient may feel absolutely free of physical tension for hours.
Herbal treatment combines with massage when Lanna medicinal herbs are moistened and heated in cloth pouches, then applied to the body to cure aches, pains or dermal afflictions. Within the traditional Thai medical context, a maw nuat (massage therapist) usually applies massage together with pharmacological and/or psycho-spiritual treatments, as prescribed for a specific medical problem.
It’s no coincidence that in most cases the same herbs and spices used in Lanna cuisine, most of them native to Southeast Asia, are also considered samun phrai (indigenous medicinal plants) with specific therapeutic attributes. For example, a clear soup dish containing a variety of ‘cooling’ vegetables—such as pumpkin shoots, winter gourds, balsam apples, and white radishes—will alleviate heartburn and reduce body temperature. Meanwhile, the ingredients of spicy herbal salads and various chilli dips stimulate digestive juices and increase the appetite. Vegetables used in such dishes, or as accompaniments, can treat constipation problems quite well.
Scientists have found that around 30 commonly used Tai culinary herbs—chiefly including galangal, lemongrass, Chinese key, and phai (Cassumunar ginger)—exhibit strong anti-carcinogenic and Epstein-Barr virus preventive properties. Galangal, for example, boasts 10 times the anti-tumour power of beta-carotene, widely regarded in the West as a powerful anti-cancer agent.
Many samun phrai are used externally as well as eaten. Traditional pharmacological therapy employs prescribed herbs from among 700 plant varieties (plus a limited number of animal sources), which are infused, boiled, powdered, or otherwise rendered into a consumable form. Common yaa klaang baan (household medicines) include: the root and stem of the bawraphet (Tinospora rumphii, a type of wood climber) for fever reduction; raak chaa-phluu (Piper roots) for stomach ailments; and various yaa hawm (fragrant medicines) used as balms for muscle pain or headaches. In all the North, such medicines are readily available over-the-counter at traditional medicine shops and, to a lesser extent, in modern pharmacies.
More complex remedies (sometimes called yaa tamrap luang, or “royally approved medicine”) are prepared and administered only by herbalists skilled in diagnosis, as the mixture and dosage must be adjusted for each patient. One of the most well known is chantha-leelaa, a powerful remedy for respiratory infections and influenza-induced fevers.
As in the Chinese tradition, many Thai herbs find their way into regional cuisine with the intent of enhancing health as well as taste. Phrík thai (black pepper), bai ka-phrao (holy basil), and bai maeng lak (Thai mint basil), are common ingredients that have proven antacid and carminative (anti-flatulent) properties.
Northern Thais eat soups containing ma-ra (bitter melon)—a known febrifuge—to bring down a fever. Many of these same natural medicines may also be used for herbal steam treatments. Even today, many Buddhist temples in former Lanna lands offer rustic herbal steam rooms open to the general public.
The process has been refined in more recent times, and Lanna herbal steams are becoming a standard component of modern spa facilities at hotels, resorts, and day spas in northern Thailand and Laos.
A more esoteric practice for ensuring health and well-being involves the application of sak yan (yantra tattoos) to the body. In Lanna lands the tradition dates back to the pre-Buddhist animism practiced by tribal Tai throughout northern Thailand, Laos, and southwestern China.
Although tattoo designs have evolved substantially over the centuries, a common theme has been the representation of auspicious animals accompanied by talismanic alphabets or runes. Representations of crocodile, geckos, and squirrels, for example, are said to make others regard the wearer in a more favourable light, or with greater compassion. The image of a lion increases one’s administrative power, while that of a tiger enhances one’s physical power.
Some designs hail from Brahmanist traditions that also preceded Buddhism in mainland Southeast Asia. Thus tattoos depicting of Hanuman, the monkey deity in India’s Ramayana epic, are thought to protect the wearer against knives, guns, and other weaponry, while those of Ganesh, the pot-bellied, elephant-headed son of Shiva, remove obstacles in one’s path.
As Buddhism became the dominant belief system in Southeast Asia, Buddhist themes combined with animist and Brahmanist motifs. Symbols such as the lotus (symbolising enlightenment), the triangle (the Triple Gems: Buddha, Dhamma, Sangha), and the wheel (Buddhist doctrine), were added to earlier repertoires. Often these motifs are combined to create yantras, intricate patterns that are thought to surround one with protective energies, or to create favourable conditions.
Centuries ago it was common for many Lanna men—and even the women of some communities—in the region to bear intricate black-ink tattoo designs on their backs, shoulders, thighs, chests, and stomachs. Under the disapproving influence of Christian missionaries, as well as more fundamentalist interpretations of Buddhism, many Southeast Asians lost interest in the sacred tattoo tradition by the middle of the 20th century. Nowadays, however, a renewed popularity of sacred tattoos assures that the art will not be lost. Although it’s tempting to view this renewed interest as linked to the popularity of fashion tattoos, sak yan masters remain adamant that a tattoo’s powers work only if the wearer strives to maintain exemplary moral conduct. Thus it is generally believed that people who wear tattoos must follow Buddhism’s five basic precepts (against lying, stealing, killing, intoxication, and adultery).
Lanna sacred tattoo designs also include short mantra-like inscriptions inked in the ancient Lanna alphabet. This makes them stand well apart from what is seen in central Thailand, for example, where masters tend to use the Khmer alphabet.
By Joe Cummings/CPA Media