Before the Kingdom of Chiang Mai was annexed to Siam in the early 20th century, health care in northern Thailand was rooted in Tai and Mon-Khmer practices dating back thousands of years. While modern Western medicine typically examines and then treats the perceived symptoms of illness, Lanna traditions take a more holistic view. Every sphere of human activity becomes an opportunity for enhancing one’s health.
Meals, for example, are ideally 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 (turmeric) relieves constipation. All three of these roots were consumed on a daily basis in northern Thailand since at least the earliest Thai chronicles were written down.
Traditional Lanna medical practitioners may express these health-enhancing properties in very different ways. Disease may be seen as blockage or imbalance in one’s vital life force. Techniques such as herbal medicine, massage, and psycho-spiritual healing are utilised to maintain balance or to bring this vital force back into balance.
Today, such therapies have been found to have enormous utility for treating chronic diseases such as arthritis, chronic fatigue, irritable bowel syndrome, nerve dysfunction, muscle pain, and certain skin conditions. As a result, traditional Lanna healing practices have recaptured the attention of Asians and Westerners alike, undergoing a rebirth of popularity in villages as well as hotels and city spas.
The most internationally famous type of northern Thai medical therapy is nuat phaen boraan (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. The human body is thought to have 72 thousand of these, of which ten are crucial. Depending on which muscles and meridiansare 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.
Bangkok and central Thailand placed the national propagation and maintenance of Thai massage at Wat Pho in Bangkok, where it remains today. Northern Thais, meanwhile, have retained their own separate massage therapy tradition, the training for which is today centred at the Traditional Medicine Hospital in Chiang Mai. Lanna massage, although not radically different from the Wat Pho approach, features a softer touch and a more continuous movement of the therapist’s hands, fingers, elbows, and feet.
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 applies the warm foot to areas of the patient’s body, such as the lower back, to relieve sore muscles.
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. Some can be used externally as well as taken with food.
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 ex-Lanna lands, such medicines are readily available over the counter at traditional medicine shops and, to a lesser extent, in modern pharmacies.
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.
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 third aspect of traditional Lanna medicine called raksaa thaang nai (inner healing) or kae kam kao(literally, “old karma repair”) includes various types of meditation or visualisation practised by the patient, as well as shamanistic rituals performed by qualified healers. These strategies represent the psycho-spiritual side of Lanna medical therapy, and like massage are usually practised in conjunction with other types of treatment.
They are also occasionally used as preventive measures, as in the Lanna bai seeritual, now common in northern Thailand, northeastern Thailand, and Laos.
This ceremony, marked by the tying of string loops around a subject’s wrists, is intended to bind the 32 khwan (personal guardian spirits) —each associated with a specific organ—to the individual. The ritual is often performed before a person departs on a major journey to ensure the traveller returns home safely.
A related healing practice specific to the Lanna region is the seup chataa (life-extending) ritual, where a devotee with perceived health problems or other misfortune will sit beneath a pyramid-shaped lattice of bamboo poles erected inside the wihaan (main temple hall) all day long while resident monks chant Buddhist verses.
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 the region. Although tattoo designs have evolved substantially over the centuries, a common theme all along has been the representation of auspicious animals accompanied by talismanic alphabets (usually Lanna or Shan script). 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 charismatic power, while that of a tiger enhances one’s physical power.
Combining diet, herbal therapy, massage, and ritual, Lanna health practices not only provide a rich alternative to allopathic medicine, they help preserve the cultural identity of northern Thais.
Photos by Luca Tettoni