Traditional medicine in Yang Talat district, Isaan, Thailand

Khwan Phusrisom
Baan Dong Bang, Thailand & UK

 

The Isaan region in Thailand
Fig 1. Baan Dong Bang village, Yang Talat district, and surroundings.

Isaan is northeast Thailand, wedged between Laos and Cambodia. I grew up there, in Yang Talat district, (Fig 1) in the Baan Dong Bang village headman’s teak house, where I saw traditional medicine in use from an early age. More recently I asked villagers including elders, farmers, teachers, monks, and the abbot what traditional plants their grandparents used medically and what they still use themselves.1,2

My oldest informant was born in 1927.3 His knowledge stemmed from nineteenth-century grandparents, when Baan Dong Bang was very isolated in high-canopy rainforest with tigers and Asian rhinos abounding.

 

Medicines from fields and gardens: an Isaan pharmacopeia

Thai garden aubergine4 roots are dried then re-soaked to drink as an analgesic cough suppressant for adults and older children. Wild eggplant5 (Fig 2) fruits are similarly eaten fresh from the fields. For cuts, crushed antiseptic leaves of Guava,6 Banana,7 or Saap seua (smell of the tiger)8 are applied. A Guava infusion boiled from its bark is drunk as an anti-diarrheal. Tamarind9 or Chebulic myrobalan10 fruits are eaten to relieve constipation.

To kill tapeworms, Magleua11 fruit is drunk crushed with coconut milk, salt, and sugar to make it palatable. Alternatives are Neem12 tree leaves and flowers boiled as tea or eaten, or fresh Ebony13 fruit. For dizziness or a rice-wine hangover, some sniff a handful of red ants for a blast of formic acid fumes, or sniff foul Sugar apple14 leaves, which is also used in solution to kill head lice. Turmeric15 root in water or breast milk is used for baby eczema, as well as wrinkles, acne, or thrush. Iron-rich red clay is applied to the skin as a damp paste to relieve water snail worm irritation. Holy basil16 is crushed and rubbed sparingly on a child’s tummy for colic.

Additionally, a boiled salt water wash helps toothache and a crushed charcoal17 pack stems bleeding from a tooth socket. The traditional treatment for a cobra bite is: Don’t get bitten in the first place. You never put hands or feet in vegetation where you cannot see. Left alone, cobras slide away.

 

Wild eggplant growing in Thailand
Fig 2. Wild aubergines. Solanum violaceum L. Source: Wikimedia commons, CC-BY-SA-3.0.

Music and dance therapy

A sixty-year-old woman who had worked hard in the fields suffered sciatica and was anxious about her upcoming surgery. A friend suggested that the local mor lam musicians and dancers from a nearby village could help. They came to the patient’s home and filled the downstairs under the ancient teak ceiling, once the open cattle stall. All wore traditional Isaan-Laotian dress, with cheerful, white frangipani flowers in their hair, picked from the Buddhist temple garden trees. The leader sang Isaan-Laotian folk songs. Her husband played the raucous kaen box-reed instrument. They performed, then gently encouraged the patient to stand and move slowly to the rhythms. She began to smile her spirits lifted. Her confidence and relaxation from the dance proved essential for the operation to proceed. The surgery worked and she became pain-free.

 

The Yang Talat medical prayer manuscripts

A young novice monk in the 1970’s rescued some palm leaf manuscripts from being thrown on a temple bonfire.18 He kept them safe and later became an abbot in Yang Talat. One leaf has four types of paired figures within a table of two lines (Fig 3). These are head-to-head, side-by-side, toe-to-toe, and head-to-toe. The Buddha’s disciples similarly comprise four pairs, referred to in the common Pali prayer chant of Namo tassa bhagavato.19 The manuscript figures could be summoning healing power through the exhaustive possibilities of body orientations. Their hands point up, down, or sideways, as if dancing. The different body arrangements and arm positions can be interpreted as explorations of order and disorder; ease and disease. The elevated arm positions also echo postures of Shiva20 and the Buddha. Combined with prayer, the figures were meant to invoke spiritual healing.

 

Figures that may represent a spiritual component of medicine
Fig 3. Human figures accompanying medical incantation text. Charcoal/oil mix in embossed Asian Palmyra Palm leaf, from a Pali-Laotian temple book. Yang Talat district, c. 1700 A.D./2243 B.E. to 1820 A.D./2363 B.E., from dated comparators.

Experimental archaeology: preventing sunstroke Iron-Age style

Isaan was largely settled in the Iron Age from the River Mekong, with a ceramic culture of cream terracotta pots, decorated with red pigment. Much Isaan traditional culture may have iron-age origins. Prehistoric pottery and current traditional medicine occur together over thousands of square miles throughout the regions’ isolated villages.

One jar found in the village of Baan Chiang21 has a scene of an iron-age hunter with a spear and launcher pursuing deer. That is rare enough as a depiction of a human figure from this time. What riveted me when I first studied it was that the figure was wearing a hat.

Head cover is very serious in Thailand. All who work outside know the danger of sunstroke, which can be fatal. So they organize drinking water, and wear hats or even cotton balaclava face covers. The iron-age hat has a rigid, wide, horizontal brim with a cone above that folds down to a point, which could only have been cloth. Archaeology has revealed iron-age bamboo strip weaving and cloth woven from silk or cotton.22 We tried to recreate the hat. When tested, cloth alone was too hot, so a bowl-shaped bamboo cover was added, as well as a cloth-edged brim to avoid bamboo cuts and shade the eyes.23 That design worked very well when worn in the paddy fields for a day.

 

The traditional sick bed

Patient on traditional Isaan sick bed
Fig 4. Patient on herbal sick bed, heated with three charcoal braziers. Baan Dong Bang, 2018.

One traditional widespread treatment that looks indigenously ancient in Isaan is the sick bed. It is a bamboo couch covered with herbs, then a cloth, and heated from underneath with charcoal braziers. The patient lies on it for three hours, twice a day. It is still used occasionally when a patient is seriously injured in an accident, like falling from a tree or building, a water buffalo injury, or more recently, motorbike accidents. When a sick bed is in use, food like chicken herb soup is given to children to bring some animation to anxious moments. The children stay up late and listen to stories of the village elders’ travels and adventures.

One recent case I witnessed and photographed was when a patient was admitted to hospital with a head injury which caused drowsiness. After discharge the patient still had no short-term memory four days after the accident, so her uncle built a sick bed. Her mother applied pleasant, strongly-aromatic leaves of Blumea balsam, Castor oil plant, Cassumunar ginger, Lemongrass, Tamarind, Kaffir lime, and Pandan, with pre-steamed whole grain sticky rice for heat retention. (Fig 4) The patient used the hot bed for three days, drinking warm ginger tea. It was impressed on her never to drink cold water during the sick bed treatment. Her memory recovered fully within two weeks after the accident.

 

Comments

It was striking that every botanical medicine reported had a referenced scientific basis. The sick bed case had an extraordinary recovery from a severe traumatic brain injury based on the duration of post traumatic amnesia. The Isaan sick bed warrants further research.

The common sense of modern villagers is striking. Nobody hesitates to use modern medicine or go to hospital. Our local emergency room is ten-minutes’ drive away and can treat emergencies. Traditional village medicine now runs alongside this. It is ancient but may harbor many lessons. It has survived since the Iron Age, perhaps because it works.

 

Caveat

This article does not cover adverse effects, purity issues, and interactions of herbal medicines.

 

Notes

  1. Thirty local interviewees were asked to focus on traditional, not recently-acquired knowledge, in 2018-2021, face to face, followed-up by telephone. Answers were strikingly consistent with prompts about specific conditions.
  2. A previous Hektoen article described the traditional obstetric care of Isaan, also based on recent interviews and my birth in a bamboo house: https://hekint.org/2020/09/08/traditional-obstetrics-in-isaan-thailand/
  3. This was Mr. Sang Bunlieng, local historian, retired buffalo dealer and Isaan classical singer. In his youth nobody went to Bangkok, as the risk of malaria over many weeks in rainforest was so grave. Its name is kai pah, literally forest fever. Isaan people often have Haemoglobin E which protects against it. Even King Mongkut of Siam contracted fatal malaria traveling in 1868 A.D./2411 B.E.
  4. Solanum virginianum L. It is native to Thailand.
  5. Solanum violaceum L. Adults eat five or more fruit. Aubergine is analgesic: Vohora S B, Kumar I, Khan M S. Effect of alkaloids of Solanum melongena on the central nervous system. J Ethnopharm. 1984, Aug; 11 (3): 331-6.
  6. Psidium guajava L. Guava is antibacterial: Hoque M, Bari M L, Inatsu Y et al. Antibacterial activity of guava (Psidium guajava L.) and Neem (Azadirachta indica A. Juss.) extracts against foodborne pathogens and spoilage bacteria. Foodborne Pathog Dis. 2007 Winter; 4 (4): 481-8.
  7. Musa acuminata L hybrid. See: Karuppiah P, Mustaffa M. Antibacterial and antioxidant activities of Musa sp. leaf extracts against multidrug resistant clinical pathogens causing nosocomial infection. Asian Pac J Trop Biomed. 2013 Sep; 3 (9): 737-42.
  8. Chromolaena odorata L. See: Anyasor G N, Aina D A, Olushola M, et al. Phytochemical constituents, proximate analysis, antioxidants, anti-bacterial and wound healing properties of leaf extracts of Chromolaena odorata. Ann Biol Res. 2011; 2: 441–51
  9. Tamarindus indica L. The laxative action is from fruit acids: Bhadoriya S S, Ganeshpurkar A, Narwaria J et al. Tamarindus indica: Extent of explored potential. Pharmacogn Rev. 2011 Jan; 5 (9): 73-81.
  10. Terminalia chebula L. Tarasiuk A, Mosińska P, Fichna J. Triphala: current applications and new perspectives on the treatment of functional gastrointestinal disorders. Chin Med. 2018 Jul 18; 13: 39.
  11. Diospyros mollis L. Maki J, Kondo A, Yanagisawa T. Effects of alcoholic extract from Ma-Klua (Diospyros mollis) on adults and larvae of the dwarf tapeworm, Hymenolepis nana in mice and on the infectivity of the eggs. Parasitology. 1983 Aug;87 (Pt 1): 103-11.
  12. Azadirachta indica L. Ash A, Bharitkar Y P, Murmu S, et al. Ultrastructural changes in Raillietina (Platyhelminthes: cestoda), exposed to sulfonoquinovosyldiacylglyceride (SQDG), isolated from Neem (Azadirachta indica). Nat Prod Res. 2017 Oct; 31 (20): 2445-2449.
  13. Diospyros ebenum L. Discussed in: Maki J, Ma-Klua, op. cit.
  14. Annona squamosa L. Tiangda C H, Gritsanapan W, Sookvanichsilp N et al. Anti-headlice activity of a preparation of Annona squamosa seed extract. Southeast Asian J Trop Med Public Health. 2000; 31 Suppl 1: 174-7.
  15. Curcuma longa L. Vaughn AR, Branum A, Sivamani R K. Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence. Phytother Res. 2016 Aug; 30 (8): 1243-64.
  16. Ocimum tenuiflorum L. There may be a combined massage and anxiolytic effect: Bhattacharyya D, Sur T K, Jana U et al. Controlled programmed trial of Ocimum sanctum leaf on generalized anxiety disorders. Nepal Med Coll J. 2008 Sep; 10 (3): 176-9.
  17. Chen Y, Chen Q, Wang X et al. Hemostatic action of lotus leaf charcoal is probably due to transformation of flavonol aglycons from flavonol glycosides in traditional Chinses medicine. J Ethnopharmacol 2020 Mar 1; 249: 112364. Epub 2019, Oct 31.
  18. Written when Yang Talat was in the Vientiane Laotian Kingdom.
  19. This is still sung in chant in virtually all Thai Buddhist services and ceremonies, paralleling the Lord’s Prayer.
  20. A thousand years ago the temples of Isaan were Hindu, under the Khmer Empire. Much Hinduism persists in Isaan ceremonies from Buddhist tolerance. Pre-Hindu animism and deities are also very widely venerated.
  21. Now in the Baan Chiang National Museum collection, Udon Thani, Thailand. Similarly decorated Iron-Age cream pottery occurs throughout Yang Talat district.
  22. Early Iron-Age cotton has survived in Lijia, Jiangxi, China. Silk fibres occur in some iron-age Baan Chiang pots. Striped cloth of 500-300 B.C./43-243 B.E. was discovered in Dong Xa, North Vietnam by Nguyen Viet.
  23. It was immensely impressive how quickly the villagers in this study worked out how to do it, made it, and got it to work—an insight into their skill and intelligence, as well as how much we have forgotten. Eye shading reduces cataract formation.

 


 

KHWAN PHUSRISOM graduated from the Faculty of Sciences in Chandrakasem Rajabhat University, Bangkok. She heads the BDBEC education centre in Yang Talat district for underprivileged children and writes about Siamese history and medical anthropology.

 

Acknowledgements

I am very grateful to all the people of Baan Dong Bang village, Yang Talat, and the surrounding area who helped this three-year project with as much keen interest in the subject as me. The sick bed patient did not hesitate to consent to the use of my photograph to support this article. (Update: She has been promoted and bought a car). Abbot Luang Por Kiao, who rescued the palm leaf manuscripts as a novice monk, explained them, and generously allowed me to photograph and start researching them for the first time for this article in 2019. Many thanks also go to Ms. Lathdavone Phommavong of Luang Prabang Teacher Training College, Laos, for her help with their Pali-Laotian text, which is continuing.

 

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