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What is Traditional Thai Medicine?

Traditional Thai Medicine is the term for all traditional medicine practices indigenous to the region currently known as Thailand.

Today, scholars differentiate between two forms of Traditional Thai Medicine: the Royal or literate tradition and the unregulated Folk traditions. The Royal tradition is espoused by medical schools and supported by the Thai government. The unregulated Folk practices have been passed orally from generation to generation by individual healers.

The Royal Tradition is a system of medicine codified by the Ministry of Public Health in the late 1990s. It is a formal medical discipline that Thai students may study in universities. Schools teach this tradition throughout the kingdom, and courses run for three to four years. Many schools also offer shorter courses that run weekly and are available and popular among tourists. Aspiring professionals must take only herbal medicine and massage but must be licensed to practice.

Royal Traditional Thai Medicine looks to Ayurveda to explain and systemize its doctrine. Royal TTM also depends on Western, Chinese and other influences. Before this codification, it was unclear how strong these influences were on Thai medicine.

The Folk or Rural Tradition exists outside of this literate tradition. The Folk Tradition is an assortment of informal practices passed down from teacher to student, varying from place to place.

The Folk Tradition consists of practices quite different from its elite counterpart – native massage, herbal medicine, tattooing, astrology, amulet-making, mediumship, exorcism, etc. Folk healers who are neither licensed nor regulated employ these practices. Such healers learn orally and experientially, and a background in scientific theory is often lacking. Healers of the Rural Tradition may seem more like shamans and witch doctors than actual physicians to a modern observer. Yet tempting as it is to dismiss it all as mere superstition or even as “quack” medicine, many Thai people still consult folk healers, even in urbanized areas.

The Royal and Folk traditions view health, illness and treatment differently. The Royal Tradition views disease as the manifestation of the body struggling between balance and chaos. This tradition believes that properly flowing energy is critical to health and, therefore, tries to balance the elements in the body.

By comparison, Thai folk tradition blames illness on spiritual possession, fear, problems, and an imbalance of elements in the body. Healers see disease and misfortune as attacks from evil beings such as angry ghosts and displaced spirits. Healers use charms, prayers, tattoos, amulets and rituals to thwart these attacks. Thais regard Thai massage as an essential form of therapy for these disorders.

Unfortunately for outsiders, a lot of secrecy surrounds Thai folk healing. Healers guard their arts jealously and transmit them orally directly to their heirs. Furthermore, the government neither endorses nor sanctions these practices and instead promotes the Royal Tradition as the legitimate form of TTM. Thai medical and massage schools teach the Royal Thai massage style, so it is challenging to learn folk traditions, especially for foreigners.

Despite the work of the government, people in Thailand continue to blame illness on spiritual possession, fear, problems, and an imbalance of elements in the body. Villagers regard massage as a vital form of therapy. They often prefer locally prepared remedies, treatments by local healers and traditional massage therapy from hospitals and doctors.


In the early-1900s, the Thai government outlawed traditional medicine in favour of Western medicine. But then, in 1993, the Ministry of Thai Medicine created the National Institute of Thai Traditional Medicine to gather, standardize and codify traditional Thai medicine.

This codification was both good and bad for traditional Thai medicine. The new system preserved many older traditions, but the Ministry of Thai Medicine chose traditions it knew the world would validate, more closely aligned with Western or Ayurvedic traditions. So many traditional practices were dropped by the Ministry of Thai Medicine but retained by local practitioners, creating four divisions of Thai medicine.

Traditional Thai Medicine (TTM)

Traditional Thai Medicine (Paet Paen Tai) is the umbrella term to describe all traditional medicine practices in Thailand. Specifically, the Ministry of Public Health systemizes and teaches Traditional Thai Medicine. The Ministry codified the tradition in the late 1990s. Thai citizens can study TTM as a four-year degree program in government-approved schools.

Traditional Medicine of Thailand (TM of T) 

Traditional Medicine of Thailand (Paet Paen-Boh-Raan) relies on ancient texts from the 1800s written in Thai and Khmer scripts. There is no standardization of TToT, so practices vary according to ancient text, practitioner and region.

Local/Indigenous Medicine

Local and Indigenous Medicine (Paet Puen Boaan) is the most common form of Thai medicine in Thailand. The theory and traditions in this division predate TTM and TToT. Local village doctors (Mor Meuang) rely on oral traditions and local texts handed down from teacher to student.

Lanna Medicine

Lanna medicine (Paet Lann-Naa) is a regional form of local/indigenous medicine. Lanna medicine comes from the Lanna people, who settled in Northern Thailand centuries ago. It is a separate division since it is the best-preserved traditional medicine of Thailand, with medical Lanna texts that date back to the thirteenth century. Lanna medicine includes specialized practices, such as Tok Sen, Thai Cupping and Ched Hak, which have become part of Thai medicine.


Thai massage is only one small component of a more extensive holistic healing system. To become a traditional Thai physician, students study with a traditional healer for many years and, through this teaching, slowly master five disciplines.

Internal Medicine (Paet Saat)

This branch involves the use of herbs and diet to promote health. Internal medicine includes food, herbal medicine, minerals and compounds. Herbal remedies come in a wide variety of forms, including snuff, inhalants, gargling solutions, teas, infusions, tonics, alcoholic macerates, oral dosages, pills, capsules, tablets, poultices, ointments, essential oils, and suppositories. Healers classify oral remedies by their taste – sweet, bitter, astringent, acrid, nutty, salty, and sour- which correlate with their healing attributes.

External Medicine (Gaai-Ya-Paap Bam-Bat)

This branch includes any therapy that takes place on the external body. External medicine includes bone setting, Thai massage, Thai cupping, and any external application of herbs in balms, compresses, and poultices.

Divinatory Sciences (Hoh Raa Saat)

Divination involves using Vedic astrology, numerology, palmistry and geomancy to determine health predisposition and remedial measures.

Spirit Medicine (Sai Ya Saat)

This branch involves shamanistic and animistic practices. Examples of this branch include amulets, incantations, Sak Yant magical tattooing, spiritual herbalism and shamanistic involvement with spirits for healing.

Buddhism (Put Ta Saat)

Buddhism plays an essential role in Traditional Thai Medicine. Dhammas, teachings and mantras are tools to treat mental health and foster harmonious living.

TTM and Thai Massage

Thailand borders Cambodia, Laos, Vietnam and Burma/Myanmar. It has always been home to busy ports and roads frequented by Chinese, Muslim and Indian merchants and travellers. Its various kingdoms tolerated and assimilated much of the knowledge and culture of their neighbours. Subsequently, Traditional Thai Medicine emerged as a unique medicinal system heavily influenced by indigenous beliefs, practices, and foreign traditions.

Tourists and travellers who study in a Thai medicine school encounter a standardized healing system heavily dependent on Ayurvedic, Yogic, and Western influences. This organized body of teachings presented in literature and school curricula are generally known as the Royal Tradition or Elite Tradition and date back to the late 18th century.

Traditionally, Thai massage evolved through the passing of knowledge over time, shared by Reusis (ascetics), ancient texts, indigenous family/folk practices and oral traditions. Teachers passed this knowledge down to students. There were no schools. Students would go to a teacher and ask permission to be a student, but the teacher had no obligation to accept students. If a teacher did take a student, the teacher would expect the student to spend months, if not years, “sitting at their feet” learning the traditions.

Thai massage began to draw the interest of Westerners in the 1970s. With the popularization of Thai massage, people began to travel to Thailand to learn Thai massage with little time and no ability to speak the language.

The result is that Thai massage began to change to meet the needs and desires of the new students. Schools began creating short courses to accommodate the new student’s vacation times. And since foreigners could not understand Thai, schools dropped TTM theory and focussed on teaching massage sequences.

The change continued as foreigners went home and started mixing Thai massage with other techniques, such as yoga and acupuncture. And without TTM knowledge, Thai massage became mixed with New Age concepts. Foreigners then returned to Thailand, asking for courses aligned with their Western understanding of Thai massage, and schools began to cater to those demands. Thai massage is now a real mishmash of traditions.

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